Npistanbul Brain Hospital

This study presents an empirical benchmarking comparison of two distinct speech-to-text approaches under identical conditions: the Speech Recognition module, which utilizes the online Google Web Speech API, and the offline Wav2Vec model developed by Facebook AI. Both approaches facilitate the transformation of spoken language into written language, although they demonstrate unique characteristics in terms of reliance on the internet, speed, and precision. This study utilizes the LJ Speech dataset, which contains short audio segments of a single reader supplemented by their corresponding transcriptions. Both examined models acquire text from the identical dataset and subsequently assess its similarity to the texts within the dataset. Our analysis reveals that wav2vec outperforms the speech recognition model in both accuracy and performance, suggesting the use of wav2vec in speech-to-speech implementations.

Immaturity, as a state of behaviors, is a subject that negatively affects social relationships and the individual’s life. It is a subject that has been studied in scientific literature as a defense mechanism. It is wondered whether immaturity is related to digital technologies. This study aimed to develop a valid and reliable dimensional immaturity scale and examine its psychometric properties with social media analysis. For this purpose, data was collected from 320 people across Turkey on a voluntary basis. As a result of the studies carried out in the research, the 4-dimensional and 18-item Uskudar Immaturity Scale (USIMS) was developed. The dimensions of the scale are named as: (1) Hastiness, impatience and suggestibility, (2) Center of attention, (3) Impulsivity, (4) Tendency to stand out and emotional instability. The scale explained 57.57% of the total variance. The Cronbach Alpha value of the scale was found to be .87. In the confirmatory factor analysis study, the scale structure was confirmed. Some of the first results are: (a) The immaturity level of those who use social media for 4 hours or more a day was found to be the highest, (b) the immaturity level increases as the frequency of live chatting on social media increases, (c) they become happy when they receive likes on social media, (d) the immaturity level of those who stated that they had a relationship and ended their relationship by fighting on social media is observed. It was concluded that the developed scale needed to be applied to different samples in further studies.

We investigate the impact of high-order moments on the learning dynamics of an online Independent Component Analysis (ICA) algorithm under a high-dimensional data model composed of a weighted sum of two non-Gaussian random variables. This model allows precise control of the input moment structure via a weighting parameter. Building on an existing ordinary differential equation (ODE)-based analysis in the high-dimensional limit, we demonstrate that as the high-order moments increase, the algorithm exhibits slower convergence and demands both a lower learning rate and greater initial alignment to achieve informative solutions. Our findings highlight the algorithm's sensitivity to the statistical structure of the input data, particularly its moment characteristics. Furthermore, the ODE framework reveals a critical learning rate threshold necessary for learning when moments approach their maximum. These insights motivate future directions in moment-aware initialization and adaptive learning rate strategies to counteract the degradation in learning speed caused by high non-Gaussianity, thereby enhancing the robustness and efficiency of ICA in complex, high-dimensional settings.

Abstract Purpose: Thalassemias negatively impact health-related quality of life (HQoL) due to chronic anaemia and complications from regular transfusions. This study aimed to investigate the effects of muscle strength loss and chronic anaemia on QoL in patients with transfusion-dependent thalassaemia (TDT) via the Short Form-36 (SF-36) health survey. Patients and Methods: A cross-sectional study was conducted with 110 participants. Muscle strength was assessed via a digital handgrip dynamometer. HQoL was evaluated through the SF-36 survey, which includes physical and mental health subdomains. Correlations between dominant arm strength and SF-36 subdomain scores were analysed. Results: Compared with control patients, TDT patients presented significantly lower dominant arm muscle strength (p < 0.001). Ferritin levels were elevated (p < 0.001), and haemoglobin levels were reduced (p < 0.001), indicating iron overload and chronic anaemia. The physical functioning (p < 0.001) and physical role difficulty (p = 0.002) scores were significantly lower in the TDT group. Muscle strength, including physical functioning (p = 0.005, r = 0.402), vitality (p = 0.009, r = 0.379), and mental health (p = 0.016, r = 0.349), was positively correlated with the SF-36 subdomain. No significant correlations were found for emotional or physical role difficulties. Conclusion: Loss of muscle strength significantly impairs HQoL in patients with TDT. These findings underscore the need for integrated treatment strategies targeting both physical and psychosocial health. Interventions such as iron chelation therapy and physical rehabilitation programs are critical to address chronic anaemia, oxidative stress, and inflammation, ultimately enhancing overall well-being in TDT patients.

Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are rare, aggressive tumors typically found along the dural sinuses. Despite their aggressive nature, complete surgical resection remains the most significant factor in reducing recurrence and improving survival. Here, we present the case of a 32-year-old male patient who presented with a new-onset headache and vertigo. Magnetic resonance imaging revealed a 50×37 mm left occipital mass originating from the falx and extending into the tentorium, with heterogeneous enhancement and compression/invasion of the left transverse sinus. Total resection was accomplished using microsurgical techniques, and histopathological analysis confirmed SFT/HPC, classified as WHO Grade II. Given the complete resection, including the venous sinus involvement, adjuvant radiotherapy was deemed unnecessary by the multidisciplinary committee. At the latest follow-up, five years post surgery, the patient showed no residual tumor or recurrence, with a reported overall well-being. Early detection and aggressive management through total resection can significantly improve survival and prognosis in patients with SFTs/HPCs.

Many successful osteotomies have been reported for the treatment of acetabular dysplasia. However, triple pelvic osteotomy remains a technically challenging procedure with potential for significant complications. This study examined a series of Tönnis periacetabular osteotomy (TPAO) procedures performed using the modified Stoppa approach to treat acetabular dysplasia in adolescents. To describe the radiographic outcomes, complications, and early functional results of TPAO using the modified Stoppa approach for acetabular dysplasia in adolescents. This study included 16 patients (20 hips) who underwent TPAO using the modified Stoppa approach for symptomatic acetabular dysplasia. The characteristics of the patients and the surgical procedure were discussed. The radiologic outcome was evaluated using the lateral center-edge (CE) and Tönnis roof angles. Perioperative data including surgery duration, blood loss, and complications were recorded. Complications were also discussed. The mean age of the patients was 11.5±1.1 (10 to 13) years. The mean preoperative anteroposterior CE angle was 14.7±3 degrees (7 to 19 degrees), and the mean postoperative angle was 35.7±3.1 degrees (30 to 42 degrees; P <0.001). The mean preoperative Sharp's angle was 55.9±5.4 degrees (48 to 65 degrees), and the postoperative mean was 33±5 degrees (24 to 40 degrees; P <0.001). The mean Tönnis angle before and after osteotomy was 23.3±7.1 degrees (17 to 36 degrees) and 7.1±2 degrees (4 to 10 degrees), respectively ( P <0.001). The mean operative time was 42.2±10.3 minutes with a mean blood loss of 167.7±50.3mL. One patient sustained a bladder injury as a major complication. The use of TPAO with the intrapelvic modified Stoppa approach in the treatment of hip dysplasia provides the benefits of a single incision, access to 2 hips in the same session, positional advantage, and abductor function preservation. Early results are satisfactory and safe. Level IV.

There is evidence that substance use and smoking cause some adverse effects on the respiratory system. The aim of this study was to assess dyspnea severity, respiratory muscle strength, cough capacity, and sleep quality in people with substance use disorder (SUD). Forty eight individuals with SUD and 28 active cigarette smokers participated in the study. Participants’ dyspnea severity was assessed using the Modified Medical Research Council Scale, respiratory muscle strength was measured with a portable electronic mouth pressure device, peak cough flow was assessed with a Peak Flow Meter, and sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The amount of daily cigarette smoking and dyspnea severity were significantly higher in individuals with SUD (p < .001). Peak cough flow values, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), MIP (%predicted), and MEP (%predicted) were not significantly different between the SUD patients and the active cigarette smokers (p > .05). However, PSQI sub-parameters such as subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, and total scores showed significant differences between the SUD patients and the active cigarette smokers (p < .05, p < .001, p = .03, p < .001, p < .001, respectively). Individuals with SUD were found to have higher dyspnea and poorer sleep quality than active smokers. However, respiratory muscle strength and cough capacities were similar.

Abstract ABSTRACT Background Individualized treatment strategies are highlighted for breast cancer patients in the last decades. Therefore aggressive surgical approaches have begun to evolve towards minimally invasive tailored interventions. SLNB is widely used in patients who received neoadjuvant treatment (NAC) and axillary lymph node dissection (ALND) is recommended for patients with axillary residual disease after NAC. In our study, we investigated regional recurrence rates in patients with limited axillary residual disease after NAC who underwent imaging-guided (MR+USG) axillary surgery plus radiotherapy (RT) instead of ALND. Materials and Methods 139 patients whose clinical stages were T1-3 and N1 at the time of diagnosis, who had a clinically good or complete axillary response after neoadjuvant therapy, and who had axillary residue (≤3 pathological lymph nodes) with favorable response to NAC (&amp;gt;50% fibrotic changes) in the final pathological examination were included in the study. The tumor stage and the number of pathological lymph nodes were assessed by USG, MMG, MR, and PET-CT examination (The minimum number of lymph nodes to be removed was determined according to imaging findings). All patients underwent imaging-guided SLNB (blue dye) and imaging-guided palpable lymph node excision. The patients were re-evaluated with their final pathology results in the multidisciplinary councils for suitable further treatments, ALND or RT. Peripheral lymphatic radiotherapy was applied to patients whose radiology and pathology results were compatible and no further surgery was done. The patients whose radiologically detected number of positive nodes was inconsistent with the number of metastases in pathology examination and who were presumed to have the gross residual disease underwent ALND. These patients were excluded from the study. Results The median age was 47 years. The median number of lymph nodes excised was 4. The total number of excised lymph nodes was between 1-3 in 64 (46%) patients and between 4-6 in 62 (45%) patients. 13 (9%) patients had ≥7 lymph nodes. 1 metastatic lymph node was found in all patients with 1 positive lymph node according to imaging findings. Of 41 patients with 2 radiologically positive lymph nodes, 1 metastatic lymph node was found in 17 (41%) patients, 2 metastatic lymph nodes in 22 (53%), and 3 metastatic lymph nodes in 2 (5%) patients respectively. Radiology reported 3 positive lymph nodes in 22 patients, of which 1 metastatic lymph node was found in 8 (36%), 2 metastatic lymph nodes in 10 (45%), and 3 metastatic lymph nodes in 4 (18%). The median follow-up period was 44 months. One patient had breast recurrence at the 31st month and one patient had lymphatic recurrence in the supraclavicular area at the 39th month. Systemic recurrence was noted in 6 (4.3%) patients. No axillary recurrence occurred during the follow-up period. Conclusions Patients with pathological-suspicious ≤ 3 lymph nodes shown by imaging (USG, MR, and PET-CT) who responded to NAC but still have residual disease in the axilla can be safely treated with SLNB(blue dye)+imaging-guided axillary approach and adjuvant RT. This approach eliminates the need for ALND in patients with low-volume residual axillary disease. Table. Patient characteristics Citation Format: Mahmut Muslumanoglu, Baran Mollavelioglu, Selman Emiroglu, Hasan Karanlik, Mustafa Tukenmez, Kamuran Ibis, Aysel Bayram, Ravza Yılmaz, Neslihan Cabıoğlu, Abdullah Igci. Imaging tailored axillary approach combined with radiotherapy eliminates axillary lymph node dissection in low-volume axillary disease after neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-23-01.

The world's population growth is causing environmental pollution and climate change, forcing industry to constantly shift to clean and renewable energy sources. Pollution and energy consumption pose significant risks as a result of materialistic government initiatives at the local levels. These days, it is critical that Turkey's natural resources and tourism attractions become economically and environmentally sustainable for the rest of the world. The most difficult task is to ensure that the interactions between the environment, matter, energy are positive. This can only be accomplished by creating model that takes holistic approach. This study offers a model for applying artificial intelligence.