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PURPOSE: Develop a spectroscopic method to assess cartilage thickness during the arthroscopic examination. METHODS: Currently, arthroscopy assesses cartilage damage visually; outcomes are based on the surgeon's subjective experience. Light reflection spectroscopy is a promising method for measuring cartilage thickness based on the absorption of light by the subchondral bone. In the presented study, in vivo diffuse optical back reflection spectroscopic measurements were acquired by gently placing an optical fibre probe on different locations of the articular cartilage of 50 patients during complete knee replacement surgery. The optical fibre probe consists of two optical fibers with a diameter of 1 mm to deliver the light and detect back-reflected light from the cartilage. Centre to centre distance between the source and the detector fibers was 2.4 mm. Actual thicknesses of the articular cartilage samples were measured under microscopy using histopathological staining. RESULTS: Using half of the samples in the patient data, a linear regression model was formed to estimate cartilage thicknesses from the spectroscopic measurements. The regression model was then used to predict the cartilage thickness in the second half of the data. The cartilage thickness was predicted with a mean error of 8.7% if the actual thickness was less than 2.5 mm (R2 = 0.97). CONCLUSION: The outer diameter of the optical fibre probe was 3 mm, which can fit into the arthroscopy channel and can be used to measure the cartilage thickness in real-time during the arthroscopic examination of the articular cartilage.
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Artroplastia do Joelho , Cartilagem Articular , Humanos , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/patologia , Análise Espectral/métodos , Artroscopia/métodos , Modelos LinearesRESUMO
This study aimed to determine the attitudes and opinions of the students of veterinary schools in Turkey regarding distance education during the COVID-19 pandemic. The study was conducted in two stages: (1) develop and validate a scale for assessing Turkish veterinary students' attitudes and opinions regarding distance education (DE) (n = 250 students; one veterinary school) and (2) widespread use of this scale amongst veterinary students (n = 1,599 students, 19 veterinary schools). Stage 2 was conducted between December 2020 and January 2021 with students from Years 2, 3, 4, and 5 who had experienced both face-to-face and distance education. The scale contained 38 questions, which were divided into seven sub-factors. Most students considered that practical courses (77.1%) should not continue to be delivered by DE; and that catch-up face-to-face programs (77%) would be required for practical skills after the pandemic. The main benefits of DE were that studies did not have to be interrupted (53.2%) and the ability to retrieve online video material for later study (81.2%). A total of 69% of students considered that DE systems and applications are easy to use. Many (71%) students considered that the use of DE would adversely affect their professional skills, 26.5% expected that the duration of their studies would be extended, but only 18.1% had considered suspending their studies for the period of the pandemic. Therefore, it appeared that face-to-face education was considered indispensable by students in veterinary schools, which provide practice-oriented education in the field of health sciences. However, the DE method can be used as a supplementary tool.
Özet Bu çalismanin amaci, Covid-19 pandemisi sürecinde Türkiye'deki veteriner fakültesi ögrencilerinin uzaktan egitime iliskin tutum ve görüslerini belirlemektir. Çalisma iki asamada gerçeklestirilmistir: Birinci asamada, veteriner fakültesi ögrencilerinin uzaktan egitime (UE) iliskin tutum ve görüslerini degerlendirmek için bir ölçek gelistirilmis ve dogrulanmis (n = 250 ögrenci; bir veteriner fakültesi); ikinci asamada gelistirilen bu ölçek veteriner fakültesi ögrencilerine uygulanmistir (n = 1.599 ögrenci, 19 veteriner fakültesi). Ikinci Asama, Aralik 2020 ve Ocak 2021 tarihleri arasinda hem yüz yüze hem de uzaktan egitimi deneyimlemis 2, 3, 4, ve 5. sinif ögrencileri ile gerçeklestirilmistir. Ölçek, yedi alt faktöre ayrilan 38 soru içermektedir. Ögrencilerin çogu, uygulamali derslerin (%77,1) UE ile verilmeye devam edilmemesi gerektigini ve pandemi sonrasinda pratik beceriler telafi edilmesi için yüz yüze programlarin (%77) gerekli olacagini düsünmektedir. UE'nin baslica faydalari, çalismalarin kesintiye ugramamasi (%53,2) ve daha sonra çalismak için çevrimiçi video materyaline ulasilabilmesi olarak belirtilmistir (%81,2). Ögrencilerin %69'u UE sistem ve uygulamalarinin kullaniminin kolay oldugunu düsünmektedir. Ögrencilerin %71'i UE kullaniminin mesleki becerilerini olumsuz etkileyecegini, %26,5'i egitim sürelerinin uzayabilecegini, ancak sadece %18,1'i pandemi süresince egitimlerine ara vermeyi düsündügünü ifade etmistir. Dolayisiyla, saglik bilimleri alaninda uygulama odakli egitim veren veteriner fakültelerinde yüz yüze egitimin ögrenciler tarafindan vazgeçilmez görüldügü ortaya çikmistir. Bununla birlikte, UE yöntemi tamamlayici bir araç olarak kullanilabilir.
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PURPOSE: The present study aims to develop a new high-resolution imaging system for the early diagnosis of cervical neoplasia based on increased vessel density of the cervical tissue. METHODS: An optical device was developed to obtain high contrast and resolution images of vascular structures of the cervix in the present study. The device utilizes a telecentric lens to capture cervix images under light illumination with a wavelength of 550 nm emitted from LEDs. Images were obtained using the telecentric lens with or without acetic acid application to the cervix. Image processing algorithms were used to contrast and extract the skeleton of the vascular structures on the cervix. In the evaluation of the vascular density, the cervical images were divided into 12 o'clock positions, and the fractal dimension of the vascularity was calculated for each dial area between the o'clock positions. The region with the largest fractal dimension was accepted as the region with the highest probability of lesion. The range of vessel sizes was split into small classes of "bins" for each dial area with the highest fractal dimension. To validate the system's success in differentiating between normal and HSIL lesions, forty five patients who underwent colposcopy and biopsy were included in a pilot study. RESULTS: The system correctly classified four HSIL cases out of five and failed to detect one HSIL case, achieving an accuracy rate of 97.8% with an 80% sensitivity and 100% specificity. CONCLUSION: The developed high-resolution optical imaging system may potentially be used in detecting cervical neoplasia just before the biopsy and reduce the number of false-positive cases.
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Displasia do Colo do Útero , Neoplasias do Colo do Útero , Biópsia , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Colposcopia , Feminino , Humanos , Projetos Piloto , Gravidez , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/patologiaRESUMO
AIM: Leukapheresis is an invasive treatment modality used for hyperleukocytosis. Various drugs and fluids are used during the leukapheresis. Aging itself and associated factors such as increased comorbidity, decreased tolerance to drugs, increased drug toxicity give rise to the application of other treatment modalities in elderly patients. Treatment of acute leukemia in the elderly differs from young patients. Consequently, we assumed that outcome, effectiveness, and side effects of leukapheresis treatment used for acute leukemia patients with hyperleukocytosis may be different in elderly compared to younger patients. METHODS: We retrospectively evaluated a total of 39 patients. Eighteen patients were 65 years and older. Indications for leukapheresis were determined as symptoms of leukostasis and prophylaxis. Acid citrate dextrose-A, calcium gluconate, and plasma were used during the leukapheresis. Age, sex, diagnosis, count, and indications of leukapheresis procedures, leukocyte count, and lactate dehydrogenase level were analyzed at the onset of and after leukapheresis; side effects, causes of death, early and total mortality rates were also analyzed. We compared the two groups with regard to effectiveness, clinical outcomes, and side effects. RESULTS: There were no statistically significant differences between the two groups with respect to sex, diagnosis, initial leukocyte count, lactate dehydrogenase level, number of leukapheresis procedures, rates of side effects, or early and total mortality (P > 0.05). Leukapheresis treatment was effective in both groups (P < 0.05) and no significant difference was found in its effectiveness between two groups (P > 0.05). CONCLUSION: Leukapheresis is an effective and safe treatment modality in elderly acute leukemia patients with hyperleukocytosis.
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Leucaférese , Leucocitose/terapia , Fatores Etários , Idoso , Feminino , Humanos , Leucaférese/métodos , Leucemia Mieloide Aguda/sangue , Leucemia Mieloide Aguda/terapia , Contagem de Leucócitos , Leucocitose/sangue , Leucostasia/sangue , Leucostasia/terapia , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To report a case of arteriovenous fistula (AVF) following bone marrow aspiration and trephine biopsy. CLINICAL PRESENTATION AND INTERVENTION: A 76-year-old man was diagnosed with acute myeloblastic leukemia. Pain and hematoma were detected in his left leg and hip 4 days after bone marrow aspiration and trephine biopsy. A pelvic arteriography was performed, and a diagnosis of AVF was made. CONCLUSION: This case shows that clinicians should be aware of AVF, especially in cases with refractory bleeding after bone marrow aspiration and trephine biopsy despite normal blood coagulation parameters.
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Fístula Arteriovenosa/etiologia , Biópsia/efeitos adversos , Biópsia/métodos , Medula Óssea , Artéria Ilíaca , Leucemia Mieloide Aguda/diagnóstico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Ultrassonografia DopplerRESUMO
In recent developments, artificial neural networks (ANNs) have demonstrated their capability to predict reaction cross-sections based on experimental data. Specifically, for predicting (α,n) reaction cross-sections, we meticulously fine-tuned the neural network's performance by optimizing its parameters through the Levenberg-Marquardt algorithm. The effectiveness of this approach is corroborated by notable correlation coefficients; an R-value of 0.90928 for overall correlation, 0.98194 for validation, 0.99981 for testing, and 0.94116 for the comprehensive network prediction. We conducted a rigorous comparison between the results and theoretical computations derived from the TALYS 1.95 nuclear code to validate the predictive accuracy. The mean square error value for artificial neural network results is 7620.92, whereas for TALYS 1.95 calculations, it has been found to be 50,312.74. This comprehensive evaluation process validates the reliability of the ANN based on the Levenberg-Marquardt algorithm in approximating the reaction sections, thus demonstrating its potential for comprehensive investigations. These recent developments confirm the feasibility of using ANN models to gain insight into (α,n) reaction cross-sections.
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CLOSER is a computer-based exercise program that aims to improve older adults' health, fitness and social lives. This pilot study aimed to examine the effect of CLOSER, the first computer-based exercise program developed for older adults on a national scale, on those with a history of falls. Forty-eight older adults (71.33 ± 7.47) with a history of falling at least once in the last year were included in the study. Older adults performed CLOSER exercises for (balance maintenance, neck rotation, rhythmic walking, knee flexion and trunk rotation) 2 sessions per week for eight weeks. All individuals were evaluated at baseline and the end of the eighth week. The primary outcome measures were the 30-s Chair-Stand Test (p = 0.002), the Berg Balance Scale (p = 0.002), the Falls Efficacy Scale International (p = 0.003), the Timed Up and Go Test (p = 0.008) and the motivation level (p = 0.007) statistically significant improvements were observed. The results show that a CLOSER-computer-based exercise program effectively increases balance and reduces the risk and fear of falling. In the future, CLOSER could significantly contribute to the healthcare system as an alternative aid for home-based exercise.
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Acidentes por Quedas , Terapia por Exercício , Equilíbrio Postural , Humanos , Acidentes por Quedas/prevenção & controle , Idoso , Projetos Piloto , Masculino , Feminino , Terapia por Exercício/métodos , Equilíbrio Postural/fisiologia , Idoso de 80 Anos ou maisRESUMO
Ionizing radiation is vital in various fields but poses health risks, necessitating effective shielding. This study investigated the photon-shielding properties of polyester-based ternary composites with barite (BaSO4) and tungsten (W) using experimental methods, theoretical calculations, and Monte Carlo simulations for energies between 81 keV and 1332.5 keV. WINXCOM was utilized for the theoretical predictions, and the MCNP6 and PHITS 3.22 algorithms were employed for the simulations. According to the results, the simulation, theoretical, and experimental data all closely aligned. At 81 keV, the composite containing the highest amount of tungsten (PBaW50) had the highest mass attenuation coefficient (3.7498 cm2/g) and linear attenuation coefficient (12.9676 cm-1). Furthermore, for a sample that was 1 cm thick, PBaW50 offered 99.88% protection at 81 keV and had the lowest HVL and TVL values. PBaW50 exhibited attenuation capabilities, making it appropriate for use in industrial, medical, and aerospace settings. In summary, the findings of this study underscore the potential of polyester-based composites doped with barite and tungsten as effective materials for gamma radiation shielding. The PBaW50 sample, in particular, stands out for its attenuation performance, making it a viable option for a wide range of applications where durable and efficient radiation shielding is essential.
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This study aimed to investigate the effect of diabetes on radiation attenuation parameters of the femur and tibia of rats using Monte Carlo Simulations. First, control and diabetic rats were identified and tibias and femurs were removed. Then, the elemental ratios of the bones obtained were calculated using EDS (Energy Dissipative X-ray Spectroscopy). Therefore, radiation permeability properties of control and diabetic bones were simulated by using the content ratios in the bones in MCNP6 (Monte Carlo N-Particle) and PHITS (Particle and Heavy Ion Transport code System) 3.22 and Stopping and Range of Ions in Matter (SRIM) simulation codes. Attenuation coefficient results were compared with the NIST database via XCOM. Although differences in absorption coefficients are observed at low energies, these differences disappear as the energy increases.
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Diabetes Mellitus Experimental , Tíbia , Ratos , Animais , Tíbia/diagnóstico por imagem , Projetos Piloto , Simulação por Computador , Fêmur/diagnóstico por imagem , Método de Monte CarloRESUMO
BACKGROUND: In patients with heart failure plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are correlated to urine neutrophil gelatinase-associated lipocalin (NGAL) levels. We prospectively evaluated the relationship among glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (ACR), urine and serum NGAL and NT-proBNP levels in 20 type II diabetic patients with macroalbuminuria at 4-month intervals. RESULTS: Compared with 20 age, gender-matched healthy controls, diabetic patients had higher urine and serum NGAL, serum NT-proBNP and lower eGFR. The eGFR of the patients at the baseline, the 4th and the 8th month were 29.6 ± 12.0, 27.8 ± 13.7 and 22.9 ± 10.4 mL/min/1.73 m(2), respectively. No significant change in urine NGAL levels was detected (p > 0.05), whereas there were significant increases in NT-proBNP, serum NGAL and urine ACR and significant decrease in eGFR as the study progressed (p < 0.05). Both the baseline and the 4th month urine ACR were positively correlated to NT-proBNP levels measured at the same periods (r: 0.451; p: 0.046; r: 0.489; p: 0.029 respectively). In all measurements, urine ACR was negatively correlated to serum albumin levels measured at the same periods (r: -0.792; p: 0.000; r: -0.716; p: 0.000; r: -0.531; p: 0.016 respectively). None of eGFR measurements was correlated with NT-proBNP (p > 0.05). Neither serum NGAL nor urinary NGAL levels are associated with NT-proBNP (p > 0.05). CONCLUSION: Our findings show an association between NT-proBNP and proteinuria in type II diabetic patients with macroalbuminuria but not with serum and urine NGAL.
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Complicações do Diabetes/sangue , Diabetes Mellitus Tipo 2/sangue , Lipocalinas/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Proteinúria/sangue , Proteínas Proto-Oncogênicas/sangue , Proteínas de Fase Aguda , Adulto , Idoso , Estudos de Casos e Controles , Creatinina/urina , Diabetes Mellitus Tipo 2/complicações , Feminino , Taxa de Filtração Glomerular , Humanos , Lipocalina-2 , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Proteinúria/complicaçõesRESUMO
Prediction of neutron-induced reaction cross-sections at around the 14.5 MeV neutron energy is crucial to calculate nuclear transmutation rates, nuclear heating, and radiation damage from gas formation in fusion reactor technology In this research, the new approach of (n,α) reaction cross-section is presented. It has been assessed by utilizing the artificial neural network (ANN) when compared to more advanced algorithms, the Levenberg-Marquardt algorithm-based ANN can be exceedingly fast. The correlation coefficients for a training R-value of 0.99283, a validation R-value of 0.991190, a testing R-value of 0.97337, and an overall R-value of 0.98515 demonstrate that Levenberg-Marquardt algorithm-based ANN is well suited for this purpose. . The obtained results were compared to theoretical calculations of TALYS 1.95 nuclear code. As a consequence, it has been demonstrated that the ANN model can be used to determine the systemic study for (n, α) reaction cross-sections.
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Algoritmos , Redes Neurais de ComputaçãoRESUMO
The main aim of this study is to develop accurate artificial neural network (ANN) algorithms to estimate level density parameters. An efficient Bayesian-based algorithm is presented for classification algorithms. Unknown model parameters are estimated using the observed data, from which the Bayesian-based algorithm is predicted. This paper focuses on the Bayesian method for parameter estimations of Gilbert Cameron Model (GCM), Back Shifted Fermi Gas Model (BSFGM) and Generalised Super Fluid Model (GSM), which are known as the phonemological level density models. Obtained level density parameters have been compared with the Reference Input Parameter Library for Calculation of Nuclear Reactions and Nuclear Data Evaluations (RIPL) data. R values of the Bayesian method have been found as 0.9946, 0.9981 and 0.9824 for BSFGM, GCM and GSM, respectively. In order to validate our results, default level density parameters of TALYS 1.95 code have been changed with our newly obtained results and photo-neutron cross-section calculations of the 117Sn(γ,n)116Sn, 118Sn(γ,n)117Sn, 119Sn(γ,n)118Sn and 120Sn(γ,n)119Sn reactions have been calculated by using these newly obtained level density parameters.
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BACKGROUND: The geriatric population in intensive care units (ICUs) has recently increased. The aim of this study was to analyse the impact of initial complete blood count (CBC)-related parameters and nutritional status on morbidity and mortality in geriatric ICU patients. METHODS: A retrospective analysis was made of geriatric patients admitted to our tertiary adult ICU for 1 year. Patients with a length of stay (LOS) of < 48 h, with hematological malignancy or age < 65 years age were excluded from the study. Initial albumin level was considered to reflect nutritional status. The prevelance and risk factors of mortality and microbiologically documented infection (MDI) were analysed. RESULTS: The study included a total of 243 patients with a mean age of 78.96 ± 6.62 years. The overall mortality rate was 40.7%. The most common cause for admission was acute respiratory failure and sepsis (17.2% vs. 16.8%). The most common MDI sources were lower respiratory tract, bloodstream, and urinary tract infections. Patients with thrombocytopenia on admission had a higher mortality rate than patients with normal platelet count (P = 0.019). The initial albumin level of non-survivors was significantly lower than that of survivors (P = 0.001). There was a significant negative correlation between albumin level and LOS (r = -0.157; P = 0.000). Patients with hypoalbuminemia (albumin < 3.2 g/dL) at the time of diagnosis had higher mortality, LOS and MDI rates than those with normal albumin levels (P < 0.05). There was no significant relationship between any other CBC-related parameter and infection and mortality (P > 0.05). CONCLUSIONS: Thrombocytopenia and hypoalbuminemia may be considered as major risk factors for morbidity and mortality in critically ill elderly patients.
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Background. There are no studies investigating the relationship between endothelial nitric oxide synthase (eNOS) gene polymorphisms and hepatorenal syndrome (HRS). Aim. The purpose of this study is to elucidate whether eNOS gene polymorphisms (G894T and T-786C) play a role in the development of type-2 HRS. Methods. This study was carried out in a group of 92 patients with cirrhosis (44 patients with type-2 HRS and 48 without HRS) and 50 healthy controls. Polymorphisms were determined by polymerase chain reaction (PCR) and melting curve analysis. Results. We did not find any significant difference in allele and genotype distributions of the eNOS -T-786C polymorphism among the groups (p = 0.440). However, the frequency of GT (40.9%) and TT (13.6%) genotypes and mutant allele T (34.1%) for the eNOS G894T polymorphism were significantly higher (p < 0.001 and p < 0.001, resp.) in the HRS group than in both the stable cirrhosis (14.6%, 4.2%, and 11.5%, resp.) and the control (22.0%, 2.0%, and 13.0%, resp.) groups. Conclusion. The occurrence of mutant genotypes (GT/TT) and mutant allele T in eNOS -G894T polymorphisms should be considered as a potential risk factor in cirrhotic patients with HRS.