182 research outputs found
Mortality surrogates in combined pulmonary fibrosis and emphysema
No full textBackground: idiopathic pulmonary fibrosis (IPF) with co-existent emphysema, termed combined pulmonary fibrosis and emphysema (CPFE) may associate with reduced forced vital capacity (FVC) declines compared to non-CPFE IPF patients. We examined associations between mortality and functional measures of disease progression in two IPF cohorts.Methods: visual emphysema presence (>0% emphysema) scored on computed tomography identified CPFE patients (CPFE:non-CPFE: derivation cohort=317:183; replication cohort=358:152), who were subgrouped using 10%, or 15% visual emphysema thresholds, and an unsupervised machine learning model considering emphysema and ILD extents. Baseline characteristics, 1-year relative FVC and diffusing capacity of the lung for carbon monoxide (DLco) decline (linear mixed-effects models), and their associations with mortality (multivariable Cox regression models) were compared across non-CPFE and CPFE subgroups.Results: in both IPF cohorts, CPFE patients with ≥10% emphysema had a greater smoking history and lower baseline DLco compared to CPFE patients with <10% emphysema. Using multivariable Cox regression analyses in patients with ≥10% emphysema, 1-year DLco decline showed stronger mortality associations than 1-year FVC decline. Results were maintained in patients suitable for therapeutic IPF trials and in subjects subgrouped by ≥15% emphysema and using unsupervised machine learning. Importantly, the unsupervised machine learning approach identified CPFE patients in whom FVC decline did not associate strongly with mortality. In non-CPFE IPF patients, 1-year FVC declines ≥5% and ≥10% showed strong mortality associations.Conclusion: when assessing disease progression in IPF, DLco decline should be considered in patients with ≥10% emphysema and a ≥5% 1-year relative FVC decline threshold considered in non-CPFE IPF patients.</p
Antacid therapy in idiopathic pulmonary fibrosis: more questions than answers?
No full textIdiopathic pulmonary fibrosis (IPF) is a progressive parenchymal lung disease of complex cause. Gastro-oesophageal reflux (GER) and microaspiration have been proposed as risk factors for the development and progression of IPF, but robust definitive data are few. A recent international guideline conditionally recommended the use of antacid therapy (proton pump inhibitors or histamine-2-receptor antagonists) for patients with IPF, in the absence of oesophageal reflux or symptoms. In this Position Paper, we summarise the literature addressing the association between GER and IPF, and also identify future research priorities that could clarify this issue. We shed light on the process through which the guideline recommendation was achieved and aim to contextualise the recommendation for providers caring for patients with IPF
Some thoughts on the relations between public health, pharmaceutical patents and International trade
No full textAkın Sunay, Nesrin (Dogus Author)Herhangi bir ırk, din, siyasi görüş, ekonomik veya sosyal durum bazında ayrımcılık olmaksızın elde edilebilecek en yüksek sağlık standartlarından faydalanmak her insanın temel haklarından biridir. Herhangi bir ayrım gözetilmeksizin tüm insanların, tıp ve yaşam bilimi araştırmalarından aynı yüksek etik standartlarından yararlanmaları gerekir. ..
Delineating associations of progressive pleuroparenchymal fibroelastosis in patients with pulmonary fibrosis
No full textBackground: computer quantification of baseline computed tomography (CT) radiologic pleuroparenchymal fibroelastosis (PPFE) associates with mortality in idiopathic pulmonary fibrosis (IPF). We examined mortality associations of longitudinal change in computer quantified PPFE-like lesions in IPF and fibrotic hypersensitivity pneumonitis (FHP).Methods: two CT scans 6-36 months apart were retrospectively examined in one IPF (n=414) and one FHP population (n=98). Annualised change in computerised upper-zone pleural surface area comprising radiologic PPFE-like lesions (∆-PPFE) was calculated. ∆-PPFE >1.25% defined progressive PPFE above scan noise. Mixed-effects models evaluated ∆-PPFE against change in visual CT interstitial lung disease (ILD) extent and annualised forced vital capacity (FVC) decline. Multivariable models were adjusted for age, gender, smoking history, baseline emphysema presence, antifibrotic use and diffusion capacity for carbon monoxide. Mortality analyses further adjusted for baseline presence of clinically important PPFE-like lesions and ILD change.Findings: ∆-PPFE associated weakly with ILD and FVC change. 22–26% of IPF and FHP cohorts demonstrated progressive PPFE-like lesions which independently associated with mortality in the IPF cohort (HR=1.25, 95% CI 1.16–1.34, p<0.0001) and the FHP cohort (HR=1.16, 95% CI 1.00–1.35, p=0.045). Interpretation: progression of PPFE-like lesions independently associates with mortality in IPF and FHP but does not correlate strongly with measures of fibrosis progression.<br/
Pleuroparenchymal fibroelastosis in idiopathic pulmonary fibrosis: survival analysis using visual and computer-based computed tomography assessment
No full textBackground: Idiopathic pulmonary fibrosis (IPF) and pleuroparenchymal fibroelastosis (PPFE) are known to have poor outcomes but detailed examinations of prognostic significance of an association between these morphologic processes are lacking. Methods: Retrospective observational study of independent derivation and validation cohorts of IPF populations. Upper-lobe PPFE extent was scored visually (vPPFE) as categories of absent, moderate, marked. Computerised upper-zone PPFE extent (cPPFE) was examined continuously and using a threshold of 2·5% pleural surface area. vPPFE and cPPFE were evaluated against 1-year FVC decline (estimated using mixed-effects models) and mortality. Multivariable models were adjusted for age, gender, smoking history, antifibrotic treatment and diffusion capacity for carbon monoxide. Findings: PPFE prevalence was 49% (derivation cohort, n = 142) and 72% (validation cohort, n = 145). vPPFE marginally contributed 3–14% to variance in interstitial lung disease (ILD) severity across both cohorts. In multivariable models, marked vPPFE was independently associated with 1-year FVC decline (derivation: regression coefficient 18·3, 95 CI 8·47–28·2%; validation: 7·51, 1·85–13·2%) and mortality (derivation: hazard ratio [HR] 7·70, 95% CI 3·50–16·9; validation: HR 3·01, 1·33–6·81). Similarly, continuous and dichotomised cPPFE were associated with 1-year FVC decline and mortality (cPPFE ≥ 2·5% derivation: HR 5·26, 3·00–9·22; validation: HR 2·06, 1·28–3·31). Individuals with cPPFE ≥ 2·5% or marked vPPFE had the lowest median survival, the cPPFE threshold demonstrated greater discrimination of poor outcomes at two and three years than marked vPPFE. Interpretation: PPFE quantification supports distinction of IPF patients with a worse outcome independent of established ILD severity measures. This has the potential to improve prognostic management and elucidate separate pathways of disease progression. Funding: This research was funded in whole or in part by the Wellcome Trust [209,553/Z/17/Z] and the NIHR UCLH Biomedical Research Centre, UK.</p
The determination on the effects of the sewing parameters to the seam strenght of the tencel fabrics
No full textOnur, Nesrin (Arel Author)Hazır giyim endüstrisinde hazırlanan giysilerin kullanımı sırasında karşılaşılan en önemli kalite problemlerinden biri dikiş mukavemetidir. Giysi kalitesi ve performansına, kumaş kalitesi yanı sıra dikiş mukavemeti, dikiş kayması, dikiş büzülmesi gibi çeşitli faktörler de etki ederler. Bu çalışmada, 4 farklı tencel kumaş ile 6 farklı tipte dikiş ipliği kullanılarak, farklı gramaj ve örgü türlerindeki tencel kumaşların, değişik yönlerde, farklı dikiş iplikleri ve dikiş sıklıklarında dikiş mukavemeti ve uzamasına etkileri incelenmiştir. Deneysel sonuçları SPSS istatistiksel paket programı kullanılarak analiz edilmiştir. Tencel kumaşlarda bez ayağı örgü yapılarının dimi örgü yapılarına göre daha fazla mukavemet gösterdikleri gözlenmiştir. Dikiş ipliklerinin kalınlaşmasıyla, atkı, çözgü ve verev yönlerde dikiş mukavemet değerlerinin arttığı, dikiş ipliklerinin incelmesiyle dikiş mukavemetinin azaldığı, verev yönde en yüksek mukavemet, çözgü yönünde en düşük mukavemet, ayrıca dikiş sıklığı artımının mukavemet ve uzamayı arttırdığı tespit edilmiştir
Controlling company's buy-out right of the minority shares (TCC art. 208)
No full textAkın Sunay, Nesrin (Dogus Author)Yeni Türk Ticaret Kanunu m.208 hükmüne göre hakim şirket, doğrudan veya dolaylı olarak bir sermaye şirketinin paylarının ve oy haklarının en az yüzde doksanına sahipse, azlık şirketin çalışmasını engelliyor, dürüstlük kuralına aykırı davranıyor, fark edilir sıkıntı yaratıyor veya pervasızca hareket ediyorsa, hakim şirket azlığın paylarını varsa borsa değeri, yoksa TTK m.202/2' de öngörülen şekilde belirlenen değer ile satın alabilir.According to the art. 208 of the new Turkish Commercial Code, if the controlling company, directly or indirectly holds at least ninety percent of shares and voting rights in a capital stock company, if the minority prevents the company from running its business, does not act in good faith, creates obvious trouble or behaves in a reckless manner, the Controlling company may purchase the shares of the minority at stock exchange value if any or at the value determined in accordance with the appropriate method proposed in art. 202/2 of the TCC
Architectural contract and the responsibility of architect in Turkish law with a special reference to "architectural contract" monography written by Mustafa Argun Köteli
No full textAkın Sunay, Nesrin (Dogus Author)Köteli, mimar ile yapı sahibi arasındaki güven ilişkisini bir ilke olarak ve bu ilkeyi taraflar arasındaki hukuki ilişkiye yön veren esaslı unsur kabul ettikten sonra, mimarlık sözleşmesine vekalet sözleşmesi hükümlerinin uygulanması gerektiğini belirterek, sözleşmenin niteliğini, mimarın borçlarını, sorumluluğunu ve sözleşmenin sona ermesini bu kapsamda değerlendirmiştir.After Köteli had accepted that trust relationship between architect and the owner is a main principle and this principle is an essential competent which dominates the legal relationship between the contracting parties, he indicated that contract of mandate provisions should be applied to architectural contracts and he assessed the characteristic of contract, obligations of architect, legal responsibility of architect and termination of the architectural contract within this scope
A Historical Review of the Author Figure from Birth to Death and Disappearance to Resurrection
No full textYazar figürü varlığı ve yokluğu etrafında şekillenen tartışmalar ile tarih boyunca edebiyatta önemli bir yer tutmuştur. Şüphesiz, bu tartışmaların en bilindik örneklerinden biri de Roland Barthes’ın “Yazarın Ölümü” denemesidir. Barthes’ın metni yaratan yazardan ziyade metnin kendisine yaptığı vurgu, metin okuma biçimlerini de kökten bir değişikliğe uğratmış, yazara karşı eleştirel bir tutum takınmış olan edebi teorilerin yaygın olarak benimsenmesi ile yazar metnin gerisine itilmiştir. Yine de yazar edebiyat dünyasında yazan kişi, yazman, karakter, Foucault açısından bir “işlev” ya da Barthes’ın deyimiyle “halıdaki figür” de olsa varlığını sürdürmeye devam etmiştir. Postmodernizm ve post-postmodernizm ise “ölmüş” olan yazarı yeniden ön plana çıkarmıştır. Postmodernizm ve sonrasındaki dönem değerlendirildiğinde postmodern ironinin yerini post-postmodern içtenliğin, yapısökümün yerini ise yeniden yapılandırmacı yöntemin almasıyla yazar algısında bir değişim yaşandığı söylenebilir. Bu çalışma, yazarın doğuşu, ölümü ve yeniden dirilişi bağlamında tarih boyunca yazar tanımının geçirdiği değişimleri ele alarak yazarlık ve otorite arasındaki ilişkiyi incelemektedir.With his absence- presence, the figure of the author has continued to occupy a significant space in literary discourse. Undoubtedly, Roland Barthes’ “The Death of the Author” is one of the most renowned debates. Barthes’ emphasis on the text itself, rather than the author who created it, has significantly transformed the methods by which texts are analysed and the author has been relegated to the periphery of the text with the widespread adoption of literary theories which have been critical of the author. Nevertheless, the author has persisted in the literary world as a writer, a scriptor, a character, a “function” as described by Foucault, or a “figure on the carpet” as Barthes puts it. Postmodernism and post-postmodernism have brought the author back to the forefront. In the context of postmodernism and its aftermath, it can be argued that there has been a shift in the perception of the author, as post-postmodern sincerity has replaced postmodern irony, and the reconstructivist method has supplanted deconstruction. This study examines the relationship between authorship and authority by delving into the definition of the author throughout history within the context of the birth, death and resurrection of the author
The death of the author and the birth of AI as a scriptor
No full textRecent advances in Artificial Intelligence and machine learning prove that while in its earlier forms, computer technologies and artificial intelligence were mainly used as a tool to aid the production of an art work, it now possesses the ability/intelligence to create, and hence becomes eligible to be treated as an author, who might lay claims to agency and autonomy. Deriving from this point, this study aims to explore the position of AI as an author and its implications for literary studies
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