On triangles with coordinates of vertices from the terms of the sequences {U_kn} and {V_kn}

In this paper, we determine some results of the triangles with coordinates of vertices involving the terms of the sequences {Ukn} and {Vkn} where Ukn are terms of a second order recurrent sequence and Vkn are terms in the companion sequence for odd positive integer k, generalizing works of Čerin. For example, the cotangent of the Brocard angle of the triangle Δkn is cot(ΩΔkn = (Uk(2n+3)V2k − Vk(2n+3)Uk) / ((−1)nU2k)

If organizational citizenship is compulsory, will job satisfaction be affected? A study in the context of job stress

Bu araştırmada zorunlu vatandaşlık davranışının iş tatminine etkisi ve bu etkide iş stresinin aracı rol üstlenip üstlenmediği incelenmiştir. Bu doğrultuda öncelikle zorunlu vatandaşlık davranışı, iş stresi ve iş tatmini kavramları açıklanmaya çalışılmış ve kavramlar arası ilişkilere ilişkin gerekli literatür taraması yapılmıştır. Elde edilen literatür taraması bulguları da referans alınarak araştırma hipotezleri geliştirilmiştir. Hipotezlerin testi için Karaman ilinde imalat sektöründe faaliyet gösteren bir işletmeden veriler toplanmıştır. Yapılan analizler sonucunda zorunlu vatandaşlık davranışının çalışanların iş tatminini negatif; iş stresini ise pozitif yönde etkilediği görülmüştür. İş stresinin iş tatminine etkisi incelendiğinde ise negatif yönde bir etkinin bulunduğu gözlenmiştir. Aracı etkiye ilişkin analiz bulgularından zorunlu vatandaşlık davranışının iş tatminine etkisinde iş stresinin kısmi aracı rolünün bulunduğu tespit edilmiştir.In this study, the effect of compulsory citizenship behavior on job satisfaction and whether job stress plays a mediating role in this effect are examined. In this context, first of all, the concepts of compulsory citizenship behavior, job stress and job satisfaction are explained, and a literature search has been made about the relationship between concepts. Research hypotheses were developed with reference to the findings of the literature review. For the testing of hypotheses, data were collected from a business in the manufacturing sector in Karaman province. As a result of the analyses, it was seen that the compulsory citizenship behavior negatively affects the job satisfaction; that the compulsory citizenship behavior positively affects the job stress. When the effect of job stress on job satisfaction was examined, it was observed that there was a negative effect. It has been determined that job stress has a partial mediator role in the effect of compulsory citizenship behavior on job satisfaction

Epicardial fat thickness is associated with retinopathy in patients with newly diagnosed hypertension

OBJECTIVE: Hypertensive retinopathy develops based on endothelial dysfunction, inflammation, and atherosclerosis. Epicardial fat secretes various cytokines associated with endothelial dysfunction, oxidative stress, inflammation, and atherosclerosis. We aimed to evaluate whether epicardial adipose tissue (EAT) thickness is a marker for retinopathy in newly diagnosed hypertensive patients. METHODS: A total of 73 newly diagnosed hypertension (HT) patients were included in the study. Transthoracic echocardiography (TTE) was used to measure EAT thickness. To evaluate the presence of retinopathy in HT patients, hypertensive retinopathy staging was performed by ophthalmologists, according to Scheie classification. RESULTS: Retinopathy was detected in 27 (37.0%) of 73 patients. EAT thickness in HT patients with retinopathy was higher than the group without retinopathy (5.07 +/- 1.45 mm vs. 4.19 +/- 1.20 mm, p=0.007). Low-density lipoprotein cholesterol (LDL-C) levels in HT patients with retinopathy were higher than the group without retinopathy (162.4 +/- 41.2 mg/dl vs. 138.1 +/- 35.6 mg/dl, p=0.010). As a result of the regression analysis, LDL-C (OR=1.016, 95% CI 1.001-1.031, p=0.043) and EAT thickness (OR=1.674, 95% CI 1.069-2.626, p=0.043) were the independent predictors of retinopathy. CONCLUSION: Increased EAT thickness is associated with the presence of retinopathy in hypertensive patients

The relationship between the low Apgar scores of the newborns and hematologic parameters which are inflammatory markers

Objective: To investigate the relationship between the 5-minute Apgar scores of the newborns checked in the cases induced due to prolonged pregnancy and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and to investigate the contributions of these parameters as prognostic markers in the low Apgar scores. Methods: A total of 169 primigravida cases for which delivery by induction was decided due to prolonged pregnancy after they completed 41 weeks of gestation between 2017 and 2018 were included in the study. The detailed previous histories of all cases were obtained at admission and they underwent cervicovaginal examination, obstetric ultrasonography for the assessment of fetal biometry and amniotic fluid, and complete blood count including hemoglobin level, total white blood cell count, differential leukocyte number and platelet count. NLR and PLR were calculated as the ratio of neutrophil number to lymphocyte number and the ratio of platelet number to lymphocyte number, respectively. The Apgar scores in the newborn assessment were determined according to the usual criteria 1 and 5 minutes after the birth. The independent samples t-test, Mann-Whitney U test and chi-square test were used for the analysis of the data. Results: The mean NLR and PLR values of the cases were calculated 4.8±2.8 and 148.8±74.9, respectively. While 108 (64%) patients delivered vaginally, 61 (36%) patients delivered by cesarean section. The Apgar score was >7 in 142 (84%) patients and <7 in 27 (16%) patients. NLR and PLR values were significantly higher in the group with Apgar score <7 than the group with Apgar score ≥7 (p<0.05). Conclusion: The elevations in NLR and PLR is the usual part of a health pregnancy; however, excessively elevated inflammation has been associated with poor prenatal and developmental outcomes in various populations. In conclusion, these markers can be used as the parameters helping clinicians to predict poor obstetric outcomes

Clinical and Operative Determinants of Acute Kidney Injury after Cardiac Surgery.

Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased morbidity and mortality. Objectives: We aimed to identify potentially modifiable risk factors for CSA-AKI. Methods: This was asingle-center retrospective cohort study of 495 adult patients undergoing cardiac surgery. AKI was diagnosed and staged using full KDIGO criteria incorporating baseline serum creatinine (SC) levels and correction of postoperative SC levels for fluid balance. We examined the association of routinely available clinical and laboratory data with AKI using multivariate logistic regression modeling. Results: A total of 103 (20.8%) patients developed AKI: 16 (15.5%) patients were diagnosed with AKI upon hospital admission, and 87 (84.5%) patients were diagnosed with CSA-AKI. Correction of SC levels for fluid balance increased the number of AKI cases to 104 (21.0%), with 6 patients categorized to different AKI stages. Univariate logistic regression analysis identified five preoperative (age, sex, diabetes mellitus, preoperative systolic pulmonary arterial pressure [PSPAP], acute decompensated heart failure) and five intraoperative predictors of AKI (age, sex, red blood cell [RBC] volume transfused, use of minimally invasive surgery, duration of cardiopulmonary bypass). When all preoperative and intraoperative variables were incorporated into one model, six predictors remained significant (age, sex, use of minimally invasive surgery, RBC volume transfused, PSPAP, duration of cardiopulmonary bypass). Model discrimination performance showed an area under the curve of 0.69 for the model including only preoperative variables, 0.76 for the model including only intraoperative variables, and 0.77 for the model including all preoperative and intraoperative variables. Conclusions: Use of minimally invasive surgery and therapies mitigating PSPAP and intraoperative blood loss may offer protection against CSA-AKI

Blood pressure and Mortality in the 4D Study

Introduction: Systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) are risk factors for cardiovascular mortality (CVM). Pulse pressure (PP) is an easily available parameter of vascular stiffness, but its impact on CVM in chronic dialysis patients with diabetes is unclear. Methods: Therefore, we have examined the predictive value of baseline, predialytic PP, SBP, DBP and MAP in the German Diabetes and Dialysis (4D) study, a prospective, randomized, double-blind trial enrolling 1255 patients with type 2 diabetes on hemodialysis in 178 German dialysis centers. Results: Mean age was 66.3 years, mean blood pressure 146/76 mmHg, mean time suffering from diabetes 18.1 years and mean time on maintenance dialysis 8.3 months. Considered as continuous variables, PP, MAP, SBP and DBP could not provide a significant mortality prediction for either cardiovascular or all-cause mortality. After dividing the cohort into corresponding tertiles, we did also not detect any significant mortality prediction for PP, SBP, DBP or MAP, both for all-cause mortality and CVM after adjusting for age and sex. Nevertheless, when comparing the HR plots of the corresponding blood pressure parameters, a pronounced U-curve was seen for PP for both all-cause mortality and CVM, with the trough range being 70-80 mmHg. Discussion: In patients with end-stage renal disease and long-lasting diabetes mellitus predialytic blood pressure parameters at study entry are not predictive for mortality, presumably because there is a very high rate of competing mortality risk factors, resulting in overall very high rates of all-cause and cardiovascular mortality, that may no longer be significantly modulated by blood pressure control

Essential requirements for free movement of products within the internal EU market and "CE" conformity marking.

Dünya piyasasında, her sektörde artan rekabetin üretim odaklı olmaktan çıkıp kalite odaklı haline gelmesi ile birlikte ürünlerin insan yaşamına etkileri tartışılmaya başlanmıştır. Piyasaya kullanım amacı ile sunulan her ürünün insan emniyeti, insan sağlığı ve çevre açısından tehdit içermemesi tamamen üreticinin sorumluluğudur. Bu amaçla harekete geçen Avrupa ülkeleri etkin bir sistem geliştirme ve bu yolla kendi vatandaşlarını ve çevreyi iç pazarlarında dolaşan muhtelif kaynaklı ürünlerden doğabilecek risklere karşı koruma yolunu seçmişlerdir. Standardizasyon, denetim ve belgelendirme ve yaptırımlar üçgeni üzerine oturan bu sistem her ürün için kabul edilebilir kalite düzeyini açık olarak ortaya koyan Avrupa normlarını (EN) ve genel emniyet koşullarını yansıtan direktifleri temel dokümantasyon olarak kullanmaktadır.Buna göre Avrupa iç pazarına girecek olan her ürün, bu dokümantasyona uygun olarak üretilecektir. Ayrıca risk düzeyi yüksek olan ürünler (Tibbi malzemeler, hidrolik presler) mutlaka akredite edilmiş (devlete bağlı akreditasyon kurumları tarafından yetkilendirilmiş) kurumlar tarafından denetlenecek, gerekli testler yapılacak ve belgelendirilecektir. Risk düzeyi düşük ürünler için üreticinin vermiş olduğu AB uygunluk deklarasyonu ve uygunluğun nasıl sağlandığını detaylı olarak açıklayan bir teknik konstrüksiyon dosyası (TCF) yeterli olacak ancak her hangi bir uygunsuzluk tespit edilmesi halinde ürünün piyasadan toplanması, firmanın pazara bir daha sokulmaması ve uygunsuzluğun tespit edildiği ülkenin kanunları gerektirdiği diğer yaptırımlar üreticinin önüne getirilecektir.Bu çalışma yukarıda verilen bu sistemi ayrıntılı olarak açıklayan bir kaynaktır. Ürün emniyeti konusunu CE uygunluk markası, denetim ve belgelendirme ve kalite güvencesi yönlerinden analiz etmektedir. Konu ile ilgili olarak verilen açıklamalara ek olarak risk analizi, kullanım kılavuzu, AB uygunluk deklarasyonu içeren bir teknik konstrüksiyon dosyasının hazırlanmasını kapsamaktadır.The increasing competition in world-wide market is converting from production based competition to quality based competition. Depending on this important change the affects of moving products in the market to the human life started to be discussed. The responsibility of products not to carry any risks against human safety, health and the environment belongs solely to the producer. In order protect their citizens from products coming from various countries the European countries came together and established an efficient protection system. This system is based on three main concepts. These are; standardization, certification and sanctions. The documentation supporting this system consists of Euronorms and directives, which gives the general safety, health and environmental protection requirements. According to the system, all products moving inside the European market will be produced conforming to these documentation. If the risk level of the product is high, (Medical devices) they have to be tested by the accredited bodies. However for the products carrying less risk for users, a declaration of conformity and a technical file including detailed explanations about the conformance will be enough. If a non-conformance appears, the producer will face great sanctions including calling back all the products, losing its permit to get inside the European market and other sanctions from the country which non-conformance appears inside its territory. This study explains product safety concept by using CE-conformity marking, certification and quality management approaches. Furthermore a technical construction file is prepared that includes risk analysis, operating instructions, EC declaration of conformity

Are shocks to tourist arrivals permanent or transitory? A comprehensive analysis on the top 20 most-visited countries

Tourism sector is highly vulnerable to shocks due to its characteristics. The purpose of this paper is to investigate whether the effects of the shocks on the tourism sector would be permanent or transitory. To this end, I analysed the number of tourist arrivals in the top 20 most-visited countries for the 1995-2018 period. I employed a battery of cross-sectional dependency tests, second-generation panel unit root tests without and with structural breaks. The findings significantly change from non-stationary to stationary when structural breaks are incorporated. The results suggest that tourist arrivals to top 20 most-visited countries are stationary under sharp structural breaks. This finding is important in that shocks hitting tourism sector are transitory and the effects of shocks will eventually die out, but the new equilibrium will not converge to its pre-shock level