134 research outputs found
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The influence of shared values in the management of project-based B2B professional relationships
In this doctoral study I conceptualise shared values in order to explore a management problem from my work place environment. I observe that business-to-business (B2B) relationships between project managers and self-employed consulting engineers terminate; project managers switching to other vendors and self-employed consulting engineers losing their contract. The findings from the doctoral study show major influence of the shared values in managing project based professional relationships. Specifically, the elements of B2B professional relationships “commitment” and “trust” embedded in relationship performance show managerial implications. Furthermore, the literature review revealed a lack of qualitative knowledge in the research domain of B2B relationships. Hence, the findings from the
doctoral study fill this gap and contribute to the academic knowledge by providing practise based qualitative evidence.This doctoral study was conducted in two phases. In the first phase, building on previous research articles, six elements of B2B professional relationships were refined and tested through qualitative interviews in order to explore their relevance in the B2B professional relationship between the project managers and self-employed consulting engineers. As a result from the first phase, a conceptual model of shared values was developed. In the second phase, the conceptual model of the shared values developed from the first phase was explored and validated through the experience of the project managers and self-employed consulting engineers
Vitamin D Insufficiency in Children with Chronic Neurological Diseases: Frequency and Causative Factors
Objective
Vitamin D insufficiency/rickets is a metabolic bone disease that leads to insufficient mineralization of bone. Chronic neurological diseases, including cerebral palsy (CP), convulsive disorders, neural tube defects, myopathy, immobility, lack of sun exposure, inadequate nutrition, and antiepileptic drugs (AEDs) can cause vitamin D insufficiency and osteopenia in children.
Materials & Methods
In this study, the authors searched the frequency and causative factors of vitamin D insufficiency in children with chronic neurological diseases such as CP, hypoxic-ischemic encephalopathy, mental motor retardation, epilepsy, neurodegenerative and neuromuscular diseases, meningitis-encephalitis sequelae, neural tube defects, paralysis, and paresis. This cross-sectional study included 108 children (forty-five [41.6%] females; sixty-three [58.4%] males), aged between one and 18 years with chronic neurological diseases, and a control group of thirty age-matched healthy children (16 [53.3%] females; 14 [46.7%] males.
Results
Vitamin D levels were significantly lower, and parathyroid hormone (PTH) levels were significantly higher in the patient group than in the control group (p<0.05). The patient group was divided into four subgroups: (i) Epilepsy (n=41; 38%), (ii) Neural tubedefects (n=14; 13%), (iii) CP (n=21; 19%), and (iv) other diseases (neurodegenerative and neuromuscular diseases, meningitis sequelae, intracranial hemorrhage, psychomotor retardation, hypoxic-ischemic encephalopathy) (n=32; 30%) to identify any differences in the measured levels. In the patient group, eighty-three (76.9%) had vitamin D deficiency, and 17 (15.7%) had vitamin D insufficiency, while in the control group, twenty-one (70%) had vitamin D insufficiency. The use of AEDs had no significant effect on serum Ca, P, ALP, PTH, orvitamin D levels (p>0.05), and serum Ca levels were significantly higher in ambulant patients than in non-ambulant patients (p<0.05). Vitamin D levels were significantly higher in the non-ambulant than in the ambulant patients (p<0.05). No rickets was determined in the control group, while in the patient group, nine (8.3%) had level-1 rickets, six (5.6%) had level-2 rickets, and two (1.9%) had level-3rickets.
Conclusion
Children with chronic neurological diseases have low serum vitamin D levels, and vitamin D prophylaxis is essential in this grou
PAVEMENTS COVERED FOR HEAT ISOLATION TO GET PEDESTRIAN THERMAL COMFORT
Civilization has been analyzed mostly with urbanization which coincides with the usage of stone and later concrete and steel in constructions. Nowadays we have been realized that construction materials used for houses, apartments, roads and pavements surrounding us create local microclimate which influences our living comfort. Local temperature increases due to asphalt roads and concrete pavements have recently been determined and they are remarkably effective in our everyday life. Usage of different types of aggregates in concrete mixtures to cast concrete pavement blocks might effective to decrease air temperature on the pavements. Therefore heat-resistant rocks were used to produce different sized aggregates where different plasters were produced from them to coat standard concrete pavement blocks. Pavement blocks plastered were then put under sun to test their surface temperatures. It was observed that heat-resistive materials used in plaster concretes influence heat distribution in the blocks and surface temperature of the concrete pavement blocks.
The Levels of Ghrelin, TNF-α, and IL-6 in Children with Cyanotic and Acyanotic Congenital Heart Disease
Background/Aim. Ghrelin has effects on nutrient intake and growth. The cause of growth retardation in congenital heart disease is multifactorial. The aim of the present study is to investigate the ghrelin in congenital heart disease and the association of ghrelin with TNF-α and IL-6.
Materials and methods. We measured serum ghrelin, TNF-α, and IL-6 levels using spesific immunoassay in 68 patients (47 acyanotic, 21 cyanotic with congenital heart disease) and in 25 control subjects.
Results. In comparison to controls, serum ghrelin, TNF-α levels were significantly higher in acyanotic patients and cyanotic patients with congenital heart disease (P<.0001). In acyanotic and cyanotic patients with congenital heart disease, there was a positive correlation between ghrelin and TNF-α (r=.485, P<.05 and r=.573, P<.01, resp.). Conclusion. Serum ghrelin levels is elevated in acyanotic and cyanotic patients with congenital heart disease. Increased ghrelin levels represents malnutrition and growth retardation in these patients. The relation of ghrelin with cytokines may be explained by the possible effect of chronic congestive heart failure and chronic shunt hypoxemia
Is acupuncture effective against pain in patients with Parkinson’s disease? A randomized controlled study
Aim: To investigate the efficacy of acupuncture application in the treatment of neck pain of musculoskeletal origin in patients with Parkinson’s disease (PD).
Methods: Forty-five patients were screened, of whom 40 were enrolled and 29 completed the study. The patients were divided into two groups, each consisting of 20 individuals. The acupuncture group (AG) received acupuncture therapy in addition to neck exercises, while the control group (CG) performed only neck exercises. Both groups were enrolled in an exercise program, every day of the week for five weeks. The AG also received 10 sessions of acupuncture, twice weekly. The Hoehn and Yahr Scale, the Visual Analog Scale (VAS), the Movement Disorder Society Unified Parkinson's Disease rating Scale-I (MDS-UPDRS-I), a Health Assessment Questionnaire (HAQ), and the Neck Disability Index (NDI) were applied as data collection tools before and at the end of treatment.
Results: Significant improvement was determined in both groups in post-treatment VAS, MDS-UPDRS-I, HAQ, and NDI values compared to pre-treatment (p<0.05). The improvement in VAS, MDS-UPDRS-I, HAQ, and NDI values was significantly greater in AG than in CG (p<0.05).
Conclusion: With its local and systemic effects, acupuncture is a safe procedure capable of use for analgesia. However, further randomized, placebo-controlled studies will permit a more detailed evaluation of its therapeutic efficacy
Serum IL-1β, IL-2, and IL-6 in Insulin-Dependent Diabetic Children
Insulin-dependent diabetes mellitus (IDDM) is a chronic disease characterized by T-cell-dependent autoimmune destruction of the insulin-producing β cells in the pancreatic islets of Langerhans, resulting in an absolute lack of insulin. T cells are activated in response to islet-dominant autoantigens, the result being the development of IDDM. Insulin is one of the islet autoantigens responsible for the activation of T-lymphocyte functions, inflammatory cytokine production, and development of IDDM. The aim of this study was to investigate serum concentrations of interleukin (IL)-1β, IL-2, IL-6, and tumor necrosis factor (TNF)-α in children IDDM. The study population consisted of 27 children with IDDM and 25 healthy controls. Children with IDDM were divided into three subgroups: (1) previously diagnosed patients (long standing IDDM) (n : 15), (2) newly diagnosed patients with diabetic ketoacidosis (before treatment) (n : 12), and (3) newly diagnosed patients with diabetic ketoacidosis (after treatment for two weeks) (n : 12). In all stages of diabetes higher levels of IL-1β and TNF- α and lower levels of IL-2 and IL-6 were detected. Our data about elevated serum IL-1β, TNF- α and decreased IL-2, IL-6 levels in newly diagnosed IDDM patients in comparison with longer standing cases supports an activation of systemic inflammatory process during early phases of IDDM which may be indicative of an ongoing β-cell destruction. Persistence of significant difference between the cases with IDDM monitored for a long time and controls in terms of IL-1β, IL-2, IL-6, and TNF-α supports continuous activation during the late stages of diabetes
Serum IL-1β, IL-6, IL-8, and TNF-α Levels in Early Diagnosis and Management of Neonatal Sepsis
Aim. To determine serum IL-1β, IL-6, IL-8, and TNF-α levels in neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow up. Methods. This prospective study was performed on newborns who were hospitalized for neonatal sepsis and who were classified as culture-proven sepsis (n=12), as culture-negative sepsis (n=21), and as healthy newborns (n=17). Results. At the time of diagnosis, serum IL-1β, IL-6, IL-8, and TNF-α levels of culture-proven sepsis were significantly higher than those of the control groups (P<.05). At the time of diagnosis, IL-1β, IL-6, IL-8, and TNF-α levels of culture-proven sepsis and culture-negative sepsis were significantly higher than levels at the seventh day after antibiotic treatment. Conclusion. Serum IL-1β, IL-6, IL-8, and TNF-α are mediators of inflammation and can be used at the diagnosis and at the evaluation of the therapeutic efficiency in neonatal sepsis
Coughing May Lead to Spontaneous Chylothorax and Chylous Ascites
Chylous ascites is a rare form of ascites resulting from the accumulation of lymph in the abdominal cavity. It is due to an interruption in the lymphatic system. Surgical management is indicated in cases of recurrence or failure after conservative treatment. We report a case of spontaneous chylous peritonitis after chylothorax, which is a rare clinical event. The primary reason was unclear and the outcome of medical and surgical treatment was successful
Length-weight relationships of 28 fish species caught from demersal trawl survey in the Middle Black Sea, Turkey
This study provides updated the length-weight relationships and Fulton's condition factor of 28 fish species belonging to 23 families from the Black Sea. Samples were collected along the depths between 0-100 meters by demersal trawl surveys conducted seasonally from May 2017 to September 2019. A total of 83,885 specimens were collected. The length-weight relationships and Fulton's condition factor, minimum, maximum and mean lengths, total weights, descriptive statistics, and growth type were provided for all the species. The results indicate that LWR parameters of b varied from 2.2039 to 3.737 and Fulton's condition factor varied between 0.004 and 1.18. These findings could be useful for monitoring and management of sustainable fisheries and habitat health
Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever - a randomized controlled noninferiority trial
Background: In this study, we examined the efficacy and safety of a once-daily dosage schema of colchicine compared with a twice-daily dosage schema in pediatric patients with familial Mediterranean fever (FMF). Methods: In this 24-week, multicenter, randomized controlled noninferiority trial, pediatric patients newly diagnosed with FMF carrying a homozygous or compound heterozygous mutation and not receiving any treatment were included. Patients were randomly assigned using a block randomization method to receive treatment with a once- or twice-daily dosage. Clinical and laboratory characteristics and medication side effects were recorded and compared between groups. The study was carried out in compliance with Good Clinical Practice and the Consolidated Standards for Reporting of Trials (CONSORT) statement. Results: A total of 92 patients were selected, and 79 patients completed the study. There were 42 patients in the once-daily dosage group and 37 in the twice-daily dosage group. The results indicated that the once-daily dosage was not inferior to the twice-daily dosage regarding decrease in attack frequency and duration as well as improvement in clinical findings and Mor severity scores. Alterations in laboratory findings indicating inflammation, such as erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A, were similar in both groups. The rates of drug side effects were similar between the once- and twice-daily dosage groups, implying comparable safety of colchicine, with the exception of diarrhea, which was slightly higher in the once-daily dosage group. Conclusions: Using colchicine with either a once- or twice-daily dosage provides similar clinical and laboratory improvements. Considering both efficacy and safety, colchicine can be prescribed with a once-daily dosage. Trial Registration ID: ClinicalTrials.gov identifier NCT02602028. Registered 5 November 2015
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