46 research outputs found
MEF FADA hangar stüdyosu
MEF Üniversitesi Sanat Tasarım ve Mimarlık Fakültesinin stüdyolarının yer aldığı Hangar bir çalışma, yaşama ve paylaşma alanı olarak kurgulandı
Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.
BACKGROUND: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. METHODS: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. RESULTS: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). CONCLUSIONS: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Biyoesinlenilmiş organik-anorganik kompozit malzemeler
Cataloged from PDF version of article.Includes bibliographical references (leaves 59-68).Thesis (M.S.): Bilkent University, Department of Materials Science and Nanotechnology, İhsan Doğramacı Bilkent University, 2016.Nature has been an inspiration and information source for scientists over centuries,
for developing new materials. A great e ort has been spent in order to
understand biological materials. The biomineralization process is observed in the
nature and it creates perfectly hierarchical structures, which give the living organisms
extraordinary properties. It is also a fact that along with the nature;
living creatures such as nacre and bacteria employ biomineralization in order to
produce minerals for protection and navigation purposes. In addition, bone is a
composite material which protects the internal organs and provides mechanical
support and is a result of biomineralization process.
In this thesis, the biomineralization processes of living organisms and bone is
mimicked by employing peptide amphiphile nano bers as templates for inorganic
materials production. Glutamic acid residue is used in order the mimic the negatively
charged domains for proteins, which play crucial roles in biomineralization
process in some organisms and bone. In order to mimic the structure of sea shell,
which is composed of calcium carbonate, and bone, which consists of calcium
phosphate, relevant mineral solutions were used. In conclusion, when organic
and inorganic components are used together, they demonstrate superior mechanical
properties, when compared to organic molecules alone.by Egemen Deniz Eren.M.S
Tasarla yap stüdyosu 2018, takip projesi
MEF Üniversitesi Tasarla ve Yap! Stüdyosu 2018 kapsamında tasarlanıp inşa edilmiştir. Proje Yeri : İbradı, Antalya Yürütücüler: Başak Eren, Egemen Nardereli MEF Üniversitesi Öğrenci Asistanları: Osman Faruk Akkum, Dilşad Turna, Melike Özden MEF Üniversitesi Öğrencileri: Berk Buluman, Berkay Kutbay, Ceren Yılmaz, Deniz İstanbullu, Dilara Tekin, Eda Kesim, Eren Burak Kuru, Fatih Kılıç, Helin Baskın, Pelinsu Çelik, Tuğba Acar, Zeynep Toper, Zeynep Toprakcı- Takip, İbradı’nın en yüksek noktalarından biri olan Hisartaşı’na eklemlenen bir seyir ve dinlenme strüktürüdür. Alanın doğal kot farklarından faydalanarak farklı ihtiyaçlara cevap veren ve hakim manzaralara yönelerek çevreye hakim bir seyir alanı kurgulİbradı Belediyes
Spillovers of funding dry-ups
We uncover a new channel for spillovers of funding dry-ups. The 2016 US money market fund (MMF) reform exogenously reduced unsecured MMF funding for some banks. We use novel data to trace those banks to a platform for corporate deposit funding. We show that intensified competition for corporate deposits spilled the funding squeeze over to other banks with no MMF exposure. These banks paid more for deposits, and their pool of funding providers deteriorated. Moreover, their lending volumes and margins declined, and their stocks underperformed. Our results suggest that banks' competitiveness in funding markets affect their competitiveness in lending markets
Determination of toxicity of Triclosan on two different pure cultures (V. fischeri and P. subcapitata) and activated sludge biomass
Effect of triclosan and its photolysis products on marine bacterium V. fischeri and freshwater alga R. subcapitata
The use of antibacterial agents in consumer products may lead to adverse effects in waters receiving treated wastewater. Triclosan is one of the antibacterial agents used widely in the world and its high usage leads to relatively high concentrations in wastewater effluents. In this study, the probable effect of triclosan in receiving waters was assessed using different organisms. The EC50 values were 668 +/- 80 mu g/L and 7.8 +/- 0.1 mu g/L, for Vibrio fischeri and Raphidocelis subcapitata, respectively, indicating the higher sensitivity of the alga. The toxicity of triclosan upon exposure to UV light decreased for both species, as suggested by the increase in EC50 values (1300 +/- 50 mu g/L and 8.7 +/- 0.6 mu g/L for V. fischeri and R. subcapitata, respectively). The effect of photolysis on toxicity reduction was higher for V. fischeri and the EC50 values were similar for direct and indirect photolysis. LC-MS/MS analysis of samples with and without UV exposure suggested a decrease in triclosan concentration as well as formation of photolysis byproducts upon photolysis. (C) 2018 Elsevier Ltd. All rights reserved