Multi-perspective evaluation of integrated active cooling systems using fuzzy decision making model

As global median temperatures continue to rise, the demand for active cooling systems (ACs) is increasing. These systems are particularly prevalent in developed countries for maintaining comfort during hot weather. Various ACs technologies are available, and assessing their performance in multi-perspective settings is necessary to determine the best option for intended usage. This requires an evaluation platform for assessment. This paper presents a novel multi-criteria decision-making (MCDM) model based on a new integrated 2-tuple linguistic Pythagorean fuzzy-weighted zero-inconsistency (2 TLP-FWZIC) and modified 2-tuple linguistic Pythagorean fuzzy multi-attributive border approximation area comparison (2TLPF-MABAC). The former is used to determine the importance of assessment criteria, while the latter is employed for selecting the optimal ACs using the obtained weights. The first-level weighting results reveal that performance criteria were predominantly favored for assessment, with ‘energy performance’ acquiring the most significant weight (0.2487) among all performance criteria. In terms of ACs selection results, among the 20 tested and assessed systems, the ‘geothermal borehole electricity-based ACs’ obtained the highest score value (0.1296), while the ‘window packaged electricity-based ACs’ had the lowest score (-0.0515). The robustness of the results was confirmed through sensitivity analysis

Turkish registry for diagnosis and treatment of acute heart failure:

Objective: The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches.Methods: Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country.Results: Mean age was 62 +/- 13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%. Coronary heart disease and hypertension were found in 61% and 53% of the patients, respectively. Valvular heart disease was the underlying cause in 46% of heart failure patients. The most frequent factor associated with decompensation was noncompliance with treatment, observed in 34% of patients. Systolic blood pressure was 125 +/- 28 mmHg and heart rate was 93 +/- 22 beats/minute in the cohort. The most common findings on physical examination were inspiratory fine crackles (84%), peripheral edema (64%), and cold extremities in 34%. Mean ejection fraction (EF) measured at admission was 33 +/- 13%. Preserved EF (>=%40) was present in 20% of patients. On admission, 60%, 46%, and 40% of patients were using angiotens-in-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, or aldosterone antagonist, respectively. In-hospital events were reported as 3.4% death, 1.6% stroke and 2% myocardial infarction.Conclusion: Compared to previous data collected around the world, AHF patients in Turkey were younger, had more frequently valvular heart disease as the underlying cause, and were more noncompliant with medical treatment, but overall mortality was lower. Drugs shown to reduce mortality, and which also form the basis of guideline-directed medical therapy, are still used inadequately

Current status of the surgical management of Peyronie's disease

Surgery is the standard treatment for patients in the chronic phase of Peyronie's disease. Reconstructive surgeries function by either shortening the convex side of the tunica albuginea (Nesbit procedure, Yachia technique and penile plication) or lengthening the concave side by incision of the plaque with subsequent grafting. Tunical shortening procedures are ideal for men with good erectile capacity, penile curvatures less than 60 and predicted postprocedural length loss of less than 20% of erect penis length. Tunical lengthening procedures with grafting are indicated in patients with severe penile length loss, curvatures greater than 60 and prominent hourglass deformities. Saphenous vein and tunica albuginea are the most commonly used autologous graft materials. Cadaveric or bovine pericardium and 4-layer small intestinal submucosa are promising nonautologous tissues. Penile implantation of a prosthesis is the standard procedure in men with erectile dysfunction who do not respond to conservative treatment. If residual penile curvature is less than 30 after implantation, no further treatment is required. However, residual curve of greater than 30 can be straightened with manual modeling. Additional procedures such as penile plication, the Nesbit procedure, or grafting can be performed if modeling fails to correct the residual deformity