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El entrenamiento de sprint por intervalos (SIT) mejora el desempeño aeróbico, así como los marcadores de salud y aptitud física en la población no atlética; sin embargo, no existe información suficiente sobre el desempeño cuando se interrumpe el SIT. El objetivo del presente estudio fue investigar las alteraciones en el proceso de desentrenamiento de la evolución de la aptitud física adaptativa causadas por el entrenamiento de sprint por intervalos de corta duración. El diseño general del estudio se clasificó como antes del SIT, período de entrenamiento, después del SIT y medidas del período de desentrenamiento. Los sujetos (n = 26) completaron las mediciones de base de la prueba de carrera de 20 m y después fueron distribuidos aleatoriamente en grupos de entrenamiento y de control. El grupo de control mantuvo su rutina diaria y el grupo de entrenamiento realizó el SIT durante 4 semanas. La prueba de carrera de 20 m fue aplicada antes y después del entrenamiento y en las semanas 4 y 8 del desentrenamiento. Después del período de entrenamiento, el desempeño aeróbico aumentó en el grupo de entrenamiento (p < .05). Además, los aumentos del desempeño aeróbico se mantuvieron durante las 4 semanas del desentrenamiento (p < .05). Por su parte, los aumentos de desempeño desaparecieron en la octava semana del desentrenamiento (p > .05). Hacer una pausa en el programa de ejercicios por más de cuatro semanas en individuos jóvenes saludables puede hacer que los efectos positivos del SIT en el consumo máximo de oxígeno (VO2máx) desaparezcan. Los participantes en el SIT no deben hacer una pausa en el ejercicio por más de cuatro semanas para mantener la ganancia aeróbica.

Abstract Digital technologies, such as virtual or augmented reality, can potentially support neurocognitive functions of the aging populations worldwide and complement existing intervention methods. However, aging-related declines in the frontal-parietal network and dopaminergic modulation which progress gradually across the later periods of the adult lifespan may affect the processing of multisensory congruence and expectancy based contextual plausibility. We assessed hemodynamic brain responses while middle-aged and old adults experienced car-riding virtual-reality scenarios where the plausibility of vibrotactile stimulations was manipulated by delivering stimulus intensities that were either congruent or incongruent with the digitalized audio-visual contexts of the respective scenarios. Relative to previous findings observed in young adults, although highly plausible vibrotactile stimulations confirming with contextual expectations also elicited higher brain hemodynamic responses in middle-aged and old adults, this effect was limited to virtual scenarios with extreme expectancy violations. Moreover, individual differences in plausibility-related frontal activity did not correlate with plausibility violation costs in the sensorimotor cortex, indicating less systematic frontal context-based sensory filtering in older ages. These findings have practical implications for advancing digital technologies to support aging societies.

Due to the increasing complexity of vehicle software, it is becoming increasingly difficult to comprehensively test all requirements. This inevitably means that alternative test methods, e.g., simulation-based methods, must be used more frequently. However, the challenge involves identifying appropriate requirements that can be technically tested in a simulation environment initially. The present work is aimed at evaluation and optimization of the effectiveness of software-in-the-loop (SiL) simulations in the testing process of vehicle software. The focus is on supporting the testing process by shifting specific test cases from hardware-in-the-loop (HiL) test benches to SiL-based simulations. For this purpose, a systematic approach was developed to analyze and categorize requirements, enabling precise and efficient allocation of test cases. Furthermore, a detailed review and recommendation for improving the ProSTEP iViP standard for virtual electronic control units (vECU) was carried out. The developed matrix associates the defined requirement clusters with different classifications of vECUs, facilitating the identification of suitable test environment types for conducting specific test cases. By assigning test cases to appropriate vECU levels, the testing processes can be targeted and cost-optimized. Finally, the theoretical results were evaluated in an SiL simulation environment. It was observed that a significant part of the requirements could effectively be tested using a vECU. These findings confirmed the potential of SiL simulation environments to not only support, but also enhance, the testing process for vehicle software by providing a cost-effective and flexible complement to traditional HiL test benches.

Tonal powertrain noise can have a strong negative impact on passengers’ quality and comfort perception in the interior of electric vehicles. Therefore, in the vehicle development process, the assessment of the perceptibility of tonal powertrain noise is essential. As wind and tire noise can possibly mask tonal noises, engineers use modern masking models to determine the masking threshold of tonal powertrain noise from vehicle interior measurements. In the presently used method, the masking threshold is mostly generated with torque-free deceleration measurements. However, the influence of torque on masking tire noise must be considered. As this requires time-consuming and costly road measurements, an extension of the method is being developed, which will also enable the use of roller dynamometer measurements for the assessment. For the extension of the method, however, the influence of the torque must also be considered. This paper presents a novel calculation method that quantifies the influence of torque on the masking threshold and converts masking thresholds from an arbitrary torque level to another. By identifying the frequency and speed range that is mainly affected by the torque-dependent tire noise, a regression model with respect to the tractive force on the tires can be used to calculate a torque-dependent correction factor. The developed method can significantly improve the validity of masking thresholds and quantitatively, the method generalizes well across different vehicle segments. The error can be reduced to below 2 dB above 2000 rpm and to below 1 dB above 4000 rpm. By using this method, more valid target level settings for tonal powertrain noise can be derived.

Tonal powertrain noise can have a strong negative impact on vehicle sound quality. Therefore, an assessment of the perceptibility of tonal noise with respect to masking noise is essential for the vehicle development process. In electric vehicles, due to the missing masking by the combustion engine, new methods are required for this purpose. In this study, listening tests were conducted to determine the masking threshold in the electric vehicle interior for various driving speeds (30 km/h, 60 km/h, and 90 km/h) with an Adaptive-Forced-Choice method. The novelty of this study is that it used vehicle interior noise as a masker, compared to broadband or narrowband white and pink noises. It could be shown that the masking threshold in electric vehicles strongly depends on the driving speed, and the investigated interior noise mainly affects frequencies up to 6400 Hz in this speed range. For frequencies greater than 6400 Hz, the masking noise has no significant effect on perceptibility of tonal noise in the investigated vehicle, and only the subjects’ individual absolute threshold of hearing is relevant. Additionally, a strong variation in the masking threshold between the subjects was found for high frequencies. With these results, methods that estimate masking thresholds in electric vehicles can be improved. Furthermore, threshold targets can be adjusted for different customer groups.

Sprint interval training (SIT) has been known to improve aerobic performance as well as health and fitness markers in non-athletic population. However, there's not enough information about performance when SIT is stopped. The aim of this study was to investigate the alterations in the detraining process of the evolution of adaptive physical fitness caused by short-term sprint interval training. The general design of the study was classified as before SIT, training period, after SIT and detraining period measurements. The subjects (n=26) completed the baseline measurements of the 20-m shuttle run test and then were randomized as training and control groups. The control group continued their daily routine and the training group ran SIT for 4 weeks. The 20-m shuttle run test was applied before and after training, and in the 4th and 8th detraining weeks. After the training period, aerobic performance increased in the training group (p0.05). Taking a break from the exercise program for more than 4 weeks in healthy young individuals may cause the positive effects of SIT on maximum oxygen uptake (VO2max) to disappear. SIT participants should not take a break from exercise for more than 4 weeks if they are to maintain aerobic gain.

Noise and whole-body vibrations (WBV) inside commercial vehicles can lead to annoyance and reduced comfort. As a result, negative effects on the driver can occur even below the legal exposure limits. In order to understand the annoyance perception and the interaction between noise and WBV, two perception experiments were conducted. For both experiments, recorded signals inside different commercial vehicles were used. Sound pressure and acceleration levels varied. In addition, the frequency content of the recorded vertical seat vibrations was reproduced in different modified variants. The varied parameters (sound pressure level, acceleration level and vibration frequency) were investigated within a three-factorial experimental design. It was found that noise and vibration levels, as well as the vibration spectrum, had a significant effect on total annoyance. Furthermore, an interaction between noise and vibration levels in both experiments could be observed. The results show that for the highest noise level, changing vibration exposure influences annoyance ratings less than the lowest noise level. The results also show that despite the same Wk-weighted RMS level of the WBV according to ISO 2631-1, vibration spectra with sinusoidal components or narrowband vibrations below

There are only a few studies about the effects of toothpastes for children on remineralization and surface roughness of primary teeth. The aim of this study was to examine the remineralization capacity of five different toothpastes for children on primary tooth enamels with artificial initial caries, their effects on enamel surface roughness, and the relationship between their abrasive effects and remineralization. Sixty of 74 samples were allocated for microhardness and AFM analyses (after initialization, demineralization, and pH cycling), and 14 samples were evaluated by SEM. Sixty samples were divided into five groups, with each group representing a different toothpaste brand, as follows: Group 1: Splat; Group 2: Logodent; Group 3: Eyup Sabri Tuncer; Group 4: Naturalive; and Group 5: Buccotherm. Fourteen samples were divided into seven groups, each representing a different processing stage, with two samples in each group, for the initial (sound enamel surface) stage, post demineralization, and after applying the five remineralizing toothpastes. Toothpastes were applied to samples in a 7-day pH cycle. Data were analyzed statistically. Each toothpaste showed increased microhardness values; however, this increase was significant only for Group 4 (Naturalive) and Group 5 (Buccotherm). The highest surface roughness values were obtained after demineralization. The toothpastes reduced surface roughness, but these reductions were not statistically significant among the different types of toothpastes. The correlation analysis revealed that the toothpastes affected surface roughness according to their remineralization potential. The results were supported by SEM images. All toothpastes recovered primary tooth enamels with artificial initial caries, but only two had significant values.

The effect of trimodal visuo-audio-tactile stimulations on perceptual realism during vehicle riding simulations in virtual reality reveals that multisensory plausibility engages cortical activities in the frontal-parietal and sensorimotor regions.

Many rooms struggle with the absorption of low-frequency sound due to its long wavelengths. The integration of existing solutions into these spaces is often challenging due to their intricate installations and large depths. To address this problem, a new type of resonance absorber has been developed: the Distributed Mode Absorber (DMA). It consists of a thin vibrating front panel and a volume of enclosed air behind it. This straightforward structure can be utilized to create acoustically functional furniture that can be seamlessly incorporated into rooms. This article is devoted to the structural optimization of the DMA front panel, using the Acoustic Black Hole (ABH) effect known within structural dynamics. A numerical model is constructed using a Finite Element Analysis (FEA) and examined numerically. Several geometric parameters of the ABH are studied with regard to their influence on the vibrations of the front panel. Prototypes are developed and manufactured based on these insights. The quality of the numerical model is verified during the subsequent validation. Finally, the sound absorption of the improved DMA is compared with that of the reference DMA.

In vehicles, noise and seat vibrations can be perceived by the driver, depending on their signal properties, as annoying or unpleasant. Because perception is a complex process, it is necessary to consider both types of stimuli at the same time to assess annoyance in such situations. A perception experiment was carried out to investigate the interaction between simultaneous noise and seat vibrations, as well as the influence of seat vibration frequency in vehicle situations. For the experiment, acoustic and optical stimuli such as seat vibrations were recorded in a mini excavator and a refuse collection vehicle from the view of the driver. The recordings were prepared for plausible reproduction in a laboratory experiment. The participants of the experiment were presented with two different vehicle scenes with simultaneous noise, seat vibrations and visuals. The average total levels of vibration and noise, as well as the vibration frequency ranges of the various vehicle scenes, were varied. The results suggest that an interaction effect between noise and vibration should be accounted for when assessing total annoyance in such situations. Models for the prediction of the relative total annoyance causes of variations in noise and vibration levels were developed.

This study shows that a concurrent active noise control strategy for engine harmonics and road noise has a complementary effect. In particular, we found that engine booming noise is additionally attenuated when road noise control is concurrently used with engine harmonics control; an additional attenuation of 2.08 dB and 1.25 dB for the C1.5 and C2.0 orders, respectively, was achieved. A parallel multichannel feedforward controller for non-stationary narrowband engine harmonics and broadband road noise was designed and implemented to reduce noise in all four seats. Two control signals were considered independent because the reference signals, engine revolution speed for the engine harmonic controller, and acceleration signal for the road noise controller are uncorrelated. However, if the reference sensor for the road noise controller is installed along the overlapping transfer path between the engine noise and road noise, the engine noise may also be suppressed by the control signal for the road noise attenuation. Based on transfer path analyses for both engine harmonics and road noise, the optimal positions for the reference sensors were selected. In addition, we identified several overlapping transfer paths between the engine booming noise and road noise. A practical active noise control system combined with a remote microphone technique was implemented for a large six-cylinder sedan using a vehicle audio system to evaluate the noise attenuation performance. The experiments showed that the interior noise from the engine and road excitation was effectively suppressed by the proposed concurrent control strategy.

This study presents comprehensive active cancellation of booming noise caused by the engine and the driveline inside a passenger car. In modern noise control systems for vehicles, booming noise caused by engine harmonics could be effectively suppressed by employing active noise control. However, practical attempts or studies for the active suppression of driveline booming noise are scarce. One of the reasons may be that since the booming noise caused by the driveline is not harmonic with the engine speed, reference signals cannot be generated conventionally. Thus, passive approaches are generally employed to improve the driveline noise. To address this limitation, we propose a method for generating reference signals from engine revolution speed to suppress the driveline noise, such as propeller shaft and tire noise. Reference signals for driveline noise suppression were generated using the information from the torque converter, gear ratio, and final drive ratio. A practical active noise control system was implemented in a six-cylindered large sedan to validate the proposed method. The experimental results showed that the engine firing order was suppressed by 8.0 dB. Moreover, the first order of the propeller shaft and the second and third orders of the tires were suppressed by 5.5 dB, 3.9 dB, and 2.3 dB for entire seat positions. Furthermore, the results presented in this study were considered effective for improving annoyance perception through subjective evaluation.

Background and objective: Hyoscine-N-butyl bromide (HBB) and paracetamol (acetaminophen)are widely used in emergency departments for abdominal pain and cramps. However, there is not enough data on the efficacy, safety, and superiority of each other in treating acute gastroenteritis (AGE) related abdominal pain and cramps. In this study HBB and paracetamol were compared for the treatment of abdominal pain and cramps related to acute gastroenteritis. Materials and methods: The study was conducted in a tertiary university hospital emergency department as a prospective, randomized-controlled, and double-blind study. Intravenous (IV) 1000 mg paracetamol and IV 20 mg hyoscine-N-butyl bromide (HBB) were used to treat abdominal pain and cramps related to AGE. Visual analogue scale (VAS) was used to evaluate the degree of abdominal pain before and after treatment. Results: HBB and paracetamol groups consisted of 123 and 158 cases respectively. In both groups, it was observed that the VAS score gradually decreased from the 0th hour to the 1st and 2nd hours (p0.05). No severe side effects were observed in any of the patients. Conclusion: HBB and paracetamol were used for symptomatic treatment in AGE patients presenting with abdominal pain and cramps. A significant reduction in pain and cramps was achieved in both patient groups. There was no difference between the two drugs in terms of treatment efficacy and side effects. IMC J Med Sci 2022; 16(1): 009. DOI: https://doi.org/10.55010/imcjms.16.007 *Correspondence: Hasan Gümüşboğa, Department of Emergency, Şehitkamil State Hospital, Gaziantep, Turkey, Posta code: 27500; Email: profhasan@hotmail.com; ORCID:0000-0003-2097-7102.

The paper presents a comprehensive review of the use of graphene to develop wearable temperature sensors. The detection of temperature over a wide range has been a growing interest in multidisciplinary sectors in the sensing world. Different kinds of flexible temperature sensors have been fabricated with a range of polymers and nanomaterials. With the additional attribute of wearable nature, these temperature sensors are used ubiquitously to determine the effect of physiochemical variations happening in the environment of the chosen biomedical and industrial applications. Graphene, owing to its exceptional electrical, mechanical, and thermal properties, has been extensively used for the development of wearable temperature sensors. The prototypes have been deployed with certain wireless communication protocols to transfer the experimental data obtained under both controlled environments and real-time scenarios. This paper underlines some of the significant works done on the use of graphene to fabricate and implement wearable temperature sensors, along with the possible remedial steps that can be considered to deal with the challenges existing in the current literature.

Abstract Background Practice guidelines provide clinicians direction for the selection of ambulatory ECG (AECG) monitors in the evaluation of syncope/collapse. However, whether patients’ understand differences among AECG systems is unknown. Methods and Results A survey was conducted of USA (n = 99), United Kingdom (UK)/Germany (D) (n = 75) and Japan (n = 40) syncope/collapse patients who underwent diagnostic AECG monitoring. Responses were quantitated using a Likert‐like 7‐point scale (mean ± SD) or percent of patients indicating a Top 2 box (T2B) for a particular AECG attribute. Patient ages and diagnosed etiologies of syncope/collapse were similar across geographies. Patients were queried on AECG attributes including the ability to detect arrhythmic/cardiac causes of collapse, instructions received, ease of use, and cost. Patient perception of the diagnostic capabilities and ease of use did not differ significantly among the AECG technologies; however, USA patients had a more favorable overall view of ICM/ILRs (T2B: 42.4%) than did UK/D (T2B: 28%) or Japan (T2B: 17.5%) patients. Similarly, US patient rankings for education received regarding device choice and operation tended to be higher than UK/D or Japan patients; nevertheless, at their best, the Likert scores were low (approximately 4.7‐6.0) suggesting need for education improvement. Finally, both US and UK/D patients were similarly concerned with ICM costs (T2B, 31% vs 20% for Japan). Conclusions Patients across several geographies have a similar but imperfect understanding of AECG technologies. Given more detailed education the patient is likely to be a more effective partner with the clinician in establishing a potential symptom‐arrhythmia correlation.

Abstract Background The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions. Methods The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay. Results Of 154 patients with undiagnosed exudative pleural effusion, 113 (73.37%) underwent pleural biopsy and drainage with VATS, while 41 (26.62%) underwent AVATS pleural biopsy. Sensitivity, specificity, positive predictive value and negative predictive value were 92, 100, 100, and 85.71% for VATS, and 83.3, 100, 100, and 78.9% for AVATS, respectively. There was no significant difference in diagnostic test performance between the groups, (p = 0.219). There was no difference in the rate of complications [15 VATS (13.3) versus 4 AVATS (9.8%), p = 0.557]. Considering additional pleural-based interventions, while pleural decortication was performed in 13 (11.5%) cases in the VATS group, no pleural decortication was performed in AVATS group, (p = 0.021). AVATS group was associated with shorter duration time of operation than VATS (22.17 + 6.57 min. Versus 51.93 + 8.85 min., p

Background: Rehospitalizations with acute coronary syndromes (ACSs) have declined over the last years, but there is a remaining need for potential further reduction of rehospitalization after ACS to determine the most predominant predictors that can guide strategies to reduce re-hospitalizations burden. Aim: This multi-center study aimed to evaluate the demographic, clinical characteristics, and medications of rehospitalized patients who suffered a new cardiac event in 12 months after admission due to ACS. Material and Methods: Patients age >18 years who have been hospitalized between November 1 2017, and April 1 2018, for ACS within12 months before the readmission for a new acute coronary event were enrolled. Results: The present study included a total of 628 (65.9% from Turkey) consecutive patients rehospitalized with ACS (ST-elevation myocardial infarction [STEMI], 23.0%; ACS without ST-elevation [NSTE-ACS], 76.9%) from 15 different countries. The majority of the rehospitalized patients were men (67.9%), and the mean age was 63.1 ± 12.53 years. 406 (64.6%) had typical, 209 (33.2%) of patients had atypical chest pain and 13 (2.07%) had not any chest pain complaint during readmission. 304 (48.41%) of patients were discharged from hospital earlier than 3 days and 107 (17.04%) of patients stayed more than 7 days. The subcategories of first index diagnosis were 227 (36.1%) STEMI; 401 (63.8%) NSTE-ACS. The mean time from index discharge to rehospitalization was 189.25 ± 118 days. 248 (39.4%) patients were re-hospitalized more than once after index discharge. The most common risk factors were diabetes mellitus (471, 75.0%). 175 (27.87%) of patients stopped taking medication before re-hospitalization. Most of the patients (69.4%) had multivessel disease. Conclusion: Several factors identify patients at higher risk of rehospitalization with ACS. Understanding and preventing these causes can prevent rehospitalization and improve their outcome.

As social media becomes increasingly ubiquitous, many events are recorded and released on social media platforms, including chemical weapon attacks. We develop an objective tool in order to evaluate brief and unstructured social media videos for analysing sarin exposure from a civilian medical pathology perspective. We developed and validated this new questionnaire using a standardized procedure that includes content domain specification, item pool generation, content validity evaluation, a pilot study, and assessment of reliability and validity. In total, 51 sarin attacks and 48 matched videos were analysed. Cronbach’s α for all 20 items was 0.75, which indicates adequate internal reliability. The test–retest reliability was 0.96, which indicates good internal reliability. The inter-observer intraclass correlation coefficient was 0.97. After verifying sampling adequacy with the Kaiser–Meyer–Olkin measure and the factorability of the items with Barlett’s test of sphericity, a factor analysis was performed. According to the principal axis factoring, a six-factor solution explained 51.86% of the total variance. The receiver-operating characteristic curve analysis showed that the Video Score Questionnaire has a sensitivity of 0.817, a specificity of 0.478, and an efficiency of 65.3. Therefore, the Video Score Questionnaire is reliable and valid for evaluating sarin attacks from brief and unstructured social media videos. Key points Chemical weapons are still used as a method of warfare. Social media videos are an important source of information. We developed a validated scale which can analyse sarin exposure in short and unstructured videos.

Abstract Background: Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA. Methods: This study was planned to be prospective, observational, and cross-sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I-II, and aged 18-70 years were included in the study. The demographic characteristics of patients were recorded. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA. Results: The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85 ± 14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (p < 0.05). The mean STAI score was found as 40.3 ± 13.8 in patients who dreamed during anesthesia. Conclusion: It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences.

Background: Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA. Methods: This study was planned to be prospective, observational, and cross-sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I−II, and aged 18−70 years were included in the study. The demographic characteristics of patients were recorded. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA. Results: The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85 ± 14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (p < 0.05). The mean STAI score was found as 40.3 ± 13.8 in patients who dreamed during anesthesia. Conclusion: It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences. Resumo: Justificativa: A ansiedade é um estado de preocupação causado pela expectativa de perigo externo ou interno. Consciência durante a anestesia (CDA) é a evocação imprevista da memória de eventos intra-anestésicos. O objetivo deste estudo foi determinar os fatores que afetam a ansiedade pré-operatória, a incidência de CDA e os níveis de ansiedade nos pacientes com antecedente de CDA. Método: O estudo foi planificado como prospectivo, observacional e transversal. Foram incluídos no estudo pacientes programados para septoplastia eletiva, admitidos ao ambulatório de anestesiologia entre Março de 2018 e Setembro de 2018, com classe funcional ASA I−II e faixa etária entre 18 e 70 anos. As características demográficas dos pacientes foram registradas. O Inventário de Ansiedade Traço-Estado (IDATE) foi utilizado para determinar a ansiedade durante a avaliação pré-operatória. Simultaneamente, o escore de consciência de Brice modificado foi usado para determinar CDA anterior. Resultados: Os escores de ansiedade dos pacientes que apresentaram CDA foram mais elevados do que de outros pacientes. A pontuação média do IDATE foi 40,85 ± 14,8 nos 799 pacientes que obedeceram aos critérios de inclusão do estudo. Quando os escores de ansiedade foram comparados, os escores foram maiores no sexo feminino do que no masculino (p < 0,05). O escore médio do IDATE encontrado foi 40,3 ± 13,8 nos pacientes que relataram sonhos durante a anestesia. Conclusão: É importante determinar no pré-operatório os níveis de ansiedade dos pacientes para evitar as complicações associadas. Ansiedade pré-operatória e a prevenção de CDA devem ser tratadas com abordagem multiprofissional. A CDA deve ser cuidadosamente investigada, avaliando-se as experiências vividas pelo paciente em anestesias pregressas.

The first aim of this paper was to determine the variability in the signal characteristics and psychoacoustic data of canister-type vacuum cleaners. Fifteen vacuum cleaners with different sound power levels, provided by the manufacturers, were selected as test units to calculate their acoustic and psychoacoustic parameters. The selection of the devices was based on an even distribution of the reported sound power levels. The investigated variability in the acoustic and psychoacoustic parameters on different vacuum cleaners was discussed to derive the common characteristics of canister-type vacuum cleaner noise. The derived common characteristics were compared with the those in the available literature on the noise generation mechanisms of vacuum cleaners. Based on these characteristics, prototypical vacuum cleaner noise was defined. The second aim of this paper was to understand the annoyance perception of vacuum cleaner noise. Annoyance assessments were obtained from two sets of listening experiments. The first listening experiment was conducted to find the correlates of annoyance evaluations. Loudness, sharpness and tonal components at lower and higher frequencies were found to be dominant correlates of vacuum cleaner noise annoyance estimations. In the second listening experiment, a possible interaction between loudness and sharpness was investigated in different listening test methods. The selected loudness and sharpness values for this experiment were consistent with the observed ranges in the first part. No significant interaction between loudness and sharpness was observed, although each separately correlated significantly positively with annoyance.

Businesses that want to keep pace with the change and time are establishing new departments. Through those departments the business can take decisions and actions rapidly and so that they can keep themselves updated. However, this situation can cause inconsistencies between managers and departments working with multi-departments such as hotel businesses in service industry. This paper provides an extensive literature review aiming to present and discuss models and methods of how the perceived service quality has been and should be studied and handled. By doing so this paper supports both academia, by providing a review of the service quality literature, and industry, by summarizing landmark studies that can be used as benchmark for daily operations and/or company strategies.

AIM: To analyze the clinical features and surgical outcomes of Duane retraction syndrome(DRS)patients.METHODS: The clinical data of 94 DRS patients were evaluated. Complete ophthalmic data including age, sex, laterality, the type of DRS, angle of deviation, abnormal head posture(AHP), globe retraction, overshoots and the type of surgical approach were recorded.RESULTS: The average age of patients was 15.4±9.18 years, and there were 78 males and 16 females. Unilateral and bilateral involvement were found in 87% and 13% of patients, respectively. In unilateral DRS patients, 65% left eyes predominance were observed. Of the 94 patients, 59.5% of the patients were type I, 29.7% of the patients were type II, 8.5% of the patients were type III and 2.1% of the patients were type IV. Most of the patients were 36(38%)esotropic and AHP over 10° was noted in 43(96%)patients, preoperatively. There were 40(43%)patients with overshoots which were more common in type II. Surgery was performed to 45(48%)patients.CONCLUSION: An excellent surgical outcome was obtained in 32(78%)patients that underwent horizontal rectus surgery and AHP improved in 24(53%)patients. Y-splitting and posterior tenon fixation of lateral rectus both have satisfactory outcomes in the presence of significant overshoots. Foster augmentation with vertical rectus transposition achieved optimal results in abduction limitation.

The employment of graphene for multifunctional uses has been a cornerstone in sensing technology. Due to its excellent electrochemical properties, graphene has been used in its pure and composite forms to detect target molecules over a wide range of surfaces. The adsorption process on the graphene-based sensors has been studied in terms of the change in resistance and capacitance values for various industrial and environmental applications. This paper highlights the performance of graphene-based sensors for detecting different kinds of domestic and industrial gases. These graphene-based gas sensors have achieved enhanced output in terms of sensitivity and working range due to specific experimental parameters, such as elevated temperature, presence of particular gas-specific layers and integration with specific nanomaterials that assist with the adsorption of gases. The presented research work has been classified based on the physical nature of graphene used in conjugation with other processed materials. The detection of five different types of gases, including carbon dioxide (CO2), ammonia (NH3), hydrogen sulphide (H2S), nitrogen dioxide (NO2) and ethanol (C2H5OH) has been shown in the paper. The challenges of the current graphene-based gas sensors and their possible remedies have also been showcased in the paper.

Introduction: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited cardiac ion channelopathy. The present study aims to examine the clinical characteristics, genetic basis, and arrhythmic outcomes of CPVT patients from China to elucidate the difference between CPVT patients in Asia and Western countries. Methods: PubMed and Embase were systematically searched for case reports or series reporting on CPVT patients from China until 19 February 2022 using the keyword: “Catecholaminergic Polymorphic Ventricular Tachycardia” or “CPVT”, with the location limited to: “China” or “Hong Kong” or “Macau” in Embase, with no language or publication-type restriction. Articles that did not state a definite diagnosis of CPVT and articles with duplicate cases found in larger cohorts were excluded. All the included publications in this review were critically appraised based on the Joanna Briggs Institute Critical Appraisal Checklist. Clinical characteristics, genetic findings, and the primary outcome of spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF) were analyzed. Results: A total of 58 unique cases from 15 studies (median presentation age: 8 (5.0–11.8) years old) were included. All patients, except one, presented at or before 19 years of age. There were 56 patients (96.6%) who were initially symptomatic. Premature ventricular complexes (PVCs) were present in 44 out of 51 patients (86.3%) and VT in 52 out of 58 patients (89.7%). Genetic tests were performed on 54 patients (93.1%) with a yield of 87%. RyR2, CASQ2, TERCL, and SCN10A mutations were found in 35 (71.4%), 12 (24.5%), 1 (0.02%) patient, and 1 patient (0.02%), respectively. There were 54 patients who were treated with beta-blockers, 8 received flecainide, 5 received amiodarone, 2 received verapamil and 2 received propafenone. Sympathectomy (n = 10), implantable cardioverter-defibrillator implantation (n = 8) and ablation (n = 1) were performed. On follow-up, 13 patients developed VT/VF. Conclusion: This was the first systematic review of CPVT patients from China. Most patients had symptoms on initial presentation, with syncope as the presenting complaint. RyR2 mutation accounts for more than half of the CPVT cases, followed by CASQ2, TERCL and SCN10A mutations.

The use of microbial cell culture a valuable tool for the biosynthesis of nanoparticles is considered a green technology as it is eco-friendly, inexpensive and simple. Here, the synthesis of nanosilver particle (AgNP) from the yeast, Saccharomyces cerevisiae, gram (+), Bacillus subtilis and gram (−), Escherichia coli was shown. In this field we are the first to study their the antimicrobial effects of the microorganisms mentioned above against pathogens and anticancer activity on MCF-7 cell line. Silver nanoparticles in the size range of 126–323 nm were synthesized extracellularly by the microorganisms, which have different cell structures. Optical absorption, scanning electron microscopy, and zetasizer analysis confirmed the silver nanoparticles formation. Antimicrobial activity of AgNPs was evaluated the minimum inhibition concentration and disc diffusion methods. AgNPs inhibited nearly 90% the growth of Gram-positive Listeria monocytogenes, Streptococcus pneumoniae and Gram-negative Haemophilus influenzae, Klebsiella pneumoniae, Neisseria meningitidis bacterial pathogens. Anticancer potentials of AgNPs were investigated by MTT method. The synthesized AgNPs exhibited excellent high toxicity on MCF-7 cells and had a dose-dependent effect on cell viability. Especially AgNP 2 eliminated 67% of the MCF-7 cells at the concentration of 3.125 μg/mL. We found that extracellular synthesis of nanoparticles from microbial culture may be ‘green’ alternative to physical and chemical methods from the point of view of synthesis in large amounts and easy process. Keywords: Antimicrobial activity, Cytotoxicity, Extracellular synthesis, Silver nanoparticle

Road traffic noise is one of the most prominent sources of urban noise pollution. Recently, as a result of the electrification of vehicles, lower noise levels are expected in urban areas at speeds below 50 km/h. The commonly used physical descriptor, the A-weighted sound pressure level, does not sufficiently characterize the perceived annoyance of either combustion engine or electric passenger car pass-by noises. Psychoacoustical descriptors are advantageous for characterization purposes. The objective of this study was to evaluate the perceived annoyance caused by the noise from internal combustion engine, electric, and hybrid passenger cars using psychoacoustical properties. To achieve this objective, the following steps were conducted. First, the binaurally recorded sounds of 40 cars from different brands with different motorization were presented to the subjects who indicated the intensity of their perceived annoyance on a quasi-continuous scale. Second, the signal and psychoacoustical properties of the recorded sounds were analyzed. Third, a new annoyance index was developed, based on annoyance judgments and signal and psychoacoustical properties, to characterize the annoyance caused by pass-by noises. One of the novel aspects of this study is the consideration of not only the pass-by sounds of the internal combustion engine passenger cars, but also the pass-by sounds of hybrid and electric passenger cars. An acceleration from idle to a target speed of 50 km/h was selected as a traffic pass-by situation, which differs from those considered in previous studies. The results of the study show that psychoacoustical properties, such as loudness, tonality, roughness, and fluctuation strength, are very useful to characterize the annoyance perception, which is caused by single passenger car pass-by sounds in the above mentioned traffic situation. The developed index, which is a weighted combination of chosen psychoacoustical properties, can be very useful for traffic planning and traffic noise prevention measures.

In the preschool period children develop rapidly in cognitive, social-emotional, physical, psycho-motor, language, and aesthetic areas. In this period, besides basic habits and skills, it is important for children to gain environmental awareness. Research shows that children are mostly affected by environmental problems. Yet, living in a clean and healthy world is a basic necessity for children. For this reason, it is possible that children can show a healthy development in all developmental areas and create a healthy future by establishing ecological balance through gaining environmental awareness during the preschool period for sustainability. Science and nature activities in the preschool education program play an important role in creating an environmental awareness of the children in this period as they include activities to acquire environmental awareness and provide important contributions to helping children gain environmental awareness for sustainability. The present study was conducted using a total of 80 students attending pre-school institutions in Konya province. The environmental pollution awareness scale was used as pre - test and post - test prepared by the researchers. The data was analyzed via the SPSS 18 program. As the post test scores of preschool students revealed, there was a significant difference for the experimental group with regard to environmental pollution awareness.

Medical therapy is recommended in various situations such as multiple cysts, high risk surgery , presence of small cyst and perioperative phase in the treatment of hydatid cyst. Present study was designed to determine the features of disseminated hydatid cyst cases, outcome of albendazole treatment , diagnosis and management of complications and patients outcome. Methods: 21 patients who had the diagnosis of hydatid cyst based on clinical, radiological, and pathological findings with multiple hydatid cyst in a single organ and/or more than one organ were retrospectively analyzed. The mean age was 34±17.9 (range, 7-71) and F/M was 17/4. Hydatid disease was detected as multiple cysts in the lung in four patients, as multiple cysts in the lung and pleura in one case, and as multiple organ involvement in 16 cases. The most common presentation was the involvement of both lung and liver. The most common symptom was cough. Four asymptomatic patients were detected during family screening. In six patients, Albendazole was started before the operation and the remainders were started after the operation. Cure was achieved in eight patients at the end of medical and/or surgical treatment. Convenient medical treatment with albendazole treatment in appropriately selected patients is an effective treatment option with minimal side effects in hydatid cyst disease. [Med-Science 2018; 7(4.000): 935-9]

Objective: This study aimed to evaluate the bilateral forehand circulation using a 64-channel multidetector computed tomography (MDCT) as a noninvasive method to define criteria for an upper extremity arterial anatomy and pathology prior to the use of arterial conduits. Materials and Methods: Fifty-five patients with coronary artery disease who underwent total arterial coronary artery bypass grafting (CABG) were randomly selected for this prospective study. MDCT angiography was performed for 110 examinations of forearm and hand arterial anatomy. Prior to MDCT, Allen tests were performed in all patients with a normal result, except four. Thirteen patients had diabetes mellitus (DM), 8 had peripheral artery occlusive disease, and 19 had a history of smoking. Results: All arteries, including axillary, ulnar artery (UA) and radial artery (RA), were clearly visualized in all patients. Upper extremity anatomical and pathological results were examined in 16 patients (29.1%). Severely calcified RA and/or UA were found in 6 patients who had a moderate renal failure. Nearly total occlusion of the RA was detected in another two patients. Focal intimal RA calcification was recorded in 1 female and 3 male patients. Ten patients who had severe calcification or intimal sclerosis of the upper extremity arteries had DM. The remaining patients had normal forehand arterial circulation. A persistent median artery with the absence of radial and ulnar arteries and a high bifurcation of RA from the brachial artery was detected as an anatomic variation in seven patients (12.7%). Conclusions: The major advantages of MDCT angiography are its non-invasiveness and the ability to detect calcific subadventitial plaques, which are difficult to diagnose using conventional angiography. MDCT may be used as a safe and non-invasive method to assess RA and UA prior to harvesting the upper limb artery. Preoperative imaging of forehand arteries is a means to avoid unnecessary forearm exploration or the use of an unsuitable arterial conduit in CABG operations, especially in patients with DM and moderate renal impairment.

Background To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections. Methods This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils). Results A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR ( r = −0.34) and CRP ( r = −0.20). Conclusion The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.

Flat panel loudspeakers are a promising alternative to conventional loudspeakers. In particular, quasi-omnidirectional radiation at higher frequencies is stressed as an advantage of these systems compared to conventional speaker systems. However, this advantage can also be considered a disadvantage. Compared to that from conventional speakers with a flat and smooth on-axis and off-axis response, this wide radiation from flat panel loudspeakers occurs with an inconstant directivity factor, which can cause coloration and unusual spatial artifacts. This paper investigated the root causes of inhomogeneous directivity by using numerical methods. Based on these analyses, specific prototypes with various damping layups were built to overcome this problem. The additional damping layer reduces the off-axis radiation without significantly reducing the pressure level in the listening window. This approach is simple, robust, inexpensive and effective for improving the directivity of flat panel loudspeakers.

Intrathoracic goiters are defined as the extension of the thyroid gland into the mediastinum. Superior Vena Cava (SVC) syndrome due to the compression of major vessels can be seen in these patients. Most cases of SVC syndrome occur as a complication of malignancy. A 75-year-old female, non-smoker, was admitted with complaints of the midline neck swell- ing for the past 45 years, mild puffiness of face, breathlessness on lying down and dry cough for last 5 years. On clinical examination, there was a massive grade IV thyromegaly. Neck computed tomography revealed a heterogeneous, hyper- trophic, nodular thyroid gland with multiple calcification and mediastinal extension with narrowed trachea. Intraoperatively, there was a huge retrosternal thyroid gland compression of the right brachiocephalic vein, the brachiocephalic trunk from behind the vessel and the right carotid artery along with the right internal jugular vein. Pathological examination showed a nodular colloid goitre without signs of malignancy. When SVC syndrome is secondary to benign thyroid disease, total thyroidectomy should be performed. [Arch Clin Exp Surg 2016; 5(4.000): 242-245]

Rectal bleeding, change in bowel habits, abdominal pain are cardinal symptoms of colorectal carcinoma. Otherwise, weight loss, fatigue and weakness do not suggest colorectal carcinoma. Carbohydrate antigen (CA) 19-9 level is higher in several malignancies, especially gastrointestinal malignancies, and some benign conditions. Herein, we present a patient who is referred to our clinic with the complaint of fatigue and significant CA 19-9 elevation, diagnosed as metastatic colorectal carcinoma. Presenting case highlights that CA 19-9 elevation might be the only finding of colorectal carcinoma in even patients with nonspecific complaints. [Med-Science 2016; 5(3.000): 914-8]

The low-frequency performance of exciter-driven flat-panel loudspeakers is technically challenging. The lower modal density results in high deviations in the frequency response, and dips of more than 20 dB are possible. This paper presents an alternative approach for optimizing the modal behavior through the additional air spring effect of an irregular shaped enclosure. The additional mode-dependent air compliance suppresses the panel’s anti-phase components, which minimizes dips in the frequency response and improves the response without adding mass to the system. The approach is analyzed with the measured and simulated results of a prototype. Furthermore, additional enclosure changes were made to visualize the influence of the air spring improved system.

In the present study, it could be shown that by integration of a piezoceramic transducer in a fiber-reinforced door side panel, a flat loudspeaker can be realized. Taking into account the given restrictions, the integration position has been identified, where the geometry decouples the vibrating membrane from the supporting surface. With the help of an acoustic finite-element simulation, the main design variables of the integration position were found and the relevant effects for sound radiation were made visible. The manufacturing of the test specimen with piezoceramic transducers was performed using vacuum-assisted resin infusion and the long fiber injection procedure. The effect on the real sound radiation behavior of the door side panel with a material-immanent loudspeaker was experimentally determined using laser scanning vibrometry and sound pressure measurements. The presented work shows, for the first time, the high potential of acoustic functionalization of lightweight structures during the manufacturing process for the realization of lightweight and space-saving loudspeakers in a production-ready process.

İşletmelerin iç kontrol sisteminde kritik yere sahip olan yönetim raporlama sistemleri, yöneticinin problemlere doğru ve zamanda yönelmesini sağlar. Bu durum işletmenin amaçlarına ulaşmasını destekleyecek sonuçlar doğurur. İşletmelerde yönetim raporlama sistemlerinin büyük bir kısmını sorumluluk muhasebesi oluşturur. Birçok firma sorumluluk raporlama sistemlerini işletme içindeki sorumluluk alanları etrafında yapılandırır. Sorumluluk muhasebesi; her bir sorumluluk merkezinin planları, bütçeleri, eylemleri ile fiili sonuçlarını ölçen bir sistemdir. Sorumluluk merkezleri için düzenlenen sorumluluk raporları genellikle finansal başarının ölçülmesine yöneliktir. İşletmelerde en sık rastlanan sorumluluk merkezleri maliyet, kar, yatırım ve gelir merkezleridir. Maliyet merkezleri, bütçelerle belirlenen limitlerde maliyet yönetimi yapabilme sorumluluğunda olan örgütsel birimlerdir.

Purpose: To report the management outcomes of diplopia in patients with blowout fracture. Materials and Methods: Data for 39 patients with diplopia due to orbital blowout fracture were analyzed retrospectively. The inferior wall alone was involved in 22 (56.4%) patients, medial wall alone was involved in 14 (35.8%) patients, and the medial and inferior walls were involved in three (7.6%) patients. Each fracture was reconstructed with a Medpore® implant. Strabismus surgery or prism correction was performed in required patients for the management of persistent diplopia. Mean postoperative follow up was 6.5 months. Results: Twenty-three (58.9%) patients with diplopia underwent surgical repair of blowout fracture. Diplopia was eliminated in 17 (73.9%) patients following orbital wall surgery. Of the 23 patients, three (7.6%) patients required prism glasses and another three (7.6%) patients required strabismus surgery for persistent diplopia. In four (10.2%) patients, strabismus surgery was performed without fracture repair. Twelve patients (30.7%) with negative forced duction test results were followed up without surgery. Conclusions: In our study, diplopia resolved in 30.7% of patients without surgery and 69.2% of patients with diplopia required surgical intervention. Primary gaze diplopia was eliminated in 73.9% of patients through orbital wall repair. The most frequently employed secondary surgery was adjustable inferior rectus recession and

The aim of the present study was to evaluate the impact of obstructive sleep apnoea syndrome (OSAS) and the effects of nasal continuous positive airway pressure (CPAP) on circulating ischaemia-modified albumin (IMA) concentrations. The study included 97 newly diagnosed OSAS patients and 30 nonapnoeic controls. Blood samples were obtained in the morning after polysomnography. After 3 months of CPAP treatment, 31 patients with moderate-severe OSAS were reassessed for serum IMA concentrations. Significantly higher serum IMA concentrations were measured in the OSAS group than in the control group [0.518±0.091 absorbance units (ABSU), 0.415±0.068 ABSU, P

Although lipomas are encapsulated benign tumors, systemic lipomatosis defines infiltrative nonencapsulated tumors resembling normal adipose tissue. Abdominal lipomatosis and intestinal lipomatosis are different clinicopathological entities with similar clinical symptoms. We describe here a case presenting with upper gastrointestinal bleeding from eroded submucosal lipoma at duodenum secondary to intestinal lipomatosis and abdominal lipomatosis.

47- year- old female patient presented in out-patient department in Afyon Chest Disease Hospital with dyspnea, cough and purulent sputum. She has been receiving regular inhaler β-agonist and corticosteroids with the diagnosis of asthma bronchial since childhood. However, the patient had a history of very often upper and lower respiratory tract infections. The patient did not smoke, drink alcohol, or use illicit drugs intravenously. She was currently on asthma medications.