Turkey's current account deficit problem of perspective energy deficit and recommendations for the future

Gelişmekte olan ülkeler başta olmak üzere tüm ülkelerin sürdürülebilir kalkınma ve makro ekonomik istikrar için gerekli unsurların başında enerji politikasının doğru konumlandırılması gelmektedir. Bu bağlamda ülkeler enerji politikalarında şu hususlar üzerinde kurmaları gerekir: Enerjinin uzun vadede kesintisiz, temiz ve güvenilir olması; enerji tüketiminin dışa bağımlılığa bağlı riskleri dağıtacak şekilde çeşitlendirilmesi ve son olarak, sağlanan enerjinin çağın teknolojik şartlarına uyum sağlayacak şekilde maliyetinin ucuz olması. Türkiye’de cari açık sorunu temelde ekonomik büyümenin ve sürdürülebilir makroekonomik istikrarın önündeki en büyük engellerin başında gelmekte ve cari işlemler açığı perspektifinde enerji açığı sorunu, Türkiye’nin iktisadi yapısının ana kırılganlık unsuru olarak görülmektedir. Türkiye’nin enerji politikasının iktisadi boyutu kadar uluslararası ilişkilerSpecifying the energy policy correctly comes first amongst the necessary elements for macroeconomic stability and sustainable development for all countries and especially for developing countries. In this context, about their energy policies countries have to focus on a continuous, clean and safe energy, varying the energy consumption in such a way that eliminates risks to be dependent on outside energy sources, and finally providing energy which is low-cost and adaptable to the modern technology. Turkey’s problem of current deficit is fundamentally is the biggest one for economic growth and a continuous macroeconomic stability, and the energy deficit is seen as the main reason for the fragility of Turkey’s economic structure. It has a grave importance to plan Turkey’s energy policy, which meets future energy needs, considering country’s geopolitical position and reserves of natural sources. The aim of this study is to evaluate the difficult position which emerges regarding to the current deficit-growth relation, and the eco-political approaches to the energy deficit problem as an important element of the current deficit.

Yenidoğan döneminde akut ürtiker ile prezente olan inek sütü proteini alerjisi

Urticaria is a common disease in children. But there are few case reportsin neonatal period. Urticaria has many causes, unfortunately it cannotbe figured out in some of the cases. Drug and food allergies, infectionsare common reasons that have been commonly shown. IgE-mediatedfood allergy should be considered in patients with acute urticaria and/orangioedema after food intake. Here we present a case of acute urticariadue to cow’s milk protein allergy in the newborn period. A 21-day-old malepatient was admitted to our emergency department with the complaintof widespread rash on the body which started one day earlier. Medicalhistory has revealed that he did not have a different drug intake beforethe onset of complaints, had no previous rashes, upper respiratory tractinfection or other infective-inflammatory disease since birth. His parentsdid not admit to another hospital. We obtained blood tests for food allergy.Total IgE: 38 IU/L and cow’s milk protein-specific IgE (f2): 2.26 kU/Lwere found to be suspicious for food allergy. According to these results,the formula which the baby was treated before has been stopped andextensively hydrolyzed formula has been started. After 12 hours, urticariahad started to fade. While going on our treatment, on 5th day the urticarialesions totally disappeared. Although urticaria is a common disease, it israrely reported in patients under six months. We want to emphasize thatfood allergies may be considered in cases presenting with urticaria inneonatal period.Ürtiker, küçük çocuklarda çok sık görülen medikal bir problemdir. Yenidoğan döneminde ise az sayıda olgu bildirimi vardır. Ürtikerin birçok olguda nedeni bulunamasa da oldukça fazla nedeni vardır. Daha çok gıda alerjisi, ilaç etkisi veya enfeksiyonlara bağlı meydana geldiği gösterilmiştir. Besin alımı sonrası akut ürtiker ve/veya anjioödem görülen hastalarda IgE aracılı besin alerjisinin olabileceği mutlaka akla getirilmelidir. Bu yazıda ise yenidoğan döneminde inek sütü proteini alerjisine bağlı gelişen akut ürtiker olgusı sunulmuştur. Yirmi bir günlük erkek hasta acil servisimize 1 gün önce başlayan vücuttaki yaygın döküntü şikayeti ile başvurdu. Hastanın öyküsünde şikayetleri başlamadan önce farklı bir ilaç alımı olmadığı, daha önce döküntülerinin olmadığı, doğumundan bu yana üst solunum yolu enfeksiyonu veya başka bir enfektif-enflamatuvar hastalık geçirmediği ve başka bir tıbbi kuruma başvurmadıkları öğrenildi. Hastanın besin alerjisi şüphesi açısından alınan tetkiklerinde Total IgE: 38 IU/L, süt spesifik IgE (f2): 2,26 kU/L olarak saptandı. Bu sonuçlara göre olgunun almış olduğu formüla mama kesilerek ileri derece hidrolize formüla başlanıldı. İzlemde olgunun 12 saat sonra vücuttaki döküntülü lezyonlar solmaya başladı ve tedavisinin 5. gününde tüm lezyonları düzeldi. Ürtiker, sık görülen bir hastalık olsa da 6 aydan küçük olgularda nadir olarak bildirilmektedir. Yenidoğan döneminde ürtiker tablosu ile başvuran olgularda besin alerjisi olabileceğinin akılda tutulması gerektiğini vurgulamak için olgumuz sunulmuştur

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

Antibakteriyel Aljinat Mikrobaloncuk Yapıların Mikroakışkan Sistemle Hazırlanması

Microbubbles produced with microfluidic systems have been used as contrast agents in ultrasound radiography for approximately 30 years. In recent years, it has been successfully used in different biomedical applications due to its simple, fast and reproducible production possibilities. These applications include drug delivery systems, gene therapy, intravenous oxygen transport agents, cancer therapy, blood-brain barrier targeted drug carriers, thrombolysis and focused ultrasound imaging. Microbubbles are also used in the production of scaffolds with homogeneous pore distribution. Pore size, homogeneity and architecture can not be fully controlled in structures produced by traditional methods such as freeze drying, phase separation, gas foaming, particle removal or use of porogen. In microfluidic systems, on the other hand, since a continuous flow production takes place, the microbubbles are stable, homogeneous and have a narrow pore size range. In this thesis, it was aimed to produce alginate/poly(vinyl alcohol)/polyethyleneimine (Alg-PVA-PEI) microbubbles using T-junction microfluidic system, and to prepare porous structures with antibacterial properties by supplementing these structures with iv silver nanoparticles (AgNP). For this purpose, Alg-PVA-PEI microbubbles were produced with T-junction microfluidic system and system parameters were optimized. By keeping the constant flow rate of 200 μL/min and the gas pressure of 9L/min in the system, microbubbles in the size range of 90-175 μm were obtained depending on the ratio of PEI and AgNP in polymer solution. On the other hand, AgNPs were synthesized to give antibacterial properties to these structures. Average diameter of AgNPs was 31.63±3.7nm, PDI value was 0.11 and surface charge zeta potential value was -21.7±9.1 mV. Antibacterial microbubbles (Alg-PVA-PEI/AgNP) were produced by adding the synthesized AgNPs to the Alg-PVA-PEI solution. Microbubble structures with high water retention capacity, extended silver nanoparticles release profile, non-toxic and antibacterial properties were obtained when microbubbles were cross-linked with calcium chloride (CaCl2). The water retention capacity of the microbubble structures were found to be between 3685-4300 %. The release profiles of AgNPs from alginate microbubble structures were examined and it was observed that AgNPs exhibited a burst release in the first 24 hours due to the highly hydrophilic natura of the microbuble structure and then release was extended up to 7 days. While microbubble structures containing 0.05% AgNP and 1% PEI showed 105% cell viability and 2605 ppb AgNP release after 72 hours. It was observed that the amount of AgNP above this value adversely affected cell viability. According to the disk diffusion test results, microbubble structures containing Alg-PVA did not show antibacterial effect, whereas microbubble structures containing PEI and AgNP exhibited high antibacterial properties against gram-negative Escherichia coli (E. coli–ATCC 25922) and gram-positive Staphylococcus aureus (S. aureus-ATCC 29213), ATCC Methicillin Resistant Staphylococcus aureus (MRSA) bacterial strains. As a result, it was concluded that PEI and AgNP containing microbubble structures could be a good wound dressing candidate for infected and highly exuding wounds, considering their long-term antibacterial activity, high water retention capacity, cellular compatibility.Mikroakışkan sistemler ile üretilen mikrobaloncuklar, kontrast ajanlar olarak ultrason radyografisinde yaklaşık 30 yıldır kullanılmaktadır. Son yıllarda ise basit, hızlı ve tekrarlanabilir üretim imkânı sağlaması nedeniyle birçok biyomedikal uygulamalarda başarıyla kullanılmaya başlanmıştır. Bu uygulamalar arasında ilaç taşıma sistemleri, gen tedavisi, intravenöz oksijen taşıma ajanları, kanser tedavisi, kan-beyin bariyeri hedefli ilaç taşıyıcılar, tromboliz ve odaklanmış ultrason görüntüleme v.b. gelmektedir. Mikrobaloncuklar aynı zamanda homojen gözenek yapısına sahip doku iskeleleri üretiminde de kullanılmaktadır. Gözenekli yapıların hazırlanmasında kullanılan geleneksel yöntemler (dondurarak kurutma, faz ayırma, gazla köpürtme, parçacık uzaklaştırma, porojen kullanımı) ile üretilen yapılarda gözenek boyutu, homojenlik ve mimari tam olarak kontrol edilememekte olup üretimden üretime varyasyonlar görülmektedir. Mikroakışkan sistemlerde ise sürekli akışlı bir üretim gerçekleştiğinden dolayı üretilen mikrobaloncuklar kararlı, homojen ve dar gözenek boyut aralığına sahiptirler. Bu tez çalışmasında T-bağlantılı mikroakışkan sistemi kullanılarak aljinat/poli(vinil alkol)/polietilenimin (Alg-PVA-PEI) mikrobaloncukların üretilmesi, bu yapılara gümüş nanopartiküllerin (AgNP) takviyesi ile antibakteriyel özellik gösteren, gözenekli yapıların hazırlanması amaçlanmıştır. Bu amaçla Alg-PVA-PEI mikrobaloncuklar T-bağlantılı mikroakışkan sistemi ile üretilerek sistem parametreleri optimize edilmiştir. Sistemde akış hızı 200 μL/dk ve gaz basıncı 9L/dk sabit tutularak, PEI ve AgNP oranına bağlı olarak 90-175 μm boyut aralığında mikrobaloncuklar elde edilmiştir. Diğer taraftan bu yapılara antibakteriyel etki kazandırmak için AgNP’ler sentezlenmiştir. AgNP’lerin ortalama çapı 31.63±3.7 nm, PDI değeri 0.11 ve yüzey yükü zeta potansiyel değeri -21.7±9.1 mV olarak bulunmuştur. Sentezlenen AgNP’ler, Alg-PVA-PEI çözeltisine eklenerek antibakteriyel mikrobaloncuklar (Alg-PVA-PEI/AgNP) üretilmiştir. Üretilen mikrobaloncuklar kalsiyum klorür (CaCl2) ile çapraz bağlanarak; yüksek su tutma kapasitesine sahip, uzatılmış gümüş salımı sağlayan, toksik etki göstermeyen ve antibakteriyel özelliğe sahip mikrobaloncuk yapılar elde edilmiştir. Elde edilen mikrobaloncuk yapıların su tutma kapasiteleri %3685-4300 arasında bulunmuştur. AgNP'lerin aljinat mikrobaloncuk yapılarından salım profilleri incelenmiş ve AgNP'lerin mikrobaloncukların yüksek hidrofilik doğası nedeniyle ilk 24 saatte hızlı salım sergilediği ve daha sonra ise salımın 7 güne kadar uzadığı gözlemlenmiştir. % 0.05 oranında AgNP ve % 1 oranında PEI içeren mikrobaloncuk yapılar %105 hücre canlılığı gösterirken 72 saat sonunda 2605 ppb AgNP salımı tespit edilmiştir. Bu değerin üzerindeki AgNP miktarının hücre canlılığını olumsuz yönde etkilediği gözlenmiştir. Disk difüzyon test sonuçlarına göre Alg-PVA içeren mikrobaloncuk yapılar antibakteriyel etki göstermez iken, PEI ve AgNP içeren mikrobaloncuk yapılar gram negatif Escherichia coli (E. coli–ATCC 25922) ve gram pozitif Staphylococcus aureus (S. aureus-ATCC 29213), Methicillin Resistant Staphylococcus aureus ATCC 43300 (MRSA)) bakteri türlerine karşı yüksek oranda antibakteriyel özellik göstermiştir. Sonuç olarak, PEI ve AgNP içeren mikrobaloncuk yapıların uzun süreli antibakteriyel aktiviteleri, yüksek su tutma kapasitesi, hücresel uyumluluğu göz önüne alındığında, enfekte ve yüksek eksudalı yaralar için iyi bir yara örtüsü adayı olabileceği sonucuna varıldı

Multiphysical modeling and optimization of vacuum bag only process with integration of resin flow, heat transfer and consolidation for composite manufacturing design

The composite manufacturing for the aerospace industry requires advance and skillful manufacturing techniques. Autoclave manufacturing technique is well understood and widely used for the aerospace industry that aims to get as low as possible void content in cured parts with higher pressure and temperature profile. The allowable geometry of manufactured parts and operational cost limits Autoclave manufacturing techniques by fulfilling high mechanical performance. Alternatively, Out of Autoclave (OoA) technique with Vacuum Bag Only (VBO) method with right process conditions and prepreg system has the potential to displace expensive composite manufacturing challenges in the aerospace industry. The successful OoA manufacturing process depends on control of multiphysics such as resin flow, heat transfer and consolidation. In this thesis, integration of multiphysical governing equations scheme for VBO manufacturing process, is developed and implemented for 2D through thickness of 1-, 2-and 4-layer of OoA prepregs via commercially available software. This model aims to capture instantaneous void content in prepreg system, hence, void initiation mechanism and air evacuation channels during VBO process. The assessment of developed model during thesis, is planned to find time dependent change of resin impregnated area during VBO process. Based on change of resin impregnated area, the multiphysical assessment of developed model configurations is evaluated to reveal effective parameters of individual physics as well as integration with each other. The effective process parameters that includes initial cure temperature, post cure temperature, dwell time and ramp rate on the temperature profile is subjected to parametric numerical experiments as well as the optimization study with Nelder-Mead algorithm. The results of studies are aimed to find right process conditions in order to achieve repeatable, scalable and controllable VBO process outcome

Design and simulation of bidirectional DC-DC converter topology for battery applications

Recently, energy storage has become a significant topic for renewable energy based power system applications. Batteries are one of the most popular energy storage devices adopted by renewable energy sources, electrical vehicles and grid connected systems. In this context, the bidirectional DC-DC converter (BDC) enables bidirectional power flow by controlling the charging and discharging stage of the battery in battery applications. Accordingly, the battery current is regulated through the duty cycle of the BDC considering the state of charge of the battery and current direction. In this study, a non-isolated BDC, has a buck and boost principle of operation, is designed, analysed and simulated under various case studies. In the designed system, BDC controls the bidirectional power flow between the battery and DC link. Specifically, in the charging stage of battery operating in buck mode, DC-link supplies the power to the battery and BDC regulates the battery current using proportional-integral (PI) controller. On the other hand, in the discharging stage of the battery operating in boost mode, when DC source is disconnected, the battery supplies the power to DC load and DC-link voltage is controlled by the BDC via PI controller. The simulation results are presented to show the operation and control of the BDC under different scenarios

ÜRETİM PARAMETRELERİNİN KAĞIT HAMURU VERİMİ VE KAPPA NUMARASINA ETKİSİ

Triticale (Triticosecale, Wittm. ex A. Camus) saplarından oksit ilaveli NaOH-O2 yöntemiyle optimum kağıt hamuru verim ve Kappa numarasını belirlemek için 27 adet pişirme denemesi yapılmıştır. Yapılan pişirme denemeleri sonucunda ekonomiklik de göz önüne alındığında pişirme sıcaklığı1200C, pişirme süresi 20 dakika, Al2O3 oranı %1, NaOH oranı %16, çözelti/sap oranı 5/1, O2 basıncı 8 kg/cm2 olduğu tespit edilmiştir. Daha sonra bu pişirme koşullarında %0,05-%0,1 oranında antrakinon (AQ) ilave edilerek toplam hamur verimi ve kapa numarası üzerine etkisi belirlenmiştir. , %0.05 AQ kullanımında toplam verimde %5.89, %0,1 AQ kullanımında ise %8.27 verim artışı tespit edilmiştir. AQ ilavesinin Kappa numarasını azaltmada belirgin bir etkisi görülmemiştir

Follow-up results of BI-RADS 3 lesions on magnetic resonance imaging: a retrospective study

PURPOSE: The categorization of Breast Imaging Reporting and Data System (BI-RADS) 3 lesions is not as clear in magnetic resonance imaging (MRI) as it is in mammography (MG). With the increasing number of MRI scans currently being conducted globally, incidentally detected lesions falling into the probably benign category are frequently being observed. In this study, our aim was to investigate the imaging characteristics and follow-up results of BI-RADS 3 lesions detected by MRI and to determine their malignancy rates. METHODS: Breast MRI scans performed between January 2010 and January 2020 and classified as BI-RADS 3 lesions were retrospectively analyzed. The study included 216 lesions with known biopsy or surgical excision results or with at least one year of radiological follow-up. We assessed the patients’ age, the presence of breast cancer, the follow-up interval, and the imaging findings at the beginning and during the follow-up. Lesions that remained stable, disappeared, or decreased in size and had a benign histopathological diagnosis were classified as benign. Lesions with the histopathological diagnosis of malignancy, identified by either biopsy or surgical excision, were classified as malignant. We determined the malignancy rate based on the histopathology and follow-up results. RESULTS: Considering the follow-up results of all cases, 8% of lesions were excised, 0.5% decreased in size, 1.4% became enlarged, 17.1% disappeared, and 73% remained stable. The malignancy rate was 2.8%. A significant relationship was found between lesion shape and malignancy, as progression to malignancy was more likely in round lesions than in other types. An irregular margin, heterogeneous enhancement, and kinetic curve (type 2) features were significant for lesion upgrade to malignancy. CONCLUSION: The malignancy rate in BI-RADS 3 lesions detected by MRI is low and falls within the accepted cancer rate for MG and sonography. Changes in size, morphology, and enhancement pattern should be considered in terms of malignancy development during follow-up. The follow-up intervals should be determined on a case-by-case basis