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Differences between the 8th and 9th editions of the tnm staging system in predicting mortality in non-small cell lung cancer patients staged with ebus
No full textBackground: The distinction between N2a and N2b in the lung cancer TNM 9th edition staging system has reduced the heterogeneity of prognosis using the previous staging system. Moreover, this distinction may enable new treatment approaches in non-small-cell lung cancer (NSCLC). We aimed to evaluate the differences in survival between 8th- and 9th-edition staging and the mortality prediction of the TNM 9th edition in NSCLC patients who did not undergo surgical staging and who were "N"-staged with solely endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) without endoscopic ultrasonography (EUS). Methods: Lung cancer patients who were newly diagnosed and staged with EBUS between May 2016 and January 2023 were retrospectively reviewed. Patients were divided into two groups, "All M0 = Model 1" and "T1-2 N1-2-3 M0 = Model 2", and compared according to their survival for both the 8th and 9th edition TNM staging systems. Cox regression analyses were performed for independent predictors of 2-year mortality. Results: In this retrospective study, a total of 90 patients were included. Most of the patients were male (84.4%), and the mean age of the study group was 64.0 +/- 9.6; deceased patients were older (p = 0.024). There were no differences between groups in terms of smoking habit, comorbidities, tumor PET/CT localization, or 8th and 9th N-staging results with EBUS. The median follow-up period was 26 (0-100) months and longer for living patients than deceased patients in both groups (42 (23-100) vs. 18 (0-74), p = 0.03; 36 (24-100) vs. 20 (1-74), p < 0.001). According to the 8th edition of TNM staging, N2 stage (HR 2.26, 95% CI 1.01-5.05, p = 0.045) and N3 disease (HR 3.31, 95% CI 1.43-7.67, p = 0.005) are independent predictors of two-year mortality for Model 1 patients. When patients were staged according to the 9th edition TNM with EBUS, the relationship between N2a and mortality was not significant, while N2B disease increased the 2-year mortality risk by 2.78-fold (95% 1.07-7.22, p = 0.035), and N3 disease increased it by 3.31-fold (95% 1.43-7.67, p = 0.005). Conclusions: According to the TNM 9th edition staging system, we demonstrated that N2b disease significantly increases the risk of mortality in NSCLC cases using systematic mediastinal staging with EBUS-TBNA alone
Structural optimisation of a passenger seat according to crash injury criteria with artificial neural networks
No full textEnsuring occupant safety in passenger seats is one of the most challenging problems. This paper studied two-place passenger seats within the scope of ECE R14 and ECE R80 regulations. Finite element model of the seat was developed, and analyses were performed according to the ECE R14 static test, with results validated by the actual test. To accurately simulate the interaction between the dummy and plastic backrest cover of the passenger seat in a dynamic test of ECE R80, sample tests were conducted for the polymer material and material and failure models were created. To optimize the negative injury criteria results, the plastic backrest cover was divided into three sections and the thickness of each section was optimized with artificial neural networks. After the optimization, the seat met the regulatory requirements and weight reduction was achieved.SVUM A.Ş
Position of knowledge of unlawfulness in the general theory of crime
No full textMistakes of law are regulated in Article 30/4 of the Turkish Penal Code. According to this provision, "Any person who makes an unavoidable mistake about whether his act was lawful or not shall not be subject to penalty". Thus, the effect of the mistake of law on criminal liability has been revealed. However, the issues regarding why and how this effect will occur need a theoretical explanation. At this point, the concept of "knowledge of unlawfulness" plays a key role. The mistake of law consists of the fact that the perpetrator does not know unlawfulness when he commits the act. Therefore, theoretically revealing the knowledge of unlawfulness will clarify the effect of the mistake of law on criminal liability. In this study, first of all, it is revealed what is the meaning of knowledge of unlawfulness. Then, the opinions on the position of knowledge of unlawfulness in the general theory of crime in German criminal law are discussed within a development process extending to the present day. The distinction between error facti and error iuris has been considered as the first opinion on this subject. Then, the Vorsatztheorie and Schuldtheorie are discussed. It was concluded that Schuldtheorie is the most logical view
Follow-up of mycosis fungoides
No full textMycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma with an indolent course. The tumor, node, distant metastasis, and blood (TNMB) staging system is still the best method for determining prognosis. Individualized, TNMB-compliant conservative treatment approach is the basis of MF patient management. Treatment responses should be evaluated according to standardized guidelines based on objective criteria. There is no consensus on the follow-up of patients with cutaneous lymphoma, and the frequency of follow-up should be planned individually for life, depending mainly on disease stage; primary cutaneous lymphoma subtype; and the treatment agent used
Efficiency analysis of tax audit on disguised profit distribution through transfer pricing in Turkey
No full textTürkiye’de 5520 sayılı Kurumlar Vergisi Kanun’unda yer alan en önemli vergi güvenlik önlemlerinden birisi Transfer Fiyatlandırması Yoluyla Örtülü Kazanç Dağıtımına ilişkin düzenlemedir. Bu düzenlemenin amacı mükellefleri transfer fiyatlandırmasına konu işlemlerinde yasalara uygun davranmasını sağlamaktır. Beyan esasının geçerli olduğu ülkemiz vergi sisteminde mükellef beyanlarının vergi idaresince denetlenmesi gereği ise tabiidir. Transfer fiyatlandırması ile ilgili yasal düzenlemelere mükelleflerin uyum düzeylerinin saptanması ise vergi denetimleri ile yapılmaktadır. Bu tezin amacı ülkemizde transfer fiyatlandırması yoluyla örtülü kazanç dağıtımına ilişkin vergi denetimlerinin etkinliğini analiz etmektir. Bu amaç doğrultusunda çalışmada literatür taraması ile nitel araştırma yöntemi tercih edilmiştir. Nitel araştırma kapsamında verilerin toplanmasında mülakat tekniği kullanılmış ve on yedi vergi müfettişiyle mülakat yapılmıştır. Elde edilen veriler MAXQDA nitel analiz programıyla çözümlenmiştir. Çalışma sonucunda; mevzuatın karışık olması, mükelleflerin yasalara uyum düzeyinin düşük olması, vergi incelemelerinin nispeten az olması, cezaların hafif ve etkin uygulanamaması gibi sebeplerden ötürü transfer fiyatlandırması yoluyla örtülü kazanç dağıtımına yönelik vergi denetimlerinde istenilen etkinliğin sağlanamadığı bulgularına ulaşılmıştır. Transfer fiyatlandırmasına yönelik vergi incelemelerinin etkinliğini artırmak için başta mevzuatın geliştirilmesi ve denetim standartlarının belirlenmesi, denetimlerde şeffaflığın artırılması, cezalarda caydırıcılığın sağlanması, incelemelerde yapay zekâ başta olmak üzere teknolojik imkânlardan yararlanılması gibi pek çok eylemin hayata geçirilmesi gerekmektedir.One of the most important tax security measures included in the corporate tax law in Türkiye is the regulation on disguised profit distribution through transfer pricing. The purpose of this regulation is to ensure that taxpayers act in accordance with the law in their transactions subject to transfer pricing. In Türkiye's tax system where the declaration principle is valid, it is natural that taxpayer declarations must be audited by the tax administration. The determination of taxpayers' compliance levels with legal regulations related to transfer pricing is carried out through tax audits. The purpose of this thesis is to analyze the effectiveness of tax audits on disguised profit distribution through transfer pricing in Türkiye. For this purpose, the study preferred the literature review and qualitative research method. Interview technique was used to collect data within the scope of qualitative research and interviews were conducted with seventeen tax inspectors. The obtained data were analyzed with the MAXQDA qualitative analysis program. As a result of the study; It has been found that the desired effectiveness has not been achieved in tax audits regarding hidden profit distribution through transfer pricing due to reasons such as the complexity of the legislation, low compliance level of taxpayers with the law, relatively few tax audits, and light and ineffective application of penalties. In order to increase the effectiveness of tax audits regarding transfer pricing, many actions such as developing the legislation and determining audit standards, increasing transparency in audits, ensuring deterrence in penalties, and utilizing technological opportunities, especially artificial intelligence, in audits should be implemented
Phylogenetic insights into three turkish native sheep breeds through microsatellite analysis
No full textAnimal genetic resources are recognized as an indispensable component of humanity's natural heritage and are essential for ensuring environmental sustainability for future generations. The aim of this study was to investigate the genetic diversity, population structure, and presence of genetic bottlenecks in three indigenous Turkish sheep breeds: Dagl & imath;& ccedil;, Karagul, and Sak & imath;z, all of which are conserved as genetic resources in Turkiye. Genomic DNA was extracted from 140 blood samples using the salt precipitation technique. These samples were collected from the Sak & imath;z (n = 53), Dagl & imath;& ccedil; (n = 58), and Karagul (n = 29) breeds, which were reared on 13 farms located in the provinces of & Idot;zmir, Afyon, and Tokat. Genotyping of the DNA samples was performed using 17 microsatellite markers, resulting in the identification of 345 different alleles. The highest number of alleles observed for a single locus was 28, while the average effective allele number and polymorphic information content were 18.32 and 0.94, respectively. The calculated GST value indicated that a substantial 98.70% of the observed genetic variance resided within individuals. Breed-specific FIS values were determined as 0.132 for Sak & imath;z, 0.120 for Dagl & imath;& ccedil;, and 0.089 for Karagul. Analysis using STRUCTURE identified three ancestral populations contributing to the genetic composition of the sampled animals, with evidence of admixture across all populations. Utilizing three distinct mutation models within the Bottleneck program, bottleneck analysis revealed that the Sak & imath;z and Dagl & imath;& ccedil; breeds have largely maintained their recent effective population size, as supported by Wilcoxon tests and mode-shift plots. However, the Karagul breed exhibited evidence suggestive of a recent bottleneck (p < 0.05). Despite this indication, the overall genetic diversity within the studied breeds appeared to be relatively well-preserved. Given the limited size of the Karagul population, careful management of breeding strategies is essential to safeguard its existing genetic pool
Dynamic response of axially loaded carbon nanotubes considering armchair, chiral, and zigzag configurations
No full textIn this study, the lateral vibration analysis of axially loaded carbon nanotubes (CNTs) with deformable ends is investigated considering different configurations: armchair, chiral, and zigzag. The axial load affecting the CNTs is considered to generate both compression and tension. The analysis is based on Eringen's nonlocal elasticity theory to capture size effects. To investigate the vibration of CNTs under deformable boundary conditions, the Fourier sine series and Stokes' transformation are used together. The solution to the eigenvalue problem resulting from this combined use provides the vibration frequencies of CNTs under various loading and boundary conditions
Finite element analysis of traumatic blast shock on a brain phantom model
No full textMore than 185,000 Veterans who use VA for their healthcare have been diagnosed with traumatic brain injuries (TBI). Protection against improvised explosive devices has improved to reduce fatalities, but there has not been much improvement in preventing traumatic injuries to the brain. TBIs occur when a sudden force causes damage to the brain and can result from the head suddenly and violently being hit by an object, striking an object, or being impacted by a nearby blast or explosion. Most brain injuries occur by direct impact with shock waves in war, with modern explosives being the primary reason for brain injuries. These intense shock waves can pose different types of injuries to brain tissue. When a shock wave hits, it can disrupt regular brain functions of the skull, cerebral spinal fluid, and brain. The primary objective of the present study is to investigate how traumatic brain shock affects the brain-skull interface at a predefined pressure. To this end, a finite element model was developed using CAD data obtained following the 3D scanning of a brain skull. In this regard, geometry cleanup operations were performed to remove imperfections due to 3D scanning to improve the mesh quality for finite element simulations. The final phantom model was a simplified CAD model representing the exact topography (i.e., shape and size) of the actual head. Within the numerical simulations, the head file was placed inside a round tube with a diameter of 3 inches. The findings of the present study could provide better insights regarding how the blast shock affects the brain tissue and how the interaction realizes between brain tissue and bone
Art education students' interaction with STEM disciplines
No full textSTEM modeli; fen, teknoloji, mühendislik ve matematik alanlarını içeren disiplinlerarası bir anlayıştır. Bu modele, sanat disiplininin eklenmesiyle STEAM ortaya çıkmıştır. Bu araştırma, sanat eğitimi öğrencilerinin yaratıcı süreçlerinde STEM disiplinleriyle kurdukları bağlantıları ve bu bağlantıları sanatsal yaratım sürecine nasıl yansıttıklarını inceleyerek, disiplinlerarası entegrasyonun sanatsal süreçlerdeki rolünü ortaya koymayı amaçlamıştır. Bu bağlamda araştırma; disiplinlerarası anlayışa açık, yaratıcı düşünmeyi destekleyen sanat disiplininin önemine dikkat çekmek ve STEAM anlayışının sanat eğitimindeki rolünü vurgulamak açısından önemlidir. Araştırmanın çalışma grubu, Bursa Uludağ Üniversitesi Eğitim Fakültesi Güzel Sanatlar Eğitimi Bölümü Resim-İş Eğitimi Anabilim Dalı’nda yer alan farklı atölyelerden (resim, heykel, grafik, tekstil, fotoğraf, özgün baskı) alan uzmanlarıyla yapılan görüşmeler sonucunda belirlenmiştir. Çalışma grubu, STEAM deneyimlerinin farklı sanat dalları üzerindeki yansımalarını ortaya koymak amacıyla, sınıf düzeyinden bağımsız olarak her atölyeden birer olmak üzere toplam 6 öğrenciyle oluşturulmuştur. Çalışmada, nitel araştırma yöntemlerinden durum çalışması kullanılmıştır. Veri toplama aracı olarak kullanılan yarı yapılandırılmış görüşme formu, doküman inceleme ile desteklenmiştir. Elde edilen bulgular tematik analiz yöntemiyle çözümlenmiştir. Araştırma bulguları, sanat eğitimi öğrencilerinin sanatsal süreçlerinde STEM disiplinlerinden çeşitli unsurları çalışmalarına dahil ettiklerini ortaya koymuştur. Bu çok yönlü etkileşimin ise sanatsal üretimleri zenginleştirdiği görülmüştür. Elde edilen bulguların, müfredat ve öğretim yöntemlerini geliştirme sürecinde sanat eğitimcilerine katkı sağlaması ve STEAM içinde sanatın rolünü vurgulayarak gelecekteki araştırmalara temel oluşturması beklenmektedir. Araştırma sonuçları doğrultusunda, araştırmacılara öneriler getirilmiştir.The STEM model represents an interdisciplinary approach that integrates the fields of science, technology, engineering, and mathematics. With the inclusion of the arts, this model evolves into STEAM. This study aims to explore how art education students interact with STEM disciplines with their creative processes and how these interactions are reflected in their art creation. In doing so, it seeks to reveal the role of interdisciplinarity in integrating with art-st-c pract-ces. In this context, the research underscores the significance of the arts as a discourse that supports interdisciplinary thinking and fosters creativity, and highlights the role of the STEAM approach in art education. The study group was selected through interviews with instructors from various studies (painting, sculpture, graphic design, text, photography, and printing) within the Department of Art Education, Faculty of Education at Bursa Uludağ University. To reflect the -mpact of STEAM exper-ences across d-fferent branches of art, the study group cons-sted of s-x students—one from each stud-o—regardless of class level. The study employed a qualitative case study methodology. A sem--structured interview form was used as the primary data collection tool and was supported by document analysis. The data obtained were analyzed using thematic analysis. The findings revealed that art education students incorporate various elements of STEM disciplines into their art processes. This multidimensional interaction was found to enhance the art-st-c product-ons. It is expected that the findings will contribute to curriculum development and instructional methods for art educators, while also emphasizing the role of the arts within the STEAM framework and serving as a foundation for future research. Based on the study’s results, recommendations have been offered for both researchers and educators
Predictors and treatment of isolated recurrence in vulvar cancer confined to the vulva or perineum
No full textAim:This study evaluated predictors and treatment of isolated vulvar recurrence (IVR) in patients with stage I-II tumors locally confined to the vulva.Methods:We retrospectively collected data from patients with stage I-II vulvar squamous cell carcinoma (VSCC) who underwent surgery for vulvar cancer between 2005 and 2021. The IVR group comprised patients with stage I-II tumors at the time of initial diagnosis who developed recurrence confined to the vulvar region after initial treatment.Results:This study included 416 patients with early-stage (stage I-II) VSCC. IVR was developed in 67 (16.1%) patients; the remaining 349 patients were included in the control group. Independent predictors of IVR were depth of invasion, perineural invasion, and positive surgical margins. Among patients with tumors confined to the vulva at the time of initial diagnosis, the 5-year overall survival rates were 59.0% and 87.0% in the IVR and control groups, respectively (P < 0.001). In the IVR group, the cumulative rates of local relapse were 38.8% in the first year, 58.2% in the second year, and 74.6% in the third year.Conclusion:Independent predictors of IVR in early-stage VSCC were depth of invasion, perineural invasion, and positive surgical margins. Approximately two-thirds of local recurrences occurred in the first 3 years after treatment