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Integration of renewable energy systems to the existing power grid has become an inevitable issue all over the world. Besides its advantages, it brings serious problems such as system frequency and tie-line power fluctuations which may result in instability or undesired situations in a power system. On the other hand, cascaded controller structures have become so popular in the literature. Because they have more degree of freedom resulting in increased flexibility according to the non-cascaded ones. Within the above-given explanations, in this study, we aim to investigate the performances of cascaded fractional and integer order controllers TI-TD and PI-PD compared to the non-cascaded ones PID and TID controllers for a two area PV-Thermal reheat power system. The designed controllers are optimized by the Mayfly algorithm (MA) to minimize the integral of the time-weighted absolute error (ITAE) performance index. A detailed performance task is considered for the controllers. These are time domain analysis, robustness, random load change, progressive nonlinearities, and cyber attack issues. The nonlinearity analysis consists of governor dead band (GDB), generation rate constraints (GRC), boiler dynamics (BD), and time delay (TD). Also, two cyber-attack models called a resonance attack (ResA) and random attack (RndA) are applied to the controller systems. Simulation results show the superiority of the optimized and cascaded controllers, especially for TI-TD controller. The performance result of the controllers is also verified by comparing each other and some reported controllers in the literature.

In this article, Pathfinder-Derivative filtered proportional-integral-derivative controller (PF-PIDF) is proposed as the optimum algorithm and controller for DC motor speed control. The Pathfinder algorithm is inspired by the collective behavior of the animal colony and imitates the leadership hierarchy of the herds in order to determine the best meal or hunting ground. The movement of all particles is not regular, they all move randomly. In order to acquire the best parameters of the derivative filtered PID controller (PIDF) controller with the Pathfinder algorithm, the objective function ITAE (Integral of the Time Multiple Absolute Error), one of the commonly used objective functions in the literature, was used. Time solution set analysis, frequency response analysis (bode), robustness analysis, pole-zero map analysis and load disturbance rejection analysis were performed in MATLAB/Simulink software to make comparisons between algorithms and controllers and to testify the sufficiency of the proposed controller. As a result of the studies, it has been seen that the with PIDF Pathfinder algorithm has better performance than the other optimization algorithms in the article.

A case of intrinsic contracture of a hand of an 18-year-old thin woman following an unrecognized mild trauma is presented. The moderate intrinsic tightness of the second, third, fourth and fifth fingers had been released from the metacarpal bones using the inter-osseous muscle sliding technique. After a 2.5 years follow-up period, no signs of recurrence were recorded and the functional outcome was favorable. Even a very mild trauma in slim patients may lead to hand edema which, in the long-term, could result in intrinsic muscle atrophy of the hand. Key words: [Hand Microsurg 2016; 5(3.000): 156-159]

A multi-objective clustering is made by using NSGA-II for WSN.Seven NSGA-II cost functions defined to handle alternatives as much as possible.Sink selects a network topology from solution set according to some preferences.Performance of the proposed system is compared to LEACH.Proposed system can have five times longer lifetime and transfer two times more packets. Ambient Intelligence is the next wave in computing and communication technology. Nano-sensors, wireless networks and unified intelligent software are the main elements of this issue. Inputs of ambient intelligence are taken from sensors in the environment. Wireless sensor networks consists of small and low cost sensors that collect and report environmental data. Wireless sensors are dispersed in an area that some phenomenon or event should be monitored. When a sensor detects the monitored event (heat, pressure, sound, light, areas having magnetic properties, vibration, etc.), the event is reported to one of the sites. This site performs an appropriate task such as sending a message or local processing based on the type of network, and then provides the appropriate response. One of the major challenges in wireless sensor networks is optimizing the energy consumption. Studies have shown that by clustering network nodes, it is possible to use their energy more efficiently. This study proposes a clustering based routing method to be used in wireless sensor networks. Multi-objective optimization algorithm named as Non-dominated sorting genetic algorithm-II is used for clustering and seven objective functions are described. It is aimed to carry out several goals at once by using multi objective algorithm. While communication cost between the objective functions and cluster-head and Sink, and cluster-head and non-cluster-head is tried to be minimized, selection of the cluster heads only from the nodes near Sink is also tried to be prevented and it is also taken into consideration for clusters to include more nodes as much as possible. Each solution of the solution set obtained with Non-dominated sorting genetic algorithm-II points a different network topology. Each solution in solution set is the best solution according to some of objective functions. It is provided that Sink simulate each solution in solution set according to a certain scenario and choose one suitable for the desired criteria. In proposed method, both operating the Non-dominated sorting genetic algorithm-II and, simulation and evaluation of the obtained solutions comes out in Sink which has sufficient operation and power sources. According to the results, the proposed method can make the life span of network five times longer than LEACH, which is the most famous clustering algorithm. Besides, while the proposed method extends the life span of network, it is also seen that it increases the number of the packet reaching Sink two times more than LEACH. The data provided by proposed method includes information about larger areas when compared to LEACH.

Inter-fragmentary rotational and axial instabilities are major challenges in nailing of complex or comminuted fractures. We aimed to compare the inter-fragmentary rotational and axial stability of novel anti-rotation interlocking nail and the conventional interlocking nail in complex or comminuted femur shaft fractures. Twenty composite femurs were divided into two groups, 30 mm was resected from the mid-portion of all composite femurs. The inter-fragmentary rotational and axial stabilities were assessed. Between 10-N m external and 6-N m internal rotation torques, mean maximum inter-fragmentary rotational arc motion in the novel nails was 1.63 mm and 291 % less than that of the conventional nails (6.38 mm, P = 0.000). Between 150 N distraction and 2300 N compression, mean axial motion in the novel nails was 0.8 mm and 257 % less than that of the conventional nails (2.86 mm, p = 0.000). An anti-rotational novel nail is superior to the conventional interlocking nail in terms of maximum inter-fragmentary rotational and axial stabilities in complex and comminuted femur shaft fractures.

Dystonia is a disorder of motion; accompanied by unintentional muscle spasms leading to repetitive movements and/or aberrant posture that appears during a specific activity. Examples of focal task-specific dystonia (TSD) are and ldquo;writer's cramp and rdquo; and and ldquo;musician's dystonia and rdquo;, and it specifically involves the hand. A 54-year-old male presented with a complaint that the index finger of his right hand moved repetitively that scratched the wrist and palm when he shook hands. He could not find a solution to his problem through non-surgical treatment options. Based on the fact that the problem was limited to the index finger, non-progressive (stable) and refractory to non-surgical treatment, it was attempted to treat the patient with a tendon transfer as a last option. A case of focal TSD of the right index finger treated with tenotomy and tendon transfer is presented here. [Hand Microsurg 2016; 5(2.000): 104-106]

Background This retrospective study aims to present and evaluate the long follow-up results of posterior instrumentation without fusion in patients with traumatic thoracic and lumbar fractures. Methods 45 patients were operated. The mean follow-up period was 147.6 months. Sagittal plane kyphosis (SPK) and anterior wedge angle (AWA) were evaluated in preoperative and follow-up. Results SPK and AWA improved significantly in the early postoperative. However, the correction was lost in the 10-year follow-up. The loss of correction was statistically significant in SPK and AWA. Conclusion Posterior instrumentation without fusion is still among the most useful in treatment of traumatic thoracolumbar fractures.

Objective: One of the problems for interlocking nailing of the femur is interfragment rotation motion, affecting fracture healing. The nails with single distal locking screw are advantageous for decreasing operation time and radiation exposure. We investigated which single distal screw nail is the best for interfragment rotational stability. Methods: We used a total of 30 composite femurs, ten for each group. We determined interfragment rotational displacement of composite femurs with three types of single distal screw nails (10 interlocking nails, 10 compression nails and 10 Mehmet anti-rotation nails compressed by tube) at 6-Nm external− 6 Nm internal and 10 Nm extern– 6 Nm internal torques, which imitating respectively the level walking and descending stairs, using an axial distraction testing machine and a custom designed rotation apparatus. Results: Between 10 Nm external and 6 Nm internal torques with single distal locking screw, the interfragment rotational displacement in the Mehmet nail compressed by the 8 Nm torque wrench was mean 1.14 mm and 540% less than mean 7.31 mm in interlocking nails and 400% less than 5.72 mm in compression nails compressed by the 2.5 Nm torque wrench. Conclusion: The single distal screw Mehmet nail is superior than other single (or even some double) distal screw nails for maximum rotational stability, with no interfragment distraction gap, no superior nail migration, decreased operation time, and less radiation exposure in axially stable transverse and short oblique femur fractures in daily activities like stair descending or level walking. This article has been retracted: please see Elsevier Policy on Article Withdrawal ( http://www.elsevier.com/locate/withdrawalpolicy ). The Turkish Association of Orthopaedics and Traumatology regrets to inform that the above mentioned article ( http://www.aott.org.tr/index.php/aott/article/view/3194/4029 ) has been retracted based on authors' request as they declared that the data provided in the article was not correct and copied from another study by mistake. This error was recognized only after the publication and correcting the results would create a major change in the conclusion of the study.

Background: Proximal locking screw deformation and screw fracture is a frequently seen problem for femur interlocking nailing that affects fracture healing. We realized that there is lack of literature for the right level for the proximal locking screw. We investigated the difference of locking screw bending resistance between the application of screws on different proximal femoral levels. Materials and Methods: We used a total of 80 proximal locking screws for eight groups, 10 screws for each group. Three-point bending tests were performed on four types of screws in two different trochanteric levels (the lesser trochanter and 20 mm proximal). We determined the yield points at three-point bending tests that a permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value of 5 mm threaded locking screws applied 20 mm proximal of lesser trochanter was 1022 ± 49 (range 986–1057) (mean ± standard deviation, 95% confidence interval). On the other hand, the mean yield point value of the same type of locking screws applied on the lesser trochanteric level was 2089 ± 249 (range 1911–2268). Which means 103% increase of screw resistance between two levels (P = 0.000). In all screw groups, on the lesser trochanter line we determined 98–174% higher than the yield point values of the same type of locking screws in comparison with 20 mm proximal to the lesser trochanter (P = 0.000). Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures.

Objectives This study aims to investigate which intramedullary nail is biomechanically better for establishing interfragmentary rotational stability. Materials and methods Thirty composite femurs were utilized in this study. We analyzed interfragmentary rotational arc displacements between 10 Nm external-6 Nm internal torques and 6 Nm external-6 Nm internal torques which imitate rotation torques while walking on a flat surface and descending stairs by administering 10 interlocking nails, 10 compression nails, and 10 Mehmet anti-rotation nails with tube compression. Results Maximum interfragmentary rotation arc displacement between 10 Nm external rotation and 6 Nm internal rotation torques was mean 1.64 mm in the Mehmet nail compressed by 7 Nm torque wrench. This value was lower by 309% (6.72 mm) from interlocking nail (p=0.000), 201% (5.42 mm) from compression nail compressed by 2.5 Nm torque wrench (p=0.000), and 26% (1.92 mm) from compression nail compressed by 7 Nm torque wrench (p>0.05). Conclusion In axially stable transvers and short oblique femur fractures, Mehmet nail is superior to other intramedullary nails with limited movement between locking screw and hole, more interfragmentary compression without locking screw deformation, and no proximal nail migration.

A frequent problem for interlocking nailing that affects the treatment of the fracture is locking screw deformation. The aim of this study is to determine whether bending resistance is different between high, low, and unthreaded locking screws of interlocking femoral nails.Ninety screws were used in this experimental study, with 10 screws used in each of 9 groups. Three-point bending tests were performed on 6 groups of 5 mm screws (titanium, stainless steel, crossed with unthreaded, low threaded, and high threaded) and the same 3 thread types of 5.5 mm stainless steel screws in a 30-mm inner diameter steel tube, imitating the level of the lesser trochanter. An axial compressor was used to determine the yield points for permanent deformation in the locking screws by way of 3-point bending tests.The mean yield point value of the 3-point bending tests of 5-mm low threaded stainless steel locking screws was 2071 N, 53% less than that of unthreaded screws (3169 N). The mean yield point value of 5-mm high threaded stainless steel locking screws was 556 N, 272% less than that of low threaded screws (2071 N).To avoid locking screw deformation, high threaded screws must not be used as locking screws. In cases of unreliable patients, 5-mm low threaded screws should not be used in the nailing of comminuted or oblique femur shaft fractures. All 5-mm unthreaded screws and 5.5-mm low threaded stainless steel screws can be used safely in full weight-bearing conditions of unreliable patients.

The aim is to present our new method of compression, a compression tube instead of conventional compression screw and to investigate the difference of proximal locking screw bending resistance between compression screw application (6 mm wide contact) and compression tube (two contact points with 13 mm gap) application. We formed six groups each consisting of 10 proximal locking screws. On metal cylinder representing lesser trochanter level, we performed 3-point bending tests with compression screw and with compression tube. We determined the yield points of the screws in 3-point bending tests using an axial compression testing machine. We determined the yield point of 5 mm screws as 1963±53 N (mean±SD) with compression screw, and as 2929±140 N with compression tubes. We found 51% more locking screw bending resistance with compression tube than with compression screw (p=0,000). Therefore compression tubes instead of compression screw must be preferred at femur compression nails.

Objectives: A frequent problem for interlocking nailing, that affects the treatment of the fracture is locking screw deformation. The research question is whether bending resistance is different between high, low and unthreaded locking screws of interlocking femoral nails. Materials and methods. : We used 90 screws for nine groups, ten screws for each group in this experimental study. We performed three-point bending tests on six group of 5 mm screws (titanium, stainless steel, crossed with unthreaded, low threaded and high threaded) and the same three thread types of 5.5 mm stainless steel screws in a steel tube that has 30 mm inner diameter, which imitates the level of lesser trochanter. We determined the yield points at three-point bending tests that permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value at 3-point bending test of 5 mm low threaded stainless steel locking screws was 2071N and 53% less than unthreaded ones (3169 N).The mean yield point value of 5 mm high threaded stainless steel locking screws was 556 N and 272% less than low threaded ones (2071 N). Conclusion: To avoid locking screw deformation, high threaded screws must not be used as locking screws. Five mm low threaded screws in nailing of comminuted or oblique femur shaft fractures of unreliable patients should not be used. All 5 mm unthreaded screws and 5.5 mm low threaded stainless steel screws can be used safely in full weight conditions of unreliable patients.

Objectives This study aims to investigate whether there is any significant difference in bending resistance between titanium and stainless steel locking screws of femur nails and to review deformation of locking screws which is a common problem in interlocking nailing. Materials and methods In this study, a total of 60 pieces of 5 mm major diameter titanium and stainless steel locking screws were used as six groups in three different thread depth structures (high threaded, low threaded, and unthreaded). Three-point bending tests were conducted on steel screws placed inside stainless steel tube with 30 mm inner diameter, which imitated the level of lesser trochanter. We used an axial compression testing machine in order to determine the yield points that permanent deformation occurred in the locking screws. Results For low threaded locking screws, which are the most frequently used thread type for locking screws, the mean bending yield points were 1413 N on the titanium screws and this level was below 1922 N (2.8 BW) of level walking loading on femur for 70 kg person. On low threaded stainless screws, bending resistance was 2071 N, which was above the value of 1922 N. For high threaded locking screws, the mean bending yield points were 874 N on the titanium screws and 556 N on stainless screws. Conclusion In comminuted femur shaft fractures (in full load bearing conditions), using stainless steel locking screws is better instead of titanium screws to avoid locking screw deformation since low threaded stainless steel screws were 46.5% more resistant to bending deformation than titanium ones. Stainless steel or titanium high threaded locking screws may only be carefully used in non-comminuted fractures.

Background: The aim of this study is to evaluate the results of radiological and clinical data of patients treated by posterior decompression and fusion who have degenerative lomber spinal stenosis (DLSS). Materials and Method: 30 patients (17 female, 13 male) evaluated in this study who diagnosed as DLSS and underwent to surgery between 1999 and 2005. Lumbar spinal canal measured with CT scans of the operated level, one level upper and one level under from the operated level. All patients evaluated with Oswestry questionnaire and clinic examination scale (existence of back pain, leg pain, numbness, prickle, motor deficiency and sensory deficiency). Preoperative and postoperative satisfaction was evaluated by Visual Analog Scale (VAS). Results: Mean follow-up time was 4.3±3.7 years. Preoperative spinal canal diameter was 12.4±3.3 mm whereas postoperative 14.0±2.8 mm. Postoperative clinic scale and Oswestry questionnaire found to be beter significantly (p, Background: The aim of this study is to evaluate the results of radiological and clinical data of patients treated by posterior decompression and fusion who have degenerative lomber spinal stenosis (DLSS). Materials and Method: 30 patients (17 female, 13 male) evaluated in this study who diagnosed as DLSS and underwent to surgery between 1999 and 2005. Lumbar spinal canal measured with CT scans of the operated level, one level upper and one level under from the operated level. All patients evaluated with Oswestry questionnaire and clinic examination scale (existence of back pain, leg pain, numbness, prickle, motor deficiency and sensory deficiency). Preoperative and postoperative satisfaction was evaluated by Visual Analog Scale (VAS). Results: Mean follow-up time was 4.3±3.7 years. Preoperative spinal canal diameter was 12.4±3.3 mm whereas postoperative 14.0±2.8 mm. Postoperative clinic scale and Oswestry questionnaire found to be beter significantly (p

A total of 179 patients (61 female, 118 male) with diabetic foot infection who have been followed up for 3 years (March 1997-March 2000) by the “Committee of Diabetic Foot” in Ege University Medical School, were evaluated retrospectively in various aspects. The mean age and the diabetes age of the patients were 58.8 (33-85) and 14.7 (1-40) respectively. Of these 179 patients, 59 had low risk (33%), 82 had high risk (46%) and 38 had serious (21%) infection. In the low risk infection group, the patients had only soft tissue infection without osteomyelitis and there was no need for amputation. Osteomyelitis was present in 28 out of 82 (34%) patients with high risk infection and 34 out of 38 (89%) subjects with serious infection. The amputation frequencies in these two groups were 35% (29/82) and 89% (34/38) respectively. Overall, 35% (63/179) of all patients were amputated. Low risk infections were usually monomicrobial and high risk and serious infections were mostly polymicrobial. Due to the various components of the diabetic foot treatment, the requirement for a collaboration among many disciplines was emphasized and different choices for antimicrobial therapy was discussed.

Spondylodiscitis is a serious and important clinical problem that can occur after iatrogenic interventions and should be kept in mind. Spondylodiscitis after transrectal ultrasonography (TRUS)-guided prostate biopsy is an extremely rare complication. A 70-year-old patient who presented with severe back pain, intermittent high fever, loss of appetite, and fatigue following TRUS-guided prostate biopsy was diagnosed with thoracic spondylodiscitis (T6-7) after clinical, laboratory and radiological assessments and he was treated surgically. We present this case to remind medical professionals to keep spondylodiscitis in mind in the presence of sudden onset back and low-back pain, since TRUS-guided prostate biopsy is a frequently used procedure.

Posterior ligaman kompleksi ile ilgili birçok invitro biomekanik inceleme yapılmıştır. Tüm bu incelemelerde, vertebra stabilitesinde posterior ligaman kompleksinin sağlamlığının önemli olduğu bildirilmiştir. Bu çalışmada, koyun vertebraları arasındaki interspinöz ligamanları sağlam ve yırtık olup telle bağlanmış olan grupları karşılaştırarak, interspinöz telleme yönteminin dayanıklılığı invitro olarak test edilmesi amaçlanmıştır. Bu amaçla 24 koyun lomber vertebrası invitro olarak biyomekanik teste tabi tutulmuş, örnekler sağlam, posterior ligamanları sakrifiye edilmiş ve interspinöz bölgeden telleme tekniği ile tespit edilmiş grup olmak üzere 3 gruba ayrılmıştır. Her grupta bulunan 8’er örnek test makinesi ile kompresyon testine tabi tutulmuş, kırılma güçleri saptanarak istatistiksel olarak değerlendirilmiştir. Her gruptaki fleksiyon güçlerine karşı direnç ve değişiklikler kaydedilmiştir. Kırılma noktasındaki güç 1. grupta ortalama 167,65 N, 2. grupta 66,36 N ve 3. grupta 242,87 N olarak saptanmıştır. Bu sonuçların birbirinden istatisitiksel olarak anlamlı olacak şekilde farklı olduğu belirlenmiştir, Several in vitro biomechanical studies about posterior ligaments of the spine performed. These studies showed that posterior ligaments of the spine support spinal stability and play an important role in restricting spinal motion. The aim of this study is to investigate the strength of interspinous wiring technique in mature sheep lumbar vertebraes in vitro. 24 sheep lumbar vertebraes divided into 3 groups as; posterior spinal ligaments intact, sacrified and fixed with interspinous wiring, and these groups tested biomechanically. Each 8 specimens compressed with testing machine and breaking forces were analyzed statistically. The resistance and changes for flexion forces saved in each groups. The mean forces at breaking point were 167,65 N in group 1, 66,36 N in group 2 and 242,87 N in group 3. The results demonstrated statistically significant difference between the groups (p

Akson içine semptomatik kanama olan spinal hematom nadir bir lezyondur ve spinal veya epidural anestezinin katastrofik bir komplikasyonudur. Spinal kord basılarının tedavisinde ilk 8 saat içinde yapılacak laminektomi spinal iskeminin geri dönüşünü sağlayacaktır. Bu olgu sunumunda total diz protezi uygulanmış ve tromboemboli profilaksisi olarak düşük molekül ağırlıklı heparin kullanan bir olguda epidural kateterin çekilmesinden sonra oluşan epidural hematom olgusu sunulmuştur., The spinal hematoma, defined as symptomatic bleeding within the spinal neuraxis, is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Spinal hematoma reveals itself with the signs of cord compression. In the case of spinal cord compression, laminectomy seems to be effective in reversing spinal ischemia if performed within the first eight hours. We report a case of epidural hematoma formation after the removal of the lumbar epidural catheter in a patient who underwent total knee replacement surgery and commenced to receive lowmolecular- weight heparin (LMWH) postoperatively for thromboembolic prophylaxis.

Objectives: Pulmonary embolism (PE) after knee arthroscopy is even a rare occurrence in older patients. In this report, we present an unusual case of PE following knee arthroscopy. Methods: A 57-year-old woman normally active patient presented to the orthopaedic clinic has been suffering a right knee pain responseless to the medical treatment for a year. Hystory was unremarkable with the exception of hypertension and cervical biopsy. Results: An arthroscopic meniscectomy was received under spinal anesthesia after the application of an Esmarch and pneumatic tourniquet. Post-operatively first day, she was discharged. While transporting, she developed dyspnea, weakness and low-right breast pain. An immediate pulmonary angiography and cardiac echograpy demonsrated the obstruction in the right common pulmonary artery and subsegmentary occlutions in the left side. Conclusion: After a 24-hour streptokinase therapy(ST), coumadine was started. Near the end of ST, she complained a severe knee pain healed by the punctures. Because of a severe epigastric pain unable to control by gastric prophilaxy and therapy.The patient was consulted by a gastroenterology specialist and gastric endoscopy showed an acute gastritis. A control pulmonary angiography on eighth day demonstrated no thrombus including right common pulmonary artery. The patient was successfully discharged on the 11th day.

One of the problems for interlocking nailing of the femur is interfragment rotation motion, affecting fracture healing. The nails with single distal locking screw are advantageous for decreasing operation time and radiation exposure. We investigated which single distal screw nail is the best for interfragment rotational stability.We used a total of 30 composite femurs, ten for each group. We determined interfragment rotational displacement of composite femurs with three types of single distal screw nails (10 interlocking nails, 10 compression nails and 10 Mehmet anti-rotation nails compressed by tube) at 6-Nm external- 6 Nm internal and 10 Nm extern- 6 Nm internal torques, which imitating respectively the level walking and descending stairs, using an axial distraction testing machine and a custom designed rotation apparatus.Between 10 Nm external and 6 Nm internal torques with single distal locking screw, the interfragment rotational displacement in the Mehmet nail compressed by the 8 Nm torque wrench was mean 1.14 mm and 540% less than mean 7.31 mm in interlocking nails and 400% less than 5.72 mm in compression nails compressed by the 2.5 Nm torque wrench.The single distal screw Mehmet nail is superior than other single (or even some double) distal screw nails for maximum rotational stability, with no interfragment distraction gap, no superior nail migration, decreased operation time, and less radiation exposure in axially stable transverse and short oblique femur fractures in daily activities like stair descending or level walking.