Makalah ini membahas tentang manusia sebagai makhluk individu dan makhluk sosial, mendiskusikan hakikat kedua konsep tersebut, interaksi sosial dan proses sosialisasi, perbedaan masyarakat dan komunitas, serta dilema antara kepentingan individu dan kepentingan sosial."
Design and Optimization of Valveless Pulsejet EngineIJERA Editor
Simple design and efficiency make pulsejet engines attractive for aeronautical short-term operation applications.
An active control system extends the operating range and reduces the fuel consumption considerably so that this
old technology might gain a new interest. During the operations of these pulsejet engines the surfaces of engine
will get more heated. In order to cool the engine surface and to get more thrust we have attached an additional
component called secondary inlet in that valve less pulsejet engine. The pulsejet is the only jet engine combustor
that shows a net pressure gain between the intake and the exhaust. The pulsejet is the only jet engine combustor
that shows a net pressure gain between the intake and the exhaust. We choose the LOCKWOOD’s design of
pulsejet engine. By using the CFD analysis we have analysed the modified design of valveless pulsejet engine.
This project provides an overview of this unique process and the results of these design modifications are
reported.
Thermo hydraulics performance of turbulent flow heat transfer through square ...IAEME Publication
This document describes an experimental study of heat transfer in square ducts with inserts. The study investigated the effects of inserts on heat transfer coefficient and pressure drop in turbulent air flow through square ducts. Experiments were conducted with a square duct heated on one wall to create a uniform heat flux condition, while other walls were insulated. Measurements of temperature, pressure drop, and other variables were taken to analyze heat transfer and flow characteristics for Reynolds numbers between 10,000 and 100,000. The results show that inserts can enhance the heat transfer coefficient in square ducts by up to 46% compared to plain ducts, though they also increase pressure drop.
Este documento presenta un resumen del Diccionario Bíblico Arqueológico. Explica que el diccionario contiene estudios de las tierras del Medio Oriente donde ocurrieron los eventos bíblicos, incluyendo Egipto, Mesopotamia, Asia Menor, Grecia y Roma. Los artículos utilizan descubrimientos arqueológicos para arrojar luz sobre personas, lugares, historia y religión del mundo bíblico. El documento también presenta biografías breves de los editores y contribuyentes
Finite Element Simulation for Determining the Optimum Blank Shape for Deep Dr...IJERA Editor
The document discusses determining the optimal blank shape for deep drawing processes using finite element simulation to minimize earing defects. It summarizes that earing occurs due to anisotropic properties of sheet metal and varies with direction. The study models deep drawing of cylindrical cups using FE software to measure earing height for different blank shapes. It modifies the initial circular blank by removing material along rolling and transverse directions to create an optimal shape that significantly reduces earing height, drawing load, and thickness variations compared to the initial blank.
Data encryption using LSB matching algorithm and Reserving Room before Encryp...IJERA Editor
Now a days, more and more attention is paid to reversible data hiding (RDH) in encrypted images, since it
maintains the excellent property that the original cover can be losslessly recovered after embedded data is
extracted while protecting the image content’s confidentiality. Previously proposed methods embed data by
reversibly vacating room from the encrypted images, which may cause some errors in data during data extraction
and/or image restoration. In this paper, a novel method of reserving room before encryption with a traditional
RDH algorithm, and thus it is easy for the data hider to reversibly embed data in the encrypted image is
proposed. The proposed method can achieve real reversibility, that is, data extraction and image recovery are
free of any error.
O documento explica como configurar as configurações de privacidade da linha do tempo no Facebook para controlar quem pode ver suas publicações e marcações e como outros usuários podem interagir com sua página.
Makalah ini membahas tentang manusia sebagai makhluk individu dan makhluk sosial, mendiskusikan hakikat kedua konsep tersebut, interaksi sosial dan proses sosialisasi, perbedaan masyarakat dan komunitas, serta dilema antara kepentingan individu dan kepentingan sosial."
Design and Optimization of Valveless Pulsejet EngineIJERA Editor
Simple design and efficiency make pulsejet engines attractive for aeronautical short-term operation applications.
An active control system extends the operating range and reduces the fuel consumption considerably so that this
old technology might gain a new interest. During the operations of these pulsejet engines the surfaces of engine
will get more heated. In order to cool the engine surface and to get more thrust we have attached an additional
component called secondary inlet in that valve less pulsejet engine. The pulsejet is the only jet engine combustor
that shows a net pressure gain between the intake and the exhaust. The pulsejet is the only jet engine combustor
that shows a net pressure gain between the intake and the exhaust. We choose the LOCKWOOD’s design of
pulsejet engine. By using the CFD analysis we have analysed the modified design of valveless pulsejet engine.
This project provides an overview of this unique process and the results of these design modifications are
reported.
Thermo hydraulics performance of turbulent flow heat transfer through square ...IAEME Publication
This document describes an experimental study of heat transfer in square ducts with inserts. The study investigated the effects of inserts on heat transfer coefficient and pressure drop in turbulent air flow through square ducts. Experiments were conducted with a square duct heated on one wall to create a uniform heat flux condition, while other walls were insulated. Measurements of temperature, pressure drop, and other variables were taken to analyze heat transfer and flow characteristics for Reynolds numbers between 10,000 and 100,000. The results show that inserts can enhance the heat transfer coefficient in square ducts by up to 46% compared to plain ducts, though they also increase pressure drop.
Este documento presenta un resumen del Diccionario Bíblico Arqueológico. Explica que el diccionario contiene estudios de las tierras del Medio Oriente donde ocurrieron los eventos bíblicos, incluyendo Egipto, Mesopotamia, Asia Menor, Grecia y Roma. Los artículos utilizan descubrimientos arqueológicos para arrojar luz sobre personas, lugares, historia y religión del mundo bíblico. El documento también presenta biografías breves de los editores y contribuyentes
Finite Element Simulation for Determining the Optimum Blank Shape for Deep Dr...IJERA Editor
The document discusses determining the optimal blank shape for deep drawing processes using finite element simulation to minimize earing defects. It summarizes that earing occurs due to anisotropic properties of sheet metal and varies with direction. The study models deep drawing of cylindrical cups using FE software to measure earing height for different blank shapes. It modifies the initial circular blank by removing material along rolling and transverse directions to create an optimal shape that significantly reduces earing height, drawing load, and thickness variations compared to the initial blank.
Data encryption using LSB matching algorithm and Reserving Room before Encryp...IJERA Editor
Now a days, more and more attention is paid to reversible data hiding (RDH) in encrypted images, since it
maintains the excellent property that the original cover can be losslessly recovered after embedded data is
extracted while protecting the image content’s confidentiality. Previously proposed methods embed data by
reversibly vacating room from the encrypted images, which may cause some errors in data during data extraction
and/or image restoration. In this paper, a novel method of reserving room before encryption with a traditional
RDH algorithm, and thus it is easy for the data hider to reversibly embed data in the encrypted image is
proposed. The proposed method can achieve real reversibility, that is, data extraction and image recovery are
free of any error.
O documento explica como configurar as configurações de privacidade da linha do tempo no Facebook para controlar quem pode ver suas publicações e marcações e como outros usuários podem interagir com sua página.
Kadınlarda Üriner İnkontinansta Yönetim- Prof. Dr. Ömer Lütfi TAPISIZ.pptxOmerLutfiTAPISIZ1
Her iki kadından biri hayatının bir döneminde üriner inkontinansı deneyimlemekte ve her 10 kadından biri de üriner inkontinans nedeni ile cerrahiye ihtiyaç duymaktadır. Bu sunumda kadınlarda üriner inkontinansın yönetimi ile ilgili detaylı bir bilgilendirme yapılmaktadır. Prof. Dr. Ömer Lütfi TAPISIZ
The World Health Organization (WHO) defined «healthy ageing»
as the process of developing and maintaining the functional ability
that enables wellbeing in older age.
Functional ability is referred to as the ability to:
- meet their basic needs,
- learn, grow and make decisions,
- be mobile,
- build and maintain relationships, and
- contribute to society
WHO describes this functional ability as being formed by interactions between intrinsic capacity and environmental characteristics.
The intrinsic capacity includes the mental and physical capacities of a person.
The environmental characteristics are related to home, community and society as a whole.
Management of menopausal symptoms for breast cancer survivorsTevfik Yoldemir
This document summarizes management strategies for menopausal symptoms in breast cancer survivors. It discusses pharmacological options like clonidine, oxybutynin, antidepressants, black cohosh, and phytoestrogens. It also covers mind-body practices like cognitive behavioral therapy and hypnosis. Non-hormonal treatments for vulvo-vaginal symptoms are discussed, as well as short-term low-dose local estrogen therapy. Management of menopausal symptoms requires a personalized approach balancing symptom relief with safety.
The document discusses several studies related to endometriosis and IVF outcomes. It provides summaries of studies that examined:
- Live birth rates, clinical pregnancy rates, number of oocytes retrieved, and miscarriage rates for patients with endometriosis undergoing IVF compared to controls.
- IVF outcomes based on the severity of endometriosis compared to controls.
- Outcomes of fresh versus frozen embryo transfers.
- The risk of embryonic aneuploidy in patients with endometriosis.
- Treatment guidelines from ESHRE on the use of IVF and surgery for infertility associated with endometriosis.
Pelvic anatomy in relation with pelvic organ prolapseTevfik Yoldemir
The document discusses pelvic organ prolapse from an anatomical perspective. It describes the layers of fascia and muscles that provide support to the pelvic organs. Damage to the fascia can result in cystocele, rectocele, or uterine prolapse as the pelvic organs lose support and protrude into the vaginal canal. The document outlines the components of the pelvic floor according to the Integral Theory and how dysfunction, such as stress urinary incontinence, can result from weakness or damage in specific areas. Assessment tools like the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire are also mentioned for evaluating patients.
Certain viruses can be transmitted from mother to fetus during pregnancy and cause fetal or neonatal damage. These include cytomegalovirus, rubella virus, varicella zoster virus, herpes simplex virus, and parvovirus B19. Cytomegalovirus is the most common cause, with an estimated 1% of newborns infected worldwide. Severe damage from cytomegalovirus, such as cytomegalic inclusion disease, occurs in about 1 in 5,000 to 1 in 20,000 births. Transmission is more likely when a mother has a primary infection compared to a recurrent infection. Clinical manifestations in the newborn are also more common following primary maternal infection.
This document discusses different types of energy modalities used in surgery including monopolar, bipolar, ultrasonic, and plasma kinetic technologies. Monopolar energy uses an active electrode at the surgical site and a return electrode elsewhere on the patient's body, allowing for tissue cutting, coagulation, and desiccation. Bipolar energy passes between two close electrodes, minimizing collateral damage. Advanced bipolar technologies like Ligasure, Plasma Kinetic Gyrus, and Enseal can additionally seal and transect tissue. Ultrasonic devices use high frequency vibrations to denature proteins for coagulation and mechanical cutting. The effects of different energies on tissue are described, noting temperatures at which protein denaturation and
This document discusses techniques for diagnosing endometriosis, including magnetic resonance imaging (MRI) and transvaginal ultrasound (TVS). It provides details on MRI protocols, including patient preparation, positioning, and rectal opacification. It also outlines four basic steps for a TVS exam when evaluating for deep infiltrating endometriosis: 1) evaluating the uterus and adnexa; 2) assessing for soft markers like tenderness and ovarian mobility; 3) using the "sliding sign" to assess the pouch of Douglas; and 4) searching for endometriosis nodules. The document also discusses agreement between observers for diagnosing deep infiltrating endometriosis using TVS in different pelvic
This document summarizes research on the effects of alternative hormonal treatments, including bazedoxifene, on various tissues in humans. It discusses preclinical and clinical data on the effects of ospemifene, tamoxifen, raloxifene, and bazedoxifene on the endometrium, vagina, breast, and bone. It then summarizes results from several clinical trials, known as the SMART trials, that evaluated the efficacy and safety of a combination of conjugated estrogens and bazedoxifene for vasomotor symptoms, quality of life, vaginal health, and bone mineral density and fracture risk reduction.
1. The document discusses premature ovarian insufficiency (POI), including delays in diagnosis contributing to low bone density. For every month of delayed diagnosis, spine bone mineral density decreases by 0.026.
2. POI can manifest as delayed puberty, primary or secondary amenorrhea, or irregular periods. Genetic factors are responsible for some cases, with mutations in meiotic and DNA repair genes linked to syndromic and non-syndromic POI.
3. Treatment of POI involves hormone replacement therapy to mimic normal estrogen and progesterone levels. Estrogen therapy should begin at age 12-13 and be gradually increased over 2-3 years. Progestogen is later added for endometrial protection
This document discusses menopause and osteoporosis, including clinical risk factors for osteoporosis, indications for bone mineral density testing, hip fractures and biochemical markers of bone turnover. It also addresses calcium content of food, pharmacologic agents for osteoporosis, changes in lumbar spine and total hip bone mineral density, vertebral and non-vertebral fractures, and risks and benefits of hormone replacement therapy, including its effects on cardiovascular disease, cancer risks, and risks of breast and endometrial cancer. Contact information is provided for further questions.
This document discusses tests that should be performed before various forms of contraception including IUD insertion, implant insertion, DMPA initiation, OCP use, and POP initiation. It also mentions that follow-up is important and that PID can sometimes be found in IUD users. The document is authored by Tevfik Yoldemir MD BSc MA and provides his contact information and links to additional information on contraception.
The document provides treatment guidelines for several sexually transmitted infections (STIs):
- Chancroid is diagnosed based on painful genital ulcers and lymphadenopathy. It is treated with azithromycin, ceftriaxone, ciprofloxacin, or erythromycin.
- Herpes is typically treated with acyclovir, valacyclovir, or famciclovir for suppressive or episodic therapy. Pregnant women may take acyclovir or valacyclovir.
- Syphilis treatment depends on stage, and involves benzathine penicillin for most cases.
This document contains a summary of topics related to early pregnancy complications and abortion. It lists bleeding in early pregnancy, ectopic pregnancy, risk factors and algorithms for diagnosis, methotrexate protocol, molar pregnancy symptoms and management, and habitual abortion as sections within the document. Contact information is provided for Dr. Tevfik Yoldemir as the author along with links to additional resources on these medical topics.
This document discusses menstrual cycle disorders and their causes and treatment. It defines menorrhagia as heavy menses in ovulatory women, and metrorrhagia as irregular bleeding during an ovulatory cycle. Common causes of abnormal uterine bleeding (AUB) include uterine fibroids, endometrial polyps, and adenomyosis. Evaluation of AUB may involve a saline-infused sonogram. Medical treatments aim to regulate hormone levels and bleeding patterns through contraceptives and cyclic progestin-only regimens.
This document discusses chronic pelvic pain and associated disorders. It covers chronic pelvic pain disorders, different physical examination positions, diagnostic tests, endometriosis, and provides contact information for questions. The document appears to be notes from a presentation or article on evaluating and diagnosing chronic pelvic pain and conditions that may cause it such as endometriosis.
This document summarizes research on endometriosis beyond late reproductive age. It discusses findings that endometriosis persists and can recur even after menopause. Studies show endometriosis symptoms continue across all age groups and surgical recurrence rates remain high. Hormone replacement therapy after menopause may increase risk of endometriosis recurrence and malignant transformation. Emerging treatments for endometriosis that are discussed include GnRH antagonists, aromatase inhibitors, and other drug classes targeting factors like angiogenesis and inflammation.
This document summarizes several studies on the impact of fibroids on fertility and in vitro fertilization (IVF) outcomes. It discusses factors like sample size calculations, reliability and validity of research data, and potential confounding factors in sham surgery trials. It then summarizes multiple studies that found no significant impact or decreased live birth rates with intramural fibroids not distorting the uterine cavity compared to controls without fibroids undergoing IVF. The document provides an expert review of the evidence on fibroids and fertility.
1. The document discusses fertility options for women over age 40, what is realistic and not realistic. It provides data from studies on pregnancy rates by age and discusses strategies like tailored stimulation protocols, embryo selection techniques, and oocyte accumulation.
2. Case studies are presented of women over 40 concerned about their fertility. The document recommends counseling based on AMH, AFC, prior response and discussing tailored protocols, cumulative success rates, and alternative options.
3. Strategies discussed include minimal or double stimulation protocols, embryo banking, oocyte donation, and new selection techniques, but individualized assessment is important due to variability.
- Maternal nutrition and environmental exposures during pregnancy can impact the fetal epigenome through DNA methylation, histone modifications, and microRNAs. This can increase the risk of health issues like metabolic syndrome later in life.
- Certain phytochemicals from foods like epigallocatechin gallate, resveratrol, genistein, and curcumin may beneficially influence the fetal epigenome by regulating enzymes involved in epigenetic modifications.
- Adequate intake of nutrients like vitamins, minerals, and phytochemicals during pregnancy and lactation may help protect the offspring by modulating the fetal epigenome.
1. 07.12.2014
1
Kimlere IUI yapalım ?
Dr. Tevfik Yoldemir
Marmara Üniversitesi
Kadın Hastalıkları ve Dogum A.D.
Üreme Endokrinolojisi ve Infertilite B.D.
tevfik@yoldemir.com
KOS/IUI prognostik faktörler
Prognostik skor
KOS/IUI prognostik faktörler
Prognostik skor
KOS/IUI prognostik faktörler
6 ay KS tedavisi – canlı doğum
KOS/IUI prognostik faktörler PKOS
PKOS
KS
KS+M
KS
KS+M
KOS/IUI prognostik faktörler
2. 07.12.2014
2
KOS/IUI prognostik faktörler PKOS
PKOS
KS
KS+M
KS
KS+M
KOS/IUI prognostik faktörler
Klinik Gebelik Çoğul gebelik
N=1438,
3375 siklus OF
EF
MF
FSH
HMG
KOS/IUI prognostik faktörler
KOS/IUI prognostik faktörler
KS / Gnd +IUI - Kaç defa?
Kimlere? PKOS
PKOS, KS dirençli
5 mg x 5 g 2.5 mg x 10 g
Kimlere? PKOS
KS dirençli PKOS – AI vs Met+KS
2.5 mg 1500 mg 2 ay ve sonra150 mg
3. 07.12.2014
3
Kimlere? PKOS
Anovulatuar DSÖ II -KS vs FSH
• KS ile klinik gebelik üç siklus boyunca %33, 41
ve %26, FSH ile ilk siklusta %52.6 ve ikinci
siklusta %35.5.
• İlk siklusun sonunda gebelik oranı FSH ile OI
sonrası %30, KS ile OI %14.6 ( 95% CI 5.3–
25.8, P < 0.003).
• İlk iki siklus sonunda gebelik oranı FSH ile OI
sonrası %50.7%, KS ile OI %32.5 ( P <0.003).
• İlk üç siklus toplam gebelik oranı KS için
%41.2, FSH için %52.1 (P < 0.021).
• Üç siklus sonrası topla canlı doğum oranı KS
için %36.9, FSH için %47.4 (P < 0.031).
50 IU 75 IU 100 IU 125 IU
Kimlere? PKOS
PKOS- KS vs Gnd
Kimlere? PKOS
PKOS- KS vs Gnd
%43
%24
Kimlere? PKOS
DSÖ II
Gebe kalma
şansı
75 IU 112.5 IU 150 IU 187.5 IU
Kimlere? PKOS
DSÖ II Gebe kalma şansı
75 IU 112.5 IU 150 IU 187.5 IU
EL - KS+ IUI
Kimlere?
4. 07.12.2014
4
Kimlere? Aİ
Açıklanamayan, KS cevapsız
Günaşırı 150 IU rFSH Letrozol 5 mg
KS ile ince EL -TMX
Kimlere?
Aİ / kötü prognoz sET vs IUIx3
Aİ
rFSH
Kimlere?
Canlı Doğum- Erkek subfertilitesi
EF
KS+HMG
Kimlere?
FASTT trial
FSH-IUI atlanabilir
Aİ
KS
21-39 yaş FSH
Kimlere?
FORT-T Trial 38-42 yaş
Aİ
KS
FSH
Kimlere?
5. 07.12.2014
5
FORT-T Trial
Hemen IVF , olamayacaksa > CC-IUI ve sonra IVF
Aİ
KS
FSH
Kimlere?
Canlı doğum
Aİ
KS
FSH
Kimlere?
Hemen IVF , olamayacaksa > CC-IUI ve sonra IVF
KS +IUI sonrası rFSH vs LTZ
Aİ
LTZ
rFSH
Kimlere?
< 40 yaş LTZ+FSH vs FSH
OF
EF
Aİ
rFSH
Kimlere?
> 40 yaş LTZ+FSH vs FSH
OF
EF
Aİ
rFSH
Kimlere?