Patients’ misperception regarding the difficulty of lumbar puncture

Aim: Lumbar puncture (LP) is a crucial method of diagnosis and treatment of neurological diseases. Despite its importance, the patients' refusal of the procedure leads to difficulties in diagnosis and treatment. One of the main reasons for patients’ refusal may be that LP is perceived to be more difficult than it actually is. Our aim was to investigate whether the patients had prejudices against the difficulty of LP treatment. Methods: Sixty-seven patients aged between 20 and 80 years were included in to the study. Immediately prior to the procedure, each patient was asked to rate the difficulty level of the operation with the Visual Analog Scale (VAS) as 0 very easy to 10 very difficult. The cause of the LP, pre-diagnosis, education status, age and sex, presence of complications and the title of the physician performing the LP were recorded. Results: A total of 20 patients refused the procedure (29.3%).  Of the 47 patients, who had the procedure performed, 21 were female and 26 were male. Twenty-seven LP were performed by first-year assistant and 21 were performed by second-year assistant. Patients' mean VAS scores before the LP were 7.9 ± 2.0 and were 4.1 ± 2.9 after the LP. Post-procedure VAS scores were significantly lower than pre-procedural VAS scores (p <0.001). The mean value of the VAS scores of the patients, whose LPs were performed by 1st year assistant, was 5.6±3.2 and the mean value of the VAS scores of the patients, whose LPs were performed by 2nd year assistant, was 3±2.2. There was a significant difference between two patient groups (p=0.004). Conclusions: The patient perception of the lumbar puncture is perceived to be worse than it actually is. Therefore, it is very important to provide sufficient information to the patients about the LP and to inform them about the necessity of the procedure

Five-year experience of neurosyphilis cases in a tertiary care hospital in Turkey

Aim: To evaluate retrospectively the cases of syphilis who applied to different clinics of our hospital in the last 5 years and to emphasize the importance of admission screening tests in the diagnosis of neurosyphilis which is a rare but serious form of syphilis. Methods: Sixty-one patients who admitted to different clinics of our hospital between 2013 and 2017 with different clinical manifestations and positive Venereal Disease Research Laboratory (VDRL) and Treponema pallidum microhemagglutination assay (TPHA) tests were recorded and analyzed retrospectively. Results: Both VDRL and TPHA tests were positive in 44 males with a mean age of 57.4 ± 18.4 years and 17 females with a mean age of 65.3 ± 19.1 years. It was found that of the 61 patients who were examined for differential diagnosis of syphilis, 36 (%59) of them were referred from neurology clinic, 15 (25%) from infectious diseases clinic, 7 (12%) from dermatology clinic and 3 (4%) from gynecology clinic.   The clinical presentation was venereal chancre in 15 cases, asymptomatic ischemic brain lesions in 17 cases, acute ischemic stroke in 13 cases, movement disorder in three cases, tabes dorsalis in two cases, tendinitis-arthritis in eight cases, Amyotrophic lateral sclerosis (ALS) in one case, Deep venous thrombosis (DVT) in one case, and pulmonary nodule in one case.  Conclusions: In conclusion, syphilis is often overlooked in the differential diagnosis in patient with neurological findings. Since neurosyphilis is an easily treatable disease, it should be considered in the differential diagnosis of patients presenting with neurological findings

Analyzing Ontario’s Climate Change Mitigation and Transportation Planning for a Low - Carbon Economy

This study is based on review and analysis of Ontario’s climate change mitigation and transportation which is eventually leading to transform into a low-carbon economy. This study is compiled into three sections. The first section provides a clear scenario of Canada’s Greenhouse Gas (GHG) emission trend over the years, the federal government’s role in GHG emission reduction and Canada’s international commitment to climate change mitigation measures along with funding. The second section focuses on a review and analysis of Ontario’s GHG emission reduction especially, in the transportation sector based on four regulatory instruments (i.e. Green Energy Act of 2009, Ontario Climate Change Strategy 2015, Ontario's Five Years Climate Change Action Plan and, Climate Change Mitigation and Low-carbon Economy Act, 2016). My analysis and arguments are focused on Ontario’s GHG emission reduction target for 2014, 2020, 2030 and 2050 to examine whether Ontario’s GHG emission reduction proceedings are heading in the right direction. The third section is an analytical review on Metrolinx’s electrification program for the Regional Express Rail (RER) system in the Greater Toronto and Hamilton areas (GTHA). Emerging issues of the province regarding GHG emission trends, progress in emission reduction, current ways and means to reduce transport sector’s GHG emissions were identified based on the results and findings of the study. Finally, a set of coherent measures have been recommended for GHG emission reduction and climate change mitigation measures applicable to Canada and Ontario. Emission reduction trend under ‘Cap and trade System’ suggests that Ontario’s GHG emission reduction target for the year 2020, 2030 and 2050 may not be achievable in one hand, on the other hand the newly elected Ontario government’s (2018) decisions on abandoning all renewable energy programs along with federal government’s controversial decision on purchasing oil pipeline will further jeopardy the transformation process to a low-carbon economy

Recombinant production and characterization of subtilisin-like serine protease from Acinetobacter baumannii

Acinetobacter genus specifically Acinetobacter baumannii is notoriously known in the past five decades as one of the most dangerous saprophytic organisms that cause broad arrays of diseases particularly nosocomial infections. One of the factors that may contribute to A. baumannii virulence are the secretory proteases that it synthesizes. In order to formulate the effective antibiotics targeting secretory proteases from A. baumannii, this protease need to be characterized for functional and structural studies. Therefore, in the present study, a subtilisin-like serine protease isolated from A. baumannii designated as ―SPSFQ‖ was cloned, purified and characterized. The nucleotide sequences of spsfq revealed 1,104 bp open reading frame corresponding to 368 amino acid residues. Amino acid sequence comparison revealed that SPSFQ shared 38.6 - 60% sequences identity with those of other serine proteases reported to have broad substrate specificity; keratinolytic and collagenolytic properties. Homology model of mature SPSFQ revealed its structure composed of 10 β-strands, 8 α-helices with connecting loops resembling a typical architecture of subtilisin-like α/β motif. Expressed recombinant SPSFQ was purified using a combination of HiTrap HP and Q-Sepharose columns prior to characterization studies. The optimum temperature and pH for SPSFQ activity were achieved at 40°C and pH 9.0, respectively. SPSFQ activity was significantly reduced by phenylmethylsulfonyl fluoride (PMSF) while the presence of Ca2+ ion significantly enhanced the activity, suggesting that SPSFQ is a serine protease that require divalent metal ions, Ca2+ as a cofactor. Substrate specificity test concluded that purified SPSFQ has high catalytic activity for casein followed by gelatin (hydrolysed collagen) and keratin. As a conclusion, this study suggests that SPSFQ from A. baumannii is a potent hydrolytic protease. This data could serve as an impetus for further in-depth study on the function of extracellular proteases and their potential role in A. baumannii pathogenicity

Kamu özel sektör işbirliği yatırımlarının finansmanında islami finans aracı : SUKUK

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Kamu Özel Sektör İşbirliği Yatırımlarının Finansmanında İslami Finans Modeli: Sukuk başlıklı üç bölümden oluşan bu tez çalışmasının ilk bölümünde; son yıllarda "Yeni Kamu Yönetimi" anlayışının hizmet sunum modeli olarak tezahür eden "Kamu Özel Sektör İşbirliği" modeli ele alınmış ve gelişimi incelenmiştir. Çalışmanın ikinci bölümünde; İslam Ekonomisi ve Finansı'nın özelikleri, fon kullanma ve kullandırma yöntemleri üzerinde durulmuştur. Türkiye'de ihraç edilen faizsiz sermaye piyasası araçlarına bakılmıştır. Bu bağlamda çalışmanın son bölümünde; son yıllarda gelişen İslami finans sermaye piyasası aracı olan Sukuk 'un özellikleri, avantaj ve dezavantajları incelenmiş, Kamu Özel Sektör İşbirliği modelinin ihtiyaç duyduğu sermayenin sağlanmasında alternatif bir finansman yöntemi olup olmayacağı üzerinde durulmuştur. İslami sermaye piyasası aracı olan Sukuk ve türleri ele alınarak değerlendirilmiştir. İslami sermaye piyasası araçlarının hangileri ile Kamu Özel Sektör İşbirliği modelinin ihtiyaç duyduğu sermayenin sağlanması uygun olabileceği araştırılmıştır. Küresel ölçekte yapılan Sukuk ihraçları ve Sukuk finansmanı ile yapılmış proje uygulamalarından örnekler verilmiştir.In the first part of this thesis which consists of three chapters titled "Islamic Finance Model in the Financing of Private Sector Cooperation Investments"; in recent years, "the Public Private Sector Cooperation model", which emerged as a service delivery model of the New Public Administration concept, was discussed and its development was examined. In the second part of the study; The characteristics of Islamic Economics and Finance, the methods of using and using funds are emphasized. Issued in Turkey were examined with interest-free capital market instruments. In this context, in the last part of the study; In the recent years, the characteristics, advantages and disadvantages of Sukuk, an Islamic finance capital market instrument, were examined and it was emphasized whether there would be an alternative financing method in obtaining the capital required by the Public Private Sector Cooperation model. Sukuk and its types, which are the tools of Islamic capital market, were evaluated and evaluated. It has been researched which Islamic capital market instruments and the Public Private Sector Cooperation model would be appropriate to provide the capital required. Sukuk issuances made on a global scale and examples of project implementations made with Sukuk financing are given

Analysis of the in-vitro nanoparticle-cell interactions via support vector regression model

Ankara : The Department of Industrial Engineering and the Graduate School of Engineering and Science of Bilkent University, 2013.Thesis (Master's) -- Bilkent University, 2013.Includes bibliographical references leaves 59-61.In this research a Support Vector Regression model is developed to understand the nanoparticle (NP)-cell interactions and to predict the cellular uptake rate of the nanoparticles, which is the rate of NPs adhered to the cell surface or entered into the cell. Examination of nanoparticle-cell interaction is important for developing targeted drug delivery systems and cell-level detection and treatment of diseases. Cellular uptake rate of NPs depends on NP type, size, shape, surface charge, concentration and incubation time. Conducting numerous experiments on the combinations of those variables to understand NP-cell interaction is impractical. Hence, a mathematical model of the cellular uptake rate will therefore be useful. The data for this study are obtained from in-vitro NP-healthy cell experiments conducted by a Nano-Medicine Research Center in Turkey. The proposed support vector regression model predicts the cellular uptake rate of nanoparticles with respect to incubation time given the size, charge and concentration properties of NPs.Akbulut, Nur MuhammedM.S

The Development of Islamic (Participation) Banking in Bangladesh and Its Contribution to the Economy

İslami bankacılık, başta ekonomi alanı olmak üzere toplumsal açıdan da insanlığa sağlamış olduğu sayısız faydaların bir sonucu olarak dünya çapında giderek popülerlik kazanmaktadır. Benzer şekilde, İslami bankacılık son zamanlarda Bangladeş'in finans sektörünün odak noktası olmuştur. İslami bankacılık sisteminin performans üstünlüğünün bir sonucu olarak, birçok geleneksel banka İslami hukuk tabanlı (çalışma) sistemlerine dönüştürülmüştür. Bu çalışmanın amacı Bangladeş’te İslami bankacılık sektörünün gelişimini araştırmak ve katkılarını değerlendirmektir. Makalede akademik makaleler, ders kitapları, raporlar, web siteleri gibi ikincil kaynaklardan yararlanılmış ve finansal oran analizi kullanılmıştır. Çalışma, İslami bankaların, küresel durgunluk ve diğer engellere rağmen, Bangladeş'teki tüm bankacılık sektöründe yaklaşık %28 (dörtte birden fazla) pazar payı ve İslami bankacılık sektöründe 49.433'den fazla çalışanı ile geleneksel bankalardan daha iyi performans gösterdiğini ortaya koymaktadır. Ayrıca, Bangladeş’te bağımsız bir İslami bankacılık yasası ve merkezi bir İslam hukuku kurulu olmamasına rağmen hızla ilerleme gösterdiği ve İslami bankacılığın Bangladeş'te muazzam bir potansiyele sahip olduğu sonucuna varmıştır

Barriers to effective communication in Petronas Dagangan Berhad (PDB) / Nur Khalisah Muhammed Zulfikri

Communication effectiveness has been one of important factors in daily life covering workplaces, relationships, and all sorts of human interaction. As a workplace or even learning Centre’s, any organization shall need to practice good and effective communication from within and out to achieve its goals. Many researchers have developed and shared various theories, models and frameworks with regards to this topic of interest due to its crucially to be achieved and practiced. However, communication is a very broad subject and is affected by many internal and external factors. The internal and external factors may both refers to communication barriers, which could be a stimulus, a situation or even an object that may hinder or prohibit any part of a communication process making it harder for messages to be encoded and decoded precisely by parties involved. The purpose of this research is to investigate the factors influencing effective communication in an organization. This research is a qualitative research that used questionnaires as the instrument for the collection of data. The data was collected and viable at 77% out of 69 respondents which was derived from the total population of 90 elements. Sample selection was based on a non-probability approach. The data collected was then evaluated by using Statistical Package for the Social Science (SPSS) through which numerous tests were converged such as reliability test, normality test, frequency distribution, descriptive analysis and multiple regression analysis. The results indicated that environmental barrier is more related to effective communication than language and culture

Implementation issues of vehicular ad hoc network applications: selected case studies in Malaysia

This paper looks into the implementation issues on Vehicular Network applications. In order to have better insights two scenarios have been chosen and simulated. A toll booth system shows the issues on a hybrid VANET application while City Taxi system provides the studies of highly mobile applications