Emphysematous pyelonephritis with left renal vein thrombosis-case report successfully treated by conservative methods

Presently emphysematous pyelonephritis is a rare but life-threatening disease, mostly seen in patients with urinary tract obstr uc- tion and diabetes mellitus. It is characterized by the production of gas and necrosis in the renal parenchyma, collecting systems, and perinephritic tissue. Radiologically, the Huang and Tseng classification is used to categorize the severity of the disease. Our case was 49 years old female pre- senting with unconsciousness, fever and bilateral Grade 3 lower extremity eodema one week after left percutaneous nephrolithotomy procedure because of urinary tract stone. Abdominal computerized tomography scan showed renal parenchymal and perinephritic tissue necrosis with the production of gas and renal vein thrombosis which was in accordance with Huang and Tseng classification Grade 3A. We treated our patient with the appropriate antibiotic, enoxaparin sodium, strict glycemic control, and supportive treatment without any surgical intervention or nephrectomy

Morfological and physiological observation on 1-MCP spreyed carnations and research on the activity of ETR1 - CTR1 genes.

TEZ8177Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2010.Kaynakça (s. 73-76) var.xiii, 77 s. : rnk. res., çizelge ; 29 cm.This study was conducted to determine the effect of 1-MCP mechanizm on shelf life and morphological characteristics of carnations (Dianthus caryophyllus). Three different 1 MCP (500 nl/l, 1000 nl/l doses and control) doses were applied for 24 hours at 20 oC on two commercial carnation species, 'Amelia' and 'Natila' after harvesting. Carnations were stored at 4 oC for 21 days after applications. During this storage time at 12th hours, 24th hours, 3rd day, 6th day, 10th day, 15th day and 21st day petal samples were obtained and morphological plant characteristics were determined and compared against each other. Real-Time PCR analysis were carried out to determine expression differences of CTR1 and ETR1 genes responsible from ethylene biosynthesis during storage. The results showed that, petal samples were still remain fresh and there was no ethylene expression in petal samples after 21 days of storage. CTR1 gene expression was more than ETR1 gene expression according to Real Time PCR analysis results.Bu tez çalışması karanfil bitkilerinde, 1-MCP'nin raf ömrü üzerine etki mekanizmasını araştırmak amacıyla yapılmıştır. Bu amaçla hasat sonrası ticari karanfil çeşitleri 'Amelia' ve 'Natila' karanfil örneklerine 20 oC sıcaklıkta, 24 saat süre boyunca 500 nl/l, 1000 nl/l dozları ve kontrol olmak üzere 3 farklı 1-MCP uygulaması yapılmıştır. Uygulama sonrasında karanfiller 3 hafta süresince soğuk hava deposunda muhafaza edilmiştir. Bu süre boyunca 12. saat, 24. saat, 3.gün, 6.gün, 10.gün, 15.gün ve 21.günlerde karanfil bitkilerinden petal örnekleri alınarak morfolojik ve fizyolojik özellikleri değerlendirilmiştir. Muhafaza sırasında belirtilen sürelerde alınan örneklerde 1-MCP uygulamaları sonucunda, etilen biyosentezinden sorumlu olan CTR1 ve ETR1 genlerinin ifadesindeki farklılıkları tespit etmek amacıyla Real-Time PCR analizleri yapılmıştır. Bu sonuçlara dayalı olarak tüm uygulamalarda 21 günlük muhafaza sonrasında örneklerin halen canlılıklarını korudukları gözlenmiş ve örneklerde etilen üretimine rastlanmamıştır. Real Time PCR analizleri sonucunda CTR1 geninin ETR1 genine göre daha yüksek düzeyde ifade edildiği görülmüştür.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir. Proje No: ZF2009BAP13

Experiences of women undergoing infertility treatment from embryo transfer until pregnancy test and their conceptualization of their embryo

Aim This study aims to explore women’s experiences with embryo transfer (ET) until pregnancy test and their conceptualization of their embryo. Method The sample of this descriptive phenomenology study consists of 17 women with ET. The data were collected through in-depth interviews. The thematic analysis developed by Braun and Clarke was used for data analysis. Results Analysis of the interviews led to the emergence of five themes and 14 sub-themes. The theme “pregnancy in biological terms” has two sub-themes: “considering herself pregnant” and “the first moment with the baby”. The theme “not an embryo, my child” has three sub-themes: “world of hope”, “ unnatural but normal” and “attachment to embryo”. The theme “daily life after ET” has three sub-themes: “living life in the usual way”, “process of self-listening”, and “the negative effects of drugs on the body”. The theme “seeking ways to ensure fertility” has four sub-themes: “complete bed rest”, “the search for information: the internet”, “practice an infertility diet” and “spiritual support with prayer”. Finally, the theme “caring after the transfer” has two sub-themes: “need more information” and “unmet women-oriented care”. Conclusion In this study, it was determined that women had intense physical and emotional experiences during the waiting period after ET and their daily lives were affected. It was also understood that the embryo means "baby/child/son/daughter" to them and that they establish a close bond with their embryos. Women’s needs are not sufficiently known until post-ET pregnancy testing. Explaining the experiences of women after IVF-ET and the meanings of their embryo will help determine the issues they need in holistic care

A Novel MDCM Approach for Sustainable Supplier Selection in Healthcare System in the Era of Logistics 4.0

The COVID-19 pandemic has led to major disruptions in workflows across all industries. All sectors are trying to sustain operations during this extremely difficult time and the healthcare sector is the most important of them. It is unthinkable to stop the operations of the health system because it serves human life. Health institutions must supply the products such as masks, gloves, and ventilators subject to service on time for certain activities to continue indefinitely under all conditions. By adopting modern logistics activities and technologies, healthcare organizations can provide sustainable diagnosis and treatments to patients by automating their various operations. With the COVID-19 pandemic, how to select an appropriate sustainable supplier has become an important task in the era of Logistics 4.0. From this viewpoint, a sustainable supplier selection framework is implemented for a health institution under the effect of the pandemic. To determine the direct effects of the pandemic in the health sector, fuzzy Multi-Criteria Decision-Making (MCDM) methods are utilized in the application. After a thorough review of the literature and interviews with experts, the criteria are organized in a comprehensive hierarchical structure. The fuzzy Best-Worst Method (F-BWM) technique is employed to find the weights for the determined criteria. Consequently, the fuzzy Additive Ratio Assessment Method (F-ARAS) method was applied to rank the alternative suppliers. In addition, with a comprehensive sensitivity analysis, alternative situations are examined against possible breaks in the supply chain. Thus, from the perspective of Logistics 4.0 and sustainability, this study contributes to the literature with an analysis of the health system’s survival in difficult and fragile periods, such as COVID-19. Investigating the importance of SSS can be a road map for the policymakers and the decision-makers is beneficial since the impact of COVID-19 on SSS is studied from the perspective of Logistics 4.0

An investigation on the seam tensile properties of ultrasonically bonded nonwoven fabrics

WOS: 000400278900008In this study, the seam tensile properties of the ultrasonically bonded nonwoven fabrics were investigated and the effects of the fabric type, roller type and sewing speed on the seam tensile properties of the samples were studied. It was deduced that fabric type, roller type and sewing speed have statistically significant effect on the seam tensile properties of the nonwoven fabrics. The experimental results indicate that, the tensile strength of the seams made with made with the engraving roller 4 mm wide point and 25 dm/min speed is the highest, and with the engraving roller 9 mm wide point and 45 dm/min is the lowest

A classification approach to order picking systems and policies: Integrating automation and optimization for future research

Picking system optimization is the main condition for improving customer satisfaction and warehouse efficiency. However, related literature does not present a standard classification for the different picking systems and warehouses. This issue implies a lack of scientific uniformity and the difficulty of conducting comparative studies on which the best approaches are, applied to picking problems and/or warehouses. Therefore, this paper aims to provide a theoretical framework on the picking system classifications most used by researchers. The research is descriptive in nature and focuses on the two major categories of picking systems: i) according to automation strategies and processes; ii) according to picking optimization policies and methods. These classifications have been revised so that researchers can combine them with a wide range of picking systems and warehouses. The main contribution of this paper is to provide a better understanding of the main specificities regarding classifications inherent to picking systems and warehouses. We also demonstrate that approaches integrating people, warehouses, technological advances, and adaptation of multi- objective algorithms should be the focus of researchers. The theoretical framework presented corroborates with future studies aimed at managing and adapting picking systems and warehouses. We concluded that integrating picking strategies and policies is critical to dealing with technological advances in warehouses

Knowledge and behaviors of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal

Among 10 global problems of 2019 determined by the World Health Organization, vaccine refusal was one of the problems mentioned. In this context, health services and health personnel whose main objectives are to keep individuals healthy and to prevent diseases have major responsibilities. This study aims to analyze knowledge and behavior of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal. This study, conducted between June and July 2019, is a descriptive cross-sectional study. It was conducted in a hospital located in Malatya in eastern Turkey. At the time of the study, 850 nurses work in this hospital. Sample size was calculated to be 263 at a confidence interval of 95% and strength of 80%. Chi-square test and Fisher’s exact test were used in statistical analyses. In the present study, 31.7% of the participating nurses stated that they had concerns about childhood vaccines. Two-thirds of nurses stated that their knowledge on vaccines was from their education. The level of hesitance in those agreeing to the fact that vaccines caused autism and infertility, those stating that they did not trust vaccine-producing companies, and those stating that catching the disease was a better immunization method than vaccination was significantly higher than those not agreeing to these and those who were indecisive (p < .05). One-third of nurses was proven to have hesitance on childhood vaccines, and this rate is rather high. Nurses, being both health personnel and the communication channel for guiding parents, should be provided necessary training and practices in order to ease their hesitance on vaccination

Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal

Introduction Although there is a lot of scientific evidence that the benefits of vaccines outweigh their risks, hesitancy about the safety of vaccines can occur in every segment of the community. In this study, we aimed to determine the knowledge, attitudes, and associated factors of vaccine hesitancy among Inonu University faculty members regarding childhood vaccinations. Method This is a cross-sectional study, and 258 faculty members were included in the study. The questionnaire used in the study explored the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors regarding childhood vaccination. A chi-square test and a fisher exact test were used for statistical analysis. Results Of the faculty members, 31.8% were hesitant about childhood vaccines, 51.9% stated that there were studies reporting the side effects of vaccines, 48.1% did not agree with giving booster doses of vaccines, 35.7% stated that vaccines could cause autism due to the chemicals contained in the vaccines. The most important information sources of university faculty regarding childhood vaccines members are scientific publications and health professionals. Conclusions Faculty members level of hesitancy about vaccines was high and since health professionals and scientific articles are the most important information sources of faculty members, misinformation here may affect their knowledge, attitudes and behaviors about vaccination

A Theoretical Study On Rh(I) Catalyzed Enantioselective Conjugate Addition Reactions of Fluoroalkylated Olefins

In this study, quantum mechanical calculations have been performed to elucidate the mechanism and enantioselectivity in rhodium-catalyzed 1,4-conjugate addition reaction of a series of aryl groups to electron-deficient 4,4,4-trifluoro-1-phenyl-2-buten-1-one in the presence of (<i>S</i>)-BINAP. Conjugate addition of unsubstituted, <i>o</i>-CH₃, <i>p</i>- and <i>o</i>-Cl substituted phenyl groups were considered to explain steric and electronic effects on the reaction mechanism. The activation energy difference between benzene and <i>o</i>-toluene-substituted systems (8.1 kcal/mol for the <i>R</i> isomer) has shown the impact of steric effects of substituents at the ortho position. The electronic effect of a Cl substituent at the ortho position was demonstrated by an even higher energy barrier (11.9 kcal/mol of energy difference between benzene and <i>o</i>-Cl for R enantiomer). The experimental unreactivity of the <i>o</i>-Cl-substituted system was also confirmed with the calculated high activation energies for both <i>R</i> and <i>S</i> (29.9 and 31.7 kcal/mol for <i>R</i> and <i>S</i>, respectively) product formations. The system with para-positioned Cl revealed almost the same barriers for benzene, indicating that substituents at the para position do not have significant electronic or steric effects in this reaction. In all the modeled sets, experimental <i>R</i> product predominance could be reproduced. The quantitative trend was satisfied with the B3LYP/6-31G* functional, where the LANL2DZ effective core potential was used for Rh, P, S, and Cl atoms. Benchmark calculations have been performed to validate the level of theory in this study