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

TAXATİON POWER AND PRİNCİPLE OF LEGALİTY OF TAXATİON

Tarih boyunca üstün güç olan devletin, kendisini oluşturan bireyler üzerindeki vergilendirmeye ilişkin yetkileri, vergilendirme alanında, Bakanlar Kurulu'na tanınan düzenleme yetkisinin sınırlarının belirlenmesi, bu yetkiyi veren yasanın anayasal vergileme ilkelerine uygunluğu, kullanılan yetkinin anayasal normlara, yetkinin verildiği yasal normlara ve kamu yararı ile hizmet gereklerine uygunluğunun denetimi ve söz konusu denetim sonucunda yargı organlarınca verilen kararlar bu çalışmanın konusunu oluşturmaktadır. Devletin toplum üzerinde sahip olduğu yetkilerin belki de en önemlisi olan vergilendirme yetkisinin, yasal ve anayasal zemine ve metne bağlanarak kendisini oluşturan bireyler karşısında sınırlandırılması devlet kavramının değişmesi ve gelişmesi ile hemen hemen bütün demokratik ülkelerin yasa ve anayasalarında yer almıştır. Özellikle sosyal devlet ilkesinin gelişmesi ile devletin ekonomik ve sosyal hayattaki faaliyetleri arttıkça, üstlendiği hizmetleri gerçekleştirebilmesi için devlet daha fazla kamu gelirine ihtiyaç duyar hale gelmiştir. İşte devletin, kamu giderlerini karşılamak amacıyla cebri ve zorunlu olarak vergi almasının devlet açısından karşılamak zorunda olduğu kamusal ihtiyaçların finansmanı için zorunlu olması, birey açısından ise vergilendirmenin keyfiliğinden korunabilmesinin sağlanması için vergiye ilişkin düzenlemelerin yasalarda yer alması gerektiği fikri vergilerin yasallığı ilkesinin ortaya çıkmasına sebep olmuştur. Vergilendirme yetkisi aslen yasama organına ait olup, yürütme organına, ekonomik hayata etkin ve hızlı müdahalelerde bulunması için vergilendirme alanında bir kısım koşullu ve sınırlı yetkiler verilmiştir. Olağanüstü hallerde Bakanlar Kurulu'nun vergilendirme yetkisini nasıl kullanacağı, bu yönetim usullerine ilişkin yasalarda önceden düzenlenmiştir. Anayasa'nın 73/4. ve 167/2. maddeleri gereği, vergilendirme alanındaki düzenleme yetkileri ise, anayasal vergilendirme ilkelerine ve yetki veren yasa hükümlerine uygun olarak sadece bakanlar kurulu tarafından kullanılmalı; başta vergilerin yasallığı ilkesi olmak üzere anayasal vergilendirme ilkelerinin dolanılması niteliğini taşıyan yetkiler yasalarla verilmemeli ve bu nitelikteki yetki kullanımlarından kaçınılmalıdır.The subject of his study is comprised of the determination of the limits of the regulatory power granted to the Council of Ministers, compliance thereof to the constittional taxation principles, control of the exercised authority in terms of its compliance to the constitutional norms, norms of the empowering law, public interest and the reguirements of the service and consequent to this control the precedents of the courts. Restriction of the taxation power, which is maybe the most important power of government's upon public, against individuals who build the state, by bounding this power with a constitutional and legal base and text, take place in constitutions and codes of almost all democratic countries. Especially, since the activities of states in economic and social area increase with the improvement of the principle of social state, demand to public revenue also increase. From the point of government, it is compulsory to demand tax from individuals to meet the expenditures of public needs. From the point of citizens, it is also a must to protect individuals from the arbitrariness of governments on taxation issues. The idea about such regulations about taxation have to be put in order in codes , bring about the principal of the legality of taxes. Originally, power of taxation belongs to the legislative body but for a fast and efficient intervention to economical life, some limited and provisory powers have been delegated. How the Council of Ministers will use the power of taxation in emergency management procedures has been envisaged in the related laws. In accordance witn the fourth paragraph of Article 73 and second paragraph of Article 167 of the Constitution, regulatory power in the area of taxation should only be exercised by the Council of Ministers in conformity with the constitutional taxation principles and with the provisions of the law delgating authority. Powers that constitutes an infringement of the princilple of legality of taxation and other constitutional principles should not be delegated by laws and this type of power exercising should be avoided

Optimization of Solar Energy Harvesting: An Empirical Approach

Renewable energy is the path for a sustainable future. The development in this field is progressing rapidly and solar energy is at the heart of this development. The performance and efficiency limitations are the main obstacles preventing solar energy from fulfilling its potential. This research intends to improve the performance of solar panels by identifying and optimizing the affecting factors. For this purpose, a mechanical system was developed to hold and control the tilt and orientation of the photovoltaic panel. A data acquisition system and electrical system were built to measure and store performance data of the photovoltaic panels. A design of experiments and Response Surface Methodology were used to investigate the impact of these factors on the yield response as well as the output optimization. The findings of the experiment showed an optimum result with a tilt of 60° from the horizon, an azimuth angel of 45° from the south, and a clean panel condition. The wind factor showed insignificant impact within the specified range