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Investigation of the musculoskeletal and respiratory system factors affecting functional capasity in multiple sclerosis
No full textMultipl Skleroz (MS)'lu bireylerin fonksiyonel egzersiz kapasitelerinde azalma görülmektedir. Fonksiyonel egzersiz kapasitesinin değerlendirilmesi ve etkileyen faktörlerin belirlenmesi bireylerin fizyoterapi ve rehabilitasyon programlarının planlanmasında önemlidir. Bu çalışmanın amacı; MS'li bireylerin denge, Transversus Abdominis (TrA) kas aktivasyonu, gövde kas kalınlıkları, alt ekstremite kas kuvveti, kavrama kuvveti, üst ekstremite fonksiyonları, yorgunluk ve solunum kas kuvvetinin fonksiyonel kapasiteleri üzerine etkilerini incelemekti. Bu çalışmaya 44 MS'li ve 23 sağlıklı birey dahil edildi. Fonksiyonel kapasite 6 Dakika Yürüme Testi (6DYT), denge Mini Denge Değerlendirme Sistemler Testi (Mini DDST), TrA kas aktivasyonu basınçlı biofeedback cihazı, gövde kaslarının kalınlığı ultrason görüntüleme yöntemi, alt ekstremite kas kuvveti 5 Kere Otur Kalk Testi (5KOKT), kavrama kuvveti el dinamometresi, üst ekstremite fonksiyonları Multipl Skleroz'da Kol Fonksiyon Anketi (MSKFA), yorgunluk Yorgunluk Şiddet Ölçeği (YŞÖ) ve solunum kas kuvveti elektronik basınç transdüseri ile Maksimal İnspiratuar Basınç (MİP) ve Maksimal Ekspiratuar Basıncın (MEP) ölçülmesi ile değerlendirildi. 6DYT'de kat edilen toplam mesafe, Mini DDST toplam puanı, TrA kas aktivasyonu, TrA kasılma, sol taraf lumbal multifidus istirahat, dominant olmayan taraf eksternal oblik kasılma sırasında kas kalınlıkları, diyafram kalınlaşma oranı, 5KOKT, MİP, MİP% ve MEP% ölçüm sonuçları açısından gruplar arasında fark saptandı (p<0,05). Fonksiyonel egzersiz kapasitesi ile denge (r=0,511, p<0,001), TrA kas aktivasyonu (r=0,441, p=0,003), dominant taraf (r=0,455, p=0,002) ve dominant olmayan taraf (r=0,433, p=0,003) kavrama kuvveti, alt ekstremite kas kuvveti (r=-0,407, p=0,006), üst ekstremite fonksiyonları (r=-0,465, p=0,001) ve yorgunluk (r=-0,478, p=0,001) arasında orta derecede, ekspiratuar kas kuvveti (r=0,379, p=0,011) ile arasında ise zayıf derecede korelasyon bulundu. Basit doğrusal regresyon analizi sonucunda MS'li bireylerde denge, TrA kas aktivasyonu, alt ekstremite kas kuvveti, kavrama kuvveti, üst ekstremite fonksiyonları, yorgunluk ve ekspiratuar kas kuvvetinin hastaların fonksiyonel egzersiz kapasiteleri üzerine etkili olduğu belirlendi. Çoklu regresyon analizi sonucunda fonksiyonel egzersiz kapasitesi üzerine TrA kas aktivasyonu ve yorgunluğun anlamlı etkiye sahip olduğu ve kümülatif varyansın yaklaşık %42'sini anlamlı bir şekilde açıkladıkları belirlendi (Radj2=0,415). Bu çalışma MS'li bireylerde denge, TrA kas aktivasyonu, alt ekstremite kas kuvveti, üst ekstremite fonksiyonları, ekspiratuar kas kuvveti arttıkça ve yorgunluk şiddeti azaldıkça fonksiyonel egzersiz kapasitesinin arttığını gösterdi. MS'li bireylerde fonksiyonel egzersiz kapasitesine etki eden kas iskelet ve solunum sistemi faktörleri içinde yorgunluk ve TrA kas aktivasyonunun diğer değişkenlere göre daha etkili olduğu saptandı. MS rehabilitasyonu çok yönlü bütüncül bir yaklaşım olması nedeni ile birçok semptomun detaylı değerlendirmesini içerir. Fizyoterapistlerin MS'li bireylerin rehabilitasyon programlarını planlarken, gelişebilecek ikincil komplikasyonların önlenmesi ve günlük yaşam aktivitelerindeki bağımsızlığın sürdürülebilmesi için fonksiyonel egzersiz kapasitelerini geliştirmede diğer değişkenlerle birlikte özellikle TrA kas aktivasyonu ve yorgunluk yönetimine yer vermelerini önermekteyiz.Individuals with Multiple Sclerosis (IwMS) experience a decrease in functional exercise capacity. Evaluating functional exercise capacity and determining the affecting factors are significant for planning physiotherapy and rehabilitation programs of individuals. This study aimed to investigate the effects of balance, Transversus Abdominis (TrA) muscle activation, trunk muscle thickness, lower extremity muscle strength, grip strength, upper extremity function, fatigue, and respiratory muscle strength on the functional capacity of IwMS. This study included 44 IwMS and 23 healthy individuals. Functional capacity was assessed using the 6-Minute Walk Test (6MWT), balance using the Mini Balance Evaluation System Test (Mini BESTest), TrA muscle activation using a pressure biofeedback device, trunk muscle thickness using ultrasound imaging, lower extremity muscle strength using the 5-Repetition Sit-to-Stand Test (5TSST), grip strength using a hand dynamometer, upper extremity function using the Arm Function in Multiple Sclerosis Questionnaire (AMSQ), fatigue using the Fatigue Severity Scale (FSS), and respiratory muscle strength using an electronic pressure transducer to measure Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP). There were differences between the groups in terms of total distance covered in the 6MWT, total Mini BESTest score, TrA muscle activation, muscle thickness during TrA contraction, left lumbar multifidus rest, non-dominant side external oblique contraction, diaphragm thickening ratio, 5TSST, MIP, MIP%, and MEP% measurement results (p<0.05). A moderate correlation was found between functional exercise capacity and balance (r=0.511, p<0.001), TrA muscle activation (r=0.441, p=0.003), dominant side (r=0.455, p=0.002) and non-dominant side (r=0.433, p=0.003) grip strength, lower extremity muscle strength, (r=-0.407, p=0.006), upper extremity function (r=-0.465, p=0.001) and fatigue (r=-0.478, p=0.001), while a weak correlation was found between expiratory muscle strength and functional exercise capacity (r=0.379, p=0.011). As a result of simple linear regression analysis, it was determined that balance, TrA muscle activation, lower extremity muscle strength, grip strength, upper extremity function, fatigue, and expiratory muscle strength in IwMS influenced their functional exercise capacity. Multiple regression analysis revealed that TrA muscle activation and fatigue had a significant effect on functional exercise capacity and explained approximately 42% of the cumulative variance (R² = 0.415). This study demonstrated that functional exercise capacity increased in IwMS as balance, TrA muscle activation, lower extremity muscle strength, upper extremity function, and expiratory muscle strength increased, and fatigue severity decreased. Among the musculoskeletal and respiratory system factors affecting functional exercise capacity in IwMS, fatigue and TrA muscle activation were found to be more effective than other variables. MS rehabilitation is a multifaceted, comprehensive approach that involves a detailed assessment of many symptoms. We recommend that physiotherapists include particularly TrA muscle activation and fatigue management, along with other variables, in developing functional exercise capacities to prevent secondary complications and to maintain independence in daily living activities when planning rehabilitation programs for IwMS
Automated Lumbar Disc Intensity Classification From MRI Scans Using Region-Based CNNs and Transformer Models
No full textThis study explores the effectiveness of deep learning methodologies in the detection and classification of lumbar disc intensity using MRI scans. Initially, region-based deep learning frameworks, including Faster R-CNN and Mask R-CNN with different backbones such as ResNet50 and ResNet101 are evaluated. Results demonstrated that backbone selection significantly impacts model performance, with Mask R-CNN combined with ResNet101 achieving a remarkable [email protected] (AP50) of 99.83%. In addition to object detection models, Transformer-based classification architectures, including MaxViT, Vision Transformer (ViT), a Hybrid CNN-ViT model, and Fine-Tuned Enhanced Pyramid Network (FT-EPN), are implemented. Among these, the Hybrid model achieved the highest classification accuracy (83.1%), while MaxViT yielded the highest precision (0.804). Comparative analyses highlighted that while Mask R-CNN models excelled in segmentation and detection tasks, Transformer-based models provided effective solutions for direct severity classification of lumbar discs. These findings emphasize the critical role of both backbone architecture and model type in optimizing diagnostic performance. The study demonstrates the potential of integrating region-based and Transformer-based models in advancing automated lumbar spine assessment, paving the way for more accurate and reliable medical diagnostic systems
Emotions and Experiences of Pregnant Women with a History of Pregnancy Loss: A Qualitative Study Based on Watson's Theory of Human Caring
No full textObjective: This study aimed to determine the feelings and experiences of pregnant women with a history of pregnancy loss. Method: A semi-structured interview form based on Watson's caritas process was used to collect data from 13 pregnant women with a history of pregnancy loss between April and June 2020. Thematic analysis was performed according to Watson's caritas processes and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. Results: Pregnant women were found to expect respect, empathy, understanding, and smiling faces from healthcare professionals. In pregnancy after loss, the participants stated that they expected healthcare workers to be more sensitive to them and needed to talk to healthcare workers, share their feelings with them, and obtain more information. Conclusion: The use of interview methods based on Watson's theory of human caring can help guide health professionals and increase the quality of care
How should we go on after iatrogenic ureteral injuries during endoscopic stone surgery: Endourological or reconstructive approach
No full text[Abstract Not Available
An acute bout of foam rolling of the biceps brachii does not affect upper extremity sensorimotor function: a randomized trial
No full textPurpose: To investigate the effects of single session foam rolling of the biceps brachii on upper extremity sensorimotor function including elbow proprioception, strength, and functional motor performance in healthy individuals. Methods: Sixty healthy participants (mean age = 21.53 ± 2.80 years) were randomly assigned into the foam rolling group (FRG, n = 30) (mean age = 22.10 ± 2.98 years) (a single session of foam rolling to the biceps brachii muscle) or control group (CG, n = 30) (mean age = 20.97 ± 2.52 years) (no application). Proprioception [joint position sense (JPS) with an inclinometer, force sense (force reproduction) with a hand-held dynamometer], muscle strength (biceps brachii muscle strength with a hand-held dynamometer), and functional motor performance [modified pull-up (MPU) test, closed kinetic chain upper extremity stability (CKCUES) test, and push-up test] were evaluated. Evaluations were done before and immediately after the single session application in a pretest-posttest design. We used the Student t-test to investigate between-group differences and we used the ?2 test for dichotomous data for analyses. We determined the significance level as p 45°=0.70, p60°=0.80, p75°=0.09), force sense (p = 0.63), and muscle strength (p = 0.11) did not change after the single session of foam rolling (p > 0.05). Foam rolling did not affect the functional motor performance test (pCKCUES?average=0.78; pCKCUES?score=0.66; pCKCUES?power=0.89; pMPU=0.10; ppush?up=0.97) results (p > 0.05). Conclusions: Single session foam rolling of the biceps brachii has no effect on upper extremity sensorimotor function including elbow proprioception, strength, and upper extremity functional motor performance. Trial registration: Clinical Trials- NCT03516149 (Date: 24/04/2018) © 2025 Elsevier B.V., All rights reserved
On the Design of a Manufacturable Radome for Monostatic RCS Reduction for Airborne Platforms: Practical Implications of Frequency-Selective Surfaces
No full textReducing the radar cross section (RCS) of airborne platforms is essential for stealth and survivability in modern defense systems. Frequency-selective surfaces (FSSs) offer band-specific transmission and reflection characteristics. Thus, they are highly suitable for radome integration. However, most of the conformal FSS radome designs proposed in the literature rely on multilayered or geometrically complex configurations. Although these designs are effective, their fabrication cost is high, which limits their practical applicability. In this study, a conformal-bandpass FSS operating in the 8-12 GHz frequency range is proposed, emphasizing both electromagnetic efficiency and manufacturability. The unit cell was designed with a simple yet effective ring-patch geometry and optimized through full-wave simulations to ensure stable bandpass behavior. The structure was then integrated into a conical radome, and its performance was evaluated by conducting monostatic RCS simulations. In this way, the scattering characteristics of the FSS-based radome were analyzed. The results demonstrate that the FSS-based radome could consistently achieve lower RCSs across the desired spectrum. Therefore, the proposed design not only reduces radar visibility but also provides a scalable and cost-effective solution. We believe that it may offer a practical pathway for next-generation low-observable radome technologies
Investigation of titanium-reinforced polymer matrix nanocomposites fabricated by stereolithography for mechanical properties and activity in L929 cells
No full textPurposeThis research aims to the investigation of the effect of titanium nanoparticles as reinforcement material in polymer composites fabricated by stereolithography technique on mechanical properties and activity in L929 cells. Titanium reinforcement was used at 0.025, 0.05, 0.075 and 0.1% by weight.Design/methodology/approachVarious modelling and characterization methods were used. To examine the activity in L929 cells, five distinct three-dimensional models were drawn in the computer-aided design environment. The model with the highest surface area was selected for further fabrication. The activities in cells of the fabricated composites were determined by cell culture, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H tetrazolium bromide (MTT) assay and adenosine 5'-triphosphate (ATP) analyses. The structural and morphological properties were determined by X-ray diffraction spectroscopy, Fourier transform infrared spectroscopy, scanning electron microscopy and contact angle analyses. Tensile, three-point bending and hardness tests were used to determine mechanical properties.FindingsIncreasing titanium nanoparticle content enhanced mechanical properties. The composite samples with 0.1 Wt.% reinforcement demonstrated enhancements of up to 60% in flexural and tensile strengths and 23% in hardness values. In cell activities, it was determined that the composite sample containing 0.025 Wt.% reinforcement achieved the highest activity and energy production, with increases of up to 13% and 25% in both MTT and ATP analyses, respectively.Originality/valueThis research offers a novel perspective on the beneficial impact of using titanium nanoparticles as a reinforcement material in polymer composites fabricated by the stereolithography technique on the mechanical properties and L929 cell activities, thereby making an important and innovative contribution to the current knowledge in this field
Distributed detecting of critical nodes for maximization of connected components in wireless multi-hop networks
No full textIn Wireless Multi-hop Networks (WMhNs), nodes whose absence significantly weakens network connectivity or partitions the network into disconnected components are called critical nodes. This paper focuses on a critical node problem, the Maximizing the Number of Connected Components (MaxNum) problem, which aims to identify critical nodes whose removal maximizes the number of connected components. Although the MaxNum problem is a well-known NP-Hard problem with various real-world applications, no distributed algorithm has been proposed to solve it. To address this gap, we propose an efficient distributed algorithm for the MaxNum problem in WMhNs. The algorithm uses a distributed depth-first search tree to identify critical nodes, requiring a bit complexity of ( x x log2 ) and a space complexity of ( + ), where denotes the maximum node degree. We evaluated the proposed algorithm through simulations and testbed networks, comparing it to the Linear Programming (LP) approach. Our findings show that the proposed distributed algorithm achieves promising outcomes, reaching nearly 90% of the optimal solution while reducing data transmission to half of that required by the centralized LP.TUBITAK (Scientific and Technical Research Council of Turkey) [121F092]This research was supported by the TUBITAK (Scientific and Techni-cal Research Council of Turkey) [Project number 121F092] . N. Akram and Y. Aygul thank TUBITAK for their scholarship support under the BIDEB 2211-C and BIDEB 2211-A programs, respectively. We also would like to thank two anonymous reviewers for their constructive comments
Evolution of thoracic outlet syndrome research: A detailed bibliometric study
No full textAim: Thoracic outlet syndrome (TOS) is a complex clinical condition caused by the compression of neurovascular structures in the thoracic outlet. Over the past few decades, research on TOS has expanded significantly. This study aims to analyze the literature on TOS using bibliometric methods to identify critical trends, influential authors, prominent themes, and emerging topics in the field. Material and Method: A comprehensive literature search was conducted using the Web of Science (WoS) database for articles on TOS published between 1980 and 2023, employing the keyword 'thoracic outlet syndrome.' The collected data were analyzed using bibliometric methods. VOSviewer software was utilized to visualize bibliometric networks and map critical findings. Citation analysis was performed to identify influential journals and significant articles in the field. Additionally, keyword clustering and trend analyses were conducted to explore the thematic landscape of TOS research. Results: In a literature search on TOS, 2248 publications were found, with 1509 journal articles (67.13%) included in the bibliometric summary. The most common research area was surgery (633 articles, 41.94%), and the United States had the highest publication productivity (684 articles, 45.32%). The University of California System had the highest number of publications among institutions (62 articles, 4.1%). These 1509 articles received 7831 citations (6596 excluding self-citations), averaging 13.1 citations per article and with an h-index of 57. 'Annals of Vascular Surgery' published the most articles (71, 4.7%), while 'Journal of Vascular Surgery' had the highest number of cited articles (65, 4.3%), accumulating Aim: Thoracic outlet syndrome (TOS) is a complex clinical condition caused by the compression of neurovascular structures in the thoracic outlet. Over the past few decades, research on TOS has expanded significantly. This study aims to analyze the literature on TOS using bibliometric methods to identify critical trends, influential authors, prominent themes, and emerging topics in the field. Material and Method: A comprehensive literature search was conducted using the Web of Science (WoS) database for articles on TOS published between 1980 and 2023, employing the keyword 'thoracic outlet syndrome.' The collected data were analyzed using bibliometric methods. VOSviewer software was utilized to visualize bibliometric networks and map critical findings. Citation analysis was performed to identify influential journals and significant articles in the field. Additionally, keyword clustering and trend analyses were conducted to explore the thematic landscape of TOS research. Results: In a literature search on TOS, 2248 publications were found, with 1509 journal articles (67.13%) included in the bibliometric summary. The most common research area was surgery (633 articles, 41.94%), and the United States had the highest publication productivity (684 articles, 45.32%). The University of California System had the highest number of publications among institutions (62 articles, 4.1%). These 1509 articles received 7831 citations (6596 excluding self-citations), averaging 13.1 citations per article and with an h-index of 57. 'Annals of Vascular Surgery' published the most articles (71, 4.7%), while 'Journal of Vascular Surgery' had the highest number of cited articles (65, 4.3%), accumulating 2563 citations. Conclusion: This bibliometric analysis provides valuable insights into the evolution and trends of research on TOS. The keyword analysis offers a roadmap for researchers to design new studies. Additionally, the study highlights the influence of economic size and development levels on academic productivity in TOS, underscoring the importance of promoting multidisciplinary studies, especially in less developed countries.63 citations. Conclusion: This bibliometric analysis provides valuable insights into the evolution and trends of research on TOS. The keyword analysis offers a roadmap for researchers to design new studies. Additionally, the study highlights the influence of economic size and development levels on academic productivity in TOS, underscoring the importance of promoting multidisciplinary studies, especially in less developed countries.Tıbbi Kayıtlar Derneğ
Investigation of Eustachian Tube Dysfunction by Tubomanometry in Patients Undergoing Tympanoplasty for Chronic Otitis Media
No full textBACKGROUND: The eustachian tube is an anatomical structure that connects the nose, nasopharynx, middle ear, and mastoid air cells and has important functions. If the physiological functions of the eustachian tube are impaired, ear diseases may occur. There are many test methods used to evaluate the functions of the eustachian tube. However, none of these methods are accepted as the gold standard due to both the application difficulties of these methods and the reliability of their results. We aim to use tubomanometry for the detection of eustachian tube dysfunction (ETD) and so to increase the success rates of ear surgeries in patients diagnosed with tubal dysfunction with easily applicable methods. METHODS: In this prospective study, the tubomanometry results of 34 patients diagnosed with chronic otitis media who underwent tympa-noplasty were compared with 34 healthy controls. The tubomanometry measurements of patients diagnosed with chronic middle ear disease (affected ear side) and the control group (healthy ears) were compared. RESULTS: A statistically significant increase in mean rising time was found between the control group and the patient group at first month post-operative, sixth month postoperative (P < .01). In the control group, eustachian function was found to be normal (R < 1) compared with that of the all patient groups (P < .01, first month postoperative comparison P < .05). CONCLUSION: In the application of surgical methods used in the treatment of ETD, the ETD must first be determined with an objective test tool. According to the results of our study, one of the most objective tests that can be used in this regard is tubomanometry. © 2025, AVES. All rights reserved