Emphysema is a progressive and irreversible disease, proceeding with the decrease in elastic recoil which is connected to tissue damage caused by chronic inflammation. Lung volume reduction coil ...(LVRC) method in patients with an advanced level of emphysema and irresponsive to medical treatment is shown to provide increase in lung volumes and exercise capacity, decrease in dyspnea, and increase in quality of life. The purpose of this study is to reveal that LVRC treatment is also efficient in severe COPD patients with hypercapnic respiratory failure.
Eleven cases with severe COPD and emphysema were included in the study. LVRC treatment method was applied in upper lobes of both lungs in patients with severe COPD (FEV1 < %45) and Type-2 respiratory insufficiency (PCO
55-80 mmHg) who were having medical treatment and CPAP treatment. The patients were followed up for a period of twelve months using arterial blood gas analysis.
Beginning with the first month of the LVRC treatment, PCO
levels were found to be significantly decreased in all patients using arterial blood gas analysis.
LVRC method can provide physiological and functional recovery and progress in quality of life in severe COPD cases. It is demonstrated that LVRC treatment caused significant decreases in carbon dioxide levels as well as causing improvement in life quality and respiratory function tests in the patients with hypercapnic respiratory failure.
•Effect of RKKY interaction on skyrmion size is investigated.•Formation of large or small sized skyrmions is strongly dependent on the type of the RKKY coupling.•Interlayer coupling induced skyrmions ...are formed in the layer without intrinsic DMI.•Zero field skyrmions are observed with spin spiral state.
We study the magnetic skyrmion formation in thin-film stacks, consist of two magnetic layers separated by a non-magnetic spacer. The Landau-Lifshitz-Gilbert equation, comprising the spin precession term and the damping term with all relevant contributions, is numerically solved within the micromagnetic framework. Through extensive systematic calculations, we find that skyrmion size can be controlled by the interlayer exchange coupling, as well as the external magnetic field. z-component of the magnetization of the layers, which can be tailored by the coupling, strongly affects the skyrmion diameter. The skyrmion phase coexists with the helical phase for both types of coupling, being antiferromagnetic or ferromagnetic, in the absence of the magnetic field. The size of the skyrmions at zero field can also be controlled by the interaction. We anticipate that our predictions not only expand our fundamental understanding of the physical mechanisms responsible for skyrmion formation but also provide rational basis for the next-generation logic/memory device applications.
This study aims to investigate characteristics of visual snow accompanied by migraine and special interest on occipital bending, electrophysiological properties, and response to treatment.
Visual ...snow is characterized by continuous dynamically flickering dots in the visual field. Most patients also have comorbid migraine. Cortical hyperexcitability is a feature of migraine. Recent studies indicate an association between occipital bending with psychiatric disorders such as depression. Here, we demonstrate a patient with visual snow, migraine with aura, left occipital bending, and cortical hyperexcitability. Treatment response to lamotrigine was objectively assessed by repetitive pattern reversal visual evoked potentials (rVEP).
A 25-year-old woman with a 10-year history of migraine with aura (2-3 attacks/week) admitted for 1-year history of visual snow. She reported continuous bright and colorful lights, palinopsia, floaters, nyctalopsia, and photopsia. Brain magnetic resonance imaging (MRI) was performed. Visual habituation response was assessed before and after lamotrigine treatment by rVEP.
Brain MRI revealed left occipital bending. On rVEP study, there was potentiation response. After lamotrigine treatment, the patient had no more complaints of visual snow, was able to sleep, and the frequency of migraine decreased to 2 attacks/month. Electrophysiologically, the cortical hyperexcitability was improved.
The visual snow and loss of habituation ability in migraine associated with occipital bending can be improved with lamotrigine treatment. This report may provide new insights on "visual snow" pathophysiology in migraine.
Body fluids and relative motion between implant and bone lead to synergistic degradation reactions, which cause failed implantation or adverse tissue reactions for implant materials used in human ...body. Because of their good chemical biocompatibility as well as acceptable mechanical properties, titanium (CP Ti) and its alloys are widely used in implant applications. β-type Ti alloys including alloying elements such as Nb, Zr and Mo have become more popular among the extensively used α- and (α+β)-type Ti alloys due to their low elastic modulus, comparable mechanical properties and high biocompatibility. This paper was mainly aimed to investigate the electrochemical and tribological properties of β-type Ti alloys. Also, traditionally used α-type Ti (α- CP Ti) and (α+β) type Ti-6Al-4V (α/β- Ti64) alloys were included for comparing the same set of the results. The XRD and SEM investigations and hardness measurements were utilized to analyze the structure, surface morphology and mechanical behavior of the alloys. Simulated body fluid (SBF) was used as corrosive environment. Tribocorrosion tests were carried out at open circuit potential (OCP), cathodic and three different anodic potentials under reciprocating sliding condition. Potentiodynamic scans were obtained with and without wear test. Friction coefficient, current density and volume loss were measured and calculated. The relative motion accelerated the material loss in corrosive environment due to the combined effect of electrochemical reaction and tribological action. All Ti alloys had almost the same sensitivity to the potentiodynamic corrosion. The ratio of depassivation/repassivation affected wear performance of titanium and its alloys during tribocorrosion tests. The rate of chemical reaction was higher in β-type Ti-15Mo (β- Ti15) and Ti-45Nb (β- Ti45) alloys as compared to others. The (α+β) type Ti-6Al-4V (α/β- Ti64) and β type Ti-13Nb-13Zr (β- Ti1313) showed lower volume loss and lower friction coefficient values during tribocorrosion tests than others. The corrosion resistance of the β- Ti64 alloy exhibited better corrosion resistance than β- Ti1313 alloy. However, considering the implants applications, the β- Ti1313 alloy may be a good candidate with relatively low elastic modulus and without toxic alloying elements.
•The tribocorrosion resistance of α/β- Ti64 and β- Ti1313 is higher than the others.•All tested materials showed passive like behavior in SBF solution.•Rubbing increased the current density of alloys and thus the corrosion.•Wear accelerates to corrosion for all tested alloys.•Increasing potential leads to reducing mechanical wear volume for β-Ti15 and β- Ti45.
Purpose: To investigate the effects of different exercise protocols on ataxia in patients with multiple sclerosis (MS).
Method: A total of 42 MS patients, 17 male and 25 female (Expanded Disability ...Status Scale (EDSS): 3-5), were enrolled in this randomized controlled study. The patients were divided into three groups: a balance training (BT) group, a lumbar stabilization (LS) group and a task-oriented training (TT) group. All groups received balance training; additionally, the LS group received lumbar stabilization exercises, and the TT group received task-oriented training. The Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), Functional Reach Test (FRT), 2-Minute Walk Test (2MWT), Sensory Organization Test (SOT), and measurement of Somatosensory Evoked Potentials (SSEPs) were performed before and at the end of the 18 training sessions.
Results: The BBS, ICARS, FRT, 2MWT, and composite balance score of the SOT were improved in all groups. The ICARS kinetic function sub-score and the left limb cortical onset amplitudes of SSEPs were increased significantly in both the TT and the LS groups. The ICARS total score, composite balance score, and 2MWT were different between groups (p < 0.05). According to multiple comparison analyses of the ICARS total score and the composite balance score, the LS, and the TT group were different from the BT group (p < 0.005), while the LS and the TT groups improved similarly (p > 0.005). The 2MWT results were better for the LS group than the BT group, while the BT and the TT groups improved similarly.
Conclusion: Balance training alone is not sufficient for rehabilitation of ataxic MS patients. A combination of lumbar stabilization exercises or task-oriented training increases the success of balance rehabilitation.
Implications for rehabilitation
Multiple sclerosis is a chronic inflammatory and autoimmune disease of central nervous system and ataxia is one of the most challenging symptoms of this disease.
Different exercise modalities are commonly employed to control ataxic symptoms in MS patients.
Lumbar stabilization exercises or task-oriented training should be considered as complementary approach to improve balance and coordination in ataxic multiple sclerosis patients.
The next-generation logic and memory devices using magnetic skyrmions as spintronic information carriers are frequently studied, thanks to their remarkable magnetic stability, extremely compact size ...and very-low-cost driving forces within nanotracks. In order to realize skyrmion-based spintronic devices, understanding the skyrmion generation and their dynamics are essential. In this study, we have carried out a systematic micromagnetic simulation study on coherent magnetic skyrmion generation in which we theoretically engineered nanotracks by embedding an anti-notch to a channel of certain width. We found that the drift velocity and the skyrmion generation frequency can be tailored by the applied spin-polarized DC current density. Moreover, skyrmion generation is crucially affected by both damping and nonadiabaticity parameters, as well as the geometry of the anti-notch. We anticipate that our predictions provide rational basis for skyrmion-based devices in which skyrmions are used as information carriers, and influence future discussions.
The International Lymphoma Radiation Oncology Group (ILROG) defined involved-site radiotherapy (ISRT) guidelines. These rules offer a certain variability that allows for autonomous decision-making in ...diverse clinical settings. However, this flexibility also gives rise to conflicts about the selection of treatment fields in the daily decision-making process. The aim of this study was to show the extent of interobserver variability when ILROG-ISRT recommendations were used in different clinical scenarios.
The 10-question survey used in our study consisted of two parts (part A and part B) and was prepared by four senior radiation oncologists experienced in the haemato-oncology field. The results were presented by stratifying according to clinical experience (<10 years, ≥10 years). Binomial tests (one-sided) were conducted to assess whether answers for each group and the whole group reached a consensus.
Twenty-six radiation oncologists, 13 of whom had less than 10 years of experience and 13 seniors, participated in the survey. Eighty per cent of respondents thought ILROG did not bring sufficient solutions for all clinical scenarios but offered solutions in some cases. In different case-based scenarios, the consensus among the respondents decreased down to 38%. Senior radiation oncologists were found to have more doubts about the adequacy of current guidelines.
ILROG guidelines allow for a high degree of variability in real-life clinical scenarios and different interpretation of the recommendations may lead to increased toxicity and recurrences. Therefore, there is a need for refinement in ISRT delineation strategies. On behalf of the Turkish Society for Radiation Oncology Hematological Oncology, Pediatric Oncology and TBI Study Group, we are planning to carry out further educational contouring sessions to detect the interobserver variability in real-life contouring cases.
This study aims at modulating the altered cerebellar-cortical interactions in patients with multiple system atrophy-cerebellar subtype (MSA-C) by using cerebellar repetitive transcranial magnetic ...stimulation (rTMS). We hypothesized that cerebellar modulation by low-frequency rTMS can resolve the abnormal cortical excitability in multiple system atrophy cerebellar subtype.
We studied detailed effects of rTMS of the cerebellum on reaction time (RT) and short-latency afferent inhibition (SAI) response in MSA-C group, Alzheimer Disease (AD) group, and a control group of healthy individuals. The RT and SAI responses were measured before and after 1 Hz cerebellar rTMS in all groups. The study was conducted in the neurophysiology laboratory in Hacettepe University Hospital.
Our results indicated that motor cortex disinhibition was predominant in patients with AD and MSA-C. In AD and control groups, there were no changes in SAI after rTMS. However, after application of rTMS over the cerebellum in MSA-C patients, the pathological disinhibition and RT results showed an improvement compared to their previous results.
Our study highlights that cerebellar rTMS impairs abnormal cerebellar-cortical inhibitory connections in case of MSA-C.
Burdur Lake is one of the largest lakes of Turkey consisting of about 23 700 ha. Unfortunately, Burdur Lake area and the lake depth decrease each year. Additionally, the salinity increased twice in ...30 years because of the aridity. Burdur Municipality Drinking Water Pipeline had been constructed under Burdur Lake in 2002. Groundwater drained from deep wells was flowed to Burdur city under Burdur Lake. Burdur drinking water pipe line under Burdur Lake was broken to pieces during the storms in 2008, 2010 and 2013.
In this study, the stability analyses of Burdur Drinking Water Underlake Pipeline system were made for 2002-2008, 2008-2010 and 2010-2013 time periods by using the techniques of wave mechanics. Stability analysis was also made for the pipeline in the ditch with the gabions as a projection. Horizontal and vertical wave forces, weights of the cement bags and marble filled gabions were used at the calculations of wave mechanics. Soil mechanics parameters of the Burdur Lake and water hammer effect of the drinking water in the pipe line were also investigated in the content of this study.
Burdur Lake’s depth decreases every year because of the aridity, so the horizontal and vertical wave forces over the pipeline increase due to the decrease of the depth. Burdur Municipality could not use this pipeline system, so pipeline system must be placed in a ditch and suitable gabions that must be used in order to obtain the stability.
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