Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

DETERMINATION OF THE ROLE OF MARKETING INNOVATION IN THE RELATIONSHIP BETWEEN DYNAMIC CAPABILITIES AND SERVICE INNOVATION IN HOTEL ENTERPRISES WITH A MODEL OF STRUCTURAL EQUALITY

Müşteri ihtiyaçlarındaki değişimler, mevcut ürün veya hizmetleri tehdit edebilir veya yenileri için birtakımfırsatlar oluşturabilir. Bu bağlamda işletmelerin başarılı olabilmeleri kaynak ve yeteneklerini geliştirmeleri ilebirlikte müşterilerin istek ve ihtiyaçları doğrultusunda piyasaya yenilikler getirme yeteneğine bağlıdır. Buaraştırma otel işletmelerinde dinamik yeteneklerin hizmet yenilikçiliği üzerindeki etkisinde pazarlamainovasyonun düzenleyici etkisinin belirlenmesi amacıyla yapılmıştır. Nedensel tarama modeline göre tasarlananbu araştırma zincir otel işletmelerinde görev yapan 396 otel yöneticisi üzerinde gerçekleştirilmiştir. Bukapsamda elde edilen bulgulara göre otel işletmelerinde dinamik yeteneklerin hizmet yenilikçiliği üzerindepozitif yönlü anlamlı etkilere sahip olduğu tespit edilmiştir. Ayrıca pazarlama inovasyonu söz konusu etkidedüzenleyici rol üstlenmektedir.Changes in customer needs can threaten existing products or services or create a number of opportunities for new one. In this context, the success of enterprises depends on the ability to develop resources and capabilities and to bring innovations to the market in line with the wishes and needs of customers. This research was conducted to determine the regulatory impact of marketing innovation on the impact of dynamic capabilities on service innovation in hotel businesses. Designed according to the causal survey model, this research was conducted on 396 hotel managers working in chain hotel businesses. According to the findings obtained in this context, dynamic capabilities in hotel enterprises have positively significant effects on service innovation. In addition, marketing innovation plays a regulatory role in this impact

Effect of dc field on ac-loss peak in a commercial Bi:2223/Ag tape

Measurements of the ac susceptibility in a commercial Bi:2223/Ag tape for some different ac magnetic field amplitudes, Hac, in the presence of bias magnetic field Hdc directed along Hac are reported. It is found that the peak values of the imaginary component of ac susceptibility χ″max versus Hac trace a valley for the orientation where applied field Ha perpendicular to wide face of the tape total. We note that the observation of the valley depends on various parameters such as field dependence parameter n in the critical current density, in the simple power law expression jc = α(T)/Bn, choice of the bias field Hdc together with selected ac field amplitudes Hac, and dimension and geometry of sample studied. Our calculations based on critical state model with jc = α(1 − T/Tcm)p/Bn using the fitting parameters of n = 0.25, p = 2.2, Tcm = 108 K gives quite good results to compare the experimental and calculated curves

Fortification of Fractured Instrument Removal Simulated Roots Using Several Calcium Silicate-Based Materials

Objectives: The aim of this study was to evaluate the forces required to fracture roots obturated with different calcium silicate – based materials, after applying a fractured instrument removal simulation. Material and Methods: Seventy-five mandibular premolars were selected and decoronated. Then, all root canals were instrumented using Reciproc system. To mimic the root canal anatomy after the removal of a fractured instrument, each canal was enlarged with a size-3 Peeso reamer. The specimens were distributed into experimental groups according to the materials used for the root fortification: G1: Negative control, G2: ProRoot MTA, G3: Ortho MTA, G4: Biodentine, G5: Endocem MTA. Then, the teeth were embedded into acrylic blocks. A vertical fracture test was applied, and the fracture loads were recorded. Statistical interpretations were made (α=0.05). Results: G2, G3, G4, and G5 showed greater fracture resistances than G1 (P<0.05). There was no significant difference among G2, G3, G4, and G5 (P>0.05). Conclusions: Any of the tested materials could be chosen to reinforce the root after the removal of a fractured instrument

Fortification of fractured instrument removal simulated roots using several calcium silicate-based materials Kirik enstrüman çikartilma simülasyonu yapilmiş köklerin farkli kalsiyum silikat i˙çerikli materyaller kullanilarak güçlendirilmesi

Objectives: The aim of this study was to evaluate the forces required to fracture roots obturated with different calcium silicate – based materials, after applying a fractured instrument removal simulation. Material and Methods: Seventy-five mandibular premolars were selected and decoronated. Then, all root canals were instrumented using Reciproc system. To mimic the root canal anatomy after the removal of a fractured instrument, each canal was enlarged with a size-3 Peeso reamer. The specimens were distributed into experimental groups according to the materials used for the root fortification: G1: Negative control, G2: ProRoot MTA, G3: Ortho MTA, G4: Biodentine, G5: Endocem MTA. Then, the teeth were embedded into acrylic blocks. A vertical fracture test was applied, and the fracture loads were recorded. Statistical interpretations were made (α=0.05). Results: G2, G3, G4, and G5 showed greater fracture resistances than G1 (P<0.05). There was no significant difference among G2, G3, G4, and G5 (P>0.05). Conclusions: Any of the tested materials could be chosen to reinforce the root after the removal of a fractured instrument