Does femoral tunnel location have an effect on functional and clinical results in medial patellofemoral ligament reconstruction?

Background/aim: Multiple reconstruction techniques have been described to mimic the normal anatomy and physiology of medial patellofemoral ligament (MPFL) reconstruction. The success of MPFL reconstruction depends on various factors such as graft selection, the location of the patellar tunnel and femoral tunnel (FT), and graft fixation methods. The aim of this study was to analyze the relationship between FT location and functional and clinical outcomes after MPFL reconstruction. Materials and methods: The midterm clinical results of patients who underwent MPFL reconstruction for patellofemoral instability in a single institution between 2013 and 2019 were evaluated retrospectively. If the FT was within the 6-mm-diameter reference circle, the center of which is Schottle’s point, the tunnel was accepted as anatomical; otherwise, it was considered a nonanatomical tunnel. The functional outcomes of the patients in both groups were evaluated with Kujala, Tampa kinesiophobia, and visual analog scale (VAS) pain scoring. Results: A total of 34 patients, 23 female (67.6%) and 11 male (32.4%), were evaluated. The mean follow-up period was 48.92 ± 2.93 (months). Tunnel position was anatomical in 22 patients (64.7%) and nonanatomical in 12 (35.3%). The postoperative VAS pain scores of those in the anatomical tunnel group were significantly lower than those in the nonanatomical tunnel group (p = 0.015). There was no statistically significant difference between the groups in terms of Kujala or Tampa kinesiophobia scores (p > 0.05). Conclusion: Although FT placement did not affect functional scores in MPFL reconstruction in this study, malpositioning of the FT is associated with a higher postoperative VAS pain score

Effect of yttrium addition on structural, mechanical and thermodynamic properties of tungsten-yttrium alloys

Based on the supercell structures of bcc-W, the effect of yttrium on the structural, mechanical, and thermodynamic properties of tungsten-yttrium alloys is investigated using first-principles calculations. In this study, five new models of tungsten-yttrium alloys are constructed, namely W15Y1, W14Y2, W12Y4, W10Y6, and W8Y8. The obtained values of elastic constants and mechanical criteria show that these alloys are mechanically stable. The mechanical parameters, including elastic moduli (bulk modulus, shear modulus, and Young's modulus), Poisson's ratio, B/G ratio, Cauchy pressure, and Vickers hardness, indicate a decrease of the mechanical properties compared to pure tungsten, though significant improvements in plasticity and ductility are observed. According to the phonon spectrum, the calculated thermodynamic parameters, such as heat capacity, entropy, and enthalpy of the alloys increase with increasing yttrium content and temperature compared to those of pure tungsten. Despite a decrease in Debye temperature, thermal conductivity and melting point with rising yttrium content, the thermal expansion coefficient shows an increasing trend. These findings provide valuable insights into the potential of tungsten-yttrium alloys for advanced applications, particularly in the context of fusion materials

Validity and reliability study of the Turkish version of the multidimensional outcome expectations for exercise scale (MOEES) in patients with cardiovascular diseases

Outcome expectations are a multidimensional construct encompassing physical, social, and self-evaluative components, significantly influencing adults' exercise behaviors. The study aimed to develop and validate a Turkish version of the 'Multidimensional Outcome Expectations for Exercise Scale' (MOEES) and assess its reliability in adults with cardiovascular disease (CVD). This cross-sectional validation included 150 participants. The MOEES was translated into Turkish, ensuring cultural and linguistic appropriateness, and reviewed by 15 healthcare professionals. Participants' demographic data were collected, and they completed the MOEES, International Physical Activity Questionnaire (IPAQ), and Tampa Scale for Kinesiophobia-Heart (TSK-H) twice, 15 days apart. The internal consistency of the MOEES was excellent, with a Cronbach's Alpha of 0.919. Test-retest reliability showed high intraclass correlation coefficients (ICC) for the physical (0.924), self-evaluative (0.921), and social (0.929) subscales. Confirmatory factor analysis (CFA) indicated an excellent fit (X-2/df = 1.782, GFI = 0.908, AGFI = 0.856, CFI = 0.962, RMSEA = 0.072, NFI = 0.918, SRMR = 0.052). Strong correlations were found between MOEES sub-dimensions and IPAQ total and TSK-H scores (p < 0.01), confirming the scale's validity. The Turkish MOEES is a reliable tool for evaluating physical, social, and self-evaluative outcome expectations regarding exercise in CVD patients, making it suitable for clinical and research applications

EL YARALANMASI GEÇİRMİŞ BİREYLERDE EL BECERİ DÜZEYİNİN EKLEM HAREKET AÇIKLIĞI, PİNÇ KUVVETİ, UYKU KALİTESİ, ÖZÜR, ANKSİYETE VE DEPRESYON DÜZEYİ İLE İLİŞKİSİ: KESİTSEL BİR ÇALIŞMA

Giriş: El yaralanmaları, bireylerin el becerilerini, fonksiyonel kapasitesini ve günlük yaşam aktivitelerini önemli ölçüde etkileyen yaygın ortopedik ve travmatik durumlardır. El becerisini değerlendirmede kullanılan Kutu ve Blok Testi (KBT), literatürde yalnızca el yaralanmaları sonrası değil aynı zamanda nörolojik etkilenimi olan bireyler ve geriatrik popülasyonda da kullanılmaktadır. Testin uygulanışı göz önüne alındığında testi doğru olarak tamamlamak için pinç kavrama, koordinasyon ve dikkat gibi bilişsel ve motor bileşenlerin birlikte çalışması gerekmektedir. Ancak, KBT ile bu parametreler arasındaki ilişkiyi inceleyen çalışmalara literatürde sınırlı düzeyde rastlanmaktadır.Amaç: Bu bağlamda, çalışmamızın amacı el yaralanması geçirmiş bireylerde KBT ile değerlendirilen el beceri düzeyinin; eklem hareket açıklığı, pinç kuvveti, uyku kalitesi, özür düzeyi, anksiyete ve depresyon düzeyleri ile olan ilişkisini incelemektir.Metod: Çalışmaya, yaralanmasından en az altı hafta geçmiş bireyler dâhil edilmiştir. Katılımcıların birinci, ikinci ve üçüncü parmaklarının total aktif hareket açıklıkları (metakarpofalangeal ve interfalangeal eklem fleksiyonlarının toplamı) parmak gonyometresi ile; ince kavrama kuvveti Baseline® marka pinçmetre ile; el becerisi KBT ile; özür düzeyi Kol, Omuz ve El Sorunları Anketi [Disabilities of the Arm, Shoulder and Hand (DASH)] ile; anksiyete ve depresyon düzeyleri sırasıyla Beck Anksiyete Ölçeği (BAI) ve Beck Depresyon Ölçeği (BDI) ile; uyku kalitesi ise Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile değerlendirilmiştir.Bulgular: Çalışmaya 41 birey (ortalama yaş: 35,6 ± 1,17; 24 erkek, 17 kadın) katılmıştır. Beceri düzeyi ile birinci ve ikinci parmakların total aktif hareket açıklıkları arasında sırasıyla r = 0.35, p &lt; 0.05 ve r = 0.31, p &lt; 0.05 olmak üzere orta düzeyde pozitif yönde anlamlı ilişkiler bulunmuştur. Ayrıca üçlü pinç kuvveti ile beceri düzeyi arasında da benzer şekilde orta düzeyde pozitif bir ilişki saptanmıştır (r = 0.39, p &lt; 0.05). Öte yandan, beceri düzeyi ile özür düzeyi arasında güçlü düzeyde negatif bir korelasyon bulunmuştur (r = -0.59, p &lt; 0.01). Bu sonuçlar, KBT performansının özellikle birinci ve ikinci parmakların total aktif hareket açıklığı ile üçlü pinç kuvvetiyle ilişkili olduğunu göstermektedir.Sonuç: Bulgular, el becerisinin kazanılmasında hem eklem hareketliliğinin hem de ince kavrama kuvvetinin önemli rol oynadığını ortaya koymaktadır. Ayrıca KBT skorlarının DASH skorlarıyla güçlü negatif korelasyon göstermesi, beceri düzeyi arttıkça bireylerin özür algısının azaldığını düşündürmektedir. Bu durum, fonksiyonel beceri ölçümlerinin öznel özür düzeyini yansıtma açısından anlamlı bir gösterge olabileceğini göstermektedir. Sonuç olarak, el yaralanması sonrası bireylerin fonksiyonel kapasitesinin yalnızca kas-iskelet sistemi parametreleriyle değil, aynı zamanda öznel değerlendirme araçlarıyla birlikte ele alınmasının, klinik değerlendirme ve rehabilitasyon sürecinde önemli katkılar sağlayacağı düşünülmektedir.</p

Coats Hastalığında Cerrahi Tedavi

Coats hastalığının tedavisinde, erken evrelerde lazer fotokoagülasyon ve kriyoterapi gibi konservatif ablasyon yöntemleri tercih edilirken, ileri evrelerde (Evre 3 ve 4) hastalığın kontrolü için daha kapsamlı cerrahi müdahaleler gerekmektedir. Bu evrelerde, genişleyen subretinal sıvı ve eksudalar, vasküler ablasyonun etkinliğini sınırladığından, tedaviye subretinal sıvı ve eksudaların drenajı eklenmelidir. En kabul gören yöntem, subretinal sıvının transskleral yolla external drenajıdır, bu teknik retina bütünlüğünü koruduğu için nispeten güvenlidir. Bununla birlikte, özellikle çoklu ablatif tedavi almış hastalarda epiretinal membran (ERM) gelişimi sıktır. Belirgin ERM’li hastalarda, external drenaj cerrahisine pars plana vitrektomi (PPV) ve membran soyulmasının eklenmesi, vitreousdaki VEGF yükünü azaltarak ve retinal traksiyonları rahatlatarak anatomik başarıyı artırabilir ve tekrarlayan tedavilere olan ihtiyacı azaltabilir. Evre 3B-4 Coats hastalığında düşük görsel beklenti göz önüne alındığında, bu hastalarda cerrahi tedavi sonrası beklenti, görme seviyelerinin artırılmasından çok, göz bütünlüğünün korunması ve hastalık aktivitesinin kontrol altına alınmasına odaklıdır.In the treatment of Coats’ Disease, conservative ablation methods such as laser photocoagulation and cryotherapy are preferred in the early stages and more comprehensive surgical interventions are required for advanced stages (Stage 3 and 4). At these stages, the expanding subretinal fluid and exudates limit the effectiveness of vascular ablation, necessitating the addition of drainage for subretinal fluid and exudates to the treatment. The most commonly accepted method is the transscleral external drainage of subretinal fluid, which is relatively safe as it preserves retinal integrity. However, the development of epiretinal membrane (ERM) are seen quite frequently, especially in patients who have received multiple ablative treatments. In patients with significant ERM, adding pars plana vitrectomy (PPV) and membrane peeling to the external drainage surgery can increase anatomical success by reducing the VEGF load in the vitreous and relieving retinal tractions, potentially reducing the need for additional ablation treatments. Considering the low visual expectations in Stage 3A-4 Coats’ disease, the focus of post-surgical treatment expectations in these patients should shift from improving vision to preserving the globe and controlling the disease activity

Fourier transform of biorthogonal polynomials in one variable*

In this paper, some new families of biorthogonal functions in one variable produced by using Fourier transforms of biorthogonal polynomials, which are suggested by Laguerre, Jacobi and Szegö–Hermite polynomials, and their orthogonality relations obtained via Parseval identity are derived

ENHANCING THERMAL INSULATION WITH SANDWICH STRUCTURES PRODUCED BY ADDITIVE MANUFACTURING

Recently, in the search for ecological and energy-efficient solutions, sandwich structures offer significant advantages in the thermal insulation of buildings. By reducing heat transfer, these structures reduce energy consumption and save energy costs. Simultaneously, by augmenting the use of materials, they both reduce costs and mitigate the impact on the environment. Additive manufacturing (AM) technologies, the ideal production technique for these structures, offer flexible and customizable design possibilities and the most suitable solutions can be applied according to the thermal insulation needs of the buildings. The goal of this study is to examine the efficiency of different unit cell designs in heat transfer by computational fluid dynamics (CFD) and numerical calculations, taking into account the environmental benefits of sandwich structures such as thermal conductivity, structural characteristics, air permeability rate, and recyclability. Additionally, body-centered cubic (BCC) and 3D re-entrant honeycomb unit cells are utilized in the design of sandwich structures and the effects of units on thermal insulation (TI) are searched. The results have observed that the void ratio in sandwich structures makes a significant contribution to internal thermal energy storage. The use of re-entrant unit cells in TI applications results in lower room temperature values compared to BCC-based sandwich structures. The average TI value of the room designed with a 3D re-entrant honeycomb sandwich structure is determined as approximately 42.03°C. In contrast, the TI value of the room designed with BCC sandwich structure is stated as 37.48°C. Therefore, the internal temperature of the room designed with 3D re-entrant unit cell is about 4.55°C lower than the room designed with BCC unit, and the heat loss efficiency is calculated to be 10.8% better