Market and Project Selection Decisions of Construction Companies: Evidence from Turkish Contractors

Globalization of the world economy has made borders between the countries lessimportant and thereby brought about unified markets. Construction industry is not differentfrom other industries when it comes to the globalization and unification of markets. Enteringinto new markets and undertaking international projects promise several benefits such asincrease in the business volume, profits, market share, etc. Turkish contractors have also beenactively operating in international markets since the 1970s. They have completed more than5,100 projects with a total value of USD 155 billion in 81 different countries until now.Undoubtedly, this success is highly subject to the extent to which they make sound decisionson market and project selection. This study aims to investigate the main attributes that mayaffect Turkish contractors' decisions on market and project selection. Review of the literature indicated that there are 57 attributes that may likely affect market and project selection decisions of contractors. These attributes were categorized into 4 main groups, namely;contractor-related attributes, country-related attributes, project-related attributes, and owner related attributes. A questionnaire consisting of 62 questions was designed and conducted among 71 Turkish contractors in order to identify the most contributing attributes. Reliability analysis was carried out to test the internal consistency of the questionnaire and factor analysis was conducted to identify the most contributing factors. Reliability analysis resultsindicated that seven attributes should be deleted to increase the internal consistency of thequestionnaire and factor analysis results revealed that the remaining 50 attributes could be described by 11 factors

Evaluation of paediatric blunt abdomen trauma patients presenting to the emergency room

INTRODUCTION: In paediatric cases, trauma remains the most cause of morbidity and disability. Although abdominal trauma is observed less frequently in paediatric cases than isolated head trauma, it is still the leading cause of morbidity and mortality among children. Previous studies at the national level have either focused on blunt abdominal trauma in all age groups or other traumas at paediatric level. The studies targeting solely paediatric abdominal blunt trauma cases have not yet been evaluated. The aim of this study was to analyse and report the demographic characteristics, causes of trauma, developed pathologies, treatment approaches, and mortality rates in patients presenting to our emergency department with blunt abdominal trauma.  MATERIAL AND METHODS: The present study was designed as a retrospective study of 36 paediatric patients admitted to the Emergency Department of Kars Harakani State Hospital with blunt abdominal trauma between 2018 and 2019.  RESULTS: In the abdominal region, the most commonly injured organ was the liver (22 cases, 52.4%), while 13 (31%) cases had splenic trauma. Thirty-one (73.8%) patients had other body injuries in addition to the abdominal trauma, the most common of which were fractures (15 patients, 35.7%) and lung traumas (12 patients, 28.6%).  CONCLUSIONS: The organs that are damaged during the injury and the parameters that can be used to detect them provide important data for the rapid interference and treatment of life-threatening situations.

Avaliação da eficácia da eletroconvulsoterapia contínua para esquizofrenia resistente ao tratamento

Background : Electroconvulsive therapy (ECT) has been reported being a safe and effective treatment in schizophrenia. However, there are a limited number of studies assessing continuation ECT utilization in patients with schizophrenia giving partial response to pharmacological treatment. Objective : The aim of this study is to evaluate the effectiveness of continuation ECT in preventing relapse in patients with treatment-resistant schizophrenia. Methods : In this retrospective analysis, schizophrenia patients (n = 73) were defined in three groups such as patients who received only AP treatment (only AP), patients who received acute ECT only during hospitalization (aECT+AP), patients who received acute ECT and continuation ECT (a-cECT+AP). Three groups were compared according to positive and negative syndrome scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scores. Results : As per comparison of only AP group, aECT+AP group and a+cECT+AP groups in terms of after discharge PANSS and after discharge BPRS scores for 1st month, 3rd month and 6th month; 3rd and 6th month’s PANSS scores of a+cECT+AP group were statistically significantly lower than other two groups. Discussion : Although this study suffers the limitations of retrospective medical chart analysis, results suggest that, in patients with a diagnosis of schizophrenia who have responded to an acute course of ECT, continuation ECT in combination with antipsychotics is more effective than antipsychotics alone in preventing relapse.Contexto : A eletroconvulsoterapia (ECT) tem mostrado ser um tratamento seguro e eficaz para esquizofrenia. No entanto, o número de estudos que avaliam a utilização contínua de ECT em pacientes com esquizofrenia e a resposta parcial ao tratamento farmacológico é limitado. Objetivo : O objetivo deste estudo é avaliar a eficácia da ECT de continuação na prevenção de recaída em pacientes com esquizofrenia resistente ao tratamento. Métodos : Nesta análise retrospectiva, pacientes com esquizofrenia (n = 73) foram alocados em três grupos: pacientes que receberam apenas o tratamento AP (somente AP), pacientes que receberam um curso agudo de ECT durante a hospitalização (aECT+AP) e pacientes que receberam um curso agudo de ECT durante a hospitalização e ECT de continuação (a-cECT+AP). Esses três grupos foram comparados de acordo com a pontuação atribuída na Positive and Negative Syndrome Scale (PANSS) e na Brief Psychiatric Rating Scale (BPRS). Resultados : De acordo com a comparação dos grupos, somente em AP, aECT+AP e a+cECT+AP, em termos de PANSS e BPRS, após descarga no primeiro, terceiro e sexto mês, as pontuações na PANSS no terceiro e sexto mês no grupo a+cECT+AP foram estatística e significativamente menores do que nos outros dois grupos. Conclusões : Embora este estudo mostre limitações causadas pela análise retrospectiva de prontuários, os resultados sugerem que a continuação da ECT em combinação com antipsicóticos é mais eficaz do que somente os antipsicóticos, na prevenção da recaída em pacientes com diagnóstico de esquizofrenia que responderam ao curso agudo de ECT

Comparison of Effects of Smoking and Smokeless Tobacco “Maras Powder” Use on Humoral Immune System Parameters

Background. The aim of this study is to assess the impacts of “Maras powder” and cigarette smoking on the parameters of the humoral immune system. Material and Methods. One hundred seventy seven subjects were included in the study. The IgA, IgG, IgM, C3 and C4 levels were detected via nephelometric method. Results. In 1.4% of the control group IgM levels were below normal where it was 10.8% and 18.6% in Maras powder group and in cigarette smoking group respectively. The IgM levels of both groups were significantly lower compared to the control group (P < .05). Nonetheless, the IgE levels of Maras powder group and smoking group were found to be remarkably higher compared to the control group (P < .01). Conclusion. Effects of Maras powder on humoral immune response were found to be similar to that of smoking

The β-blocker Nebivolol Is a GRK/β-arrestin Biased Agonist

Nebivolol, a third generation β-adrenoceptor (β-AR) antagonist (β-blocker), causes vasodilation by inducing nitric oxide (NO) production. The mechanism via which nebivolol induces NO production remains unknown, resulting in the genesis of much of the controversy regarding the pharmacological action of nebivolol. Carvedilol is another β-blocker that induces NO production. A prominent pharmacological mechanism of carvedilol is biased agonism that is independent of Gαs and involves G protein-coupled receptor kinase (GRK)/β-arrestin signaling with downstream activation of the epidermal growth factor receptor (EGFR) and extracellular signal-regulated kinase (ERK). Due to the pharmacological similarities between nebivolol and carvedilol, we hypothesized that nebivolol is also a GRK/β-arrestin biased agonist. We tested this hypothesis utilizing mouse embryonic fibroblasts (MEFs) that solely express β2-ARs, and HL-1 cardiac myocytes that express β1- and β2-ARs and no detectable β3-ARs. We confirmed previous reports that nebivolol does not significantly alter cAMP levels and thus is not a classical agonist. Moreover, in both cell types, nebivolol induced rapid internalization of β-ARs indicating that nebivolol is also not a classical β-blocker. Furthermore, nebivolol treatment resulted in a time-dependent phosphorylation of ERK that was indistinguishable from carvedilol and similar in duration, but not amplitude, to isoproterenol. Nebivolol-mediated phosphorylation of ERK was sensitive to propranolol (non-selective β-AR-blocker), AG1478 (EGFR inhibitor), indicating that the signaling emanates from β-ARs and involves the EGFR. Furthermore, in MEFs, nebivolol-mediated phosphorylation of ERK was sensitive to pharmacological inhibition of GRK2 as well as siRNA knockdown of β-arrestin 1/2. Additionally, nebivolol induced redistribution of β-arrestin 2 from a diffuse staining pattern into more intense punctate spots. We conclude that nebivolol is a β2-AR, and likely β1-AR, GRK/β-arrestin biased agonist, which suggests that some of the unique clinically beneficial effects of nebivolol may be due to biased agonism at β1- and/or β2-ARs. © 2013 Erickson et al

The Effects of Oxidative Stress in Urinary Tract Infection During Pregnancy

The purpose of this study was to determine the effect of urinary tract infection (UTI) on antioxidant systems and lipid peroxidation (LPO) levels during pregnancy. We also investigated if these antioxidant systems and LPO levels differed in each trimester. One hundred forty-three nonpregnant women, as a control group, and 77 pregnant women were included in the study. Urine cultures were performed according to standard techniques. Catalase (CAT), superoxide dismutase (SOD), and LPO levels were measured using a spectrophotometer. UTI was observed in 14 of 77 pregnant women and the isolated microorganisms were Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus. CAT, SOD, and LPO levels were increased in pregnant women compared with nonpregnant women (P < .01). CAT, SOD activities, and LPO levels were increased from the first trimester to the third trimester in pregnancy without UTI. However, CAT and SOD activities were decreased, LPO levels were increased from the first trimester to the third trimester in pregnancy with UTI (P < .01). Pregnancy causes oxidative stress and also UTI during pregnancy may aggravate oxidative stress