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JENERİK İLAÇLARIN PAZARLAMASI
No full textKüresel boyutta sağlık harcamaları son yirmi senede önemli oranda artarken, ilaç giderleri ise toplam giderler arasında personel giderlerinden sonra ikinciyi sırayı almıştır. Artan nüfus ve ortalama ömür, sağlık hizmetlerinin yaygınlaşması ve kamunun sağlık hizmetlerini finanse etmesi, şehirleşme ve sanayileşme ve sağlık pazarlamasının artması nedeniyle toplumdaki sağlık harcaması geçmişe göre artış göstermiştir. Kamunun maliyetin katlandığı yüksek seviyedeki sağlık harcamaları her devletin üzerinde durduğu stratejik bir konu haline gelmiştir. Özellikle kamu finansmanı ile gerçekleşen reçeteli ilaç pazarında önleyici sağlık anlayışının dışında, kamu harcamalarını düşürecek en önemli kalem ilaç fiyatlarıdır. İlaç fiyatları sadece kamu açıklarına yol açmamakta, ayrıca sağlık hizmetlerine erişimi sınırlandırmaktadır. Hastalar, reçeteli ilaçları, yüksek fiyatları nedeniyle alamamakta, jenerik yerine markalı ilaç almak zorunda kalan hastalar ise tedavileri için gerekli olan ilaçları devam ettirme konusunda maddi sorun yaşayıp, sağlık durumlarının daha da kötüye gitmesi durumuyla karşı karşıya kalmaktadır. Bu nedenle, markalı ilaç yerine daha düşük fiyat seviyesinde olan jenerik ilaç kullanımı sağlık harcamalarını önemli ölçüde düşürecek bir politika aracı olarak durmaktadır. Markalı ilaçlar ile jenerik ilaçlar arasında ciddi fiyat farkları bulunduğundan sağlık sektöründe ilaç giderlerini kontrol etmek için jenerik ilaç üretimi teşvik edilmektedir. Bu çalışmada; pazarlama ve tanıtım yasağı olan Türkiye ilaç pazarı jenerik ilaç özelinde ve pazarlama bağlamında farklı paydaşların jenerik ilaç algısı literatür desteğinde sunulacaktır. İlaçların etkinliği konusunda uzmanlıktan kaynaklı bilgi asimetrisi, jenerik ilaçlara yönelik davranışı hastalar, eczacılar ve doktorlar açısından incelenmeye değer kılmaktadır
Evaluating interleukin-6 levels and the rs1800795 variant in Turkish patients with COVID-19: a prospective cohort study
No full textBackgroundCoronavirus disease 2019 (COVID-19) is a multisystem disease of global significance. Interleukin (IL)-6 is a soluble cytokine with a pleiotropic effect on inflammation and the immune response.ObjectivesInvestigate the relationship between the interleukin 6 (IL6) rs1800795 variant and IL6 level in Turkish patients with COVID-19 disease.DesignProspective cohort study.SettingTertiary care hospital.Patients and MethodsReal-time polymerase chain reaction (RT-PCR)-positive and/or chest computerized tomography (CT) scan-compatible COVID-19 patients were enrolled in the study. The clinical data and whole blood samples were collected from April 1, 2020, to August 1, 2020. IL6 rs1800795 genotyping was performed by the PCR-restriction fragment-length polymorphism (RFLP) method in 148 patients. Serum IL-6 concentrations were measured using the ELISA method in 89 patients. We evaluated the patients in three groups: asymptomatic, symptomatic, and intensive care unit patients.Main Outcome MeasuresIL6 rs1800795 genotype frequencies and serum IL-6 levels in COVID-19 patients with different clinical presentations.Sample size148 cases.ResultsIL6 rs1800795 GG genotype and G allele frequency increased in PCR positive patients compared to PCR-negative patients (p < 0.000). IL6 rs1800795 GC genotype and C allele frequency were lower in PCR-positive patients than in PCR-negative patients. IL6 rs1800795 GG genotype and G allele frequency were higher in asymptomatic patients than in the symptomatic and intensive care unit groups. The IL6 rs1800795 C allele frequency was lower in asymptomatic patients than in the symptomatic and intensive care unit groups. IL6 rs1800795 GG genotype and G allele frequency were higher in CT negative patients than CT positive patients, while IL6 GC genotype and C allele frequency were higher in CT positive patients than negative patients. IL6 level elevation was seen in the asymptomatic patients compared to the symptomatic and intensive care unit groups.ConclusionsThese findings suggest that IL6 rs1800795 may contribute to the susceptibility of COVID-19 in people to Turkish origin.LimitationsFurther large-scale studies in different genetic populations are needed as this is a single-center, prospective study
Focal modulation network for lung segmentation in chest X-ray images
No full textSegmentation of lung regions is of key importance for the automatic analysis of Chest X-Ray (CXR) images, which have a vital role in the detection of various pulmonary diseases. Precise identification of lung regions is the basic prerequisite for disease diagnosis , treatment planning. However, achieving precise lung segmentation poses significant challenges due to factors such as variations in anatomical shape and size, the presence of strong edges at the rib cage and clavicle , overlapping anatomical structures resulting from diverse diseases. Although commonly considered as the de-facto standard in medical image segmentation, the convolutional UNet architecture and its variants fall short in addressing these challenges, primarily due to the limited ability to model long-range dependencies between image features. While vision transformers equipped with self-attention mechanisms excel at capturing long-range relationships, either a coarse-grained global self-attention or a fine-grained local self-attention is typically adopted for segmentation tasks on high-resolution images to alleviate quadratic computational cost at the expense of performance loss. This paper introduces a focal modulation UNet model (FMN-UNet) to enhance segmentation performance by effectively aggregating fine-grained local and coarse-grained global relations at a reasonable computational cost. FMN-UNet first encodes CXR images via a convolutional encoder to suppress background regions and extract latent feature maps at a relatively modest resolution. FMN-UNet then leverages global and local attention mechanisms to model contextual relationships across the images. These contextual feature maps are convolutionally decoded to produce segmentation masks. The segmentation performance of FMN-UNet is compared against state-of-the-art methods on three public CXR datasets (JSRT, Montgomery, and Shenzhen). Experiments in each dataset demonstrate the superior performance of FMN-UNet against baselines.TUBITAK grant [118C543]This work was supported by a TUBITAK 118C543 grant awarded to S.Ozturk. S.O.: Conceptualization, methodology, data curation, software, formal analysis, visualization, investigation, validation, writing - original draft. T.C.: Conceptualization, methodology, supervision, writing - original draft
The effects of high-pressure, enzymatic, and high-pressure-assisted enzymatic treatment on the properties of soluble dietary fibers and their use in jelly prepared with grape waste extract
No full textThis study aimed to investigate the physicochemical attributes of soluble dietary fibers (SDFs) of grape, which were isolated after enzymatic (using cellulase [0.1 MPa/60 degrees C/30 min]), high-pressure (HP) (100 MPa/60 degrees C/30 min), or HP-assisted enzymatic treatment (using cellulase [100 MPa/60 degrees C/30 min]), then to evaluate textural properties, color, and microbiological load of jelly prepared using grape waste extract and either pectin or SDF types. HP-assisted enzymatic treatment increased glucose adsorption capacity by more than 50%, and the water-holding capacity of SDF more than twofold as compared to the levels measured in untreated-SDF. After treatments, glucose and galactose contents decreased, whereas fructose, mannose, xylose, arabinose, and rhamnose ratios increased. The arabinose ratio increased more than twice by the effect of HP, whereas the xylose content increased almost fivefold with HP-assisted enzymatic treatment. For the textural properties of jelly, HP-assisted enzymatic treated-SDF provided almost double values in gel strength and adhesiveness than those contributed by untreated-SDF. It was followed by HP-treated SDF jelly. The results showed that HP-assisted enzymatic treatment developed more similar outcomes with enzymatic treatment, rather than HP treatment alone. HP-assisted enzymatic hydrolysis is recommended for treating SDF for use in jelly due to its synergistic effect.Practical ApplicationHigh-pressure-assisted cellulase treatment provided the best properties to SDF for jelly. In combined treatment, impacts of cellulase treatment were more prominent than HP effects. Therefore, the use of HP assistance for enzymatic hydrolysis shortens the processing time. Moreover, the technological and functional properties (water holding, glucose adsorption capacity, and monosaccharide composition) of the combined treated-fiber can improve. In addition, the color and textural properties of the jelly prepared with this treated-fiber can be enhanced. In this way, it may be possible to obtain a good thickening agent. This material can also be an alternative to pectin
The comparative study of the specific heat capacity of uranium dioxide according to the fractal structure
No full textIn the present study, we investigate the effectiveness of existing methods for evaluating the heat capacity of uranium dioxide (UO2) by considering the fractal structure of materials. Two well-known theoretical methods were investigated in this work which have the advantages of giving accurate and efficient calculation results for the heat capacities of uranium dioxide for a wide range of temperatures. To verify the effectiveness of these theoretical methods, we compare the calculation results with existing experimental data from the literature. Based on the concept of fractality, the results obtained in this work are useful for determining the best theoretical approaches, i.e., those that are more convenient and meaningful for the evaluation of the heat capacities of uranium dioxide. The approaches and results presented in this study can provide useful knowledge for accurate investigations of the physical properties of other nuclear fuels
Endometrioid Karsinomanın Çoklu Beyin Metastazında Eşzamanlı Tümöriçi Kanama: Nadir Bir Metastazın Nadir Bir Bulgusu
No full textMetastasis of endometrioid carcinomas to the brain is rare, usually solitary, and has a poor prognosis. Intratumoral bleeding is also a poor prognostic factor for metastatic brain tumors but rarely occurs in gynecological cancers. A female patient who was under chemotherapy for endometrioid carcinoma was admitted to the emergency department for recent deterioration and seizures. She had confusion and left hemiparesis, along with an elevated systolic blood pressure and platelet count of 45,000/mL. An emergent computerized tomography and subsequent magnetic resonance imaging revealed multiple hemorrhagic metastatic lesions in both hemispheres and cerebellum. Brain metastasis of endometrioid carcinoma is rare and can present with intratumoral hemorrhage, which is associated with a poor prognosis and is more likely to occur in the setting of low platelet counts. This case highlights the importance of monitoring brain metastasis in patients with endometrioid carcinoma and considering the possibility of intratumoral hemorrhage. © 2023, Duzce University Medical School. All rights reserved
Türkiye Türkçesi Ağızlarında “Topallık” Kavram Alanı
No full textKavram alanı, sözcüklerin anlamını temel alan ve birbiriyle benzeşen sözcükleri inceleyen bir dil alanı kuramıdır. Alman dil bilimci Jost Trier tarafından geliştirilen bu kuram daha çok kelimelerin eş anlamlı, yakın anlamlı veya anlam yönüyle birbirini tamamlayan yönlerini ele alır. Kavram alanı kuramına göre, kelimelerin kavramsal değeri ancak bulundukları alan içerisinde belirlenebilmektedir. Bu çalışmada Türkiye Türkçesi ağızlarında kullanılan “topallık” kavram alanı belirlenmeye ve tespit edilen söz varlığı toplu olarak ortaya konulmaya çalışılmıştır. Çalışmada kaynak eser olarak Derleme Sözlüğü kullanılmıştır. Derleme Sözlüğü taranarak topallık kavram alanına giren söz varlığı tespit edilmiştir. Derleme Sözlüğünün yanında ağızlarla ilgili çeşitli eserler de taranmış, Derleme Sözlüğünde olmayan söz varlığı da çalışmaya dâhil edilmiştir. Çalışmada kısa bir inceleme bölümünün ardından tespit edilen topallık kavram alanına giren söz varlığının alfabetik listesi verilmiştir. Türkiye Türkçesi ağızları ile ilgili çalışmaların daha çok belli bir ağız bölgesinin ses ve şekil bilgisi özelliklerinin belirlenmesi ile söz varlığının tespit edilmesi şeklinde olduğu görülür. Buna karşın ağızların tematik olarak ele alınıp incelendiği çalışmalar ise oldukça sınırlıdır. Türkiye Türkçesi ağızları ile ilgili tematik çalışmaların yapılması sonucunda ağızlardaki kavram alanları belirlenebilecektir. Bu sebeple Türkiye Türkçesi ağızları ile ilgili tematik çalışmalara büyük ihtiyaç vardır
SOME PROPERTIES OF ®-g-SUPPLEMENTED MODULES
No full textIn this work (R) - g-supplemented modules are defined and some properties of these modules are investigated. It is proved that the finite direct sum of (R) - g-supplemented modules is also (R) - g-supplemented. Let M be a distributive and (R) - g-supplemented R-module. Then every factor module and homomorphic image of M are (R) - g-supplemented. Let M be a (R) - g-supplemented R-module with SSP property. Then every direct summand of M is (R) - g-supplemented.Ondokuz Mayis University [PYO.EGF.1901.17.003]This research was in part supported by grants from Ondokuz Mayis University (Project No: PYO.EGF.1901.17.003)
Tribological behavior of epoxy nanocomposites under corrosive environment: effect of high-performance boron nitride nanoplatelet
No full textThis paper sheds light on the impact of corrosive service conditions on the mechanical and tribological performances of epoxy nanocomposites containing 0.5 wt.% hexagonal boron nitride (BN) nanoplatelets as fillers. The composite samples were aged in 10 wt% H2SO4 solutions by immersion for 504 hours. Variation in mechanical and tribological behaviors during immersion was investigated using tensile and ball-on disk tests. The ball-on disk tests were performed at room temperature under a 10 N constant load and 0.8 m/s speed for 3000 seconds. The high-performance BN nanoplatelets improved neat Epoxy's tensile strength, toughness, and wear performance by 17%, 27%, and 56%, respectively. The aging results revealed that H2SO4 exposure deteriorates the mechanical performance of all epoxy composite samples, even though BN/Epoxy nanocomposites exhibited better resistance to the corrosive environment. In contrast, the tribological performance increased with the acidic solution exposure that acts as a lubricant and forms a corrosive protective layer after the immersion of 504 hours
Substituted naphthoxy-phthalonitrile derivatives: Synthesis, substituent effects, DFT, TD-DFT Calculations, antimicrobial properties and DNA interaction studies
No full textHerein, substituted-naphthol derivatives 4a-e were synthesized in two steps, namely the Diels Alder cycload-dition and Cu-catalyzed aromatization reactions, respectively. Then, pththalonitrile derivatives 7-12 have been prepared by a nucleophilic displacement reaction of 3-nitrophthalonitrile with the naphthol derivatives 4a-e, 5 and, obtained in excellent yields. Structural characterization of the compounds was identified by different spectroscopic techniques. Antimicrobial properties of the synthesized compounds were determined by the microdilution procedure against Gram-positive, Gram-negative bacteria, and yeast. Furthermore, the DNA interaction of the compounds were determined by gel electrophoresis. One of the most prominent findings is that compounds 9 and 10 have more inhibitory effects on Gram-positive bacteria than Gram-negative bacteria. These compounds especially exhibited the highest antibacterial potency against S. aureus (625 mu g/mL) among Gram-positive bacteria. According to the plasmid DNA interaction results, the synthesized compounds caused changes in the structure and mobility of the plasmid DNA. Then, geometry optimizations and frequency calcu-lations were conducted at B3LYP/6-311 G(d,p) level of DFT, and optimized structures were used for further analyses. The NBO results revealed that the rc -> rc * and n -> rc * interactions were greatly contributed to lowering the stabilization energy of all compounds (7-12). FMO energy analyses showed that compound 9 has the biggest electrodonating power