Centralized Microgrid Control System in Compliance with IEEE 2030.7 Standard Based on an Advanced Field Unit

The necessity for the utilization of microgrids emerges from the integration of distributed energy resources, electric vehicles, and battery storage systems into the conventional grid structure. In order to achieve a proper operation of the microgrid, the presence of a microgrid control system is crucial. The IEEE 2030.7 standard defines the microgrid control system as a key element of the microgrid that regulates every aspect of it at the point-of-interconnection with the distribution system, and autonomously manages operations such as the transitions of operating modes. In this paper, a microgrid control system is developed to achieve real-time monitoring and control through a centralized approach. The controller consists of a centralized server and advanced field units that are also developed during this work. The control functions of the centralized server ensure the proper operation during grid-connected and island modes, using the real-time data received via the advanced field unit. The developed server and the field unit constitute a complete system solution. The server is composed of control function and communication, database, and user interface modules. The microgrid control functions comprise dispatch and transition core-level functions. A rule-based core-level dispatch function guarantees the security of supply to critical loads during the islanded mode. The core-level transition function accomplishes a successful transition between the operation modes. Moreover, a communication framework and a graphical user interface are implemented. The presented system is tested through thecases based on the IEEE 2030.8 standard

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

Adrenal schwannomas are rare benign tumors with no specific imaging and laboratory findings to diagnose preoperatively. Due to the limited number of cases in the literature, clinical, imaging, and pathological findings are presented in this study. Case 1 is a 61-year-old woman patient who has a 31-mm mass in the right adrenal gland. This mass was nonfunctional; in imaging studies, this mass had a cystic necrotic component, and high 18-fluorodeoxyglucose (FDG) uptake was seen. There was no metaiodobenzylguanidine (MIBG) uptake. Laparoscopic transabdominal right adrenalectomy was performed, and the pathology result was consistent with adrenal schwannomas. Case 2 is a 63-year-old man patient who presented with a 38-mm mass in the left adrenal gland. This mass was nonfunctional and similar to that in Case 1; this mass had a cystic component. Laparoscopic transabdominal left adrenalectomy was performed. The diagnosis of adrenal schwannoma with degeneration was revealed. Case 3 was a 72-year-old woman patient admitted to the hospital for a 125-mm left adrenal mass. Similar to Case 1, this mass also had a cystic necrotic component in imaging studies. High FDG uptake was seen, and the patient underwent conventional adrenalectomy due to the suspicion of malignancy. After pathological evaluation, a diagnosis of adrenal schwannoma was made. A main diagnostic challenge in adrenal schwannomas is the preoperative diagnosis. These masses have no pathognomonic finding or specific hormonal function. Imaging findings of these masses may increase the suspicion of malignancy, which may affect decisions for surgery and the surgical technique

Medical artificial intelligence readiness scale for medical students (MAIRS-MS) - development, validity and reliability study

Karaca, Ozan/0000-0001-5431-0942; Demir, Kadir/0000-0001-9568-9450; Caliskan, S. Ayhan/0000-0001-9714-6249WOS:000620927800001PubMed: 33602196BackgroundIt is unlikely that applications of artificial intelligence (AI) will completely replace physicians. However, it is very likely that AI applications will acquire many of their roles and generate new tasks in medical care. To be ready for new roles and tasks, medical students and physicians will need to understand the fundamentals of AI and data science, mathematical concepts, and related ethical and medico-legal issues in addition with the standard medical principles. Nevertheless, there is no valid and reliable instrument available in the literature to measure medical AI readiness. in this study, we have described the development of a valid and reliable psychometric measurement tool for the assessment of the perceived readiness of medical students on AI technologies and its applications in medicine.MethodsTo define medical students' required competencies on AI, a diverse set of experts' opinions were obtained by a qualitative method and were used as a theoretical framework, while creating the item pool of the scale. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were applied.ResultsA total of 568 medical students during the EFA phase and 329 medical students during the CFA phase, enrolled in two different public universities in Turkey participated in this study. The initial 27-items finalized with a 22-items scale in a four-factor structure (cognition, ability, vision, and ethics), which explains 50.9% cumulative variance that resulted from the EFA. Cronbach's alpha reliability coefficient was 0.87. CFA indicated appropriate fit of the four-factor model (chi (2)/df=3.81, RMSEA=0.094, SRMR=0.057, CFI=0.938, and NNFI (TLI)=0.928). These values showed that the four-factor model has construct validity.ConclusionsThe newly developed Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) was found to be valid and reliable tool for evaluation and monitoring of perceived readiness levels of medical students on AI technologies and applications.Medical schools may follow 'a physician training perspective that is compatible with AI in medicine' to their curricula by using MAIRS-MS. This scale could be benefitted by medical and health science education institutions as a valuable curriculum development tool with its learner needs assessment and participants' end-course perceived readiness opportunities

Outsourcing distribution and logistics services within the automotive supplier industry

This paper reports on an empirical study that examined a suite of distribution and logistics services commonly used to manage inbound materials en route to plants. The sourcing decision is examined through the lenses of transaction cost economics and the resource-based view of the firm and the results lend limited support for both theories in the context of such services. Results further indicate that there is little evidence supporting differences between internal versus external decision-makers.Transaction cost economics Resource-based view Outsourcing Logistics

Different Courses of Hepatitis B Reinfection After Renal Transplant: A Case Report

Hepatitis B surface antigen-positive allografts may be a source of transmission in patients who undergo renal transplantation.Treatment of hepatitis B virus infection with nucleoside/nucleotide analogs in kidney recipients who have hepatitis B virus infection or who have received transplants from hepatitis B surface antigen-positive donors improves long-term patient survival. Antiviral agents are administered as a preemptive or prophylactic therapy at the time of kidney transplantation, rather than as salvage treatment. In this report, we present 2 renal transplant recipients who had hepatitis B virus reinfection or who had developed seroconversion with immunosuppressive treatment. These case reports also demonstrate the unexpectedly different courses of hepatitis B reinfection after kidney transplantation

Classification of Uroflowmetry and EMG Signals of Pediatric Patients using Artificial Neural Networks

UF-EMG test, in which non-invasive uroflowmetry (UF) and electromyography (EMG) signals are simultaneously recorded, is frequently used in children diagnosed with lower urinary tract dysfunction disease (AUSD) and its treatment. In the literature, independent (single) UF signals and integrated (dual) UF-EMG signals are graded many times but there is no classification study of UF-EMG integrated signals with Artificial Neural Networks (ANN), although studies have been done to classify UF signals with ANN. In this paper, it was aimed to classify the UF-EMG signals recorded from pediatric patients during the UF-EMG tests in Urodinami Center of Gulhane Education and Research Hospital using ANN. 773 (80%) of the 967 patients with an average age of 8 were used for training and 194 (20%) were used for the test. In YSA, the contribution of the features obtained from the EMG signals played a crucial role and was the main reason to improve the signal classification from 58% to 84.02%. The new classification method created by the obtained data does facilitate the interpretation of UF-EMG results for the clinical personnel in diagnosis, follow-up and treatment of patients. It is also aimed that the pediatric patients living in regions with less access to health care can be treated by providing an early and easy preliminary diagnostic tool.Günümüzde çocuklarda alt üriner sistem disfonksiyonu (AÜSD) hastalıklarının teşhisinde ve tedavinin takibinde, girişimsel olmayan (noninvaziv) üroflovmetri (UF) ve elektromiyografi (EMG) sinyallerinin eşzamanlı olarak kaydedildiği UF-EMG testi sıklıkla kullanılmaktadır. Literatürde, bağımsız UF sinyalleri ve UF-EMG sinyalleri birçok defa derecelendirilmiş, UF sinyallerinin Yapay Sinir Ağları (YSA) ile sınıflandırılmasına dair çalışmalar yapılmış olmasına rağmen, UF-EMG sinyallerinin birlikte kullanıldığı YSA ile sınıflandırma çalışması bulunmamaktadır. Bu çalışmada, Gülhane Eğitim ve Araştırma Hastanesi Ürodinami Merkezinde, pediatrik hastalara uygulanan UFEMG testleri sırasında kaydedilen sinyallerin YSA kullanılarak sınıflandırılması amaçlanmıştır. Yaş ortalaması 8 olan 967 hasta verisinden 773 adedi (%80) eğitim, 194 adedi (%20) ise test amaçlı kullanılmış, YSA’da EMG sinyallerinden elde edilen özniteliklerin katkısı başarı oranının %58‘den %84,02 seviyelerine gelmesini sağlamıştır. Elde edilen veriler ile oluşturulan yeni sınıflandırma metodu hastaların tanı, takip ve tedavisinde sağlık personelinin UF-EMG sonuçlarını yorumlamasında kolaylık sağlamayı; sağlık hizmetine ulaşma imkânı daha az olan bölgelerdeki çocuk hastalara, daha erken ve kolay ön tanı konularak uygun tedaviye yönlendirme imkânı sağlamayı hedeflemektedir

Relationship between adnexal mass and endometrial thickness in postmenopausal period

Endometrial cancer is the most common gynecological cancer. Increased postmenopausal endometrial thickness may be an indicator of endometrial cancer. Transvaginal ultrasound (TV-USG) is the primary imaging method for evaluating endometrial thickness in the postmenopausal period. The aim was to employ transvaginal ultrasonography in the evaluation of adnexal masses synchronously seen in postmenopausal women with increased endometrial thickness. The work was designed as a retrospective study. The medical records of 155 patients evaluated for increased postmenopausal endometrial thickness were examined. Ultrasonography had been performed on the women in the study for routine follow-up, postmenopausal hemorrhage, pelvic pain, pelvic mass on examination and family history of gynecological cancer. All patients had undergone endometrial evaluation with fractional dilatation and curettage (D & C) or pipelle endometrial sampling. Histopathological diagnosis was based on endometrial sampling results. Adnexal mass was present simultaneously in 17.4% (n = 27) of the women included in the study, while 82.6% (n = 128) had no gynecological pathology other than increased endometrial thickness. The endometrial thickness in the women with postmenopausal adnexal masses was greater than in those without adnexal mass (11.7 mm vs. 7.8 mm, p = 0.009). Non-atypical and atypical endometrial hyperplasia was more frequent in the group with postmenopausal adnexal mass (11.1% vs. 2.8%, 11.1% vs. 3.79, p = 0.03, p = 0.04, respectively). Final histopathological evaluation of patients operated on for adnexal masses revealed tubo-ovarian abscess in 1.9% (n = 1), benign ovarian tumor in 25.9% (n = 7) and malignant ovarian tumor in 11.1% (n = 3) of the patients. In postmenopausal women, adnexal masses can be seen simultaneously with increased endometrial thickness. In this regard, transvaginal ultrasound offers important opportunities for evaluation of both the endometrium and adnexa. Pre-surgery transvaginal ultrasound as well as multivariate serum markers may be used in evaluation models. [Med-Science 2018; 7(4.000): 848-51

Functional outcomes of intersphincteric resection in low rectal tumors

Objective: Currently, sphincter-saving procedures are increasingly performed in the treatment of low rectal cancers. This study aimed to evaluate the outcomes of patients who underwent intersphincteric resection. Material and Methods: This was a single-center, retrospective, cross-sectional study. We evaluated the electronic data files of 29 patients who had intersphincteric resections at our institute between 2008 and 2018. Bowel function outcomes were assessed prospectively using Wexner incontinence score. Histopathological, surgical and functional outcomes were analyzed. Results: Mean age of nine female and 20 male patients included in the study was 55.8 +/- 12.8 (30-76) years. A tumor-free surgical margin was achieved in all patients. Anastomotic leakage was detected in two patients. Mean Wexner incontinence score of 20 patients who still had functional anastomosis was 8.35, whereas 65% of the patients (n= 13) had a good continence status. There was no relationship between the continence status and sex, tumor distance from anal verge, T stage, distal surgical margin, and lymph node involvement. Twenty-one patients underwent primary coloanal anastomosis and eight patients underwent two-stage coloanal anastomosis. Conclusion: In the treatment of distal rectal cancer, adequate oncological surgery and relatively acceptable functional outcomes can be obtained with intersphincteric resection technique in suitable patients