MXene-based smart contact lenses demonstrate a cutting-edge advancement in wearable ophthalmic technology,combining real-time biosensing,therapeutic capabilities,and user comfort in a single platform.These devices tak...MXene-based smart contact lenses demonstrate a cutting-edge advancement in wearable ophthalmic technology,combining real-time biosensing,therapeutic capabilities,and user comfort in a single platform.These devices take the advantage of the exceptional electrical conductivity,mechanical flexibility,and biocompatibility of two-dimensional MXenes to enable noninvasive,tear-based monitoring of key physiological markers such as intraocular pressure and glucose levels.Recent developments focus on the integration of transparent MXene films into the conventional lens materials,allowing multifunctional performance including photothermal therapy,antimicrobial and anti-inflammation protection,and dehydration resistance.These innovations offer promising strategies for ocular disease management and eye protection.In addition to their multifunctionality,improvements in MXene synthesis and device engineering have enhanced the stability,transparency,and wearability of these lenses.Despite these advances,challenges remain in long-term biostability,scalable production,and integration with wireless communication systems.This review summarizes the current progress,key challenges,and future directions of MXene-based smart contact lenses,highlighting their transformative potential in next-generation digital healthcare and ophthalmic care.展开更多
The impact of earthquakes in urban centers prone to disastrous earthquakes necessitates the analysis of associ- ated risk for rational formulation of contingency plans and mitigation strategies.In urban centers,the se...The impact of earthquakes in urban centers prone to disastrous earthquakes necessitates the analysis of associ- ated risk for rational formulation of contingency plans and mitigation strategies.In urban centers,the seismic risk is best quantified and portrayed through the preparation of'Earthquake Damage and Loss Scenarios.'The components of such scenarios are the assessment of the hazard,inventories and the vulnerabilities of elements at risk.For the development of the earthquake risk scenario in Istanbul,two independent approaches,one based on intensities and the second on spectral displacements,are utilized.This paper will present the important features of a comprehensive study,highlight the method- ology,discuss the results and provide insights to future developments.展开更多
BACKGROUND Obsessive-compulsive disorder(OCD)is a heterogeneous disease in many respects and exhibits this diversity in terms of phenomenology.It also displays several different characteristics in children compared to...BACKGROUND Obsessive-compulsive disorder(OCD)is a heterogeneous disease in many respects and exhibits this diversity in terms of phenomenology.It also displays several different characteristics in children compared to adults.AIM To describe the socio-demographic and phenomenological features of children with OCD and to investigate the impact of these features on response to pharmacotherapy.METHODS This retrospective study was carried out with 150 children and adolescents who had been diagnosed with OCD between 2014 and 2018.Data was collected by examining the files of the patients with diagnosis of OCD and similar disorders from the hospital database.Yale-Brown Obsessive-Compulsive Scale for Children was used for the assessment of obsession-compulsion subtypes.The Clinical Global Impression(CGI)scale was used to evaluate the severity of the disease(CGI-S)and global improvement(CGI-I).The predictors of treatment response were evaluated using linear regression analysis.The level of significance for all statistic tests was set as P<0.05.RESULTS The sample was divided into prepubertal(44%)and adolescent(56%)age groups.The most prevalent obsessions were contamination and aggression obsessions,and the most frequent compulsions were washing and checking.While contamination was observed more commonly in the prepubertal age group,the religious obsession was seen more frequently in adolescents.Patients with aggression obsession presented a higher frequency of comorbid anxiety(P=0.022)and mood subgroups(P>0.05).A lower CGI-I score was linked to a lower CGI-S score(95%confidence interval 0.21-0.39,P<0.001)and the prepubertal age of admission(95%confidence interval 0.03-0.87,P=0.020).CONCLUSION The phenomenology of OCD shows differences depending on the age group and the comorbid psychiatric disorders.Earlier identification and treatment of OCD may help to prevent the impairment of the mental health of children and adolescents.展开更多
Since the 18th century, the irritating but also fascinating scenes of urbanity--a complex phenomenon with cultural, social, political, economic, temporal, spatial, functional, and formal dimensions--have been describe...Since the 18th century, the irritating but also fascinating scenes of urbanity--a complex phenomenon with cultural, social, political, economic, temporal, spatial, functional, and formal dimensions--have been described in literary works. Many seemingly opposite facts, such as individuality/society, freedom/loneliness/socialization, anonymity/strangeness/identity/belonging, diversity/chaos/segregation, indifferent city-dweller/initiative citizenship, have been revealed through literary works, travel and utopian writing, urban theories, scientific studies, manifestos, and newspaper articles. On the one hand, there are those who advocate a life outside the city because they consider the problems produced by the city and the phenomenon of density which they perceive merely in quantitative terms, as unsolvable problems. On the other hand, there are those who see the production of loose urban fabric as a solution or those who accept the （seemingly） opposite facts of urbanity as positive values and therefore support city life. All of these ideas are still as actual today as they were in the past. We are often unable to use our citizen rights to the city, to encounter different classes （social/etlmic/religious）, to experience heterogeneity as an aspect inherent in city life and in the route of our daily life--following the orders of the capitalist system mainly organized around work--and we are often drawn into the same districts on the same paths. Our perception of our urban environments may get monotonous and shallow, but the irritating yet fascinating features of the first big cities still exist and may be grasped and brought into consciousness. Throughout their architectural education, especially in urban design studios, students can be encouraged to investigate the rhythm of their daily life, the conditions of their urban environments, and discovering the city as an intellectual and sensual programme, so that the phenomenon of urbanity can be grasped not just on formal, but on various other dimensions as well. This study focuses on the process and outcomes of two urban studios located in Taksim Square and along the shores of the Golden Horn in Istanhul. Taking the multidimensional content of urbanity into account, acquired theoretically through literary works and studies on urban planning and its history, the main aim of these studios has been the phenomenological understanding of the dynamic content of urbanity by the students. Through creative analysis of permanent/temporary spaces engendered by the diversity of user profiles and actions discovered on phenomenological excursions, students examine the qualitative values of density and global and local dynamics. We believe that designing spaces as ＂prototypes＂ helps highlight the multidimensional content of urbanity. The present study aims not only to highlight the multidimensional content of urbanity, but also to encourage its discussion in architectural design education and to emphasize the positive contribution of theoretical readings and phenomenological studies to urban design studios. The present study also aims to emphasize the beneficial correlation of global and local dynamics as the two faces of urbanity; important more than ever for the big cities of the 21 st century if we advocate for a vivid and resilient city life and citizens.展开更多
With coming in force of The Law of Transformation of Areas at Disaster Risks numbered 16.5.2012/6306 by Ministry of Environment and Urbanization,the concept of urban transformation has entered to our life in Turkey.Ge...With coming in force of The Law of Transformation of Areas at Disaster Risks numbered 16.5.2012/6306 by Ministry of Environment and Urbanization,the concept of urban transformation has entered to our life in Turkey.Gentrification as one of the forms of urban transformation brought the existence of liberated zones produced by neo-liberal mentality.Sulukule area(Neslisah Sultan settlement)which is subject to research is counted among“the areas to be renewed and to be put under preservation”by numbered 2006/10299 decision of Council of Ministers.Due to the shortage of lands in the city,it is observed especially in 1980s that the families in high-income group have preferred to live in horizontally expending villa towns far from the center.While these residential areas are deepening the distance from the center in time,the pressure of housing demand of middle-income people and rent circles who are not planning to leave the city center caused to have an eye on these areas which are residential areas of mostly low-income people and appeared in certain regions as they are established without infrastructure and healthy conditions.With this law,the transformation has started in the areas such as Fikirtepe,Dolapdere,Esenler,and Banks of Halic(Golden Horn)where structural life is completed,and floor area ratio has been raised to 4.0 from 2.07.Vertical housing is stimulated by adding the street between the parcels to the blocks,it has been tried to prevent the victimization of local people to unearned income.There are some quarters that,under the name of gentrification,Romany citizens who passed to permanent settlement from nomadic culture at the Ottoman era,and who are engaged in activities such as handicraft,adornments,shoe making,weaving beside the show business at Fatih Sulukule district are convicted to lodge in the houses built in suburban if they have title deed,and in jerry-built tents if they don’t have deed.Chamber of Architects,Chamber of City Planners Istanbul Branch and Roma Culture Development and Solidarity Association filed“nullity suit”and“stay of execution”.Despite the continuing judicial process,the demolition started in 2009,and starting the constructing the villas in 2010 breaking the resistance of Romany citizens,the area was victimized to rent.展开更多
Restoration of historical buildings is important because they maintain cultural and historical continuity and transmit the cultural and social values from our precedents to future generations.Historical buildings need...Restoration of historical buildings is important because they maintain cultural and historical continuity and transmit the cultural and social values from our precedents to future generations.Historical buildings need to adapt themselves to a changing cultural,social,economic,and political context.In this paper refunctioning project of a historic Ottoman,warehouse is presented.The aim of the project is to re-gain this historical structure for public use by re-newing it to the modern comfort level and making the required functional changes.The main structural system of the warehouse consists of thick masonry stone walls.The idea in the proposed restoration project is to build a two-story steel structure inside the available volume of the warehouse.The columns of the new steel construction run parallel to the existing structural system of the historic building and are fixed at their base to the existing building foundation.Hence,there is no connection between the proposed steel structure walls and the existing masonry walls,and this will save the historic fabric of the warehouse.The project proposal shows the details of planned restoration stages,the process of programming the new interior space,construction materials,and lighting and ventilation solutions.Furthermore,in this project,two-and threedimensional computer drawings were used.Finally,the proposed parallel steel structure is able to regain the warehouse and renew it to be used as a modern housing and workshop.展开更多
Emerging evidence underscores the critical role of intestinal microbiota in postoperative recovery and long-term outcomes of gastrointestinal procedures.In this editorial,we comment on the retrospective study by Niu e...Emerging evidence underscores the critical role of intestinal microbiota in postoperative recovery and long-term outcomes of gastrointestinal procedures.In this editorial,we comment on the retrospective study by Niu et al,which highlights the beneficial impact of dietary fiber supplementation on gut microbiota restoration following endoscopic mucosa resection.The findings highlight the potential of fiber supplementation to modulate gut microbiota and support recovery following endoscopic mucosa resection.Nonetheless,we also emphasize the need for prospective,randomized studies to delineate the optimal type,dose,and duration of fiber supplementation.This research represents a significant step toward evidence-based nutritional interventions in minimally invasive gastrointestinal surgery and underscores the importance of microbiota-targeted therapies in personalized postoperative care.展开更多
Detection of Autism Spectrum Disorder(ASD)is a crucial area of research,representing a foundational aspect of psychological studies.The advancement of technology and the widespread adoption of machine learning methodo...Detection of Autism Spectrum Disorder(ASD)is a crucial area of research,representing a foundational aspect of psychological studies.The advancement of technology and the widespread adoption of machine learning methodologies have brought significant attention to this field in recent years.Interdisciplinary efforts have further propelled research into detection methods.Consequently,this study aims to contribute to both the fields of psychology and computer science.Specifically,the goal is to apply machine learning techniques to limited data for the detection of Autism Spectrum Disorder.This study is structured into two distinct phases:data preprocessing and classification.In the data preprocessing phase,four datasets—Toddler,Children,Adolescent,and Adult—were converted into numerical form,adjusted as necessary,and subsequently clustered.Clustering was performed using six different methods:Kmeans,agglomerative,DBSCAN(Density-Based Spatial Clustering of Applications with Noise),mean shift,spectral,and Birch.In the second phase,the clustered ASD data were classified.The model’s accuracy was assessed using 5-fold cross-validation to ensure robust evaluation.In total,ten distinct machine learning algorithms were employed.The findings indicate that all clustering methods demonstrated success with various classifiers.Notably,the K-means algorithm emerged as particularly effective,achieving consistent and significant results across all datasets.This study is expected to serve as a guide for improving ASD detection performance,even with minimal data availability.展开更多
Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening...Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening for comorbid symptoms of“childhood traumatic experiences”and“dissociation”,where specific characteristics are significant to the presence of psychosis and schizophrenia,may lead to an acceptable definition.In recent years,researchers have also reported crucial advances in the understanding of dissociative psychosis and dissociative schizophrenia.Although clinical studies in this area have been ongoing for a long time,research has not demonstrated that a clear and valid relationship exists between dissociation,childhood traumatic experiences,and schizophrenia or psychotic spectrum disorders.However,some results of statistical comparisons have supported the existence of the clinical manifestation known as dissociative psychosis and dissociative schizophrenia.Dissociation,childhood traumatic experiences,and positive psychotic symptoms may be a prominent part of dissociative psychosis and schizophrenia.The intense presence of negative symptoms may indicate classical schizophrenia.In research and clinical practice,researchers and clinicians may use psychometric tests to detect symptoms of dissociative psychosis.Psychotic persons with traumatic experiences likely benefit from treatment focused on trauma symptomatolgy.展开更多
Application of variable speed limits(VSL)is gradually increasingly implemented especially on highways.As a result of conducted studies and implementations,it is observed that the variable speed limits have reduced the...Application of variable speed limits(VSL)is gradually increasingly implemented especially on highways.As a result of conducted studies and implementations,it is observed that the variable speed limits have reduced the number of car accidents as well as proved positive results in terms of delays and environmental factors.Purpose of this study is to develop an algorithm for VSL application that is considered to be applied on Istanbul D100 highway and to assess the effects of application.Algorithm that is developed for VSL is a different VSL algorithm and compared with the constant speed system.According to obtained results,when the proposed system is compared to current system,it is observed that the number of delays and average stops are reduced%30 and%40 respectively and also emissions reduced at the rate of%12.展开更多
Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threateni...Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threatening and necessitate an immediate diagnosis and referral,but many others,like conjunctivitis or episcleritis,are benign and self-limiting.To prevent complications,such as irreversible vision loss or the spread of infection throughout the body,it is essential to accurately and promptly distinguish between benign and serious causes.With a broad range of etiologies covered,this review offers a thorough,evidence-based method for assessing red eye in primary care.For inflammatory,infectious,traumatic,and non-inflammatory disorders,we look at important clinical characteristics,diagnostic factors,and therapeutic approaches.Dry eye syndrome,pterygium,scleritis,episcleritis,keratitis,conjunctivitis,uveitis,blepharitis,hordeolum,endophthalmitis,orbital cellulitis,hyphema,trichiasis,and subconjunctival hemorrhage are among them.Whereas episcleritis usually responds to topical treatment,inflammatory conditions like scleritis and uveitis need systemic corticosteroids or immunosuppressive therapy.Infections such as keratitis,conjunctivitis,and endophthalmitis require treatments specific to the pathogen,while diseases like orbital cellulitis and hyphema may require hospitalization or surgery.External conditions like dry eye and blepharitis are treated conservatively with lubrication and cleanliness.This review aims to provide general practitioners with useful clinical tools for timely assessment,efficient triage,and referral by defining red flag symptoms,hallmark signs,and updated treatment protocols.Regular eye exams and patient education also improve results and lower recurrence.展开更多
BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-ma...BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.展开更多
In the Fatira(Abu Zawal)mine area,located in the northern Eastern Desert of Egypt,fieldwork and mineralogical analysis,integrated with machine learning techniques applied to Landsat-8 OLI,ASTER,and Sentinel-2 multi-sp...In the Fatira(Abu Zawal)mine area,located in the northern Eastern Desert of Egypt,fieldwork and mineralogical analysis,integrated with machine learning techniques applied to Landsat-8 OLI,ASTER,and Sentinel-2 multi-spectral imagery(MSI)data delineate gold-sulfide mineralization in altered rocks.Gold(Au)anomalies in hydrothermal breccias and quartz veins are associated with NE-oriented felsite dykes and silicified granitic rocks.Two main alteration types are identified:a pyrite-sericite-quartz and a sulfide-chlorite-carbonate assemblage,locally with dispersed free-milling Au specks.Dimensionality reduction techniques,including principal component analysis(PCA)and independent component analysis(ICA),enabled mapping of alteration types.Sentinel-2 PC125 composite images offered efficient lithological differentiation,while supervised classifications,i.e.,the support vector machine(SVM)of Landsat-8 yielded an accuracy of 88.55%and a Kappa value of 0.86.ASTER mineral indices contributed to map hydrothermal alteration mineral phases,including sericite,muscovite,kaolinite,and iron oxides.Results indicate that post-magmatic epigenetic hydrothermal activity significantly contributed to the Au-sulfide mineralization in the Fatira area,distinguishing it from the more prevalent orogenic gold deposits in the region.展开更多
This study investigates laminar convection in three regimes(forced convection,mixed convection,and natural convection)of a bi-nanofluid(Cu-Al_(2)O_(3)-water)/mono-nanofluid(Al_(2)O_(3)-water)inside a square enclosure ...This study investigates laminar convection in three regimes(forced convection,mixed convection,and natural convection)of a bi-nanofluid(Cu-Al_(2)O_(3)-water)/mono-nanofluid(Al_(2)O_(3)-water)inside a square enclosure of sliding vertical walls which are kept at cold temperature and moving up,down,or in opposite directions.The enclosure bottom is heated partially by a central heat source of various sizes while the horizontal walls are considered adiabatic.The thermal conductivity and dynamic viscosity are dependent on temperature and nanoparticle size.The conservation equations are implemented in the solver ANSYS R2(2020).The numerical predictions are successfully validated by comparison with data from the literature.Numerical simulations are carried out for various volume fractions of solid mono/hybrid-nanoparticles(0≤ϕ≤5%),Richardson numbers(0.001≤Ri≤10),and hot source lengths((1/5)H≤ε≤(4/5)H).Isothermal lines,streamlines,and average Nusselt numbers are analyzed.The thermal performance of nanofluids is compared to that of the base heat transfer fluid(water).Outcomes illustrate the flow characteristics significantly affected by the convection regime,hot source size,sidewall motion,and concentration of solid nanoparticles.In the case of sidewalls moving downward,using hybrid nanofluid(Cu-Al_(2)O_(3)-water)shows the highest heat transfer rate in the enclosure at Ri=1,ε=(4/5)H and volume fraction ofφ=5%where a significant increment(25.14%)of Nusselt number is obtained.展开更多
The rapid advancement of Artificial Intelligence(AI)has transformed educational practices,yet its integration with experiential pedagogies such as drama remains underexplored in English Language Teaching(ELT),particul...The rapid advancement of Artificial Intelligence(AI)has transformed educational practices,yet its integration with experiential pedagogies such as drama remains underexplored in English Language Teaching(ELT),particularly in pre-service teacher education.This study examines how AI-supported drama pedagogy contributes to the professional development of pre-service English teachers,focusing on reflective practice,pedagogical adaptability,creativity,intercultural awareness,and sustainability-oriented teaching perspectives.Grounded in sociocultural theory,experiential learning,and Education for Sustainable Development(ESD),the research adopts an interpretive qualitative case study design conducted over a 12-week elective course titled“Drama in ELT”at a foundation university in Istanbul,Türkiye.Participants included 40 second-year pre-service teachers,with 15 volunteers taking part in semi-structured focus group interviews.Data were collected through open-ended questionnaires and focus groups and analyzed using reflexive thematic analysis.Four interrelated themes emerged:creativity and pedagogical innovation,intercultural awareness and empathy,problem-solving and adaptability,and reflective professional growth with ethical awareness.Findings suggest that AI acted as a mediational scaffold that enriched drama-based learning while preserving human agency.The study concludes that integrating AI with drama offers a meaningful model for sustainable teacher education aligned with SDG 4(Quality Education)and SDG 9(Industry,Innovation and Infrastructure).展开更多
Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its cli...Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its clinical necessity remains controversial.This study aimed to assess the necessity of routine postoperative thoracic imaging for detecting pulmonary complications in patients undergoing supracostal mini percutaneous nephrolithotomy(m-PCNL)surgery.Methods:A retrospective analysis was conducted on data from patients who underwent supracostal m-PCNL between 2017 and 2022 in a tertiary center.Excluding patients under 18,with kidney/skeletal anomalies,or active thoracic disease,112 eligible patients were included.Patients were divided into two groups:those with routine postoperative chest X-ray(CXR)(Group 1,n=40)and those without(Group 2,n=72).Complications and operative data were compared between groups.Results:Mean ages were 44.3±11.4(Group 1)and 42.6±13.1(Group 2),with no significant difference(p=0.102).Stone sizes were 30.8±8.6 mm(Group 1)and 24.8±8.4 mm(Group 2),also not significantly different(p=0.313).High fever occurred in 10% of Group 1 and 4% of Group 2(p=0.246).Minimal effusion was found in 10% of Group 1,with no treatment due to lack of symptoms.However,subsequent CXR revealed hydropneumothorax in 2.5% of cases,necessitating thoracic tube insertion.In Group 2,5% developed postoperative respiratory symptoms,with significant pneumothorax in 1.3%,requiring thoracic tube placement.Thoracic tube insertion rates did not significantly differ between groups(Group 1:2.5%vs.Group 2:1.3%,p=0.671).Conclusions:Routine postoperative thoracic imaging did not show any significant benefit in detecting pulmonary complications post-supracostal m-PCNL.展开更多
Peripheral artery disease(PAD)remains a significant global health issue,with current treatments primarily focused on relieving symptoms and addressingmacrovascular issues.However,critical immunoinflammatory mechanisms...Peripheral artery disease(PAD)remains a significant global health issue,with current treatments primarily focused on relieving symptoms and addressingmacrovascular issues.However,critical immunoinflammatory mechanisms are often overlooked.Recent evidence suggests that monocyte phenotypic plasticity plays a central role in PAD development,affecting atherogenesis,plaque progression,ischemia-reperfusion injury,and chronic ischemic remodeling.This narrative review aims to summarize the latest advances(2023-2025)in understanding monocyte diversity,functional states,and their changes throughout different stages of PAD.We discuss both established and emerging biomarkers,such as circulating monocyte subset proportions,functional assays,immune checkpoint expression,and multi-omics signatures,highlighting their potential for prognosis and the challenges in translating them to clinical practice.We also present a stage-specific approach to mapping out potential therapies,linking monocyte phenotypes to molecular targets and possible interventions.Additionally,we address regulatory,economic,and implementation considerations for applying these findings in a clinical setting.The goal of this review is to facilitate the development of targeted immunomodulatory strategies to improve limb and cardiovascular outcomes in PAD by combining mechanistic understanding with therapeutic innovation.展开更多
Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the ...Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.展开更多
This paper investigates the reliability of internal marine combustion engines using an integrated approach that combines Fault Tree Analysis(FTA)and Bayesian Networks(BN).FTA provides a structured,top-down method for ...This paper investigates the reliability of internal marine combustion engines using an integrated approach that combines Fault Tree Analysis(FTA)and Bayesian Networks(BN).FTA provides a structured,top-down method for identifying critical failure modes and their root causes,while BN introduces flexibility in probabilistic reasoning,enabling dynamic updates based on new evidence.This dual methodology overcomes the limitations of static FTA models,offering a comprehensive framework for system reliability analysis.Critical failures,including External Leakage(ELU),Failure to Start(FTS),and Overheating(OHE),were identified as key risks.By incorporating redundancy into high-risk components such as pumps and batteries,the likelihood of these failures was significantly reduced.For instance,redundant pumps reduced the probability of ELU by 31.88%,while additional batteries decreased the occurrence of FTS by 36.45%.The results underscore the practical benefits of combining FTA and BN for enhancing system reliability,particularly in maritime applications where operational safety and efficiency are critical.This research provides valuable insights for maintenance planning and highlights the importance of redundancy in critical systems,especially as the industry transitions toward more autonomous vessels.展开更多
AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This o...AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.展开更多
文摘MXene-based smart contact lenses demonstrate a cutting-edge advancement in wearable ophthalmic technology,combining real-time biosensing,therapeutic capabilities,and user comfort in a single platform.These devices take the advantage of the exceptional electrical conductivity,mechanical flexibility,and biocompatibility of two-dimensional MXenes to enable noninvasive,tear-based monitoring of key physiological markers such as intraocular pressure and glucose levels.Recent developments focus on the integration of transparent MXene films into the conventional lens materials,allowing multifunctional performance including photothermal therapy,antimicrobial and anti-inflammation protection,and dehydration resistance.These innovations offer promising strategies for ocular disease management and eye protection.In addition to their multifunctionality,improvements in MXene synthesis and device engineering have enhanced the stability,transparency,and wearability of these lenses.Despite these advances,challenges remain in long-term biostability,scalable production,and integration with wireless communication systems.This review summarizes the current progress,key challenges,and future directions of MXene-based smart contact lenses,highlighting their transformative potential in next-generation digital healthcare and ophthalmic care.
文摘The impact of earthquakes in urban centers prone to disastrous earthquakes necessitates the analysis of associ- ated risk for rational formulation of contingency plans and mitigation strategies.In urban centers,the seismic risk is best quantified and portrayed through the preparation of'Earthquake Damage and Loss Scenarios.'The components of such scenarios are the assessment of the hazard,inventories and the vulnerabilities of elements at risk.For the development of the earthquake risk scenario in Istanbul,two independent approaches,one based on intensities and the second on spectral displacements,are utilized.This paper will present the important features of a comprehensive study,highlight the method- ology,discuss the results and provide insights to future developments.
基金The study protocol was approved by the Marmara University School of Medicine Clinical Research Ethics Committee(Protocol No:09.2019.360,date:April 5,2019).
文摘BACKGROUND Obsessive-compulsive disorder(OCD)is a heterogeneous disease in many respects and exhibits this diversity in terms of phenomenology.It also displays several different characteristics in children compared to adults.AIM To describe the socio-demographic and phenomenological features of children with OCD and to investigate the impact of these features on response to pharmacotherapy.METHODS This retrospective study was carried out with 150 children and adolescents who had been diagnosed with OCD between 2014 and 2018.Data was collected by examining the files of the patients with diagnosis of OCD and similar disorders from the hospital database.Yale-Brown Obsessive-Compulsive Scale for Children was used for the assessment of obsession-compulsion subtypes.The Clinical Global Impression(CGI)scale was used to evaluate the severity of the disease(CGI-S)and global improvement(CGI-I).The predictors of treatment response were evaluated using linear regression analysis.The level of significance for all statistic tests was set as P<0.05.RESULTS The sample was divided into prepubertal(44%)and adolescent(56%)age groups.The most prevalent obsessions were contamination and aggression obsessions,and the most frequent compulsions were washing and checking.While contamination was observed more commonly in the prepubertal age group,the religious obsession was seen more frequently in adolescents.Patients with aggression obsession presented a higher frequency of comorbid anxiety(P=0.022)and mood subgroups(P>0.05).A lower CGI-I score was linked to a lower CGI-S score(95%confidence interval 0.21-0.39,P<0.001)and the prepubertal age of admission(95%confidence interval 0.03-0.87,P=0.020).CONCLUSION The phenomenology of OCD shows differences depending on the age group and the comorbid psychiatric disorders.Earlier identification and treatment of OCD may help to prevent the impairment of the mental health of children and adolescents.
文摘Since the 18th century, the irritating but also fascinating scenes of urbanity--a complex phenomenon with cultural, social, political, economic, temporal, spatial, functional, and formal dimensions--have been described in literary works. Many seemingly opposite facts, such as individuality/society, freedom/loneliness/socialization, anonymity/strangeness/identity/belonging, diversity/chaos/segregation, indifferent city-dweller/initiative citizenship, have been revealed through literary works, travel and utopian writing, urban theories, scientific studies, manifestos, and newspaper articles. On the one hand, there are those who advocate a life outside the city because they consider the problems produced by the city and the phenomenon of density which they perceive merely in quantitative terms, as unsolvable problems. On the other hand, there are those who see the production of loose urban fabric as a solution or those who accept the （seemingly） opposite facts of urbanity as positive values and therefore support city life. All of these ideas are still as actual today as they were in the past. We are often unable to use our citizen rights to the city, to encounter different classes （social/etlmic/religious）, to experience heterogeneity as an aspect inherent in city life and in the route of our daily life--following the orders of the capitalist system mainly organized around work--and we are often drawn into the same districts on the same paths. Our perception of our urban environments may get monotonous and shallow, but the irritating yet fascinating features of the first big cities still exist and may be grasped and brought into consciousness. Throughout their architectural education, especially in urban design studios, students can be encouraged to investigate the rhythm of their daily life, the conditions of their urban environments, and discovering the city as an intellectual and sensual programme, so that the phenomenon of urbanity can be grasped not just on formal, but on various other dimensions as well. This study focuses on the process and outcomes of two urban studios located in Taksim Square and along the shores of the Golden Horn in Istanhul. Taking the multidimensional content of urbanity into account, acquired theoretically through literary works and studies on urban planning and its history, the main aim of these studios has been the phenomenological understanding of the dynamic content of urbanity by the students. Through creative analysis of permanent/temporary spaces engendered by the diversity of user profiles and actions discovered on phenomenological excursions, students examine the qualitative values of density and global and local dynamics. We believe that designing spaces as ＂prototypes＂ helps highlight the multidimensional content of urbanity. The present study aims not only to highlight the multidimensional content of urbanity, but also to encourage its discussion in architectural design education and to emphasize the positive contribution of theoretical readings and phenomenological studies to urban design studios. The present study also aims to emphasize the beneficial correlation of global and local dynamics as the two faces of urbanity; important more than ever for the big cities of the 21 st century if we advocate for a vivid and resilient city life and citizens.
文摘With coming in force of The Law of Transformation of Areas at Disaster Risks numbered 16.5.2012/6306 by Ministry of Environment and Urbanization,the concept of urban transformation has entered to our life in Turkey.Gentrification as one of the forms of urban transformation brought the existence of liberated zones produced by neo-liberal mentality.Sulukule area(Neslisah Sultan settlement)which is subject to research is counted among“the areas to be renewed and to be put under preservation”by numbered 2006/10299 decision of Council of Ministers.Due to the shortage of lands in the city,it is observed especially in 1980s that the families in high-income group have preferred to live in horizontally expending villa towns far from the center.While these residential areas are deepening the distance from the center in time,the pressure of housing demand of middle-income people and rent circles who are not planning to leave the city center caused to have an eye on these areas which are residential areas of mostly low-income people and appeared in certain regions as they are established without infrastructure and healthy conditions.With this law,the transformation has started in the areas such as Fikirtepe,Dolapdere,Esenler,and Banks of Halic(Golden Horn)where structural life is completed,and floor area ratio has been raised to 4.0 from 2.07.Vertical housing is stimulated by adding the street between the parcels to the blocks,it has been tried to prevent the victimization of local people to unearned income.There are some quarters that,under the name of gentrification,Romany citizens who passed to permanent settlement from nomadic culture at the Ottoman era,and who are engaged in activities such as handicraft,adornments,shoe making,weaving beside the show business at Fatih Sulukule district are convicted to lodge in the houses built in suburban if they have title deed,and in jerry-built tents if they don’t have deed.Chamber of Architects,Chamber of City Planners Istanbul Branch and Roma Culture Development and Solidarity Association filed“nullity suit”and“stay of execution”.Despite the continuing judicial process,the demolition started in 2009,and starting the constructing the villas in 2010 breaking the resistance of Romany citizens,the area was victimized to rent.
文摘Restoration of historical buildings is important because they maintain cultural and historical continuity and transmit the cultural and social values from our precedents to future generations.Historical buildings need to adapt themselves to a changing cultural,social,economic,and political context.In this paper refunctioning project of a historic Ottoman,warehouse is presented.The aim of the project is to re-gain this historical structure for public use by re-newing it to the modern comfort level and making the required functional changes.The main structural system of the warehouse consists of thick masonry stone walls.The idea in the proposed restoration project is to build a two-story steel structure inside the available volume of the warehouse.The columns of the new steel construction run parallel to the existing structural system of the historic building and are fixed at their base to the existing building foundation.Hence,there is no connection between the proposed steel structure walls and the existing masonry walls,and this will save the historic fabric of the warehouse.The project proposal shows the details of planned restoration stages,the process of programming the new interior space,construction materials,and lighting and ventilation solutions.Furthermore,in this project,two-and threedimensional computer drawings were used.Finally,the proposed parallel steel structure is able to regain the warehouse and renew it to be used as a modern housing and workshop.
文摘Emerging evidence underscores the critical role of intestinal microbiota in postoperative recovery and long-term outcomes of gastrointestinal procedures.In this editorial,we comment on the retrospective study by Niu et al,which highlights the beneficial impact of dietary fiber supplementation on gut microbiota restoration following endoscopic mucosa resection.The findings highlight the potential of fiber supplementation to modulate gut microbiota and support recovery following endoscopic mucosa resection.Nonetheless,we also emphasize the need for prospective,randomized studies to delineate the optimal type,dose,and duration of fiber supplementation.This research represents a significant step toward evidence-based nutritional interventions in minimally invasive gastrointestinal surgery and underscores the importance of microbiota-targeted therapies in personalized postoperative care.
文摘Detection of Autism Spectrum Disorder(ASD)is a crucial area of research,representing a foundational aspect of psychological studies.The advancement of technology and the widespread adoption of machine learning methodologies have brought significant attention to this field in recent years.Interdisciplinary efforts have further propelled research into detection methods.Consequently,this study aims to contribute to both the fields of psychology and computer science.Specifically,the goal is to apply machine learning techniques to limited data for the detection of Autism Spectrum Disorder.This study is structured into two distinct phases:data preprocessing and classification.In the data preprocessing phase,four datasets—Toddler,Children,Adolescent,and Adult—were converted into numerical form,adjusted as necessary,and subsequently clustered.Clustering was performed using six different methods:Kmeans,agglomerative,DBSCAN(Density-Based Spatial Clustering of Applications with Noise),mean shift,spectral,and Birch.In the second phase,the clustered ASD data were classified.The model’s accuracy was assessed using 5-fold cross-validation to ensure robust evaluation.In total,ten distinct machine learning algorithms were employed.The findings indicate that all clustering methods demonstrated success with various classifiers.Notably,the K-means algorithm emerged as particularly effective,achieving consistent and significant results across all datasets.This study is expected to serve as a guide for improving ASD detection performance,even with minimal data availability.
文摘Even if dissociation has various facets,it is clear that knowledge of dissociative psychosis and a dissociative schizophrenia-based viewpoint may provide new perspectives on mental disorders.Many researchers screening for comorbid symptoms of“childhood traumatic experiences”and“dissociation”,where specific characteristics are significant to the presence of psychosis and schizophrenia,may lead to an acceptable definition.In recent years,researchers have also reported crucial advances in the understanding of dissociative psychosis and dissociative schizophrenia.Although clinical studies in this area have been ongoing for a long time,research has not demonstrated that a clear and valid relationship exists between dissociation,childhood traumatic experiences,and schizophrenia or psychotic spectrum disorders.However,some results of statistical comparisons have supported the existence of the clinical manifestation known as dissociative psychosis and dissociative schizophrenia.Dissociation,childhood traumatic experiences,and positive psychotic symptoms may be a prominent part of dissociative psychosis and schizophrenia.The intense presence of negative symptoms may indicate classical schizophrenia.In research and clinical practice,researchers and clinicians may use psychometric tests to detect symptoms of dissociative psychosis.Psychotic persons with traumatic experiences likely benefit from treatment focused on trauma symptomatolgy.
文摘Application of variable speed limits(VSL)is gradually increasingly implemented especially on highways.As a result of conducted studies and implementations,it is observed that the variable speed limits have reduced the number of car accidents as well as proved positive results in terms of delays and environmental factors.Purpose of this study is to develop an algorithm for VSL application that is considered to be applied on Istanbul D100 highway and to assess the effects of application.Algorithm that is developed for VSL is a different VSL algorithm and compared with the constant speed system.According to obtained results,when the proposed system is compared to current system,it is observed that the number of delays and average stops are reduced%30 and%40 respectively and also emissions reduced at the rate of%12.
文摘Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threatening and necessitate an immediate diagnosis and referral,but many others,like conjunctivitis or episcleritis,are benign and self-limiting.To prevent complications,such as irreversible vision loss or the spread of infection throughout the body,it is essential to accurately and promptly distinguish between benign and serious causes.With a broad range of etiologies covered,this review offers a thorough,evidence-based method for assessing red eye in primary care.For inflammatory,infectious,traumatic,and non-inflammatory disorders,we look at important clinical characteristics,diagnostic factors,and therapeutic approaches.Dry eye syndrome,pterygium,scleritis,episcleritis,keratitis,conjunctivitis,uveitis,blepharitis,hordeolum,endophthalmitis,orbital cellulitis,hyphema,trichiasis,and subconjunctival hemorrhage are among them.Whereas episcleritis usually responds to topical treatment,inflammatory conditions like scleritis and uveitis need systemic corticosteroids or immunosuppressive therapy.Infections such as keratitis,conjunctivitis,and endophthalmitis require treatments specific to the pathogen,while diseases like orbital cellulitis and hyphema may require hospitalization or surgery.External conditions like dry eye and blepharitis are treated conservatively with lubrication and cleanliness.This review aims to provide general practitioners with useful clinical tools for timely assessment,efficient triage,and referral by defining red flag symptoms,hallmark signs,and updated treatment protocols.Regular eye exams and patient education also improve results and lower recurrence.
文摘BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.
基金the National Science Foundation of China (Grant No. NSFC: 92162213)the Geology Department Faculty of Science of Al-Azhar University (Assiut Branch)+2 种基金the China Scholarship CouncilChang'an UniversityIstanbul Technical University's Scientific Research Project (BAP Project ID: 45396, code: FHD-2024-45396)
文摘In the Fatira(Abu Zawal)mine area,located in the northern Eastern Desert of Egypt,fieldwork and mineralogical analysis,integrated with machine learning techniques applied to Landsat-8 OLI,ASTER,and Sentinel-2 multi-spectral imagery(MSI)data delineate gold-sulfide mineralization in altered rocks.Gold(Au)anomalies in hydrothermal breccias and quartz veins are associated with NE-oriented felsite dykes and silicified granitic rocks.Two main alteration types are identified:a pyrite-sericite-quartz and a sulfide-chlorite-carbonate assemblage,locally with dispersed free-milling Au specks.Dimensionality reduction techniques,including principal component analysis(PCA)and independent component analysis(ICA),enabled mapping of alteration types.Sentinel-2 PC125 composite images offered efficient lithological differentiation,while supervised classifications,i.e.,the support vector machine(SVM)of Landsat-8 yielded an accuracy of 88.55%and a Kappa value of 0.86.ASTER mineral indices contributed to map hydrothermal alteration mineral phases,including sericite,muscovite,kaolinite,and iron oxides.Results indicate that post-magmatic epigenetic hydrothermal activity significantly contributed to the Au-sulfide mineralization in the Fatira area,distinguishing it from the more prevalent orogenic gold deposits in the region.
文摘This study investigates laminar convection in three regimes(forced convection,mixed convection,and natural convection)of a bi-nanofluid(Cu-Al_(2)O_(3)-water)/mono-nanofluid(Al_(2)O_(3)-water)inside a square enclosure of sliding vertical walls which are kept at cold temperature and moving up,down,or in opposite directions.The enclosure bottom is heated partially by a central heat source of various sizes while the horizontal walls are considered adiabatic.The thermal conductivity and dynamic viscosity are dependent on temperature and nanoparticle size.The conservation equations are implemented in the solver ANSYS R2(2020).The numerical predictions are successfully validated by comparison with data from the literature.Numerical simulations are carried out for various volume fractions of solid mono/hybrid-nanoparticles(0≤ϕ≤5%),Richardson numbers(0.001≤Ri≤10),and hot source lengths((1/5)H≤ε≤(4/5)H).Isothermal lines,streamlines,and average Nusselt numbers are analyzed.The thermal performance of nanofluids is compared to that of the base heat transfer fluid(water).Outcomes illustrate the flow characteristics significantly affected by the convection regime,hot source size,sidewall motion,and concentration of solid nanoparticles.In the case of sidewalls moving downward,using hybrid nanofluid(Cu-Al_(2)O_(3)-water)shows the highest heat transfer rate in the enclosure at Ri=1,ε=(4/5)H and volume fraction ofφ=5%where a significant increment(25.14%)of Nusselt number is obtained.
文摘The rapid advancement of Artificial Intelligence(AI)has transformed educational practices,yet its integration with experiential pedagogies such as drama remains underexplored in English Language Teaching(ELT),particularly in pre-service teacher education.This study examines how AI-supported drama pedagogy contributes to the professional development of pre-service English teachers,focusing on reflective practice,pedagogical adaptability,creativity,intercultural awareness,and sustainability-oriented teaching perspectives.Grounded in sociocultural theory,experiential learning,and Education for Sustainable Development(ESD),the research adopts an interpretive qualitative case study design conducted over a 12-week elective course titled“Drama in ELT”at a foundation university in Istanbul,Türkiye.Participants included 40 second-year pre-service teachers,with 15 volunteers taking part in semi-structured focus group interviews.Data were collected through open-ended questionnaires and focus groups and analyzed using reflexive thematic analysis.Four interrelated themes emerged:creativity and pedagogical innovation,intercultural awareness and empathy,problem-solving and adaptability,and reflective professional growth with ethical awareness.Findings suggest that AI acted as a mediational scaffold that enriched drama-based learning while preserving human agency.The study concludes that integrating AI with drama offers a meaningful model for sustainable teacher education aligned with SDG 4(Quality Education)and SDG 9(Industry,Innovation and Infrastructure).
文摘Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its clinical necessity remains controversial.This study aimed to assess the necessity of routine postoperative thoracic imaging for detecting pulmonary complications in patients undergoing supracostal mini percutaneous nephrolithotomy(m-PCNL)surgery.Methods:A retrospective analysis was conducted on data from patients who underwent supracostal m-PCNL between 2017 and 2022 in a tertiary center.Excluding patients under 18,with kidney/skeletal anomalies,or active thoracic disease,112 eligible patients were included.Patients were divided into two groups:those with routine postoperative chest X-ray(CXR)(Group 1,n=40)and those without(Group 2,n=72).Complications and operative data were compared between groups.Results:Mean ages were 44.3±11.4(Group 1)and 42.6±13.1(Group 2),with no significant difference(p=0.102).Stone sizes were 30.8±8.6 mm(Group 1)and 24.8±8.4 mm(Group 2),also not significantly different(p=0.313).High fever occurred in 10% of Group 1 and 4% of Group 2(p=0.246).Minimal effusion was found in 10% of Group 1,with no treatment due to lack of symptoms.However,subsequent CXR revealed hydropneumothorax in 2.5% of cases,necessitating thoracic tube insertion.In Group 2,5% developed postoperative respiratory symptoms,with significant pneumothorax in 1.3%,requiring thoracic tube placement.Thoracic tube insertion rates did not significantly differ between groups(Group 1:2.5%vs.Group 2:1.3%,p=0.671).Conclusions:Routine postoperative thoracic imaging did not show any significant benefit in detecting pulmonary complications post-supracostal m-PCNL.
文摘Peripheral artery disease(PAD)remains a significant global health issue,with current treatments primarily focused on relieving symptoms and addressingmacrovascular issues.However,critical immunoinflammatory mechanisms are often overlooked.Recent evidence suggests that monocyte phenotypic plasticity plays a central role in PAD development,affecting atherogenesis,plaque progression,ischemia-reperfusion injury,and chronic ischemic remodeling.This narrative review aims to summarize the latest advances(2023-2025)in understanding monocyte diversity,functional states,and their changes throughout different stages of PAD.We discuss both established and emerging biomarkers,such as circulating monocyte subset proportions,functional assays,immune checkpoint expression,and multi-omics signatures,highlighting their potential for prognosis and the challenges in translating them to clinical practice.We also present a stage-specific approach to mapping out potential therapies,linking monocyte phenotypes to molecular targets and possible interventions.Additionally,we address regulatory,economic,and implementation considerations for applying these findings in a clinical setting.The goal of this review is to facilitate the development of targeted immunomodulatory strategies to improve limb and cardiovascular outcomes in PAD by combining mechanistic understanding with therapeutic innovation.
文摘Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.
基金supported by Istanbul Technical University(Project No.45698)supported through the“Young Researchers’Career Development Project-training of doctoral students”of the Croatian Science Foundation.
文摘This paper investigates the reliability of internal marine combustion engines using an integrated approach that combines Fault Tree Analysis(FTA)and Bayesian Networks(BN).FTA provides a structured,top-down method for identifying critical failure modes and their root causes,while BN introduces flexibility in probabilistic reasoning,enabling dynamic updates based on new evidence.This dual methodology overcomes the limitations of static FTA models,offering a comprehensive framework for system reliability analysis.Critical failures,including External Leakage(ELU),Failure to Start(FTS),and Overheating(OHE),were identified as key risks.By incorporating redundancy into high-risk components such as pumps and batteries,the likelihood of these failures was significantly reduced.For instance,redundant pumps reduced the probability of ELU by 31.88%,while additional batteries decreased the occurrence of FTS by 36.45%.The results underscore the practical benefits of combining FTA and BN for enhancing system reliability,particularly in maritime applications where operational safety and efficiency are critical.This research provides valuable insights for maintenance planning and highlights the importance of redundancy in critical systems,especially as the industry transitions toward more autonomous vessels.
文摘AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.
