IMPACT OF THE GLOBAL CRISIS ON THE GOVERNANCE STRUCTURES OF INTERNATIONAL FINANCIAL INSTITUTIONS

The global financial crisis dragged many countries into recession, demonstrated that the internationalfinancial system has structural problems and started discussions about restructuring of the international financialinstitutions. The main objective of this paper is to investigate the impact of the global financial crisis on thegovernance structures of the international financial institutions. To this end, studies made at different internationalplatforms were evaluated. The debates and negotiations among the developed and developing countries aboutgovernance structures of the international financial institutions were analyzed. Developing countries’ demand toreform the decision-making mechanisms of the Bretton Woods institutions, the IMF and the World Bank anddeveloped countries’ reservations were investigated. It was concluded that the new shape of the internationalfinancial architecture and governance structures of international financial institutions will depend on internationalpolitics as well as the evolution of the global crisis and the economic dynamics

Maxillary Sinus Augmentation for Dental Implants

Pneumatization of the maxillary sinus secondary to posterior maxillary tooth loss is an extremely common finding. Significant atrophy of the maxilla prevents dental implant placement in this region. Grafting the floor of the maxillary sinus has emerged as the most common surgical modality for correcting this inadequacy. Graft material is introduced into the space created inferior to the sinus membrane. Various grafting materials and techniques might be used in this procedure. The aim of this article is to review the essentials of maxillary sinus augmentation, clarify this procedure for otolaryngologists, explain its function, and describe the augmentation materials, techniques, and complications

Abortion policies around the world and in Turkey and its reflection on women’s health

Approximately 46 million women experience abortion all around the world every year and about 22 million of those being done in precarious conditions. 13 % of the maternal mortality is associated with unsafe abortion practices. Every year near 5 million women are hospitalized because of unsafe abortion. The cost for treatment of the complications related to unsafe abortion is estimated to be 680 million dollars annually. Two third of the maternal mortality occurs in African countries and when these rates are thoroughly analysed it can be seen that African and Asian countries’ law limit abortion practices. In the developed countries where discretionary abortion is not legally limited, maternal mortality rates stay under 1 %, on the other hand, abortion limited/banned countries show the highest rates

An alternative method for analysing buckling of laminated composite beams

U radu su primjenom Gâteauxove derivacije izvedena dva nova funkcionala kako bi se provela analiza izvijanja simetričnih križno uslojenih ravnih lameliranih kompozitnih greda. Funkcional sadrži četiri nezavisne varijable, a to su progib, rotacija, poprečna sila i moment savijanja za Timošenkovu gredu, te dvije nezavisne varijable, progib i moment savijanja, za Euler-Bernoullijevu gredu. Mogućnost primjene i učinkovitost predložene mješovite formulacije konačnih elemenata prikazana je na nekoliko numeričkih primjera.In this study, two new functionals are derived based on Gâteaux differential in order to analyse buckling of symmetric cross-ply laminated composite straight beams. The functional comprises four independent variables, i.e. deflection, rotation, shear force and bending moment for Timoshenko beam, and two independent variables, deflection and bending moment, for Euler-Bernoulli beam. The application possibilities and performance of the proposed mixed finite element formulation are presented on several numerical examples

Validation of tracheal intubation of wire-reinforced endotracheal tube with ultrasonography

Objective. Te use of ultrasonography (US) is a new method for verifying the location of the endotracheal tube. Design. Our study was designed as a paired-data and investigator-blind clinical study for evaluating the efectiveness of US for verifcation of wire-reinforced endotracheal tube (WR-ETT) placement compared with capnography. Setting. Tis study was conducted on 56 patients scheduled for elective surgery under general anesthesia. Patients. Fify patients completed the study as 6 were excluded for various reasons. Intervention. Two diferent investigators performed the ultrasonography and intubation independently from one another. While investigator 1 attempted to verify the location of the WR-ETT with a portable ultrasonography with sagittal trans-tracheal view, investigator 2 intubated the patient and verifed the location of the ETT using capnography. Measurements. Time for verifying the location of the ETT using both US and capnography was recorded. Main Results. When the ultrasonography method was compared with capnography for verifcation of the WR-ETT placement, the results showed 95.75% sensitivity and 100% specifcity. Te average verifcation times for endotracheal intubation were 12.78 ± 7.46 s. and 24.44 ± 1.45 s. with US and capnography, respectively (p=0.003). Conclusion. Our results suggest that ultrasound identifcation of a WR-ETT within the trachea is a rapid and accurate method for confrmation of tracheal placement. Larger studies are needed before widespread use of this technique

Turkish translation, validation, and reliability analysis of pediatric eosinophilic esophagitis symptom severity module version 2.0

The Paediatric Eosinophilic Esophagitis Symptom Severity Modules Version 2.0 (T-PEESv2.0) was developed in English as a valid, reliable questionnaire for follow up. This work aimed to develop a Turkish version of T-PEESv2.0 via translation and cultural adaptation and then to test its validation and reliability. Methods: The PEESv2.0 was translated into Turkish by standardized procedural steps completed in cooperation with the Mapi Research Trust. The final version of the questionnaire was submitted to eosinophilic oesophagitis patients or their parents at 2 times point separated by 1 week. An age-matched control group was used to test the discriminant validity. Construct validity was tested using the Wilcoxon test, and internal consistency was tested using Cronbach's alpha. Test-retest reliability was measured with Cohen's kappa and intraclass correlation coefficient. Results: One hundred twenty-eight participants (70 patients, 58 parents) were enrolled. Fifty-eight (39.1%) of them completed T-PEESv2.0-parent by proxy and 70 (54.7%) were T-PEESv2.0. The Cronbach's alpha coefficient and intraclass correlation coefficient for test-retest reliability were >0.70 for both questionnaires and for all domain (frequency and severity) and total scores. For discriminant validity analysis, subscale (frequency and domain) and total scores of the patient group were compared with those of the control group. The subscale and total scores were significantly different between the groups (P < 0.05). Conclusion: T-PEESv2.0 appeared to be valid and reliable, ready to be introduced as a clinical and research tool for the assessment of patients with eosinophilic oesophagitis

Evaluation of Emergency Interhospital Patient Transfers from Province of Mardin to Out-of-Province Hospitals in a Year

Abstract Objective: This study aimed to assess patients who were transferred from emergency services throughout the province of Mardin to out-of-province hospitals by ambulance in a year. Material and Methods: In this study, all patients transferred from emergency services in the province of Mardin to out-of-province hospitals via ambulances by the Patient Referral Assessment Committee, founded under the Provincial Directorate of Health, between the dates of December 31, 2010 and December 31, 2011 were evaluated retrospectively. No exclusion criteria were used. Patients were grouped and analyzed according to their demographic characteristics, transport properties, and reasons for referral. Results: The total number of the patients included in the study was 1518 (55.8% males, 41±27 mean age). Of all, 621 patients (40.9%) were transferred from the center of Mardin province, and the other patients were transferred from 8 district hospitals and two private hospitals. It was found that the patients were transferred to 37 hospitals in 8 provinces, and a total of 562 patients (37%) were transferred to private hospitals. Cardiology (23.3%), pediatrics (11.5%), and obstetrics and gynecology (8.8%) departments were the first three clinics that patients were transferred to frequently, respectively. In total, 274 patients (18.1%) were transferred inappropriately. There was a statistically significant difference between patients&apos; transfer hospitals (state hospital/private hospital) and the age of the patients (younger than 18 years/18 years or older) (p&lt;0.001). In addition, the rate of adult patients&apos; transfers to tertiary healthcare centers was significantly higher (p&lt;0.001). Conclusion: In Mardin, cardiology, pediatrics and obstetrics and gynecology patients are the most common group of emergency patients transferred by 112 ambulances to out-of-province hospitals. Approximately 40% of the patients were transferred to private hospitals. Inappropriate patient transfers seem to be a major problem in this study, as in other studies conducted in Turkey. (JAEM 2014; 13: 62-6

A genomic snapshot of demographic and cultural dynamism in Upper Mesopotamia during the Neolithic Transition

Upper Mesopotamia played a key role in the Neolithic Transition in Southwest Asia through marked innovations in symbolism, technology, and foodways. We present thirteen ancient genomes (c.8500-7500 calBCE) from Pre-Pottery Neolithic Çayönü in the Tigris basin together with bioarchaeological and material culture data. Our findings reveal that Çayönü was a genetically diverse population, carrying a mixed ancestry from western and eastern Fertile Crescent, and that the community received immigrants. Our results further suggest that the community was organised along biological family lines. We document bodily interventions such as head-shaping and cauterization among the individuals examined, reflecting Çayönü's cultural ingenuity. Finally, we identify Upper Mesopotamia as the likely source of eastern gene flow into Neolithic Anatolia, in line with material culture evidence. We hypothesise that Upper Mesopotamia's cultural dynamism during the Neolithic Transition was the product not only of its fertile lands but also of its interregional demographic connections

Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis)

Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favor multimodality diagnosis

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens