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Securing and optimizing IoT offloading with blockchain and deep reinforcement learning in multi-user environments (vol 31, pg 3255, 2025)
No full textThe growth of the Internet of Things (IoT)-related innovations has resulted in the invention of numerous IoT objects. However,
the resource limitations of individual items remain a challenge that can be overcome through offloading. A key limitation of
previous research is the absence of an integrated offloading framework that can operate securely in offline/online environments. The security and calculated online/offline offloading issues in a multi-user IoT-fog-cloud system with blockchain are
investigated in this article at the same time. First, we provide a reliable access control system utilizing blockchain to enhance
offloading security. This technique can guard cloud resources against unauthorized offloading practices. Next, we define a
computation offloading issue by optimizing the offloading decisions, allocating computing resources and radio bandwidth,
and intelligent contract use to address the computation management of authorized mobile devices. This optimization challenge focuses on the long-term system costs of latency, energy use, and intelligent contract charge among all mobile devices.
We create a new Deep Reinforcement Learning (DRL) technique employing a double-dueling Q-network to address the suggested offloading problem. We provide a Markov Decision Process (MDP)-based DRL solution to the IoT offloading-enabled
blockchain dilemma. The supposed system works in both online and offline settings, and when operating online, we use the
Post Decision State (PDS) method. The contributions of this work include a new integrated offloading framework that can
operate in offline/online environments while preserving security and a novel approach that incorporates fog platforms into
IoT blockchain-enabled networks for improved system efficiency. Our method outperforms four benchmarks in cost by 5.1%,
computational overhead by 4.1%, energy use by 3.3%, task failure rate by 3.6%, and latency by 3.9% on average
Multiple Sklerozlu bireylerde kognitif fonksiyonların fonksiyonel performans, yorgunluk, kinezyofobi ve fiziksel aktivite düzeyi ile ilişkisi
Get PDFGiriş-Amaç: Multiple skleroz (MS) santral sinir sistemin (SSS) inflamatuar, demiyelinizasyon ve plaklarla karakterize nörodejeneratif hastalığıdır. Plakların yaygınlığı ve lokalizasyonu MS'te semptom tablosunu çeşitlendirmektedir. MS'te kognitif bozukluklar sıklıkla bilişsel işlem hızı ile ilişkilidir. Motor fonksiyonlardaki azalmanın kognitif fonksiyonlardaki bozuklukların belirteçlerinden olduğunu gösteren çalışmalar mevcut olsa da MS'de gelişen kognitif fonksiyonlardaki bozuklukların etiyopatogenezi tam olarak aydınlatılamamıştır. Bu nedenle çalışmamızın amacı MS'li bireylerde kognitif fonksiyonların fonksiyonel performans, yorgunluk, kinezyofobi ve fiziksel aktivite düzeyi ile ilişkisini incelemektir. Gereç ve Yöntem: Çalışmamız Özel Bingöl Özel Eğitim ve Rehabilitasyon Merkezi'ne yönlendirilen ve dahil edilme kriterlerini karşılayan 40 MS tanılı ve 40 sağlıklı birey ile gerçekleştirildi. Katılımcılar MS ve kontrol grubu şeklinde ikiye ayrıldı. Tüm katılımcıların sosyodemografik verileri demografik bilgi formu ile, kognitif fonksiyonları Montreal Bilişsel Değerlendirme (MOBİD) ve İz Sürme Testi (İST A-B formu), fonksiyonel performans; 6 dakika yürüme testi (6DYT), 30 Saniye Otur Kalk Testi (30-sn OKT), Zamanlı Kalk Yürü Testi (ZKYT) ile; yorgunluk, Yorgunluk Şiddet Ölçeği (YŞÖ) ile kinezyofobi; Tampa Kinezyofobi Ölçeği (TKÖ) ve fiziksel aktivite ise Uluslararası Fiziksel Aktivite Anketi Kısa Form (UFAA-KF) ile değerlendirildi. Verilerin analizinde SPSS 16.0 paket programı kullanıldı. X2-testi ile niteliksel değişkenlerin analizi yorumlandı. Verilerin gruplar arasındaki fark değerleri, veriler normal dağılıma uygun olanlar Independent Sample T test, normal dağılıma uygun olmayanlar ise Mann Whitney U testi ile değerlendirildi. Sağlıklı katılımcıların verileri ile karşılaştırmak için One Sample T testi kullanıldı. Veriler arasındaki ilişki değerlendirmesi, Pearson veya Spearman korelasyon testi ile değerlendirildi. İstatistiksel olarak anlamlılık p<0,05 olarak kabul edildi. Bulgular: Çalışmamızda gruplar arası karşılaştırmada çalışma durumu, MOBİD (p<0.002), İST A-B (p<0.001) değerlerinde, 6DYT VAS (p<0.001), dispne (p<0.001), yorgunluk (p<0.001) skorları hem başlangıç hem de bitiş değerlerinde , yürüme mesafesinde (p<0.001); 30-sn OKT (p<0.001), ZKYT (p<0.001), yorgunluk (p<0.001), kinezyofobi (p<0.001), UFAA-KF toplam puan (MET-dk/hafta) (p=0.035) ve fiziksel aktivite düzeylerinde (p=0.041) istatistiksel olarak anlamlı farklılık saptandı. MOBİD ile 6DYT yürüme mesafesi (r=0.405, p=0.035), 30-sn OKT (r=0.401, p=0.048), YŞÖ (r=-0.550, p=0.032) ve UFAA-KF (MET-dk/hafta) (r=0.495, p=0.047) arasında; İST A-B ile 6DYT yürüme mesafesi (A: r=0.465, p=0.045; B: r=0.420, p=0.039) ve 30-sn OKT (A: r=0.410, p=0.038; B: r=0.405, p=0.045) arasında istatistiksel olarak anlamlı ilişki bulundu. Sonuç: Sonuçlarımız, MS hastalarında kognitif fonksiyonlardaki bozulmaların fonksiyonel performans düşüşü, artmış yorgunluk seviyeleri, yüksek kinezyofobi ve azalmış fiziksel aktivite düzeyleri ile anlamlı derecede ilişkili olduğunu göstermiştir. MS hastalarında kognitif fonksiyonların kapsamlı bir şekilde değerlendirilmesinin, kişiselleştirilmiş rehabilitasyon programlarının geliştirilmesinde ve fiziksel ile psikolojik iyilik halinin artırılmasında önemli bir role sahip olduğunu göstermektedir. Anahtar kelimeler: Fiziksel aktivite, fonksiyonel performans, kinezyofobi, kognitif fonksiyon, Multiple skleroz, yorgunlukIntroduction-Purpose: Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system (CNS) characterized by inflammation, demyelination and plaques. The prevalence and localization of plaques diversify the symptom picture in MS. Cognitive impairments in MS are often associated with cognitive processing speed. Although studies show that decreased motor function is a marker of impaired cognitive function, the etiopathogenesis of cognitive impairment in MS has not been fully elucidated. Therefore, our study aimed to examine the relationship between cognitive functions and functional performance, fatigue, kinesiophobia and physical activity level in individuals with MS. Materials and Methods: Our study was conducted with 40 individuals diagnosed with MS and 40 healthy individuals referred to Bingol Special Education and Rehabilitation Center and met the inclusion criteria. Participants were divided into two groups MS and control group. Sociodemographic data of all participants were obtained using the demographic information form, cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) and Trail Making Test (TMT A-B form), functional performance; 6-minute walk test (6MWT), 30-second Sit to Stand Test (30-sSTST), Timed up and Go test (TUG), fatigue; Fatigue Severity Scale (FSS), kinesiophobia; Tampa Kinesiophobia Scale (TSK) and physical activity; International Physical Activity Questionnaire Short Form (IPAQ-SF). SPSS 16.0 package program was used for data analysis. The analysis of qualitative variables was interpreted with X2-test. The difference values of the data between the groups were evaluated with the Independent Sample T test if the data were suitable for normal distribution and the Mann-Whitney U test if the data were not suitable for normal distribution. One Sample T test was used for comparison with the data of healthy participants. The relationship between the data was evaluated by Pearson or Spearman correlation test. Statistical significance was accepted as p<0.05. Results: In our study, employment status, MoCA (p<0.002), IST A-B (p<0.001) values, 6MWT VAS (p<0.001), dyspnea (p<0.001), fatigue (p<0.001) scores both at baseline and end, walking distance (p<0.001); 30-s STST (p<0.001), TUG (p<0.001), fatigue (p<0.001), kinesiophobia (p<0.001), IPAQ-SF total score (MET-min/week) (p=0.035) and physical activity levels (p=0.041). MoCA was correlated with 6MWT walking distance (r=0.405, p=0.035), 30-s STST (r=0.401, p=0.048), FSS (r=-0.550, p=0.032) and IPAQ-SF (MET-min/week) (r=0.495, p=0. 047), and statistically significant correlations were found between TMT A-B and 6MWT walking distance (A: r=0.465, p=0.045; B: r=0.420, p=0.039) and 30-s STST (A: r=0.410, p=0.038; B: r=0.405, p=0.045). Conclusion: Our results showed that impairments in cognitive function in MS patients were significantly associated with decreased functional performance, increased fatigue levels, increased kinesiophobia, and decreased physical activity levels. This suggests that a comprehensive assessment of cognitive functioning in MS patients has an important role in developing personalized rehabilitation programs and improving physical and psychological well-being. Keywords: Physical activity, functional performance, kinesiophobia, cognitive function, Multiple sclerosis, fatigu
Accuracy and safety of ChatGPT-4o responses in rhinoplasty postoperative counseling: a panel-based study
No full textBackgroundChatGPT and other large language models have emerged as new tools for patient education, yet their clinical safety and reliability remain unclear.ObjectiveTo assess the accuracy and safety of ChatGPT-4o's responses to common postoperative questions following rhinoplasty.MethodsTen consensus-based postoperative questions were identified via a modified Delphi process. ChatGPT-4o responses were generated and evaluated by three independent otolaryngologists using a 10-point Likert scale. Reviewers also assessed the presence of critical errors.ResultsThe average Likert score across responses was 8.87 (95% CI, 8.39 to 9.34), No critical errors were detected. Inter-rater reliability was high (ICC(2,k) = 0.876).ConclusionsChatGPT-4o provided clinically accurate and safe answers to common rhinoplasty postoperative questions.SignificanceThese findings suggest that ChatGPT-4o may serve as a useful adjunct for postoperative patient counseling in structured settings, particularly when physician access is limited
Evaluation of Four Different Adhesive Systems' Bonding Strength Between Superficial and Deep Dentin
Get PDFThe success of adhesive restorations largely depends on the optimal bond strength between the tooth structure and the restorative material. The aim of this study was to evaluate the shear bond strength (SBS) of four different adhesives applied to mandibular molars on deep and superficial dentin. The total of 56 teeth used in the study were randomly divided into 2 subgroups of superficial dentin and deep dentin participants (n = 28). Superficial and deep dentin groups were randomly divided into 4 subgroups (n = 7) for application with different adhesive agents. We formed the following groups: Group 1 (G1)-deep dentin and GC bonding agent (G-Premio BOND); Group 2 (G2)-superficial dentin and GC bonding agent; Group 3 (G3)-deep dentin and Clearfil S3 bond bonding agent (Clearfil TM S3 BOND); Group 4 (G4)-superficial dentin and Clearfil S3 bond bonding agent; Group 5 (G5)-deep dentin and KerrOptibond bonding agent (KerrOptibondTM Universal); Group 6 (G6)-superficial dentin and Kerr Optibond bonding agent; Group 7 (G7)-deep dentin and 3M-ESPE universal bonding agent (3M ESPE); Group 8 (G8)-superficial dentin and 3M-ESPE universal bonding agent. The silicone block with a diameter of 3 mm and a thickness of 1 mm was placed in the middle of the occlusal surface and the test composite was loaded. All prepared specimens were aged in thermal cycles at 5-55 degrees C for 5000 cycles. The teeth were subjected to SBS (shear bond strength) tests at a crosshead speed of 1 mm/min in a universal testing machine. In all adhesive systems, deep dentin showed a higher bond strength than superficial dentin and the bond strength value was statistically significant (p = 0.05). The bond strength in all tested adhesive systems was observed to be significantly higher in deep dentin than in superficial dentin
Evaluation of Thrombomodulin, Heart-Type Fatty-Acid-Binding Protein, Pentraxin-3 and Galectin-3 Levels in Patients with Myocardial Infarction, with and Without ST Segment Elevation
No full textBackground: Medical history, ECG findings and cardiac markers are used in the diagnosis of myocardial infarction (MI). Biomarkers used especially for the diagnosis of MI include high-sensitivity troponins (hsTns), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), myoglobin, cardiac myosin-binding protein C and new cardiac biomarkers. This study evaluated the levels of serum thrombomodulin (TM), heart-type fatty-acid-binding protein (H-FABP), pentraxin-3 (PTX-3) and galectin-3 (Gal-3) to determine their utility in distinguishing between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Methods: This study included a total of 180 patients (90 patients with acute STEMI and 90 patients with NSTEMI) who presented to the Gaziosmanpa & scedil;a Training and Research Hospital, Cardiovascular Surgery and Emergency Department, with ischemic chest pain lasting longer than 30 min. Ninety healthy volunteers were included as the control group. Results: Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), TM, H-FABP, PTX-3 and Gal-3 were significantly different across the STEMI, NSTEMI and control groups (p < 0.001). Strong positive correlations were observed between NT-proBNP and TM, H-FABP, PTX-3 and Gal-3 in the STEMI group. ROC analysis demonstrated excellent diagnostic accuracy for these biomarkers in distinguishing STEMI from NSTEMI and control groups. Conclusions: Vascular inflammation plays an important role in the pathophysiology of STEMI and NSTEMI. A comprehensive cardiac biomarker panel enhances diagnostic accuracy and risk stratification, particularly when distinguishing between STEMI and NSTEMI. The biomarkers hs-TnI, CK-MB, NT-proBNP, TM, H-FABP, PTX-3 and Gal-3 offer complementary information when used together as a panel. Further research and validation are essential to establish standardized protocols for their widespread use
Clinical and radiographic evaluation of two different apexification protocols in traumatized immature permanent incisors
No full textBACKGROUND: Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques. METHODS: Forty-one patients aged between 7 and 12 years with traumatized immature permanent maxillary incisors were included in the study. These patients were divided into two groups: those who had previously received endodontic treatment and those who had not. Twenty-four patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (Group 1). Seventeen patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (Group 2). The patients were followed for a period of 24 months. Clinical success rates were evaluated, and pre-treatment and control radiographs were analyzed to calculate the percentage increase in root dentin width and root length. RESULTS: After 24 months of follow-up, positive periapical healing was detected in the radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in assessing the effectiveness of the chosen methods. CONCLUSION: The revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma
Video Head Impulse Test in Children-A Systematic Review of Literature
No full textBackground and Objectives: The video head impulse test is a landmark in vestibular diagnostic methods to assess the high-frequency semicircular canal system. This test is well established in the adult population with immense research since its discovery. The usefulness and feasibility of the test in children is not very well defined, as research has been limited. This systematic review investigated and analysed the existing evidence regarding the test. The objectives were to derive meaningful inferences in terms of the feasibility, implementation, and normative vestibulo-ocular reflex (VOR gain) in normal children and in children with vestibular hypofunction. Methods: Research repositories were searched with keywords, along with inclusion and exclusion criteria, to select publications that investigated the vHIT in both a normative population of children as well as in pathological cohorts. The average normal VOR gain was then calculated in all semicircular canals for both the normal and the vestibular hypofunction groups. For the case-control studies, a meta-analysis was performed to assess the heterogeneity and pooled effect sizes. Results and Discussion: The review analysed 26 articles that included six case-control studies fulfilling the study selection criteria, out of more than 6000 articles that have been published on the vHIT. The described technique suggested 10-15 head impulses at 100-200 degrees/s head velocity and 10-20 degrees displacement fixating on a wall target 1 to 1.5 m away. The average VOR gain in the lateral semicircular canals combining all studies was 0.96 +/- 0.07; in anterior semicircular canals, it was 0.89 +/- 0.13, and for posterior semicircular canals, it was 0.9 +/- 0.12. The normal VOR gains measured with individual equipment (ICS Impulse, EyeSeeCam and Synapsys) in the lateral semicircular canals were largely similar (p > 0.05 when ICS Impulse and EyeSeeCam were compared). The pooled effect size in the control group was 1, and the heterogeneity was high. It was also observed that implementing the test is different from that in adults and requires considerable practice with children, factoring in the issue of peripheral and central vestibular maturation. Special considerations were suggested in terms of the pupillary calibration, goggle fitting, and slippage and play techniques. Conclusions: The vHIT as a diagnostic test is possible in children with important caveats, practice, and knowledge regarding a developing vestibular system. It yields significantly meaningful inferences about high-frequency semicircular canal function in children. Adult norms should not be extrapolated in children, as the VOR gain is different in children
Albumin-based nanocarriers loaded with novel Zn(II)-thiosemicarbazone compounds chart a new path for precision breast cancer therapy
No full textThis study explores the therapeutic potential of albumin-bound Zn(II)-thiosemicarbazone compounds (Alb-ZnTcA, Alb-ZnTcB) against breast cancer cells. Previous research indicates that these compounds hinder cancer cell proliferation by blocking DNA synthesis, promoting oxidative stress to induce apoptosis, and disrupting the cell cycle to inhibit cellular division. This study focuses on the loading and characterization of these potentially chemically unstable compounds on bovine serum albumin-based nanocarriers. Accordingly, unlike previous studies using albumin nanoparticles, in this study, ultraviolet light was used to precisely bind the therapeutic agent to albumin during the integration of thiosemicarbazones, achieving controlled nanoparticle size to control nanoparticle size. The mean diameter of Alb-ZnTcA nanoparticles was 32 nm, while Alb-ZnTcB exhibited an average diameter of 43 nm. Notably, Alb-ZnTcA displayed the highest cytotoxicity toward breast cancer cells, suggesting an optimal size for cellular uptake. Additionally, albumin-bound compounds showed enhanced cytotoxicity at lower concentrations, potentially minimizing adverse side effects. Apoptosis analysis indicated that both Alb-ZnTcA and Alb-ZnTcB induce cell death predominantly through apoptosis, effectively preventing the uncontrolled proliferation of cancer cells. These findings demonstrate the potential of Zn(II)-thiosemicarbazone compounds loaded on albumin-based nanocarriers for breast cancer treatment. The increased potency of Alb-ZnTcA and Alb-ZnTcB compared to free compounds, along with their ability to activate apoptotic signaling pathways in MCF-7 breast cancer cells, highlights a promising approach for future cancer therapies. This study suggests that albumin-bound Zn(II)-thiosemicarbazone compounds could offer a targeted and effective strategy in breast cancer treatment, leveraging the advantages of nanocarrier-based delivery systems
Terminally Ill Patients: Self-Care Abilities and Compassion in Nurses and Informal Caregivers
No full textBackground: Palliative care units are centers where comprehensive care is provided, primarily by nurses, but also by informal caregivers who are usually the patients' relatives. The difference is that nurses fulfill this duty professionally, and their levels of self-care and compassion are not expected to be affected by their work. In this regard, comparing the levels of compassion and self-care in patients' relatives and nurses will provide evidence to help raise awareness and support both groups. Aims: This study aimed to determine the relationship between the self-care abilities and compassion of nurses and informal caregivers. Design: This was a descriptive, cross-sectional study. Settings/Participants: The study was conducted between August 2023 and July 2024 in palliative care units in Istanbul. A total of 98 nurses and 96 informal caregivers participated in the study. They were administered the Exercise of Self-Care Agency Scale and the Compassion Scale. Results: The mean compassion scores of the informal caregivers and nurses were high, with no significant difference (P > .05). However, a significant difference was observed in their self-care ability scores, with nurses scoring lower in self-care compared to informal caregivers (P < .05). Conclusions: Nurses working in palliative care had a similar level of compassion as the primary relatives of the patients. However, it is concerning that the nurses had less ability to engage in self-care than the informal caregivers. This result indicates that nurses need support to enhance their self-care
A cross-sectional assessment of oral health status and hygiene practices of the Turkish population following the 2023 Turkiye-Syria earthquakes
Get PDFBackground Natural disasters such as earthquakes disrupt not only access to basic healthcare but also routine health behaviors. Despite its relevance to overall health, oral care is often neglected in postdisaster public health responses. This study investigated oral hygiene practices and access to dental care among individuals residing in temporary shelters following the 2023 Turkiye-Syria earthquakes. Methods A cross-sectional study was conducted with 401 participants residing in a container city in Turkiye approximately 10 weeks postdisaster. The questionnaire collected data on sociodemographic variables, pre- and postdisaster oral hygiene practices, access to oral hygiene products, and the presence of orodental trauma related to the earthquake, while routine dental screenings were conducted to assess oral health status via the Decayed-Missing-Filled Teeth (DMF-T) index and the Simplified Oral Hygiene Index (OHI-S). Results Seventeen participants reported earthquake-related orodental trauma. While 32.4% of the participants regularly brushed their teeth before the earthquake, 92.3% reported disruption postdisaster. Toothbrush availability was 84.8%, yet interdental cleaning tool ownership remained below 2%. The mean DMFT score was 11.19 +/- 8.58; the mean OHI-S score was 3.22 +/- 1.40. Females and participants with toothbrush access had significantly better oral hygiene scores (p < 0.001). The number of remaining teeth was inversely associated with all other clinical indices (p < 0.001). Conclusion The earthquake significantly disrupted oral hygiene routines and limited access to oral care tools, particularly for those who previously maintained regular habits. These findings highlight the need for postdisaster oral health support and resource distribution to mitigate long-term public health consequences and suggest that emergency relief packages should also include provisions that help maintain oral hygiene practices following disasters