Distributed TDMA Scheduling for Autonomous Aerial Swarms: A Self-Organizing Approach

Self-organization is a key strategy for improving the performance of an aerial swarm ad hoc network. The proliferation of low-cost VTOL drones has broadened the application domain of aerial swarms, and the need for synchronized communication among network entities has become crucial. However, existing ad hoc approaches struggle to maintain multi-hop connections in contested environments characterized by frequent topology changes and intermittent links. To overcome these limitations, we introduced STDMA protocol, which enables the self-configuration of drones without reliance on a ground controller. In continuation of the earlier work, we conduct extensive experiments to evaluate the performance of the proposed protocol. Comparative simulation experiments cover various scenarios with different network sizes, frame lengths, and traffic loads. The STDMA protocol achieves optimal access delay in highly contested environments and reduces delay by approximately 19.181%. Moreover, it exhibits improved channel utilization compared to the E-ASAP/SM protocol, with a 4.5 times increase

Angioedema and Urticaria Associated with Fluoxetine in a Preadolescent Boy

Angioedema is defined as increased permeability and dilatation of the capillaries in the deep dermis or subcutaneous or submucosal tissues leading to localized swelling, often affecting the upper respiratory and gastrointestinal tracts. It can also be observed as a rare adverse effect of selective serotonin reuptake inhibitors, as is the case with many other drugs. Here, we report a 10-year-old boy who had urticaria with fluoxetine use, showed recovery after cessation of the drug, and manifested with urticaria and angioedema after re-prescription. In the literature, there are two previous case reports of angioedema with fluoxetine. One case of angioedema accompanied by urticaria and showed a flu-like presentation 2 days after ingestion of high-dose fluoxetine. The other case, reporting angioedema with 10 mg/day, was without urticaria and thought to be a pseudoallergic reaction. We assume that our case is unique in this respect for that angioedema developed with therapeutic doses and thought to be allergic

Oblique Parameters and Extra Generations via OPUCEM

Recent improvements to OPUCEM, the tool for calculation of the contributions of various models to oblique parameters, are presented. OPUCEM is used to calculate the available parameter space for the four family Standard Model given the current electroweak precision data. It is shown that even with the restrictions on Higgs boson and new quark masses presented in the 2011 autumn conferences, there is still enough space to allow a fourth generation with Dirac type neutrinos. For Majorana type neutrinos, the allowed region is even larger. The electroweak precision data also favors non-zero mixing between light and fourth generations, thus effectively reducing current experimental limits. Additionally, calculations with OPUCEM show that even 5th and 6th generations are compatible with the existing electroweak precision data, with a probability comparable to or higher than the Standard Model with 3 generations.Comment: 11 pages, 21 figures, 5 tables - Version accepted by EPJ-

The real-life efficacy of the second line treatment strategy in advanced pancreas cancer

ABS TRACT Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer. Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 patients were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate anal-yses, an Eastern Cooperative Oncology Group performance status ≥2, age ≥65 years, hypoalbuminemia, thrombocytosis, presence of metastatic peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ≥3 were identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prog-nosis. In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and pre-dicting the survival of these patients

Global cancer control : responding to the growing burden, rising costs and inequalities in access

The cancer burden is rising globally, exerting significant strain on populations and health systems at all income levels. In May 2017, world governments made a commitment to further invest in cancer control as a public health priority, passing the World Health Assembly Resolution 70.12 on cancer prevention and control within an integrated approach. In this manuscript, the 2016 European Society for Medical Oncology Leadership Generation Programme participants propose a strategic framework that is in line with the 2017 WHO Cancer Resolution and consistent with the principle of universal health coverage, which ensures access to optimal cancer care for all people because health is a basic human right. The time for action is now to reduce barriers and provide the highest possible quality cancer care to everyone regardless of circumstance, precondition or geographic location. The national actions and the policy recommendations in this paper set forth the vision of its authors for the future of global cancer control at the national level, where the WHO Cancer Resolution must be implemented if we are to reduce the cancer burden, avoid unnecessary suffering and save as many lives as possible

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Hacettepe Üniversitesine 2000-2016 yılları arasında başvuran Diffüz Büyük B Hücreli Lenfoma vakalarının incelenmesi.

According to the Turkish Health Ministry 2010 Statistics, Non-Hodgkin lymphoma (NHL) incidence is 5.2/100000 in women 7.7 in men. Although diffuse large B-cell lymphoma (DLBCL) accounts for majority of cases; little known about real incidence, clinical and demographical data and prognosis of this prevalent NHL subtype. The aim of this study is to summarize the demographics of DLBCL patients of past 16 years and to investigate histopathologic characteristics from the pathology department of a tertiary reference hospital of Turkey. A total of 939 cases who were diagnosed in or referred to University of Hacettepe between 1/2000 and 11/2015 were included. Mean age of patients was 54±17; 56.2% of patients were males and 43.8% were females. It was found that 15.8% of patients were diagnosed at stage I; 23.4% patients Stage II; 21.1% were in stage III and 39.7% were diagnosed in stage IV. There was no differences in groups of stages when compared according to gender. When categorized according to the organs of involvement, it was found that they were diagnosed most frequently from the lymph nodes (39.9%) followed by the gastrointestinal system (17.3%). When gender differences was examined according to extranodal involvement, no difference was found (p = 0,18). GIS, CNS and bone involvement were the most common sites of EN involvement. There were no gender predominance in these involvement areas (0,33). Bone marrow involvement was not related to DBBHL subgroup according to Hans criteria (p = 0.76). Median overall survival is 94±12.3 months. At 5 years, 93.2% of patients were alive and at 10 years 85.2% of patients were alive. DLBCL is the most common subtype of NHL in our center with distinctive features. Although the presented results of this study was valid for single center experience, the pathology department of Hacettepe University is a tertiary reference center who get consultation around Turkey. Hence, these results might be extrapolated to whole Turkey.ONAY iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN v TEŞEKKÜR vi ÖZET vii ABSTRACT viii KISALTMALAR x ŞEKİLLER xi TABLOLAR xii 1. GİRİŞ 13 2. GENEL BİLGİLER 15 2.1. B Lenfosit Gelişimi, B Hücreli Lenfomalar ile Hodgkin Dışı Lenfomaların Sınıflandırılması 15 2.2. DBBHL: Tanımı, Patobiyolojisi ve Sınıflaması 22 2.3. DBBHL Epidemiyolojisi ve Risk Faktörleri 24 2.4. DBBHL Klinik Özellikleri ve Evrelendirilmesi 25 2.5. DBBHL Prognozu 26 3. GEREÇ ve YÖNTEM 30 4. BULGULAR 34 5. TARTIŞMA 49 6. SONUÇ ve ÖNERİLER 57 7. KAYNAKLAR 59 8. ÖZGEÇMİŞ 65Türk Sağlık Bakanlığı 2010 İstatistiklerine göre Hodgkin dışı lenfoma insidansı erkeklerde 7,7/ 100.000, kadınlarda 5,2 / 100.000'dir. Diffüz büyük B-hücreli lenfoma (DBBHL) vakaların çoğunu oluştursa da gerçek insidans, klinik ve demografik veriler ile prognoz hakkında bilgi kısıtlıdır. Bu çalışmanın amacı, son 16 yılda Türkiye'deki bir referans hastanenin patoloji anabilim dalına olan başvuruların retrospektif olarak incelenmesi ile DBBHL hastalarının demografik ve histopatolojik özellikleri araştırmaktır. Bu amaçla çalışmaya 1/2000 ve 12/2015 arasında patoloji bilim dalında tanı alan 939 vaka dahil edilmiştir. Yaş ortalaması 54±17 olarak saptandı. Olguların %43,8'i kadın (n=411); %56,2'si (n=528) erkekti. Ann-Arbor evrelerine göre sınıflandırıldığında %15,8 hasta Evre I; %23,4 hasta Evre II; %21,1 hasta Evre III ve %39,7 hasta Evre IV ile tanı aldıkları tespit edildi. Bu evre grupları arasında cinsiyet açısından farklılık saptanmadı. Vakaların en sık lenf nodundan tanı aldıkları (%39,9), bunu gastrointestinal (GI) sistemin (%17,3) takip ettiği tespit edilmiştir. Ekstranodal tutulumu olanlarda kadın/erkek oranı bakımından fark olmadığı saptandı (p=0,18). En sık EN tutulum alanı olan GI sistem, santral sinir sistemi ile kemik tutulumlu vakaların dağılımı incelendiğinde cinsiyet açısından farklılık olmadığı görüldü (p=0,33). Kemik iliği tutulumunun DBBHL subgrubu ile ilişkili olmadığı sonucu tespit edildi (p=0,76).Medyan genel sağkalım süresi 94 ay (Standart hata: 12,3; %95 GA 69,9-118,1) idi. DBBHL merkezimizde tanı alan en sık lenfoma türüdür ve farklı histomorfolojik özelliklere sahiptir. HÜTF Patoloji AD tek bir merkez olsa da tüm Türkiye'den hasta konsülte edilen tersiyer bir ünite olması; vaka sayısı, dağılımı ve heterojenitesi nedeniyle bu araştırmanın sonuçları ülke genelini yansıtmakta önem taşımaktadır

Clinical Applications of Immunotherapy Combination Methods and New Opportunities for the Future

In the last decade, we have gained a deeper understanding of innate immune system. The mechanism of the continuous guarding of progressive mutations happening in a single cell was discovered and the production and the recognition of tumor associated antigens by the T-cells and elimination of numerous tumors by immune-editing were further understood. The new discoveries on immune mechanisms and its relation with carcinogenesis have led to development of a new class of drugs called immunotherapeutics. T lymphocyte-associated antigen 4, programmed cell death protein 1, and programmed cell death protein ligand 1 are the classes drugs based on immunologic manipulation and are collectively known as the “checkpoint inhibitors.” Checkpoint inhibitors have shown remarkable antitumor efficacy in a broad spectrum of malignancies; however, the strongest and most durable immune responses do not last long and the more durable responses only occur in a small subset of patients. One of the solutions which have been put forth to overcome these challenges is combination strategies. Among the dual use of methods, a backbone with either PD-1 or PD-L1 antagonist drugs alongside with certain cytotoxic chemotherapies, radiation, targeted drugs, and novel checkpoint stimulators is the most promising approach and will be on stage in forthcoming years

News on child abuse in the press presentation

Çocuklar, genel anlamda insanlığın ve özel anlamda toplumun geleceği açısından önem taşımaktadır. İnsanların bilişsel, davranışsal ve duygusal gelişimleri çocukluk çağında gerçekleşmektedir. Ülkemizde 0-17 yaş arası nüfusun yaklaşık 23 milyon olduğu bilinmektedir. Ve bu yüzden ülkemiz açısından çocukların önemi kat kat artmaktadır. Yaşamımızın her alanında kitle iletişim araçlarının etkin olması, çocukların da gelişim sürecinde onlara maruz kalmasına neden olmaktadır. Çocuklar, hem medya tarafından kendilerine sunulan temsiller aracılığıyla hem de medyada birebir yer alarak bazı davranışlar ve tutumlar edinmektedirler. Ulusal basınımız ele alındığında sıradan olan çocuklarımızın genelde mağdur (istismar edilerek) ya da fail oldukları durumlarda basında yer aldıkları görülmektedir. Bu çalışmada, çocuğa yönelik istismarın yazılı basında nasıl sunulduğu tespit edilmiştir. Bu bağlamda Türkiye'nin en çok okunan; Cumhuriyet, Hürriyet, Milliyet, Posta, Sabah, Yeni Şafak ve Zaman gazetelerinin, 2010 yılında yer alan 1 yıllık nüshaları incelenmiştir. Gazetelerde hangi istismar türlerine, ne kadar yer verildiğini tespit etmek amacıyla haber ve fotoğraf sayıları tespit edilmiştir. Çocuğa yönelik istismar haberlerinin verilmesi açısından niceliksel ve niteliksel olarak incelenen gazeteler arasında belirgin farklar olduğu saptanmıştır. Yazılı basında, çocuğa yönelik istismar türleri içinde cinsel istismara yoğun ilgi gösterildiği ve bütün istismar türleri haberleştirilirken, gazetelerin yayın politikalarıyla doğru orantılı olarak ya olayla ilgili sadece bilgi verilmekten öteye gidilmediği, herhangi bir uzman görüşüyle haberlerin desteklenmediği ya da popülerleştirilmeye çalışıldığı tespit edilmiştir.The children have a special and great importance for the future of humanity in general and for the future of society in special. The cognitive, behavioral and emotional development of the people occur during the childhood process. It is known that there are 23 million people who are between the ages of 0-17. Thus, the importance of the children in our country is getiing more and more effective. The effectiveness of the mass media in our every field of life cause the children being exposed to it in their childhood process. The children gain some attitude and behaviour via mass media which they see and take sometimes parts in. When our national media is dealed, the ordinary children are seen on the mass media when they are aggrieved (by being captalized) or when they are perpetrator. In this survey, it is established how the abuse of the children is published in the printed media.In this regard, CUmhuriyet, Hürriyet, Milliyet, Posta, Yeni Şafak and Zaman's one yearling series ,the most read papers of Turkey, are searched.In order to identify abusement types and their frequencies, the number of the news and photo was designated. As a conclusion it is seen that there are distinctive discrepancy between the newspaper's news about the child abuse. In the mass media, it is concluded that sexual abuse of the children has more attention among the child abuse and while all the abuse types are being made news, by directly proportional the news politics of the newspapers, either the journalists just give information about the incident and there is no specialists view or they try to make popular the news

Neuropathic Cancer Pain: What We Are Dealing With? How To Manage It?

Cancer pain is a serious health problem, and imposes a great burden on the lives of patients and their families. Pain can be associated with delay in treatment, denial of treatment, or failure of treatment. If the pain is not treated properly it may impair the quality of life. Neuropathic cancer pain (NCP) is one of the most complex phenomena among cancer pain syndromes. NCP may result from direct damage to nerves due to acute diagnostic/therapeutic interventions. Chronic NCP is the result of treatment complications or malignancy itself. Although the reason for pain is different in NCP and noncancer neuropathic pain, the pathophysiologic mechanisms are similar. Data regarding neuropathic pain are primarily obtained from neuropathic pain studies. Evidence pertaining to NCP is limited. NCP due to chemotherapeutic toxicity is a major problem for physicians. In the past two decades, there have been efforts to standardize NCP treatment in order to provide better medical service. Opioids are the mainstay of cancer pain treatment; however, a new group of therapeutics called coanalgesic drugs has been introduced to pain treatment. These coanalgesics include gabapentinoids (gabapentin, pregabalin), antidepressants (tricyclic antidepressants, duloxetine, and venlafaxine), corticosteroids, bisphosphonates, N-methyl-D-aspartate antagonists, and cannabinoids. Pain can be encountered throughout every step of cancer treatment, and thus all practicing oncologists must be capable of assessing pain, know the possible underlying pathophysiology, and manage it appropriately. The purpose of this review is to discuss neuropathic pain and NCP in detail, the relevance of this topic, clinical features, possible pathology, and treatments of NCP.PubMedWoSScopu