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PID controller desggn and optimisation for cardiac pacemaker
No full textBu çalışmada, kardiyak pacemaker (kalp pili) sistemlerinde PID (Proportional-Integral-Derivative) kontrol parametrelerinin optimizasyonu amaçlanmıştır. Kalp pili sistemlerinin güvenilirliğini ve etkinliğini artırmak için PID denetleyici parametrelerinin optimize edilmesi kritik bir rol oynamaktadır. Optimizasyon sürecinde, çeşitli meta-sezgisel algoritmalar kullanılarak PID parametreleri üzerinde iyileştirmeler yapılmıştır. Bu algoritmalar arasında Parçacık Sürüsü Optimizasyonu (PSO), Genetik Algoritma (GA), Gri Kurt Algoritması (GWO), Sarhoş Adam Yürüyüşü (DWO), Karınca Kolonisi Optimizasyonu (ACO) ve Ziegler-Nichols yöntemi yer almaktadır. Ayrıca, pekiştirmeli öğrenme (Reinforcement Learning) yaklaşımı da kullanılarak sistemin öğrenme kapasitesi artırılmış ve PID parametrelerinin optimize edilmesinde yenilikçi bir yol izlenmiştir. Elde edilen sonuçlar, önerilen optimizasyon tekniklerinin geleneksel yöntemlerle kıyaslandığında sistemin performansını belirgin şekilde artırdığını ve daha hassas kalp pili kontrolü sağladığını göstermektedir. Bu çalışma, kardiyak pacemaker sistemlerinde PID kontrolünün optimizasyonu için etkili bir yaklaşım sunmakta olup, klinik uygulamalarda daha güvenilir ve verimli sonuçlar elde edilmesine katkıda bulunmayı hedeflemektedir.This study aims to optimize the PID (Proportional-Integral-Derivative) control parameters in cardiac pacemaker systems. Optimizing the PID controller parameters plays a critical role in enhancing the reliability and effectiveness of pacemaker systems. Various metaheuristic algorithms are employed to improve the PID parameters during the optimization process. These algorithms include Particle Swarm Optimization (PSO), Genetic Algorithm (GA), Grey Wolf Optimization (GWO), Drunkard's Walk Algorithm (DWO), Ant Colony Optimization (ACO), and the Ziegler-Nichols method. Additionally, Reinforcement Learning is applied to enhance the system's learning capability and introduce an innovative approach to optimizing PID parameters. The results show that the proposed optimization techniques significantly improve system performance compared to traditional methods, leading to more precise pacemaker control. This study provides an effective approach to optimizing PID control in cardiac pacemaker systems and aims to contribute to more reliable and efficient outcomes in clinical applications
Boundary value problems for bi-polyanalytic functions on the upper half plane
No full textIn this study, explicit solutions for certain boundary value problems in the upper half-plane are obtained. Various types of boundary conditions are examined in detail, and their effects on the solutions are analyzed. The solution methodology relies on higher-order Cauchy-Pompeiu representations, which are used to address boundary value problems for bi-polyanalytic functions and inhomogeneous Cauchy-Riemann equations. In this context, the solutions obtained extend classical boundary value problems, including the Schwarz, Dirichlet and Neumann problems, providing a more general framework for analyzing these equations. © 2025 Elsevier B.V., All rights reserved
Surgical and Non-surgical Treatments in Pleural Empyema
No full textObjective: Increasing number of patients are developing complicated pleural infection. We aimed at revealing the differences of treatment modalities performed in patients with empyema. Methods: Patients those had been diagnosed and treated for empyema were assessed in a retrospective design. For the definitive diagnosis of empyema, thoracentesis was made. We categorized the patients in two groups as therapeutic drainage (group 1) and open surgery (group 2). Results: A total of 360 patients, 57 of whom were women, were included. Tube drainage was applied to the patients in group 1, and therapeutic thoracentesis was applied to those not suitable for drainage. Patients who did not provide adequate drainage due to loculation were deloculated with fibrinolytic agent or video-assisted thoracoscopic surgery. In patients with advanced empyema with multiloculation and remarkable pleural thickening, which constituted group 2, decortication was performed by thoracotomy. Thoracoplasty was added in those who had insufficient lung volume. There were 292 (81.2%) patients in group-1 and 68 (18.8%) patients in group 2. In comparison of two groups, a significant difference was detected for lactate dehydrogenase (p<0.001) in pleural fluid and leukocyte count (p=0.05), hemoglobin (p=0.01), albumin (p=0.002), urea (p=0.3), and creatinine (p=0.21) levels in blood. The treatment results revealed no significant difference between three groups (recovered, sequelae changes, death), except for blood neutrophil count and antibiotic duration. Conclusion: Medical treatment plus therapeutic drainage therapy may be chosen as first treatment instead of open surgery in empyema
Care Dependency and Influencing Factors in Individuals Undergoing Peritoneal Dialysis|Periton Diyaliz Uygulanan Bireylerde Bakım Bağımlılığı ve Etkileyen Faktörler
No full textAim: This descriptive study was conducted to evaluate care dependency and the influencing factors among patients undergoing peritoneal dialysis treatment. Materials and Methods: The sample of the study consisted of 96 patients who were followed in the peritoneal dialysis clinic of a university hospital, met the inclusion criteria, and agreed to participate in the study. Data were collected using a Personal Information Form and the Care Dependency Scale. Results: The mean total score of the patients on the Care Dependency Scale was 76.20±12.98, indicating a high level of independence in care. All participants reported having received education about peritoneal dialysis, and 38.5% evaluated the quality of this education as good. Complications related to peritoneal dialysis that required hospitalization were reported by 42.7% of the patients. Additionally, 53.1% stated that they received support for peritoneal dialysis, with 39.6% indicating that this support was related to the preparation and continuation of the procedure. Conclusion: The findings suggest that care dependency among peritoneal dialysis patients is low and influenced by a variety of factors, including both physical and psychosocial components. These factors hold significant importance for nursing practice. Nurses can develop strategies in collaboration with patients and their families to reduce care dependency, focusing on education, individual and psychosocial support, promotion of physical activity, regular monitoring and evaluation, encouragement of independence and autonomy, and self-management skills. © 2025 Elsevier B.V., All rights reserved
Kolayda Malların Satın Alma Niyeti ve Kalite Algısı Üzerinde Tipik Ambalaj Tasarımı ve Tasarım Farkındalık Düzeyinin Etkisi
No full textBu çalışmanın amacı, kolayda mallarda ambalaj tasarım elemanlarından renk ve şekil uyaranlarının tipik olup olmamasının, tüketici satın alma niyeti ve kalite algısı üzerindeki etkisini araştırmaktır. Çalışmada ayrıca, tüketicilerin tasarım farkındalık düzeylerinin kolayda mallardaki tipik ve tipik olmayan ambalaj tercihiyle ilişkisi araştırılmaktır. Kısmi deneysel, kontrol gruplu son test, olarak tasarlanan araştırma, benzer demografik özelliklere sahip bir kontrol ve iki deney grubundan oluşan toplam 180 orta gelirli tüketici üzerinde gerçekleştirilmiştir. Deneyde tipik olarak belirlenen ve manipüle edilen, kolayda bir mal olan Türk kahvesinin ambalajına nitel bir ön çalışma sonucunda ulaşılmıştır; tipik olmayan ambalajlar ise yazarlar tarafından tasarlanmıştır. Çalışmanın sonunda, kolayda mallarda, ambalajın sahip olduğu renk ve şekil unsurlarının tipik olmasının tüketiciler tarafından daha olumlu yanıtlar uyandırdığı sonucuna varılmıştır. Ayrıca, tasarım farkındalık düzeyi yükseldikçe renk açısından tipik olmayan ambalajların satın alma niyetlerinde bir azalış tespit edilmiştir
Evaluation of autoimmune diseases in pediatric patients with type 1 diabetes mellitus
No full textAim: The incidence of other autoimmune diseases is higher in Type 1 Diabetes Mellitus (T1DM). Autoimmune thyroiditis and celiac disease often accompany T1DM.The aim of this study was to determine how frequently autoimmune thyroiditis and celiac disease occur at the time of diagnosis and during follow-up in T1DM pediatric patients. Material and Methods: Sixty pediatric patients were included in the study. As laboratory parameters, thyroid function tests (fT4, TSH), Anti-thyroid peroxidase antibody (a-TPO), serum thyroglobulin antibody (a-TG), tissue transglutaminase antibodies (TGA), islet cell antibody, anti insulin antibodies and HbA1c levels were evaluated. Results: The average diabetes duration of the patients was 3.8 +/- 3.2 years and the mean HbA1c value was 9.02% +/- 2.18. In the T1DM cases, 36 of the 60 patients (60%) tested positive for any of the DM antibodies. TPO antibodies were found to be positive in 18 of the 60 patients (30%). Of these 18 patients, 15 were female (83.3%) and 3 were male (16.7%). TPO antibody positivity was statistically higher in females. All patients with positive TPO antibodies were diagnosed with autoimmune thyroiditis. TG antibodies were found to be positive in 9 of the 60 patients (15%), 8 of whom were female (88.8%) and 1 was male (11.2%). Tissue transglutaminase IgA antibodies were positive in 6 of the 60 patients (10%). Three of these patients (all of whom were female) were diagnosed with celiac disease. Discussion: Our study suggested that children diagnosed with type 1 diabetes should be followed up in terms of autoimmune thyroiditis and celiac disease
Regulation of Gut Microbiota in Acute Ischemic Stroke Patients
No full textOBJECTIVES: There is a bidirectional relationship between stroke and infection, with stroke increasing susceptibility to infections and contributing to poorer clinical outcomes and higher mortality rates. Stroke-induced dysmotility, impaired gut barrier integrity, and systemic dissemination of resident gut microbiota have recently been implicated in the pathogenesis of poststroke infections. We hypothesize that early modulation of the gut microbiota within the first week of acute stroke may help prevent or mitigate post-stroke infections, mortality, and morbidity. METHODS: This prospective study was conducted between 2020 and 2024 and included patients with moderate-to-severe acute stroke who were monitored in the intensive care unit (ICU) for at least 4 weeks. Probiotic agents containing Saccharomyces Boulardii were administered to the study group either orally or through a nasogastric tube. National Institutes of Health Stroke Scale (NIHSS) scores, patient survival rates, and poststroke infections were recorded during the first month and compared with those of the control group, who were not given probiotics. RESULTS: The study group had significantly lower rates of poststroke infection and mortality ( P= 0.010 and P= 0.023, respectively). In addition, NIHSS scores were significantly higher in the control group ( P =0.032). Laboratory analyses revealed significantly higher neutrophil and platelet counts, C-reactive protein (CRP), and total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were also significantly higher in the control group ( P <0.05). CONCLUSION: This study demonstrated that probiotic administration may reduce the risk of poststroke infections, improve functional outcomes, and decrease both mortality and morbidity in patients with acute ischemic stroke. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicin
Search for high-mass resonances in a final state comprising a gluon and two hadronically decaying W bosons in proton-proton collisions at ?s=13 TeV
No full textA search for high-mass resonances decaying into a gluon, g, and two W bosons is presented. A Kaluza-Klein gluon, gKK, decaying in cascade via a scalar radion R, g(KK) -> gR -> gWW, is considered. The final state studied consists of three large-radius jets, two of which contain the products of hadronically decaying W bosons, and the third one the hadronization products of the gluon. The analysis is performed using proton-proton collision data at root s = 13TeV collected by the CMS experiment at the CERN LHC during 2016-2018, corresponding to an integrated luminosity of 138 fb(-1). The masses of the gKK and R candidates are reconstructed as trijet and dijet masses, respectively. These are used for event categorization and signal extraction. No excess of data events above the standard model background expectation is observed. Upper limits are set on the product of the gKK production cross section and its branching fraction via a radion R to gWW. This is the first analysis examining the resonant WW+jet signature and setting limits on the two resonance masses in an extended warped extra-dimensional model.FWF; FNRS; FWO (Belgium); CNPq; CAPES; FAPERJ; FAPERGS; FAPESP (Brazil); BNSF (Bulgaria); MoST; NSFC (China); CSF (Croatia); RIF (Cyprus); SENESCYT (Ecuador); ERC PRG [MoER TK202]; Academy of Finland; MEC; CEA; CNRS/IN2P3 (France); SRNSF; BMBF; DFG; HGF (Germany); NKFIH (Hungary); DAE; DST; IPM; SFI (Ireland); INFN (Italy); NRF (Republic of Korea); MES (Latvia); MOE; UM (Malaysia); BUAP; CONACYT; UASLP-FAI (Mexico); PAEC (Pakistan); FCT (Portugal); MESTD (Serbia); PCTI (Spain); MOSTR (Sri Lanka); Swiss Funding Agencies (Switzerland); NSTDA; TUBITAK; DOE; NSF; Marie-Curie program; European Research Council; Horizon 2020 Grant [675440, 724704, 752730, 758316, 765710, 824093, 101115353, 101002207]; COST Action [CA16108]; Leventis Foundation; Alfred P. Sloan Foundation; Alexander von Humboldt Foundation; Science Committee [22rl-037]; Belgian Federal Science Policy Office; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium); FWO (Belgium) under the Excellence of Science - EOS [30820817]; Beijing Municipal Science & Technology Commission [Z191100007219010]; Fundamental Research Funds for the Central Universities (China); Ministry of Education, Youth and Sports (MEYS) of the Czech Republic; Shota Rustaveli National Science Foundation [FR-22-985]; Deutsche Forschungsgemeinschaft (DFG) [EXC 2121, 390833306, 400140256 - GRK2497]; Hellenic Foundation for Research and Innovation (HFRI) [2288]; Hungarian Academy of Sciences [K 131991, K 133046, K 138136, K 143460, K 143477, K 146913, K 146914, K 147048, 2020-2.2.1-ED-2021-00181, TKP2021-NKTA-64]; Council of Science and Industrial Research, India; ICSC -National Research Center for High Performance Computing, Big Data and Quantum Computing - NextGenerationEU program (Italy); Latvian Council of Science; Ministry of Education and Science [2022/WK/14]; National Science Center [Opus 2021/41/B/ST2/01369, 2021/43/B/ST2/01552]; Fundacao para a Ciencia e a Tecnologia [CEECIND/01334/2018]; National Priorities Research Program by Qatar National Research Fund; ERDF a way of making Europe [MDM-2017-0765]; Programa Severo Ochoa del Principado de Asturias (Spain); National Science, Research and Innovation Fund via the Program Management Unit for Human Resources & Institutional Development, Research and Innovation [B39G670016]; Kavli Foundation; Nvidia Corporation; SuperMicro Corporation; Welch Foundation [C-1845]; Weston Havens Foundation (U.S.A.)We congratulate our colleagues in the CERN accelerator departments for the excellent performance of the LHC and thank the technical and administrative staffs at CERN and at other CMS institutes for their contributions to the success of the CMS effort. In addition, we gratefully acknowledge the computing centers and personnel of the Worldwide LHC Computing Grid and other centers for delivering so effectively the computing infrastructure essential to our analyses. Finally, we acknowledge the enduring support for the construction and operation of the LHC, the CMS detector, and the supporting computing infrastructure provided by the following funding agencies: SC (Armenia), BMBWF and FWF (Austria); FNRS and FWO (Belgium); CNPq, CAPES, FAPERJ, FAPERGS, and FAPESP (Brazil); MES and BNSF (Bulgaria); CERN; CAS, MoST, and NSFC (China); MINCIENCIAS (Colombia); MSES and CSF (Croatia); RIF (Cyprus); SENESCYT (Ecuador); ERC PRG, RVTT3 and MoER TK202 (Estonia); Academy of Finland, MEC, and HIP (Finland); CEA and CNRS/IN2P3 (France); SRNSF (Georgia); BMBF, DFG, and HGF (Germany); GSRI (Greece); NKFIH (Hungary); DAE and DST (India); IPM (Iran); SFI (Ireland); INFN (Italy); MSIP and NRF (Republic of Korea); MES (Latvia); LMTLT (Lithuania); MOE and UM (Malaysia); BUAP, CINVESTAV, CONACYT, LNS, SEP, and UASLP-FAI (Mexico); MOS (Montenegro); MBIE (New Zealand); PAEC (Pakistan); MES and NSC (Poland); FCT (Portugal); MESTD (Serbia); MCIN/AEI and PCTI (Spain); MOSTR (Sri Lanka); Swiss Funding Agencies (Switzerland); MST (Taipei); MHESI and NSTDA (Thailand); TUBITAK and TENMAK (Turkey); NASU (Ukraine); STFC (United Kingdom); DOE and NSF (U.S.A.). Individuals have received support from the Marie-Curie program and the European Research Council and Horizon 2020 Grant, contract Nos. 675440, 724704, 752730, 758316, 765710, 824093, 101115353, 101002207, and COST Action CA16108 (European Union); the Leventis Foundation; the Alfred P. Sloan Foundation; the Alexander von Humboldt Foundation; the Science Committee, project no. 22rl-037 (Armenia); the Belgian Federal Science Policy Office; the Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium); the F.R.S.-FNRS and FWO (Belgium) under the Excellence of Science - EOS - be.h project n. 30820817; the Beijing Municipal Science & Technology Commission, No. Z191100007219010 and Fundamental Research Funds for the Central Universities (China); the Ministry of Education, Youth and Sports (MEYS) of the Czech Republic; the Shota Rustaveli National Science Foundation, grant FR-22-985 (Georgia); the Deutsche Forschungsgemeinschaft (DFG), among others, under Germany's Excellence Strategy - EXC 2121 Quantum Universe - 390833306, and under project number 400140256 - GRK2497; the Hellenic Foundation for Research and Innovation (HFRI), Project Number 2288 (Greece); the Hungarian Academy of Sciences, the New National Excellence Program -UNKP, the NKFIH research grants K 131991, K 133046, K 138136, K 143460, K 143477, K 146913, K 146914, K 147048, 2020-2.2.1-ED-2021-00181, and TKP2021-NKTA-64 (Hungary); the Council of Science and Industrial Research, India; ICSC -National Research Center for High Performance Computing, Big Data and Quantum Computing and FAIR -Future Artificial Intelligence Research, funded by the NextGenerationEU program (Italy); the Latvian Council of Science; the Ministry of Education and Science, project no. 2022/WK/14, and the National Science Center, contracts Opus 2021/41/B/ST2/01369 and 2021/43/B/ST2/01552 (Poland); the Fundacao para a Ciencia e a Tecnologia, grant CEECIND/01334/2018 (Portugal); the National Priorities Research Program by Qatar National Research Fund; MCIN/AEI/10.13039/501100011033, ERDF a way of making Europe, and the Programa Estatal de Fomento de la Investigacion Cientifica y Tecnica de Excelencia Maria de Maeztu, grant MDM-2017-0765 and Programa Severo Ochoa del Principado de Asturias (Spain); the Chulalongkorn Academic into Its 2nd Century Project Advancement Project, and the National Science, Research and Innovation Fund via the Program Management Unit for Human Resources & Institutional Development, Research and Innovation, grant B39G670016 (Thailand); the Kavli Foundation; the Nvidia Corporation; the SuperMicro Corporation; the Welch Foundation, contract C-1845; and the Weston Havens Foundation (U.S.A.)
Is This Really Burnout? Speech and Language Therapists’ Perspective
No full textBackground: The World Health Organization defines burnout as ‘the syndrome of chronic workplace stress that cannot be successfully managed’. Due to daily contact with individuals having communication disorders and their families, along with stressful working conditions, professional devaluation, occupational overload and poor management, speech and language therapists (SLTs) are at risk of experiencing burnout. The burnout level of SLTs working with such client profiles and under such an intense workload is a matter of curiosity. Aim: This study aims to determine the burnout levels of Speech and Language Therapists in Türkiye and to investigate the related factors. Methods and Procedures: Consisting of 138 women and 29 men, a total of 167 SLTs participated in the study. Their responses to the Demographic Form and the Maslach Burnout Inventory (MBI) were analyzed using SPSS 22.0 software. Descriptive statistics, including mean, frequency, standard deviation and range, were employed to characterize the participants. To investigate the differences among the variables, independent groups t-tests, one-way analysis of variance (ANOVA) and post-hoc analyses (Tukey, LSD) were conducted. Outcomes and Results: The results indicate that the percentage of the SLTs with moderate-level burnout in the Emotional Exhaustion subscale was 43.1% while 62.3% were determined to have low-level burnout on the Depersonalization subscale. Furthermore, 74.9% of the participants reported low-level burnout on the Low Sense of Personal Accomplishment subscale. The factors identified to significantly impact burnout levels are gender, age, educational background, work setting, length of professional experience, monthly income and concerns about shifting jobs (p 0.05). Conclusions and Implications: Although the current study indicates that SLTs do not experience high levels of burnout, a potential risk is suggested. Therefore, it is crucial to raise awareness about burnout among SLTs and to implement preventive measures. WHAT THIS PAPER ADDS: What is already known on the subject The World Health Organization (WHO) defines burnout as “the syndrome of chronic workplace stress that is not successfully managed”. The addition of three items to the existing definition by WHO aims to raise awareness about burnout: the presence of feelings of energy depletion or exhaustion, increased mental distance from one's work or negative feelings towards one's career, and decreased professional productivity. Burnout among SLTs can be attributed to factors such as stressful working conditions, professional devaluation, occupational overload and poor management, as well as the challenges, relationships and expectations of clients and their families. Although there are some studies regarding burnout levels of SLTs and related factors, there is no study in Türkiye where the field of speech and language therapy is emerging. What this paper adds to existing knowledge A total of 43.1% of SLTs in Türkiye have a moderate level of Emotional Exhaustion. While 62.3% were determined to have low-level burnout on the Depersonalization, 74.9% reported low-level burnout on the Low Sense of Personal Accomplishment subscale. Gender, age, educational background, work setting, length of professional experience, monthly income and concerns about shifting jobs significantly impact the burnout levels. On the other hand, city, the number of workdays per week, the frequency of weekly assessments or therapy sessions, and the way of commuting to the workplace do not significantly influence burnout levels. What are the potential or actual clinical implications of this work? As a result of this research, the participant will be able to summarize the burnout levels of speech and language therapists, see the factors that lead to burnout, and gain awareness of this issue. Research and Highlight: Turkish SLTs are facing with moderate level of Emotional Exhaustion, low-level Depersonalization, and Low Sense of Personal Accomplishment. Gender, age, educational background, work setting, length of professional experience, monthly income, and concerns about shifting jobs significantly affect the burnout. Although it is found that SLTs in Türkiye do not experience high levels of burnout, it is vital to raise awareness about burnout, its consequences, and preventive measures. © 2025 Elsevier B.V., All rights reserved
The Therapeutic Effect of Flavan-3-Ols from Organic Extracts of Juniperus drupacea Fruit Against Elastase-Induced Chronic Obstructive Pulmonary Disease in Rats
No full textBACKGROUND/AIMS: Chronic obstructive pulmonary disease (COPD) is a common chronic airway disease with acute exacerbations of varying frequency that is the main cause of disease morbidity and mortality. The aim of this study was to investigate the utility of extracts rich in flavanol-3-ols (85-92%) from Juniperus drupacea (J. drupacea) fruit in the treatment of rats with porcine pancreatic elastase (PPE)-induced COPD. MATERIALS AND METHODS: Thirty female rats of the Wistar albino breed were randomly divided into four groups: control, PPE, PPE + methanol extract (ME), PPE + water extract. The emphysema in the lung tissues of rats and lymphocyte, [B-cells, cytotoxic T-lymphocyte, natural killer (NK) cells], cytokines [interleukin-8 (IL-8), IL-6, and tumor necrosis factor-alpha (TNF-?)], and blood gas values in blood samples were analyzed. RESULTS: It was observed that emphysema occurred rats after PPE exposure, and the number of inflammatory cells, except for NK-cells, and IL-6, IL-8, and TNF-? cytokines in their blood increased. Among the blood gas values, PaCO2 increased with emphysema, and PaO2 decreased. The rats with PPE-induced COPD showed a decrease in the number of B-cells and NK-cells as a result of treatment with J. drupacea fruit extracts. CONCLUSION: Our results showed that PPE application causes COPD, and water and ME as flavan-3-ols-rich J. drupacea fruit can protect against the development of elastase-induced lung injuries as an anti-inflammatory and antioxidant factor