IEU GCRIS Database (İzmir Ekonomi Üniversitesi)
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A Column Generation Heuristic for Simultaneous Lot-Sizing and Scheduling Problems With Secondary Resources and Setup Carryovers
No full textSafak, Cevdet Utku/0000-0002-0055-9598; Yilmaz, Gorkem/0000-0001-8845-4389This study introduces an innovative approach to address the Capacitated Lot-Sizing and Scheduling Problem with Sequence-Dependent Setups (CLSD), considering both the sequence-dependent setups and costs. Facing the challenge of large-scale instances, a Column Generation-based Neighbourhood Search (CGNS) algorithm is proposed, efficiently handling real-life CLSD scenarios with extensions like secondary resources and setup carryover and crossovers. The algorithm demonstrates superior performance compared to commercial solvers and fix and relax-based benchmark algorithms, producing high-quality solutions within specified time limits on large data sets. The study's contributions include a distinctive pattern and column structure in the proposed formulation, effectively managing the exponential increase in decision variables. Test instances and a real- life case study validate the algorithm's applicability to production systems under the CLSD and Capacitated Lot-Sizing Problem (CLSP) frameworks, making it a valuable tool for optimising simultaneous lot-sizing and scheduling challenges in practical settings.Scientific and Technological Research Council of Turkey (TUBITAK) [118C138]The work reported in this paper was supported by the The Scientific and Technological Research Council of Turkey (TUBITAK) 2244 Industrial Ph.D. Fellowship Programme under grant number 118C138
Balancing Aspiration and Reality: Autarky in Turkish Defence Industrial Policy
No full textCountries with limited financial resources, internal markets, and human resources, such as Turkey, face significant challenges in achieving defence autarky and competing with multinational corporations in the international arms market. Consequently, the literature suggests that these countries should adjust their defence industrialisation goals to match their financial capabilities. However, Turkish decision-makers maintain a public discourse emphasising the goal of defence autarky despite the defence industry’s financial crises and structural problems. Even though there is a growing recognition of the limits of the pursuit of defence autarky, Turkey still needs to devise a defence industrial policy focusing on niche markets. This paper argues that the persistent rhetoric of defence autarky enjoys very strong public appeal in domestic politics. Defence industrialisation, coupled with nationalism, creates a zone of impunity for the ruling party. This dynamic allows the ruling party to deflect criticism by highlighting successes in defence production, directly appealing to nationalist sentiments. Ultimately, the political gains for the ruling elites outweigh financial limitations, preventing an open shift toward a more moderate defence industrialisation goal. © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor ; Francis Group
The Clinical Predictors of Biochemical Hyperandrogenemia and Its Relation To Treatment Resistance in Women With Acne
No full textIntroduction: The prevalence of biochemical hyperandrogenemia (BHA) in female acne varies across studies. While certain phenotypic features may suggest hormonal evaluation, clinical predictors of BHA are unclear. Furthermore, the predictors of treatment outcome remain inconclusive, and despite common belief, no strong evidence links BHA to treatment resistance. Aim: To identify determinants of BHA and treatment response in female acne. Material and methods: Female acne patients who underwent hormonal tests (androstenedione, DHEAS04, E2, FSH, LH, free testosterone, prolactin, SHBG, TSH, total testosterone, and 17-OHP) from January 2020 to September 2022 were analysed for associations of clinical parameters with BHA, PCOS, and treatment resistance. Results: Among 86 females (mean age: 24, range: 14-41), acne categories were as follows: persistent (46.5%), adult-onset (26.7%), recurrent (19.8%), and adolescent (7%). Clinical and BHA rates were 65.1% and 70.9%, respectively. The most common elevated hormones were 17-OHP (65%) and androstenedione (40%). Hirsutism and truncal acne were associated with BHA. High DHEAS04 and menstrual irregularity were linked to the persistent category, and 17-OHP elevation was related to a chronic course. PCOS prevalence (17.4%) was associated with high DHEAS04, Free Androgen Index, TT, low E2, and hirsutism. Persistent/recurrent acne and hirsutism were associated with treatment failure. Conclusions: The persistent course and prolonged duration of acne in females, combined with hirsutism and truncal location, are associated with BHA. Patients without androgenic signs may have BHA, and PCOS diagnosis can be established through appropriate referral. Treatment response does not correlate with hormone levels; however, prolonged duration/persistent course and hirsutism predict poorer outcomes
Workplace Violence Against Emergency Physicians: a Cross-Sectional Study on the Role of Communication Skills
No full textOBJECTIVES:Workplace violence (WPV) is a critical issue affecting healthcare professionals, posing significant risks to their safety and well-being. This study investigates WPV among emergency physicians in T ; uuml;rkiye, examining the relationship between WPV and physicians' communication skills.METHODS:A cross-sectional study was conducted from March to June 2023, involving 63 emergency physicians recruited through a convenience sampling method. Participants completed an online survey that included demographic questions, the Turkish version of the Health Professionals Communication Skills Scale (HP-CSS-TR), and self-evaluation items on communication skills.RESULTS:The findings revealed high WPV prevalence, with 85.7% of participants reporting verbal aggression during their residency and 90.5% during their specialty period. Physical violence was reported by 31.7% of participants during residency and 27.0% during their specialty period. Participants' HP-CSS-TR scores averaged 86.08, indicating relatively high communication skills. No significant relationships were found between HP-CSS-TR scores and demographic characteristics such as gender, age, or years of experience. A moderate positive correlation was observed between participants' self-evaluations and their HP-CSS-TR scores in the dimensions of empathy and respect, suggesting alignment between perceived and actual communication skills in these areas. Weak correlations were found in informative communication and social skills, highlighting areas for improvement in communication training programs.CONCLUSIONS:This study highlights the critical issue of WPV against emergency physicians and its association with communication skills, emphasizing the complexities of high-stress environments such as emergency departments. It underscores the need for continued research and systemic interventions to enhance workplace safety and the well-being of healthcare professionals
Current Status of Kidney Replacement Therapy in Türkiye: a Summary of 2023 Turkish Society of Nephrology Registry Report
No full textBackground: Turkish Society of Nephrology registry collects data on hemodialysis, peritoneal dialysis (PD), and transplantation annually. Registry reports are printed every year as a booklet, and this is the 34th year of the registry reports. The registry is in close collaboration with international registries. Methods: In this paper, we summarized data from the 2023 registry report and provided yearly trends for managing end-stage kidney disease. Results: The number of patients on kidney replacement therapy (KRT) increased; at the end of 2023, 89 527 patients were on KRT. The prevalence and incidence of end-stage kidney disease were 1048.7 and 159.8 per million population, respectively. Diabetes was the most common cause of end-stage kidney disease. Hemodialysis (70.88%) was the most common type of treatment modality, followed by transplantation (25.01%) and PD (4.11%). Conclusion: End-stage kidney disease is a critical and growing health problem for our country. The kidney registry of the Turkish Society of Nephrology is one ofthe leading tools for providing current and sound data on this public health problem
Six-Spot Step Test Under Three Different Task Conditions To Assess Dual-Task Ability in People With Multiple Sclerosis
No full textBackground: The Six-Spot Step Test (SSST) is a valid measure to assess the ability of people with multiple sclerosis (pwMS) to maintain balance whilst challenging stability during walking. This study aimed to compare the performance of three different SSST conditions in pwMS and healthy controls (HC) and to explore whether incorporating cognitive tasks into the SSST improves its discriminative capacity by increasing cognitive load. Methods: Fifty-two pwMS (median EDSS = 1.75) and 19 HC were recruited. Participants performed the SSST under three different task conditions: conventional SSST, SSST with word-list generation task (WLG), and SSST with the serial-7 backward task. The dual-task cost (DTC) was calculated for two cognitive task conditions. Results: There was a significant difference across different SSST conditions in both groups. There was also significant condition*group interaction [F (2,132) = 3.69, p = 0.028, eta(2) = 0.053]. PwMS completed all SSST conditions in a longer duration compared to HC. The DTC of SSST with backward and WLG tasks was greater in the MS group than in HC. However, there was no significant differences in the number of correct answers during the dual-task conditions between pwMS and HC. All three conditions showed excellent discriminative ability between pwMS and HC (Area Under Curve value > 0.8). Significance: The SSST had the ability to discriminate between pwMS and HC in both conventional method and with secondary cognitive task. The SSST could be used to evaluate early walking and dual-task deficits even in pwMS with mild disability for future research and clinical practice
The Superiority of Using the Esr Dating Method in Mollusc Shells Compared To 14c and 230th/234u: a Case Study at the Eastern Part of Konya Closed Basin, Central Türki̇ye
No full textThe Konya Closed Basin in central Anatolia preserves Quaternary lacustrine sediments, providing critical evidence for regional paleoclimatic reconstructions. Accurate dating of these is essential for understanding Quaternary climate evolution in the area. In this study, fossil mollusc shells systematically collected from the eastern part of the basin were dated for the first time using ESR spectroscopy. Prior to dating analyses, comprehensive geological investigations and paleontological classifications were conducted. ESR spectra recorded at room temperature on both natural and gamma-irradiated samples revealed freely rotated CO2− radical signals at g=2.0007. Kinetic studies confirmed the long-term stability of the CO2− radical, with high activation energies (∼1.3 eV) and thermal lifetimes exceeding ∼106 years, reconfirming its reliability as a dating signal throughout the Quaternary period. Most ESR ages were derived from the 2.0007 signal, while the signal of the orthorhombic CO2− radical at g=1.9973 was utilized for a few samples. Dose–response curves were best fitted to a single exponential saturation function and equivalent doses were calculated accordingly. ESR ages ranged from 138 to 6ka, showing stratigraphic consistency with the sedimentary record. Comparative dating using 14C AMS and 230Th/234U techniques demonstrated general agreement with ESR ages, although minor discrepancies were observed due to the open-system behavior of mollusc shells. Overall, the results support the chronological reconstruction of Holocene to Middle Pleistocene paleoenvironmental events in the Konya Closed Basin. © 2025 Elsevier LtdEuropean Society of Radiology, ESR; Türkiye Bilimsel ve Teknolojik Araştırma Kurumu, TUBITAK, (114Y237); Türkiye Bilimsel ve Teknolojik Araştırma Kurumu, TUBITAK; Selçuk Üniversitesi, SU, (16401146); Selçuk Üniversitesi, S
Standardized Definition of Progression Independent of Relapse Activity (Pira) in Relapsing-Remitting Multiple Sclerosis
No full textLugaresi, Alessandra/0000-0003-2902-5589; Foschi, Matteo/0000-0002-0321-7155Importance Progression independent of relapse activity (PIRA) is a significant contributor to long-term disability accumulation in relapsing-remitting multiple sclerosis (MS). Prior studies have used varying PIRA definitions, hampering the comparability of study results. Objective To compare various definitions of PIRA. Design, Setting, and Participants This cohort study involved a retrospective analysis of prospectively collected data from the MSBase registry from July 2004 to July 2023. The participants were patients with MS from 186 centers across 43 countries who had clinically definite relapsing-remitting MS, a complete minimal dataset, and 3 or more documented Expanded Disability Status Scale (EDSS) assessments. Exposure Three-hundred sixty definitions of PIRA as combinations of the following criteria: baseline disability (fixed baseline with re-baselining after PIRA, or plus re-baselining after relapses, or plus re-baselining after improvements), minimum confirmation period (6, 12, or 24 months), confirmation magnitude (EDSS score at/above worsening score or at/above threshold compared with baseline), freedom from relapse at EDSS score worsening (90 days prior, 90 days prior and 30 days after, 180 days prior and after, since previous EDSS assessment, or since baseline), and freedom from relapse at confirmation (30 days prior, 90 days prior, 30 days before and after, or between worsening and confirmation). Main Outcome and Measure For each definition, we quantified PIRA incidence and persistence (ie, absence of a 3-month confirmed EDSS improvement over >= 5 years). Results Among 87 239 patients with MS, 33 303 patients fulfilled the inclusion criteria; 24 152 (72.5%) were female and 9151 (27.5%) were male. At the first visits, the mean (SD) age was 36.4 (10.9) years; 28 052 patients (84.2%) had relapsing-remitting MS, and the median (IQR) EDSS score was 2.0 (1.0-3.0). Participants had a mean (SD) 15.1 (11.9) visits over 8.9 (5.2) years. PIRA incidence ranged from 0.141 to 0.658 events per decade and persistence from 0.753 to 0.919, depending on the definition. In particular, the baseline and confirmation period influenced PIRA detection. The following definition yielded balanced incidence and persistence: a significant disability worsening compared with a baseline (reset after each PIRA event, relapse, and EDSS score improvement), in absence of relapses since the last EDSS assessment, confirmed with EDSS scores (not preceded by relapses within 30 days) that remained above the worsening threshold for at least 12 months. Conclusion and Relevance Incidence and persistence of PIRA are determined by the definition used. The proposed standardized definition aims to enhance comparability among studies.The work was supported by grants from the Swiss Science Foundation (P500PM_214230 and P5R5PM_225288 to Dr Mueller) and by National Health and Medical Research Council Investigator grants (2026836 to Dr Kalincik and 2033165 to Dr Roos). Dr Roos is supported by a MS Australia postdoctora lfellowship grant. The MS Base Foundation is anot-for-profit organization that receives support from Biogen, Novartis, Merck, Roche, Teva,and Sanofi GenzymeSwiss Science Foundation [P500PM_214230, P5R5PM_225288]; National Health and Medical Research Council Investigator grants [2026836, 2033165]; MS Australia; Biogen; Novartis; Merck; Roche; Teva; Sanofi Genzym
Zeytinin Kolektif Bilgisi Yoluyla Döngüsel Tasarımın İncelenmesi: Toroidality Modeli
No full textThe ecological crisis is corrupting the natural cycles, damaging the networks among presences, and disrupting the ecosystem's equilibrium, as a result of anthropocentric worldview. To reverse these negative impacts, the concepts of sustainability and circularity try to respond with remedial interventions. However, these interventions are insufficient to regenerate the whole ecosystem and maintain ecological integrity, because of the same anthropocentric conception. So, it is crucial to propose an alternative model for circularity to reach ecological integrity by following its notions. This thesis focuses on designing, developing and testing a circular design model, by considering the potential of collective knowledge and phenomenal references, the interobjectivity of human and non-human entities, and the power of commons. This model, named 'Toroidality' is structured through the intertwined cycles of collective knowledge and collective value-creation, based on the collaborative methodology of participatory action research. To experiment and evaluate the Toroidality, a case study named the 'Circular Journey of Olive' is designed. Along the case study, the phases of Toroidality have been performed through one expert workshop and three co-design workshops. At the end of the case study, the research design, methods, outputs, participatory dynamics, functioning of Toroidality and the utilisation of collective knowledge are evaluated. Following the evaluation, Toroidality is discussed comprehensively, by addressing the problem definition, conceptual background and case study. To conclude the thesis by attributing further studies of Toroidality, the positioning of collective knowledge and participatory action in circular practices, and also the circularity within the context of ecological integrity.Ekolojik kriz, insanmerkezci dünya görüşü sonucu doğal döngüleri dağtmakta, varlıklar arasındaki ağları zedelemekte ve ekosistemin dengesini bozmaktadır. Bu olumsuz etkileri tersine çevirebilmek için sürdürülebilirlik ve döngüsellik konseptleri, iyileştirici müdahalelerle cevap vermeye çalışmaktadır. Ancak, bu müdahaleler aynı insanmerkezci anlayış nedeniyle ekosistemi tamamen rejenere etmek ve ekolojik bütünlüğü korumak için yetersizdir. Dolayısıyla, ekolojik bütünlüğe ulaşmak için alternatif bir döngüsellik modeli önerilmesi gerekliliği ortaya çıkmaktadır. Bu tez, kolektif bilgi ve fenomenolojik referansların potansiyelini, insan ve insan-dışı varlıkların karşılıklı etkileşimini ve müştereklerin gücünü göz önünde bulundurarak bir döngüsel tasarım modelinin tasarımını, geliştirilmesini ve test edilmesini konu almaktadır. 'Toroidality' olarak adlandırılan bu model, kolektif bilgi ve kolektif değer yaratımının iç içe geçmiş döngüleri ile yapılandırılmış olup, metodolojisi katılımcı eylem araştırmasının ortak çalışma yaklaşımına dayanmaktadır. Toroidality'yi denemek ve değerlendirmek amacıyla 'Zeytinin Döngüsel Yolculuğu' adlı bir vaka çalışması tasarlanmıştır. Vaka çalışması kapsamında, Toroidality'nin aşamaları, bir uzman atölyesi ve üç ortak tasarım atölyesi eşliğinde gerçekleştirilmiştir. Vaka çalışmasının sonunda, araştırma tasarımı, yöntemler, çıktılar, katılımcı dinamikleri, Toroidality'nin işleyişi ve kolektif bilginin kullanımı değerlendirilmiştir. Değerlendirmenin ardından, Toroidality, problem tanımı, kavramsal arka plan ve vaka çalışması ele alınarak kapsamlı bir şekilde tartışılmıştır. Bu tez, Toroidality'nin gelecekteki çalışmalarına, kolektif bilgi ve katılımcı eylemin döngüsel uygulamalardaki konumuna ve ekolojik bütünlük bağlamında döngüselliğe atıfta bulunularak sonuçlandırılmıştır
Breast Cancer Recurrence in Initially Clinically Node-Positive Patients Undergoing Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in the Neosentiturk-Trials Mf18-02/18-03
No full textCelik, Burak/0000-0002-8626-7675; kocer, belma/0000-0002-9888-0661Background. This study aims to identify factors predicting recurrence and unfavorable prognosis in cN+ patients who have undergone sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC). MethodsThe retrospective multi-centre "MF18-02" and the prospective multi-centre cohort registry trial "MF18-03" (NCT04250129) included patients with cT1-4N1-3M0 with SLNB+/- axillary lymph node dissection (ALND) post-NAC. Results. A total of 2407 cN+ patients, who later achieved cN0 status after NAC and subsequently underwent SLNB, were studied. The majority had cT1-2 (79.1%) and N1 (80.7%). After a median follow-up time of 41 months, the rates of locoregional recurrence and axillary recurrence (AR) were 1.83% and 0.37%, respectively. No significant difference in locoregional recurrence or AR rates was observed between the SLNB/targeted axillary dissection-only (n = 1470) and ALND (n = 937) groups. Factors significantly linked with AR included age younger than 45 years, nonpathological complete response (non-pCR) in the breast, and nonluminal pathology. Locoregional recurrences were associated with nonluminal or HER2(+) pathology, non-pCR in the breast, and ALND. Poor prognostic factors for disease-free survival (DFS) included having cT3-T4, no breast pCR (non-pCR), ypN(+), and nonluminal pathology. No significant difference was found in DFS or disease-specific survival (DSS) rates among ypN0, ypN-isolated tumour cells, ypNmic, and ypN1. However, significant decreases in DFS and DSS rates were observed when comparing ypN2 or ypN3 disease with ypN0. Conclusions. The present large registry data indicate that younger patients (45), those with nonluminal pathology, and those who only partially respond in the breast are more susceptible to axillary and locoregional recurrences