29 research outputs found

    Pairwise Multiple Comparison Adjustment Procedure for Survival Functions with Right-Censored Data

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    The aim of this study is to propose a new pairwise multiple comparison adjustment procedure based on Genz’s numerical computation of probabilities from a multivariate normal distribution. This method is applied to the results of two-sample log-rank and weighted log-rank statistics where the survival data contained right-censored observations. We conducted Monte Carlo simulation studies not only to evaluate the familywise error rate and power of the proposed procedure but also to compare the procedure with conventional methods. The proposed method is also applied to the data set consisting of 815 patients on a liver transplant waiting list from 1990 to 1999. It was found that the proposed method can control the type I error rate, and it yielded similar power as Tukey’s and high power with respect to the other adjustment procedures. In addition to having a straightforward formula, it is easy to implement

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Proceedings: 1st International Conference on Food and Agricultural Economics: SUSTAINABLE DEVELOPMENT AND SUSTAINABLE AGRICULTURE IMPLEMENTATIONS IN AN AGRI-FOOD COMPANY: CASE OF KAYSERI SUGAR FACTORY

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    Sustainable development means programming the life of today and tomorrow so that it can balance the natural environment with human beings and allow the needs of future generations to be met without finishing the entire natural resources. Sustainable development suggests that natural resources should be used to remain in future generations. For this reason, sustainable development has become an important issue globally. The 2030 Sustainable Development Goals accepted by 193 countries at the UN Sustainable Development Summit held in 2015 is one of the best examples of importance of sustainable development. In this study, sustainable development in agriculture, which is one of the most important topics of sustainable development, is discussed. The social, economic, environmental, sectoral, geographical and temporal dimensions that are among the generally accepted dimensions of sustainable development are defined. Later, the UN 2030 sustainable development targets were introduced and the current situation in the world and in Turkey in sustainable development was examined. Then, sustainability in agriculture was addressed and the ecological, social and economic dimensions of sustainable agriculture were discussed. Within the scope of this study, in Kayseri Şeker Fabrikası A.Ş., one of the most important producers of agricultural production in Turkey and Kayseri, sustainable agriculture studies carried out were examined. Kayseri Şeker Fabrikası A.Ş. According to sales from production, it is among the top 500 industrial enterprises and it is the 101st largest enterprise in Turkey according to the data of 2015. A case study has been carried out in the study and social, environmental, economic and temporal dimensions within the context of the sustainable agricultural activities carried out in the last 5 years by the company have been reviewed and interpreted. Among the findings of the study, the social aspects of sustainable agricultural activities carried out in the business seem to have come to the fore such as open door, happy employee- happy business, farmer awareness and farmer promotion. In the economic dimension of sustainability, economic benefits such as water savings, savings in transportation costs, energy savings and new products obtaining from wastes have come to the forefront. On the other side, in the environmental dimension the issues of soil-rehabilitation, waste management, environmentally sensitive struggle against soil and beet pests come forward. Finally, in terms of temporal dimension the land and product tracking system comes to the forefront through the geographic information system

    Comparison of the Effects of Sevoflurane, Desflurane and Totally Intravenous Anaesthesia with Propofol on Haemodynamic Variables Using Transesophageal Doppler

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    Sevoflurane and desflurane inhalation anaesthetics are in routine use providing more rapid recovery than pre-existing inhalation anaesthetics. We wanted to compare the effect of different anaesthetic agents on haemodynamic parameters with using transesophageal echo-Doppler in ASA I-II patients. A total of 45 American Society of Anes-thesiologists (ASA) physical status I-II patients age between 18-65 scheduled for elective major abdominal surgery were admitted to this prospective randomized study and divided into three groups. Induction of anaesthesia was provided with 1µgkg -1 fentanyl, 6-8 mgkg -1 thiopenthal and 0.1 mgkg -1 vecuronium in sevoflurane (Group S, n=15), and desflurane (Group D, n=15), and 1µgkg -1 remifentanil, 2mgkg -1 propofol, and 0.1 mgkg -1 vecuronium in totally intrave-nous anaesthesia (TIVA) group (Group T; n=15). For maintenance of anaesthesia, patients received an infusion of 0.15 µgkg -1 min remifentanil, 4-6 mgkg -1 h -1 propofol, sevoflurane 2%, or desflurane 6% at 1.0 MAC. Bispectral index (BIS) values of 40-60 were targeted during operation. After endotracheal intubation, the haemodynamic and respira-tory parameters, and BIS were recorded 5 min after the intubation (T 0 ), 30 min after the intubation (T 1 ), 60 min after the intubation (T 2 ) and before the extubation (T 3 ) with using haemodynamic monitoring (Hemosonic 100). After induction of anaesthetic agents, heart rate (HR) increased significantly in desflurane group (Group D) compared with group sevoflurane (Group S) and TIVA (Group T) groups at 5 min after the intubations, 30 min after the intubations, 60 min after the intubations and compared with group sevoflurane before the extubation. The Stroke Volume (SV) values increased significantly at the 5th minute intubation in Group S as compared to the Group D and in Group D as compared to the Group T. Compared with Group D, maximum acceleration (Acc) increased significanly in Group T before extubation. The BIS values were significantly lower in the Groups S and D at all the time intervals as com-pared to the Group T. Although a significant increase in HR and no significant decrease in Acc were noted in the desflurane group, sevoflurane and desflurane provided similar cardiovascular effects in the present study. The BIS values were significantly lower in the sevoflurane and desflurane groups compared with the TIVA

    Staphylococcal empyema secondary to IgA nephropathy

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    A 27-year-old male patient, applied to the emergency unit with complaints of high fever, nausea, vomiting, and hematuria. In his physical examination, fever was 38 degrees C with normal findings in all other systems. The laboratory values were as follows: urea 58 mg/dL, creatinine 2.4 mg/dL, white blood cell count 15.9K/mu L (PNL: 79 %). In his urine analysis; +1 proteinuria and +3 hematuria were detected. Kidney biopsy was performed. Kidney biopsy interpreted in favor of IgA nephropathy. As the patient had tonic-clonic seizures, cranial CT examination was performed. In the cranial CT, there was a subdural effusion in the anterolateral area of the right cerebral hemisphere with the left shift in the midline secondary to the effusion. Empyema fluid, which was drained postoperatively, was cultured. In the direct examination of the empyema fluid, Gram positive cocci and abundant amount of PNLs were observed. There was no growth in the culture. Although the most commonly encountered agents for post-infectious glomerulonephritis are streptococcus infections, it has been reported that glomerulonephritis attacks may be rarely observed due to staphylococcus infections. Proliferative glomerulonephritis cases are rarely encountered conditions characterized by mesangial IgA accumulations secondary to staphylococcus infections

    The effect of cold ischemia time on delayed graft function and acute rejection in kidney transplantation

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    The objective of this study is to evaluate the impact of cold ischemia time (CIT) on delayed graft function (DGF) and acute rejection (AR) among deceased donor kidney transplant recipients. The medical records of 111 patients who underwent kidney transplantation from deceased donors between November 1994 and July 2009 were retrospectively analyzed. DGF was observed in 54% of the patients and the prevalence of AR in the first year after transplantation was 9.9%. The incidence of DGF was higher among patients with longer CIT. There was no correlation between CIT and AR episodes. Higher body weight of recipients and donors, history of prior blood transfusion and advanced donor age were related with DGF. Patients with DGF had higher serum creatinine levels at the first, third and fifth years. There was a negative correlation between recipient body weight and creatinine clearance at the first year. CIT has an important role in the development of DGF as a modifiable risk factor. Moreover, donors with advanced age and higher body weight as well as recipients with higher body weight and history of blood transfusions are at risk for the development of DGF. Prevention of DGF may help to improve graft function at the first, third and fifth years and shorten the hospital stay

    The relation between serum testosterone levels and cardiovascular risk factors in patients with kidney transplantation

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    The objective of the study is to evaluate the relationship between serum testos-terone levels and cardiovascular risk factors (CVRF) in patients after kidney transplantation and with chronic kidney disease (CKD). Seventy-five male patients, aged between 18 and 68 years, who had kidney transplantation at least six months earlier, were enrolled into the study. Only renal transplant recipients and CKD patients with a creatinine level of 0.05). Serum testosterone levels were independent risk factors affecting IVC collapse index, systolic BP and LA. m-TORi and CNIs drugs might have no negative effect on serum testosterone levels, and improvement of the serum testosterone levels after transplantation might have a positive contribution on cardiac risk factors

    Relationship between the degree of malnutrition and echocardiographic parameters in hemodialysis patients

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    43rd ERA-EDTA Congress -- JUL 15-18, 2006 -- Glasgow, SCOTLANDWOS: 000239919003115ERA, EDT
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