Product development process using multiple criteria decision making approach

<!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:14.0pt; mso-bidi-font-size:10.0pt; font-family:Arial; mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman"; mso-fareast-language:EN-US;} p.zetmetni, li.zetmetni, div.zetmetni {mso-style-name:"Özet metni"; margin-top:6.0pt; margin-right:0cm; margin-bottom:0cm; margin-left:0cm; margin-bottom:.0001pt; text-align:justify; mso-pagination:widow-orphan; font-size:11.0pt; mso-bidi-font-size:10.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-fareast-language:EN-US; font-style:italic; mso-bidi-font-style:normal;} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:35.4pt; mso-footer-margin:35.4pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:14.0pt; mso-bidi-font-size:10.0pt; font-family:Arial; mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman"; mso-fareast-language:EN-US;} p.MsoHeader, li.MsoHeader, div.MsoHeader {margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; tab-stops:center 207.65pt right 415.3pt; font-size:14.0pt; mso-bidi-font-size:10.0pt; font-family:Arial; mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman"; mso-fareast-language:EN-US;} p.MsoFooter, li.MsoFooter, div.MsoFooter {margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; tab-stops:center 207.65pt right 415.3pt; font-size:14.0pt; mso-bidi-font-size:10.0pt; font-family:Arial; mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman"; mso-fareast-language:EN-US;} @page Section1 {size:595.3pt 841.9pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:35.4pt; mso-footer-margin:35.4pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> Ekonomilerin küreselleşmesi ile beraber pazarlardaki yüksek rekabet, ürünlerin ve servislerin kalitesinin güvence altına alınmasını sağlayan ürün/servis geliştirme ve iyileştirme yöntemlerinin önemini arttırmıştır. Bu stratejik kalite yönetimi araçlarından biri de, Kalite İşlev Konuşlandırma (KİK) (Quality Function Deployment-QFD)’dır. KİK yöntemi, müşteri talep ve ihtiyaçları doğrultusunda yeni ürünlerin/hizmetlerin tasarımı veya mevcut ürünlerin/hizmetlerin geliştirilmesi için organizasyon içinde farklı işlevleri olan takım üyelerinin kullandığı müşteri-odaklı bir tasarım aracıdır. KİK, müşteri memnuniyetini, üretim sürecinin ilk aşaması olan tasarım aşamasında sağlayarak, ürün üretildikten veya hizmet sunulduktan sonra gereken düzeltme çalışmalarının önüne geçmeyi amaçlamaktadır. KİK’nın temel girdisi olan müşteri istek ve gereksinimleri, müşteriler tarafından sözcüklerle ifade edildiklerinden, genel olarak ölçülmesi güç bir yapıya sahiptirler. Buna bir çözüm olarak çalışmada bulanık mantık kavramı temel alınmıştır. KİK sürecindeki Müşteri Gereksinimleri (MG) ile Tasarım Özelliklerinin (TÖ) kendi aralarındaki bağımlılık ilişkilerini ve müşteri gereksinimleri ile tasarım özellikleri arasındaki ilişkiyi değerlendirmek için analitik serim sürecini kullanılmıştır. Piyasadaki en iyi ürün/hizmetin belirlenmesi için Uzlaşık Programlama (UP) yöntemi önerilmiştir. MG’ler ile TÖ’ler arasındaki ilişkiyi belirlemek için doğrusal regresyon denklemleri oluşturulmuştur. Bütün bu aşamalar sonucu elde edilen veriler bütçe kısıtını içeren hedef programlama yöntemine aktarılıp çözülmüştür. Amaç, seçilen ürünün/hizmetin performansının MG’leri karşılayacak şekilde arttırılmasıdır. Türkiye’deki yüksek öğrenim kurumlarının sunduğu elektronik eğitime ilişkin gerçek bir uygulama, önerilen yöntemlerin uygulanabilirliğini göstermektedir.   Anahtar Kelimeler: Kalite işlev konuşlandırma, analitik serim süreci, uzlaşık programlama, hedef programlama, elektronik eğitim.  The globalization of the economies diminishes the differences between local and foreign products/ services. Nowadays, both the number of the product/ service providers and also the variety of the place of the origins are increasing. Consequently, the firms are facing a tough competition while trying to keep and increasing their market shares. Unavoidably, the firms began to look out for the little differentiations which will ensure their success over their competitors. Thus, they are developing products/services tailor-made for their customers. The main idea behind all these efforts is to determine somehow the requirements of the customers and to ensure that, the products produced and the services provided will satisfy these needs. In this work, an application in the area of e-learning, which is a term recently established following the late developments in the area of the networks like the Internet, is proposed. E-learning can be basically defined as, the transformation from the face-to-face conventional education into distance based, independent from time and place education form. Its main difference from the conventional education is that, previously the academics controlled the pace, place, time and the presentation of the education, whereas, now, e-education gave the control of these attributes to the learners. As the decision makers are the learners during the e-learning process, new development procedures should be prepared differing from the procedures of conventional type of learning. In order to ensure the satisfaction of the customers with the new developments, their needs should be known forehand. Additionally the attention of the customer could only be kept alive, not only by satisfying their current needs, but also foreseeing their future needs, when developing the products/services. Thus, in this study, Quality Function Deployment (QFD), which is one of these key design activities, is used to solve the product definition problem during the new product development process. The aim is, to study, evaluate and suggest improvements for the e-learning applications in Turkey, in order to satisfy the customers. The QFD methodology, which will be used to develop e-learning products, is defined as, a customer-oriented design tool with cross-functional team members used to develop new products/ services or to improve current products/services regarding the needs and the requirements of the customers. QFD tries to satisfy the customers at the initial production stage, namely the design stage, preventing corrective actions to be made after the product has been produced. QFD starts after the development team consisting of team members from all the divisions of the organization reaches a consensus in the identification of the Customer Needs (CNs), which will be used during the design process. This data, will be used to establish the ?house of quality?, which is a king planning matrix transforming the CNs into measurable Product Technical Requirements (PTRs). During the development process, both the needs meaningless and the needs crucial for the customers are distinguished to ensure to remove or include them according these finding. In order to categorize the needs as mentioned, the inner dependencies among the CNs, the relationships between the CNs and the PTRs and lastly the inner dependencies among the PTRs should be measured. According to these relationships, it will be foreseen, how and in which direction, a modification in the design of the product could affect the CNs. The proposed approach tries to solve the problem of measuring the CNs and requirements which are usually expressed in customers? own phrases. It consists of fuzzy logic theory integrated with Analytic Network Process (ANP), Compromise Programming (CP), linear regression and Goal Programming (GP) methods. The ANP is used to identify the importance ratings of the PTRs which will maximize the satisfaction of the CNs, with regard to the relationship between and among the CNs and the PTRs. The CP employed identifies the ideal and the anti-ideal performance values for the CNs and the distances from them for each product in the market. As the distances for each CN are summed, the distance value indicating the performance of this product is defined. Fuzzy linear regression is integrated to the model to integrate the relationships between the CNs and the PTRs into the GP model. The GP model uses the best products distance value as the goal along with the budget limitation of the organization. The solution to the optimization model defines the target PTR performance values to be the best product in the market by satisfying the customers.   Keywords: Quality function deployment, analytic network process, compromise programming, goal programming, e-learning

Multi criteria operating system selection using fuzzy replacement analysis and AHP

Bu çalışma Karar Alıcılar (KA) için İşlem Sistemi (İS) seçim sistemi kurmayı hedeflemektedir. Karar Alıcılar teknoloji seçiminde hem ekonomik hem de ekonomik olmayan unsurları göz önüne almak zorunda olduklarından, geliştirilen sistemde her iki unsura da yer verilmiştir. Karar alma sürecinin ekonomik yanı, Bulanık Yenileme Analizi kullanılarak geliştirilmiştir. Ekonomik olamayan unsurlar ve finansal veriler ise Bulanık Analitik Hiyerarşi Süreci (AHS) yaklaşımı kullanılarak biraraya getirilmiştir. Çalışma içerisinde aynı zamanda sayısal bir örneğe de yer verilmiştir. AHS yaklaşımının finansal yönü geliştirilen Bulanık Yenileme Analizi altyapısı tarafından desteklenmiştir. Bulanık AHS yönteminin Mühendislik Ekonomisi’nin ana konularından olan Yenileme Analizleri’nde kullanılması araştırmacılara yatırım alternatiflerinin değerlendirilmesinde etkin yollar sağlamaktadır.Anahtar Kelimeler: Bulanık kümeler, yenileme analizleri, analitik hiyerarşi süreci, teknoloji seçimi.This study aims at creating an Operating System (OS) selection framework for decision makers (DMs). Since DMs have to consider both economic and non-economic aspect of technology selection, both factors have been considered in the developed framework. The economic part of the decision process has been developed by Fuzzy Replacement Analysis. Non-economic factors ve financial figures have been combined using Fuzzy Analytic Hierarchy Process (Fuzzy AHP) approach. A real numerical application has also been demonstrated. This study developed a fuzzy AHP framework to select best OS alternative. While fuzzy AHP requires cumbersome computations, it is a more systematic method than the others are, and it is more capable of capturing a human?s appraisal of ambiguity when complex multi-attribute decision-making problems are considered. This is true because pairwise comparisons provide a flexible and realistic way to accommodate real-life data. The financial side of the framework is based on fuzzy replacement analysis. The results of fuzzy replacement analysis are included into fuzzy AHP analysis. Using Fuzzy AHP concept in Replacement Analysis investment decisions in fuzzy environment results a very effective way to evaluate alternatives. Using the very same developed framework, a subjective comparison, such as the comparison of diverse operating systems, has been conducted and demonstrated to readers.Keywords: Fuzzy sets, replacement analysis, AHP, technology selection

Real options approach for valuation of enterprise resource planning systems

Günümüzde tüm dünya genelindeki sağlık kurumları, hizmet kalitelerini iyileştirmeyi ve maliyetleri düşürmeyi amaçlayan bilişim teknolojileri yatırımlarının önemini kavramışlardır. Sağlık sektörünün sürekli yükselen standartları ve sigorta sistemlerinin artan gereksinimleri karar vericileri, hastanelerde Kurumsal Kaynak Planlama (KKP) sistemlerinin sağlık sektörünün gerek ve ihtiyaçlarına göre uyarlanmış ve geliştirilmiş hali olan Hastane Bilgi Sistemi (HBS) yatırım uygulamalarını dikkate almalarını zorunlu kılmaktadır. Bu tür yatırımların ekonomik değerlemesi karmaşık yapıları nedeniyle her zaman zor olmuştur. Bununla beraber bu yatırımların, bünyelerinde barındırdığı ve firmalara rekabet ortamında avantajlar sağlayan birçok faydası da mevcuttur. Geleneksel iskontolanmış nakit akışı yöntemleri, bu sistemlerin içinde varolan ve yatırım kararını haklı çıkartacak, yönetsel ve stratejik esnekliklerin değerini dikkate almamaktadır. Reel opsiyon yaklaşımı karar vericilere, geleneksel değerleme yöntemlerindeki bu yetersizliklerin üstesinden gelme olanağını sunmaktadır. Bu çalışmada, reel opsiyonları temel alan bir yaklaşımla, birden fazla opsiyonun birarada yer aldığı bir KKP sistemi yatırımının değerlemesine imkan tanıyan bir model önerilmektedir. Binom ağacı modelini temel alarak geliştirilen değerleme modelinin yapısı KKP yatırım fırsatının bünyesindeki birleşik opsiyonları değerlemeye imkan tanıyacak şekilde genişletilmiş ve dolayısıyla karar vericilere yeni bir katma değer sunulmuştur. Geliştirilen modelin potansiyel uygulaması gerçek bir HBS yatırımı değerlemesiyle gösterilmektedir. Yapılan uygulama geleneksel değerleme yöntemlerince kabul edilir görülmeyen yatırımların bile, bünyelerinde barındırdıkları stratejik ve yönetsel unsurlar sayesinde ve gelecekte oluşması muhtemel koşullar dahilinde kabul edilebilir bir hal alabileceğini ortaya koymaktadır. Anahtar Kelimeler: KKP yatırımlarının değerlemesi, reel opsiyonlar, birleşik opsiyonlar, opsiyon değerleme modelleri.Nowadays in order to improve the quality of care delivery and reduce costs, healthcare organizations globally recognize the importance of investing in information technologies (IT). The key drivers of healthcare sector like continuous improvement of healthcare standards and insurance systems have introduced new requirements for hospitals, which in return provided a solid ground for decision-makers to consider implementing hospital information system investment. Hospital information systems (HIS) are the customized and improved versions of enterprise resource planning (ERP) systems, designed according to the needs and the requirements of healthcare sector. It has been always difficult to value such investments in monetary terms due to their complex nature. This type of investments also has many inherent benefits that can provide significant competitive advantages. These inherent benefits can only be viable for decision support if strategic and managerial flexibilities can be utilized. However, traditional capital budgeting techniques, such as net present value (NPV), do not enable decision-makers to consider these flexibilities. Due to its idle valuation approach, NPV only considers a static scenario that ignores the possible dynamic changes in the market affecting future cash flows and interest rates. NPV's passive commitment strategy also forces the decision-makers pre-committing today to a "go" or "no-go" decision considering information only available today. Thus, it is clear that the traditional NPV methods ignore the value of managerial and strategic flexibility inherent in the investments which undermines a company's strategic opportunities. Investment science experts agreed that it is a must to integrate financial and strategic issues and study them together for making an investment decision. Recognizing the shortcomings of traditional NPV methods, real options (RO) technique has been suggested as an alternative approach. RO whose methodology is based upon financial options theory enable the decisions makers to analyze the true value of a real life investment opportunity through better modeling of the uncertainty within the investment. RO method does not only value the managerial flexibility through the investment horizon, it also supports and expands the firm's strategic frame. It gives a road map to the managers to optimize the medium and long-term strategies according to the expectations. RO can be categorized to six main managerial options according to the flexibility they have: option to defer, option to stage, option to expand/contract, option to abandon, option to switch and growth option. In a real-life investment scenario it is usually viable to have more than one real option concurrently. The first applications of real options are about mining and operating natural resource investments. Besides, the new application areas for RO are growing rapidly. Regardless of an industry, it can be used in many cases like entering a new market, deciding the initial scale of an investment, scaling up or down in the future according to the needs, managing multi-staged complex projects, and freezing up or completely ending an investment. Developing with dynamic market conditions due to the continuous improvements, IT investments are also an appropriate application area for RO. This study introduces a RO based methodology that enables decision-makers to value an ERP system investment incorporating multiple options. The option valuation model developed in this study extends the binomial lattice framework to model an ERP investment opportunity with compound options. The potential application of the proposed model is presented to evaluate an HIS implementation project of a Turkish health care organization. For this purpose, considering the ever changing dynamics of the market affecting possible cash flows, a computer-based decision support framework is developed to provide a flexible and efficient solution to decision-makers. In this manner, for simulating various possible future market conditions, different scenarios are generated via triggering conditional changes in model variables and parameters. Results are interpreted with tables and graphs for submitting a thorough road map to decision-makers that can be utilized as a managerial asset for understanding the interactions between model parameters. Further investigations have shown that even an investment that is not approved to be undertaken with traditional valuation methods, can be valuable for a firm considering the strategic and managerial flexibilities inherent in the investment, with the effect of the possible market conditions in the future. Thus, it is also emphasized that real options approach generally presents a new point of view for valuing IT investment projects. Keywords: Evaluation of ERP investments, real options, compound options, option valuation models

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Preparing a data-base software of computation of expense for tractors

Yüksek Lisans TeziBu araştırmada tarımsal işletmelerde masraf hesaplamalarında kullanılmak üzere bir veritabanı yazılımı geliştirilerek, işletmelerde bu veritabanı programının kullanılması amaçlanmıştır. Ülkemizdeki tarım işletmelerinde kayıt altına alınmış ve planlı bir tarımsal üretim yapılmadığı ve tarımda bilgisayar kullanımının çok düşük seviyelerde olduğu bilinen bir gerçektir. Tarımsal üretim çok sayıda girdinin bir araya gelmesini gerektiren bir sistemdir. Özellikle işletme masraflarının hesaplanması ve bu doğrultuda bilinçli üretim yapılmasını sağlamak ve sonucunda da işletmenin kâr etmesini sağlamak gerekir. Veri denetimleri sayesinde işletmenin kârlılığı ve masrafların hesaplanması en iyi şekilde saptanmış olur. Ayrıca zaman ve işgücünden de tasarruf sağlanmış olur. Bu çalışmada örnek olarak seçilen bir traktör incelenerek ve çeşitli kaynaklar araştırılarak, kayıt altına alınması gereken kriterler ve veri tabanında bulunması gereken bilgiler saptanmıştır. Daha sonra bu verilerin bilgisayar ortamında kayıt altına alınabilmesi, verilerin daha hızlı, kolay ve güvenilir bir biçimde işlenebilmesi için bir veri tabanı yazılımı geliştirilmiştir. Yazılımın geliştirilmesinin ardından, traktör üreticileri tarafından ve araştırmalar sonucunda günümüzde yaygın olarak kullanılan traktörlere ait veriler bu yazılıma yüklenerek tüm kayıt, takip ve raporlama işlemleri program vasıtasıyla yürütülmüş, elde edilen sonuçlar neticesinde programın tarım işletmeleri için uygulanabilirliği değerlendirilmiştir.In this study, by developing a data-base software for agricultural companies the usage of data-base program for companies is aimed. It is known that in our country there is no planned agricultural production and the usage of computer in agriculture is not very common. Agricultural production is a system in which it is necessary to put lots of data together. Especially the computation of the expenses of the company and through this way to provide the company to do conscious production and as a result to provide the company to get benefit is necessary. The benefit of the company and the computation of the expenses can be determined in the best way with the control of data. In addition, a careful use of time and labour force can be provided. In this study the criteria which must be recorded and information which must be exist in data-base was determined by the investigation of a tractor which was chosen as an example. Following this, a data-base software was developed to record these data in a computer and to process these data in a more quick, easy and reliable way. After developing software, today, by downloading the data of tractors to this software by the producers of tractors and in the end of the researches all recording, observation, and reporting processes was done by this program and by means of the results obtained the applicability of this program for the agricultural companies was investigated

P53 gene therapy for hepatocellular carcinoma

Hepatocellular carcinoma is a malignant tumor with a very high morbidity and mortality. It has a poor prognosis due to its common infiltrating. Liver carcinogenesis is driven by genetic alterations in combination with viral and environmental factors. P53 mutations represent main genetic alteration described in hepatocellular carcinoma. Because of this, p53 gene therapy is proposed as a potential treatment. P53 tumour suppressor gene is responsible for apoptotic signals in tumour signals and thus for their uncontrolled proliferation and recurrence. New approaches to hepatocellular carcinoma treatment are needed to improve patient survival

Incidentally detected gastrointestinal stromal tumor: A case report

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors located primarily in the gastrointestinal tract. We aimed to present a case report of GIST incidentally detected during laparoscopic cholecystectomy.A 60-year-old woman was admitted to the emergency room due to abdominal pain for one day. The physical examination revealed sensitivity on the right upper quadrant. In the laboratory examinations, white blood cell count 6,490 k/uL, hemoglobin 12 g/dL, hematocrit 35% and other biochemical tests were normal. Abdominal ultrasound revealed hydropic gallbladder, several gallstones with a maximum diameter of 15 mm and pericholecystic fluid collection was present. Laparoscopic cholecystectomy was planned due to acute cholecystitis. In exploration, beside the presence of acute cholecystitis, a mass of approximately 5 cm, located 15 cm distal to the ligament of Treitz was detected. Laparoscopic cholecystectomy was performed. Conversion to open laparotomy was done; small intestine resection with end-to-end anastomosis was performed. Gastrointestinal stromal tumor with CD117, CD34 and S100 positivity was detected on histopathologic examination.It is thought that GISTs are mesenchymal tumors originating from precursors of Kajal cells. GISTs are usually detected in their 60s. The first option for treatment is surgical resection