Performance comparison of plate heat exchangers designed using Taguchi method and computational fluid dynamics

In this study, thermal and hydraulic performances of cross flow plate heat exchangers, designed using Taguchi method and Computational Fluid Dynamics, in a small capacity (50-200 m(3)/h) air to air heat recovery device were compared. The plate heat exchangers, which are designed to have high flow effectiveness and sensible effectiveness, number of sub-channel, channel height, average air velocity and sheet material variables were determined. The equations for flow effectiveness and recovered thermal power, including variables and second order interactions of variables, were derived by multiple regression analysis for flow effective and thermally effective plate heat exchangers. The performances of 3-dimensional plate heat exchangers using finite volume based ANSYS/Fluent were compared in different volumetric flow rates. The channel height and average air velocity were determined as the most influential variables in the design of plate heat exchanger. It was found that on average 50% more heat was recovered and thermal effectiveness was on average 35% higher in the thermal effective model, while pressure drop was on average 2.5 times less and flow effectiveness was on average 10% higher in the flow effective model When the recovered thermal power at the fresh side and flow effectiveness are evaluated together, the optimum average flow velocities for both models was determined to be range of 1.5-2 m/s (similar to 90 divided by similar to 110 m(3)/h)

A research to determıne the medıatıng role of green consumptıon ın the effect of altruısm on muslım consumer behavıor

Bu çalışmada bütün dinlerde altın kural olarak ifade edilen “özgecilik” düzeyinin Müslüman tüketici davranışı üzerindeki etkisi araştırılmaktadır. İkinci olarak ise, bu çalışma yeşil tüketimin aracılık etkisini ölçmeyi amaçlamaktadır. Çalışmanın örneklemini Türkiye’de yaşayan tüketiciler oluşturmaktadır. Kolayda örnekleme yöntemi ve online anket aracılığı ile 523 kişiden veri toplanmıştır. Araştırma hipotezleri yapısal eşitlik modellemesi kullanılarak test edilmiştir. Yine değişkenlerin aracılık rolüne ilişkin etkinin hesaplanmasında Sobel testinden faydalanılmıştır. Özgecilik konusunda daha önce yapılan çalışmalara bakıldığında, Müslüman tüketici davranışı üzerinde yeşil tüketimin aracılık rolünün değerlendirildiği herhangi bir çalışmaya rastlanılmamıştır. Bu çalışma yeşil tüketimin aracılık rolünü araştırarak literatüre katkı sağlamaktadır. Çalışma ayrıca akademisyenler, pazarlamacılar ve bu alanda yer alan diğer çalışanlar için faydalı olacaktır. Araştırmadan elde edilen bulgulara göre, özgecilik değişkeninin yardım ve bağış boyutunun Müslüman tüketici davranışı üzerinde herhangi bir etkisi olmadığı tespit edilmiştir ki bu sonuç beklenmedik bir sonuçtur. Aracılık etkisi açısından bakıldığında ise, Baron ve Kenny’nin yaklaşımı kullanılarak yapılan analiz sonucunda, yeşil tüketimin bağımlı ve bağımsız değişkenler arasında kısmi bir aracılık rolüne sahip olduğu görülmektedirIn this study, the effect of “altruism” which is accepted as the golden rule in all religions, is investigated on the Muslim consumer behavior. Secondly, this study aims to explore the mediating role of green consumption. The sample was chosen from consumers living in Turkey. Using a quantitative research method, data were gathered by online survey with 523 consumers. Research hypothesis were tested by Structural Equation Modelling. The mediating role of variables was also tested by Sobel test. Previous research on altruism has not been considered the mediating role of green consumption on Muslim consumer behavior. The contribution of this study to literature is investigating the mediating role of green consumption. The study will also useful to academics, marketers and other researchers working in this area. Charity and donation dimension of altruism has no effect on Muslim consumer behavior, which is an unexpected outcome. In terms of mediation effect, Using Baron and Kenny’s approach, green consumption partially mediated the relationship between dependent and independent variables

Second trimester abortion as a cause of maternal death: a case report

Each year, an estimated 529 000 maternal deaths occur worldwide. In literature, it is known that  maternal mortality can occur during pregnancy, peripartum and also in postpartum period. Although very rare, maternal deaths may occur after spontaneous abortion. In present case, 37 year old G5P4  (Caesarean Section) women was admitted to Adnan Menderes University, Obstetrics and Gynecology  clinic with diagnosis of missed abortion at 18 weeks' gestation. She had been hospitalized in the public maternity hospital for five days due to abortus incipience and prolapse of amnion membranes but had no  contractions. Fetal heart beats ceased at the second day of hospitalization. Medically induced abortion  was recommended but not accepted by the patient. At the fifth day of hospitalization, she was referred to our clinic due to deterioration of general health condition, low blood pressure and tachycardia. In  emergency department, it was determined that she was not oriented, had confusion, had blood pressure  of 49/25 mmHg and tachycardia. In ultrasonographic examination, 18 week in utero ex fetus was  determined and there was free fluid in abdominopelvic cavity. The free fluid was suspected to be amniotic fluid due to rupture of uterus. Laparotomy was performed, no uterine rupture, hematoma or atony was observed. However during laparotomy, a very bad smelling odor, might be due to septicemia, was felt in the operation room. Cardiac arrest occurred during that operation. In autopsy report, it was concluded that maternal death was because of remaining of inutero ex fetus for a long time. In conclusion, although very rare, maternal deaths after spontaneous abortion may occur. Because spontaneous abortion is a common outcome of pregnancy, continued careful, strict monitoring and immediate treatment of  especially second trimester spontaneous abortion is recommended to prevent related, disappointing, unexpected maternal deaths.Key words: Second trimester, spontaneous abortion, maternal death

Preeklamptik hastalarda eritrosit indeksleri

Objective: The purpose of study was to investigate erythrocyte indices in patients with preeclampsia. Materials and Methods: The study population consisted of 102 patients with preeclampsia (49 mild, 53 severe preeclampsia) and 98 control pregnant patients. For the entire study population, red blood cell indices, including baseline mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and red blood cell (RBC) were measured by using an automatic blood counter. Results: In the preeclampsia group, the median RDW was 15% (13.8-16.57), whereas in the control group it was 13.9% (13-15.6) (p<0.01). On the other hand, the mean MCV value was 80.42±7.86 (fL) in preeclampsia group and 83.88±2.31 (fL) in control group (p=0.003). Besides, the mean MCHC value was 33.66±1.71 (g/dL) in preeclampsia group and 33.09±1.48 (g/dL) in control group (p=0.012). However MCH and RBC values were not statistically different between the groups. (p>0.05) Moreover, subgroup analysis revealed that RDW levels were significantly increased in preeclampsia subjects than in mild preeclampsia patients (15.4% (13.9-17.45) vs 14.3% (13.7-15.7), p=0.031), MCV levels were decreased (78.81±7.91 (fL) vs 82.16± 7.43 (fL), p=0.03), RBC values were increased (4.16 (3.79-4.85)x(1012/L) vs 3.82 (3.45- 4.34)x(1012/L), (p=0.006)) in patients with severe preeclampsia when compared to the patients with mild preeclampsia. In the receiver operator characteristic (ROC) analysis of subjects with and without preeclampsia, RDW and MCV showed high predictive values (p<0.01). Besides, in ROC analysis of preeclampsia patients with different severities, RDW and RBC showed the ideal predictive values (p=0.006, p=0.031, respectively). Conclusion: Our study results revealed that among the red blood cell indices, only increased RDW values were associated with both the presence and the severity of preeclampsia.Amaç: Bu çalışmanın amacı preeklampsi tanısı konmuş hastalarda eritrosit indekslerini araştırmaktır. Gereç ve Yöntemler: Bu çalışmaya 102 preeklampsi (49 hafif ve 53 şiddetli preeklampsi olmak üzere) ve 98 kontrol hastası dahil edilmiştir. Tüm çalışma grubunda eritrosit indeksleri olan ortalama korpuskular hacim (MCV), ortalama korpuskular hemoglobin (MCH), ortalama korpuskular hemoglobin konsantrasyonu (MCHC), eritrosit sayımı ve eritrosit dağılım genişliği değerleri otomatik kan sayım cihazı ile ölçüldü.Bulgular: Preeklampsi grubunda, medyan RDW %15 (13,8-16,57), ortalama MCV değeri 80,42±7,86 (fL), ortalama MCHC değeri 33,66±1,71 (g/dL) ve kontrol grubunda medyan RDW %13,9 (13-15,6), ortalama MCV değeri 83,88±2,31 (fL), ortalama MCHC değeri 33,09±1,48 (g/dL) idi (sırasıyla p0,05). Preeklampsi grubunda subgroup analizi yapıldığında, hafif preeklampsi grubuna göre, ciddi preeklampsi grubunda artmış RDW değerleri (% 15,4 (13,9-17,45) vs %14,3 (13,7-15,7), p=0,031), azalmış MCV değerleri (78,81±7,91 (fL) vs 82,16±7,43 (fL), p=0,03), artmış RBC değerleri (4,16 (3,79-4,85)x(1012/L) vs 3,82 (3,45-4,34)x(1012/L), (p=0,006) saptandı. Preeklampsi ve kontrol grubu hastalarının Receiver operatör karakteristik (ROK) analizi sonuçlarına göre eritrosit sayımı ve eritrosit dağılım genişliğinin hastalığı tespit etmede yüksek prediktif değerleri saptandı (p<0,01). Ayrıca ROK analiz sonuçlarına göre, hafif ve ciddi preeklampsili hastalarda RDW ve RBC değerleri hastalığın ciddiyetini belirlemede ideal prediktif değerlere sahip idi (p=0,006, p=0,031). Sonuç: Eritrosit indeksleri arasında artmış RDW değerleri hem preeklampsi tanısı, hem de hastalığın ciddiyeti ile ilişkilidir

True umbilical cord cyst: a case report

Umbilical cord cysts are important due to their association with fetal chromosomal abnormalities and fetal structural defects and in case of their rapid growth of umbilical cord cysts they are associated with compression of umbilical vessels and fetal distress. In this article we aimed to present a case with two umbilical cord cysts detected by ultrasonography at 31 weeks of gestation and who had delivered a healthy male fetus by cesarean section at 37 weeks of gestation. Histopathological examination of placenta and umbilical cord after birth revealed that cysts were true allantoic cysts. An additional urachal pathology and anomaly was not observed and the newborn was discharged after primary excision. As a result, we think that ultrasound examination of umbilical cord should be an important and routine part of obstetric ultrasonography

Meckel-gruber syndrome, a rare fetal anomaly: a case report

Otozomal resesif geçisli bir hastalık olan Meckel-Gruber Sendromu (MGS), multipl konjenital anomali içeren nadir bir hastalıktır ve letal seyreden bir sendromdur. MGS'nin klasik triadı; bilateral kistik renal displazi, oksipital ensefalosel ve postaksiyal polidaktilidir. Bunlardan üçünden en az ikisinin olması tanıyı koydurur. Bu yazıda intrauterinMGSsaptanan bir olgu sunulmasını amaçladık. Son adet tarihine göre 23 hafta 5 günlük gebelik + multipl fetal anomali nedeni ile gebe poliklinigimize refere edilen olgu obstetrik ultrasonografi ile degerlendirildi. Yasayan 2 saglıklı çocugu olan 26 yasındaki olgunun hikayesinden, daha önce 32. gebelik haftasında ölü dogum öyküsü oldugu, nedeninin bilinmedigi ama polidaktilisi bulundugu ögrenildi. Olgunun yapılan ultrasonunda fetal bilateral multikistik displastik böbrek, her iki elde polidaktili, bilateral ventrikülomegali ve anhidroamniyos saptandı. MGS düsünülen ve anhidramniyosu olan gebeye konsey kararı sonucu ve ailenin istegi ile tıbbi tahliye uygulandı. 750 gram agırlıgında bir erkek bebek ölü olarak dogurtuldu. Genetik incelemesi yapılan fetusun kromozom analizi normal (46, XY) olarak geldi. Otopsi sonucunda bilateral polikistik böbrek, her iki el ve ayaklarda polidaktili ve micrognati mevcuttu. Prenatal bilateral genislemis multikistik böbrek tanısı MGS'yi akla getirmelidir ve santral sinir sistemi malformasyonları ve polidaktili arastırması yapılmalıdır. Bununla birlikte fetal otopsinin tanının dogrulanmasında önemlidir.Meckel-Gruber Syndrome (MGS), an autosomal recessive disease, is a rare and lethal syndrome with congenital polymalformations Classical triad of MGS is bilateral cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. For diagnosis, two out of these three findings required to be present. In this article, we aimed to present a case with intrauterineMGS. Patient with 23 weeks and five days pregnancy (according to her last menstrual period) with multiple anomalies was evaluated by obstetric ultrasonography. The obstetric history of the 26-year-old patient revealed that she had 2 healthy living children and one previous intrauterine ex fetus with polydactyly and an unknown cause at 32 weeks of gestation. Ultrasonographic examination of the case showed fetal bilateral multicystic dysplastic kidney, polydactyly in hands, bilateral ventriculomegaly and anhidroamnios. The case was diagnosed as MGS and underwent medical termination of pregnancy with the consent of family and the council of doctors. An ex male infant weighing 750 grams was delivered. Genetic analysis showed normal chromosome analysis (46, XY). Bilateral polycystic kidneys, and polydactyly of both hands and feet, and microgynathy were found in autopsy. Investigation of central nervous system malformations and polydactyly should be conducted in patients with prenatal detection of bilateral enlarged multicystic kidneys, when MGS is considered as a possible diagnosis. Furthermore verification of the diagnosis with fetal autopsy is important

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning