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Prenatal determination of placenta accreta spectrum (PAS) and its severity is crucial, as it is a highly morbid condition. The aim was to investigate the intraplacental fetal artery (IFA) as a novel ultrasonographic marker in predicting cesarean-hysterectomy need in PAS. A prospective observational cohort study was conducted with a total of 62 women with placenta previa and ≥1 previous cesarean-section who were managed for PAS between September 2022 and January 2024. All women were classified according to the ultrasonographic classification system for prenatal PAS, and ultrasonographic assessments for IFA were performed. Odds ratios were calculated to test the association of IFA and other parameters related to PAS with cesarean-hysterectomy need. Receiver operating characteristic analysis was performed to evaluate the ability of maximum diameter (D-max) of IFA to predict cesarean-hysterectomy need. The study was completed with 49 women who underwent a cesarean-section with uterus-sparing surgery (n = 22) and a cesarean-hysterectomy (n = 27). Outer placental-half extension of IFA and each 1 mm increase in IFA D-max >3.5 mm were associated with a 58.82- and 3.52-fold increased risk of cesarean-hysterectomy, respectively. An IFA D-max of >3.5 mm was associated with cesarean-hysterectomy need at any PAS stage [area under the curve (AUC) = 0.845, 95 % CI:0.71–0.93, p < 0.001)] and in PAS 2 patients (AUC = 0.750, 95 % CI:0.56–0.89, p = 0.010), in whom prenatal prediction of cesarean-hysterectomy need is difficult. Evaluation of D-max and outer placental-half extension of IFA along with other markers of PAS improved the ability of ultrasonography to predict cesarean-hysterectomy need. • PAS are associated with serious consequences for baby and mother. • Rising cesarean rates are responsible for the increasing incidence of PAS. • Accurate detection of severe PAS provides appropriate and safe management. • Ultrasound plays a crucial role in determining the severity of PAS. • Intraplacental fetal artery is a useful marker for cesarean-hysterectomy need in PAS. [ABSTRACT FROM AUTHOR]

Preeclampsia is a serious pregnancy complication requiring early detection to improve outcomes. Profilin-1 (PFN1), linked to vascular dysfunction, may serve as a biomarker for diagnosing preeclampsia and predicting adverse neonatal outcomes. The aim of this study was to determine the serum Profilin-1 levels in patients diagnosed with preeclampsia and to investigate its association with disease severity and adverse neonatal outcomes. A prospective cross-sectional study was conducted at Etlik City Hospital involving 40 women with preeclampsia and 40 healthy controls. Serum PFN1 levels were measured by ELISA and results were compared between groups. The results were compared between the groups. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of PFN1. Serum PFN1 levels were significantly higher in the preeclampsia group compared to controls (46.48 [30.23–60.29] vs. 26.41 [19.65–41.76], p < 0.001). The ROC curve showed good diagnostic accuracy for PFN1 in detecting preeclampsia with an AUC of 0.741 (95 % CI: 0.631–0.832, p < 0.001), a sensitivity of 95 % and a specificity of 42.5 %. PFN1 levels were also associated with composite neonatal outcomes, with an AUC of 0.622 (95 % CI: 0.520–0.716, p = 0.042). PFN1 is a potential biomarker for the diagnosis of preeclampsia. However, further studies are needed to validate its role in predicting adverse neonatal outcomes and to improve its specificity for clinical use. • Serum Profilin-1 levels are significantly elevated in preeclampsia patients. • Profilin-1 shows good diagnostic accuracy for detecting preeclampsia (AUC: 0.741). • Elevated Profilin-1 levels are associated with adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]

In the presented study, the focus is on the exergy efficiency of a textile factory that has the potential to optimize itself using solar energy and waste heat. Two distinct scenarios are considered in this study. In Scenario 1 (S-1), the whole system components operate solely for hydrogen production, while in Scenario 2 (S-2), the whole system components are utilized for both electricity, heat water and hydrogen production. For the harnessing waste heat, a 25 kW capacity Organic Rankine Cycle (ORC) system, 20 evacuated tube solar collectors (ETSC) for solar energy utilization, and a water electrolyzer for hydrogen production are employed. As a result of the thermodynamic analysis of the whole system, the energy and exergy efficiency is calculated as 5.17 %, 2.63% and 39.32%, 21.74%, respectively, according to the S-1 and S-2 scenarios. Furthermore, considering S-1 and S-2 conditions, hydrogen production amounts to 5197 kg/annual and 2209 kg/annual, respectively. • The highest hydrogen production amount is calculated as 5197 kg/annual, depending on S-1 Scenario operating conditions. • The highest energy efficiency is calculated as 39.32% based on S-2 Scenario operating conditions. • The highest exergy efficiency is calculated as 21.74% based on S-2 Scenario operating conditions. [ABSTRACT FROM AUTHOR]

The single-stack fuel cell system is utilized extensively in several industries. Unfortunately, the main problems are its low efficiency and durability, and unsatisfied reliability, especially in the high-power situation. Due to its significant performance, which includes high output power, durability, and reliability, multi-stack fuel cell systems (MFCS) are becoming more and more attractive. In this study, it is aimed to develope a control algorithm in parallel structure in the Matlab/Simulink software for the efficient use of hydrogen fuel consumption of PEM fuel cells – based boost converter using PI controller with PSO method. Models of both single and parallel connected PEM fuel cells were created in Matlab using mathematical equations in this paper. The analysis made in the study were applied for both models. PEMFCs were connected in parallel and only one DC-DC converter was used for the entire system. According to the load change, the required number of cells are activated due to control algorithm to provide the required power. As a result, the proposed method reduces hydrogen consumption by approximately 5 times under the same load, while optimized parameters reduce output voltage oscillation. • A new control algorithm for parallel connected PEM fuel cell has been successfully implemented. • The suggested method reduces hydrogen consumption by approximately 5 times under the same load. • Using small-capacity fuel cells instead of huge ones minimizes hydrogen consumption. • Optimized parameters decrease the voltage oscillation. [ABSTRACT FROM AUTHOR]

• The half of patients with heart failure have an increased risk of falls. • Patients with decreased functional capacity show an increased likelihood of fall risk. • 6-minute walk test has discriminative tool to screen for increased fall risk. • The cut-off point for 6-minute walk test predict increased fall risk is 248 m. Given the increased risk of falls in patients with heart failure (HF), there is limited information in the literature about the possible relationship between fall risk and functional capacity. To investigate the relationship between functional capacity and fall risk in patients with HF and to determine whether there are differences in clinical parameters between patients with and without fall risk. The study included 64 patients with HF. The Activity-Specific Balance Confidence Scale (ABC) determined the fall risk. Functional capacity was assessed with the 6-minute walk test (6MWT). The Berg Balance Scale (BBS), the timed up-and-go test (TUG), and the five times sit-to-stand (5-STS) test were used to evaluate functional balance and mobility. Comorbidities and dyspnea perception were assessed with the Charlson Comorbidity Index (CCI) and modified Medical Research Council (mMRC), respectively. The 6MWT was associated with fall risk in logistic regression with an odds ratio of 0.979 (0.970–0.989, p < 0.001). Furthermore, the 6MWT had a discriminative value for increased fall risk in patients with HF, with a cutoff value of 248 m. Patients with increased fall risk had lower 6MWT distance, BBS, and gait speed, and higher CCI and mMRC, number of falls, duration of TUG and 5STS compared to patients with no increased fall risk (p < 0.05). The study results demonstrated that 6MWT may be a clinically useful tool in quickly identifying potential balance problems and increased fall risk by providing insight into fall risk/balance confidence in addition to assessing functional capacity. [ABSTRACT FROM AUTHOR]

In this study, a solar-Organic Rankine Cycle (ORC) assisted hydrogen production system was experimentally investigated. An evacuated tube heat pipe solar collector (ETHPSC) was used for thermal energy generation. The tubes used in this study were produced differently from the tubes of the conventional heat pipe. The condenser area of the vacuum tubes used was made of glass instead of copper. Moreover, acetone was used as the fluid in the tube. The thermal energy obtained from the collector was used as a heat source for electrical energy in the ORC system. A uniquely designed ORC system is modeled and manufactured. The electrical energy obtained from the ORC unit was used for hydrogen production by means of the proton exchange membrane electrolyzer (PEMe). As a result of the study, two different efficiency analyses were made. If all of the electricity produced in the S-1 scenario was spend on hydrogen production, the energy and exergy efficiency were calculated as 3.45% and 2.15%, respectively. In the S-2 scenario, if some of the electricity produced was spend on hydrogen production, the energy and exergy efficiency of the whole system were found to be 0.01446% and 0.002146% respectively. In addition, 0.000004433 kg/s hydrogen production was obtained from the presented system. • Novelty solar-ORC based hydrogen production system is performed. • The energy efficiency of the S-1 integrated system was determined as 3.45%. • The energy efficiency of the S-2 integrated system was determined as 0.01446%. • Hydrogen production was calculated as 0.000004433 kg/s. [ABSTRACT FROM AUTHOR]

While unemployment benefits constitute a significant share of welfare transfers in developed countries, the computable general equilibrium (CGE) literature ignores the impact of unemployment rate changes on these transfers. This paper investigates the impacts of alternative welfare transfer determination rules by using a dynamic CGE model for Ireland. We find that indexing the nominal welfare transfer budget to the consumer price index (CPI) and the aggregate unemployment rate is superior to the CPI alone. Although both specifications generate similar macroeconomic outcomes, our novel specification improves household welfare as well as income distribution across households. We argue that it is more in line with the behaviour of governments and that the literature ignores the progressivity elements embedded in the welfare system, which will reduce the welfare cost of carbon taxation. The results can be generalised in analysing the impacts of tax reform in countries where unemployment benefits are essential elements of welfare transfers. • We developed a multi-sectoral, multi-household intertemporal CGE model. • We analysed the Irish carbon tax with different welfare transfer budget (WTB) rules. • CGE literature updates the fixed WTB in real terms by the consumer price index (CPI). • We argue that the WTB should be responsive both to the CPI and the unemployment rate. • Considering unemployment benefits in the WTB lowers the carbon tax's regressivity. [ABSTRACT FROM AUTHOR]

There is no universally accepted standard technique for measuring the scapholunate interval and no specific sources of measurement error have been identified. We aimed to establish a set of normal radiological criteria for the scapholunate interval that could be used in comparative studies of wrist pathology to determine interobserver reliability and to identify potential errors that might influence measurements. A total of 60 healthy volunteers participated in the study. Scapholunate interval was measured by three independent observers using X-ray, CT, and US in four positions, including neutral, fist, radial and ulnar deviation. Inter-observer reliability was tested using intraclass correlation coefficient. Generalizability theory was applied to evaluate specific sources of measurement error related to participant, observer, imaging modality and measurement position. In neutral position, the scapholunate interval measured by X-ray, CT, and US was 3.1 mm, 3.5 mm and 3.5 mm respectively. The interval remained constant during fist and radial deviation but decreased during ulnar deviation. Correlation coefficients ranged from 0.874 to 0.907 for X-ray, 0.773–0.881 for CT and 0.964–0.979 for US. In the generalizability study, the participant x modality x position interaction accounted for the largest proportion of total variance (29%). X-ray, CT, and US are reliable modalities for measuring the scapholunate interval, with US having the highest reliability. Participant and position factors may independently contribute to measurement error. Therefore, standardized measurement positions are recommended to obtain reliable measurement results. [ABSTRACT FROM AUTHOR]