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
Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients age...Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients aged 65 years and over,who were admitted to the Emergency Department of Baskent University Ankara Hospital between January 2011 and January 2015 and diagnosed with vertebral trauma.The information of the patients was obtained from the medical records.The clinical characteristics of patients including localizafions and types of fracture,presence of additional system injuries and treatment options were investigated.Results:The most common cause was fall,accounting for 51 (79.7%),with 7 (10.9%) due to intra-vehicle traffic accident,and 6 (9.4%) due to out-of-vehicle pedestrian injury.The most common site of trauma was the lumbar region.Of the fractures,46.9% (n=30) were in the lumbar region,37.5% (n=24) in the thoracic region and 15.6% (n=10) were in the cervical vertebra region.Fourteen (21.9%) patients had an additional injury.Given the fracture types,47 fractures (74.6%) were compression,14 fractures (22.2%) were spinous process and 2 fractures (3.2%) were burst fractures.Twenty patients (31.2%) had multilevel vertebral fractures.Conclusions:The results of our study demonstrated the importance of vertebral fractures in the geriatric age group.In this age group,falls and motor vehicle accidents are the leading causes of vertebral traumas.Taking the necessary measures to prevent the risk factors which increase with aging is the most important step in preventing the mortality and morbidity that may occur as a result of vertebral fracture.展开更多
BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.Th...BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.展开更多
Metabolic dysfunction-associated steatotic liver disease(MASLD)and inflam-matory bowel disease(IBD)are chronic conditions with complex aetiologies,in which environmental factors and interactions between the gut and li...Metabolic dysfunction-associated steatotic liver disease(MASLD)and inflam-matory bowel disease(IBD)are chronic conditions with complex aetiologies,in which environmental factors and interactions between the gut and liver play a key role.Both conditions are characterised by disturbances in the gut microbiota,which can affect local and systemic inflammatory responses.In particular,inc-reased intestinal permeability promotes the translocation of bacterial components into the portal circulation,contributing to the development of inflammation in the liver.There is growing evidence that modulation of the gut microbiota and imp-roved intestinal barrier function may be of therapeutic importance.The purpose of this review is to discuss the pathogenetic mechanisms that link MASLD and IBD,with a particular emphasis on the influence of the microbiota and environ-mental factors on the development of these diseases.展开更多
BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better...BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better short-term outcomes,including less postoperative pain,shorter operative time,faster return to work,and higher patient satisfaction.However,there is a risk-benefit debate surrounding SH due to significant complications from the procedure,such as anal stenosis,rectovaginal fistula,fecal incontinence,and recurrence.AIM To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.METHODS This retrospective,single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis.Early(less than 7 days after SH)and late(7 or more days after SH)complications were analyzed.Recurrence rates were calculated as well.RESULTS Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups.Recurrence was observed in 4 patients(23.6%)with grade IV hemorrhoids,and no recurrence was noted in patients with grade III hemorrhoids.Postoperative bleeding,incomplete defecation,urgent defecation,incontinence,skin tags,and anal fissure were complications reported by both groups.CONCLUSION Due to the high recurrence rate,SH is not an appropriate treatment option for patients with grade IV hemorrhoids.Open surgery may be a more suitable option for these patients.展开更多
In this article,a well-known anisotropic solution,the Tolman-Finch-Skea(TFS)solution,is studied using the gravitational decoupling approach within the framework of 4D Einstein-Gauss-Bonnet(EGB)gravity.The radial metri...In this article,a well-known anisotropic solution,the Tolman-Finch-Skea(TFS)solution,is studied using the gravitational decoupling approach within the framework of 4D Einstein-Gauss-Bonnet(EGB)gravity.The radial metric potential is modified linearly through the minimal geometric deformation approach,while the temporal component of the metric remains unchanged.The system of EGB field equations is decomposed into two distinct sets of field equations:one corresponding to the standard energy-momentum tensor and the other associated with an external gravitational source.The first system is solved using the aforementioned known solution,while the second is closed by imposing the mimic constraint on pressure.Moreover,the junction conditions at the inner and outer surfaces of the stellar object are examined,considering the Boulware-Deser 4D space-time as the external geometry.The physical properties of the stellar model are analyzed using parameters such as energy conditions,causality conditions,compactness,and redshift.展开更多
The Internet has been enhanced recently by blockchain and Internet of Things(IoT)networks.The Internet of Things is a network of various sensor-equipped devices.It gradually integrates the Internet,sensors,and cloud c...The Internet has been enhanced recently by blockchain and Internet of Things(IoT)networks.The Internet of Things is a network of various sensor-equipped devices.It gradually integrates the Internet,sensors,and cloud computing.Blockchain is based on encryption algorithms,which are shared database technologies on the Internet.Blockchain technology has grown significantly because of its features,such as flexibility,support for integration,anonymity,decentralization,and independent control.Computational nodes in the blockchain network are used to verify online transactions.However,this integration creates scalability,interoperability,and security challenges.Over the last decade,several advancements in blockchain technology have drawn attention fromresearch communities and industries.Blockchain technology helps IoT networks become more reliable and enhance security and privacy.It also removes single points of failure and lowers the cost.In recent years,there has been an increasing amount of literature on IoT and blockchain technology applications.This paper extensively examines the current state of blockchain technologies,focusing specifically on their integration into the Internet of Things.Additionally,it highlights the benefits,drawbacks,and opportunities of recent studies on security issues based on blockchain solutions into categories.The survey examined various research papers fromdifferent types of publications.Also,a review of the other IoT applications has been included,focusing on the security requirements and challenges in IoT-based systems.Future research directions are gathered for the effective integration of Blockchain and IoT.展开更多
Changes in the Atmospheric Electric Field Signal(AEFS)are highly correlated with weather changes,especially with thunderstorm activities.However,little attention has been paid to the ambiguous weather information impl...Changes in the Atmospheric Electric Field Signal(AEFS)are highly correlated with weather changes,especially with thunderstorm activities.However,little attention has been paid to the ambiguous weather information implicit in AEFS changes.In this paper,a Fuzzy C-Means(FCM)clustering method is used for the first time to develop an innovative approach to characterize the weather attributes carried by AEFS.First,a time series dataset is created in the time domain using AEFS attributes.The AEFS-based weather is evaluated according to the time-series Membership Degree(MD)changes obtained by inputting this dataset into the FCM.Second,thunderstorm intensities are reflected by the change in distance from a thunderstorm cloud point charge to an AEF apparatus.Thus,a matching relationship is established between the normalized distance and the thunderstorm dominant MD in the space domain.Finally,the rationality and reliability of the proposed method are verified by combining radar charts and expert experience.The results confirm that this method accurately characterizes the weather attributes and changes in the AEFS,and a negative distance-MD correlation is obtained for the first time.The detection of thunderstorm activity by AEF from the perspective of fuzzy set technology provides a meaningful guidance for interpretable thunderstorms.展开更多
Thunderstorm detection based on the Atmospheric Electric Field(AEF)has evolved from time-domain models to space-domain models.It is especially important to evaluate and determine the particularly Weather Attribute(WA)...Thunderstorm detection based on the Atmospheric Electric Field(AEF)has evolved from time-domain models to space-domain models.It is especially important to evaluate and determine the particularly Weather Attribute(WA),which is directly related to the detection reliability and authenticity.In this paper,a strategy is proposed to integrate three currently competitive WA's evaluation methods.First,a conventional evaluation method based on AEF statistical indicators is selected.Subsequent evaluation approaches include competing AEF-based predicted value intervals,and AEF classification based on fuzzy c-means.Different AEF attributes contribute to a more accurate AEF classification to different degrees.The resulting dynamic weighting applied to these attributes improves the classification accuracy.Each evaluation method is applied to evaluate the WA of a particular AEF,to obtain the corresponding evaluation score.The integration in the proposed strategy takes the form of a score accumulation.Different cumulative score levels correspond to different final WA results.Thunderstorm imaging is performed to visualize thunderstorm activities using those AEFs already evaluated to exhibit thunderstorm attributes.Empirical results confirm that the proposed strategy effectively and reliably images thunderstorms,with a 100%accuracy of WA evaluation.This is the first study to design an integrated thunderstorm detection strategy from a new perspective of WA evaluation,which provides promising solutions for a more reliable and flexible thunderstorm detection.展开更多
Reconfiguration,as well as optimal utilization of distributed generation sources and capacitor banks,are highly effective methods for reducing losses and improving the voltage profile,or in other words,the power quali...Reconfiguration,as well as optimal utilization of distributed generation sources and capacitor banks,are highly effective methods for reducing losses and improving the voltage profile,or in other words,the power quality in the power distribution system.Researchers have considered the use of distributed generation resources in recent years.There are numerous advantages to utilizing these resources,the most significant of which are the reduction of network losses and enhancement of voltage stability.Non-dominated Sorting Genetic Algorithm II(NSGA-II),Multi-Objective Particle Swarm Optimization(MOPSO),and Intersect Mutation Differential Evolution(IMDE)algorithms are used in this paper to perform optimal reconfiguration,simultaneous location,and capacity determination of distributed generation resources and capacitor banks.Three scenarios were used to replicate the studies.The reconfiguration of the switches,as well as the location and determination of the capacitor bank’s optimal capacity,were investigated in this scenario.However,in the third scenario,reconfiguration,and determining the location and capacity of the Distributed Generation(DG)resources and capacitor banks have been carried out simultaneously.Finally,the simulation results of these three algorithms are compared.The results indicate that the proposed NSGAII algorithm outperformed the other two multi-objective algorithms and was capable of maintaining smaller objective functions in all scenarios.Specifically,the energy losses were reduced from 211 to 51.35 kW(a 75.66%reduction),119.13 kW(a 43.54%reduction),and 23.13 kW(an 89.04%reduction),while the voltage stability index(VSI)decreased from 6.96 to 2.105,1.239,and 1.257,respectively,demonstrating significant improvement in the voltage profile.展开更多
BACKGROUND Traumatic spinal cord injury(SCI)is a life-altering condition that results in long-term complications,including progressive neurodegeneration and cord atrophy.It presents a significant unmet medical need wi...BACKGROUND Traumatic spinal cord injury(SCI)is a life-altering condition that results in long-term complications,including progressive neurodegeneration and cord atrophy.It presents a significant unmet medical need with extensive social and economic burdens.AIM To evaluate the safety and preliminary efficacy of allogeneic mesenchymal stem cells derived from Wharton’s jelly(WJ-MSCs)in patients with chronic complete SCI.The primary objective was to assess whether WJ-MSCs could facilitate neurological recovery and improve the quality of life in this patient population.METHODS This open-label,multicenter phase I study investigated the effects of administering WJ-MSCs via three delivery routes:Intrathecal(for localized spinal targeting);intramuscular(for targeting end organ);and intravenous(for systemic immunomodulation).While all three routes were used concurrently to enhance therapeutic synergy,neurological,sensory,and functional scales were used to assess overall efficacy.Participants with chronic SCI(duration of at least 6 months)who had significant impairment and disability were eligible for inclusion.WJ-MSCs were administered twice monthly for 2 months,with each route receiving a dose of 1×10^(6)cells/kg.Patients were closely monitored for 1 year following treatment.RESULTS At baseline,participants displayed considerable functional deficits,as indicated by the following scores:Functional independence measure of 77.5±2.26;Modified Ashworth Scale of 15.83±4.83;American Spinal Injury Association(ASIA)Motor score of 1.67±2.66;ASIA Light Touch and Pin-Prick scores of 62±18.42 each;Wexner Incontinence Score of 20;and Qualiveen Short Form,a validated questionnaire specifically designed to assess the impact of urinary dysfunction on quality of life in individuals with SCI,score of 32.Following WJ-MSC therapy,significant improvements were observed in all neurological functions over the 1-year follow-up.Notably,the ASIA Motor score improved significantly(χ^(2)=23.938,P<0.001),and Qualiveen Short Form scores demonstrated a substantial enhancement in quality of life(z=-2.214,P<0.05).CONCLUSION This phase I study,conducted without a control group,suggests that the administration of WJ-MSCs through multiple routes is both safe and potentially effective in patients with chronic complete SCI.However,the observed neurological improvements cannot be solely attributed to WJ-MSC therapy,as concurrent pharmacological and rehabilitative interventions were not controlled.These findings indicated that WJ-MSC therapy may offer a promising approach for enhancing neurological function and quality of life in this challenging patient population.Further research with larger cohorts and extended follow-up is necessary to validate these preliminary results.展开更多
The field of photocatalysis has witnessed a significant advancement in the development of bioinspired and biomimetic photocatalysts for various biomedical applications,including drug delivery,tissue engineering,cancer...The field of photocatalysis has witnessed a significant advancement in the development of bioinspired and biomimetic photocatalysts for various biomedical applications,including drug delivery,tissue engineering,cancer therapy,and bioimaging.Nature has evolved efficient light-harvesting systems and energy conversion mechanisms,which serve as a benchmark for researchers.However,reproducing such complexity and harnessing it for biomedical applications is a daunting task.It requires a comprehensive understanding of the underlying biological processes and the ability to replicate them synthetically.By utilizing light energy,these photocatalysts can trigger specific chemical reactions,leading to targeted drug release,enhanced tissue regeneration,and precise imaging of biological structures.In this context,addressing the stability,long-term performance,scalability,and costeffectiveness of these materials is crucial for their widespread implementation in biomedical applications.While challenges such as complexity and stability persist,their advantages such as targeted drug delivery and personalized medicine make them a fascinating area of research.The purpose of this review is to provide a comprehensive analysis and evaluation of existing research,highlighting the advancements,current challenges,advantages,limitations,and future prospects of bioinspired and biomimetic photocatalysts in biomedicine.展开更多
Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinata...Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinatal outcome as well as the responses to the treatment of ursodeoxycholic acid(UDCA).Methods:This prospective,case control study included 88 pregnant women(44 women with ICP and 44 healthy controls).The primary end points were the perinatal outcome and the response to UDCA therapy.A logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes and reduced response to UDCA therapy.Results:Women with ICP had significantly higher serum syndecan-1(1.27±0.36 ng/m L vs.0.98±0.50 ng/m L;P=0.003),glypican-3(1.78±0.13 ng/m L vs.1.69±0.16 ng/m L;P=0.004),AST(128.59±1.44 vs.13.29±1.32 U/L;P<0.001),and ALT(129.84±1.53 vs.8.00±3.67 U/L;P<0.001)levels compared with the controls.The increased levels of syndecan-1(OR=4.715,95%CI:1.554–14.310;P=0.006),glypican-3(OR=8.465,95%CI:3.372–21.248;P=0.007),ALT(OR=1.382,95%CI:1.131–1.690;P=0.002),and postprandial bile acid(PBA)(OR=3.392,95%CI:1.003–12.869;P=0.026)were correlated to ICP.The adverse neonatal outcome was related to increased glypican-3(OR=4.275,95%CI:2.726–5.635;P=0.039),and PBA(OR=3.026,95%CI:1.069–13.569;P=0.037).Increases of syndecan-1(OR=7.464,95%CI:2.130–26.153,P=0.017)and glypican-3(OR=6.194,95%CI:2.951–13.002;P=0.025)were the risk factors of decreased response to UDCA treatment.Conclusion:Syndecan-1 and glypican-3 might be powerful determinants in predicting adverse perinatal outcome in patients with ICP,and they can be used to predict the response to the UDCA treatment.展开更多
Today,self-healing graphene-and MXene-based composites have attracted researchers due to the increase in durability as well as the cost reduction in long-time applications.Different studies have focused on designing n...Today,self-healing graphene-and MXene-based composites have attracted researchers due to the increase in durability as well as the cost reduction in long-time applications.Different studies have focused on designing novel self-healing graphene-and MXenebased composites with enhanced sensitivity,stretchability,and flexibility as well as improved electrical conductivity,healing efficacy,mechanical properties,and energy conversion efficacy.These composites with self-healing properties can be employed in the field of wearable sensors,supercapacitors,anticorrosive coatings,electromagnetic interference shielding,electronic-skin,soft robotics,etc.However,it appears that more explorations are still needed to achieve composites with excellent arbitrary shape adaptability,suitable adhesiveness,ideal durability,high stretchability,immediate self-healing responsibility,and outstanding electromagnetic features.Besides,optimizing reaction/synthesis conditions and finding suitable strategies for functionalization/modification are crucial aspects that should be comprehensively investigated.MXenes and graphene exhibited superior electrochemical properties with abundant surface terminations and great surface area,which are important to evolve biomedical and sensing applications.However,flexibility and stretchability are important criteria that need to be improved for their future applications.Herein,the most recent advancements pertaining to the applications and properties of self-healing graphene-and MXene-based composites are deliberated,focusing on crucial challenges and future perspectives.展开更多
BACKGROUND Hypoxic-ischemic encephalopathy(HIE)is one of the leading causes of death and long-term neurological impairment in the pediatric population.Despite a limited number of treatments to cure HIE,stem cell thera...BACKGROUND Hypoxic-ischemic encephalopathy(HIE)is one of the leading causes of death and long-term neurological impairment in the pediatric population.Despite a limited number of treatments to cure HIE,stem cell therapies appear to be a potential treatment option for brain injury resulting from HIE.AIM To investigate the efficacy and safety of stem cell-based therapies in pediatric patients with HIE.METHODS The study inclusion criteria were determined as the presence of substantial deficit and disability caused by HIE.Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)were intrathecally(IT),intramuscularly(IM),and intravenously administered to participants at a dose of 1×10^(6)/kg for each administration route twice monthly for 2 mo.In different follow-up durations,the effect of WJ-MSCs administration on HIE,the quality of life,prognosis of patients,and side effects were investigated,and patients were evaluated for neurological,cognitive functions,and spasticity using the Wee Functional Independence Measure(Wee FIM)Scale and Modified Ashworth(MA)Scale.RESULTS For all participants(n=6),the mean duration of exposure to hypoxia was 39.17+18.82 min,the mean time interval after HIE was 21.83±26.60 mo,the mean baseline Wee FIM scale score was 13.5±0.55,and the mean baseline MA scale score was 35±9.08.Three patients developed only early complications such as low-grade fever,mild headache associated with IT injection,and muscle pain associated with IM injection,all of which were transient and disappeared within 24 h.The treatment was evaluated to be safe and effective as demonstrated by magnetic resonance imaging examinations,electroencephalographies,laboratory tests,and neurological and functional scores of patients.Patients exhibited significant improvements in all neurological functions through a 12-mo follow-up.The mean Wee FIM scale score of participants increased from 13.5±0.55 to 15.17±1.6 points(mean±SD)at 1 mo(z=-1.826,P=0.068)and to 23.5±3.39 points at 12 mo(z=-2.207,P=0.027)post-treatment.The percentage of patients who achieved an excellent functional improvement(Wee FIM scale total score=126)increased from 10.71%(at baseline)to 12.03%at 1 mo and to 18.65%at 12 mo posttreatment.CONCLUSION Both the triple-route and multiple WJ-MSC implantations were safe and effective in pediatric patients with HIE with significant neurological and functional improvements.The results of this study support conducting further randomized,placebo-controlled studies on this treatment in the pediatric population.展开更多
Familial gastrointestinal stromal tumor(GIST)is a rare autosomal dominant disorder associated with mutations in the KIT gene in the majority of cases.Although,exon 11 appears to be the hot spot region for approximatel...Familial gastrointestinal stromal tumor(GIST)is a rare autosomal dominant disorder associated with mutations in the KIT gene in the majority of cases.Although,exon 11 appears to be the hot spot region for approximately 95%of germline mutations,pathogenic variations have also been identified in exon 8,13 and 17.Exon 13 germline mutations are extremely rare amongst familial GISTs and seven families with a germline mutation have been reported to date.Moreover,the role of imatinib mesylate in this rare familiar settings is not completely known so far.We describe here clinical,imaging,pathological and genetic findings of a family with four affected members;grandmother,his son and two grand-sons having a germline gain-of-function mutation of KIT in exon 13 and discuss the imatinib mesylate treatment surveillance outcomes towards disease management.展开更多
BACKGROUND Peripheral nerve injury can result in significant clinical complications that have uncertain prognoses.Currently,there is a lack of effective pharmacological interventions for nerve damage,despite the exist...BACKGROUND Peripheral nerve injury can result in significant clinical complications that have uncertain prognoses.Currently,there is a lack of effective pharmacological interventions for nerve damage,despite the existence of several small compounds,Despite the objective of achieving full functional restoration by surgical intervention,the persistent challenge of inadequate functional recovery remains a significant concern in the context of peripheral nerve injuries.AIM To examine the impact of exosomes on the process of functional recovery following a complete radial nerve damage.METHODS A male individual,aged 24,who is right-hand dominant and an immigrant,arrived with an injury caused by a knife assault.The cut is located on the left arm,specifically below the elbow.The neurological examination and electrodiagnostic testing reveal evidence of left radial nerve damage.The sural autograft was utilized for repair,followed by the application of 1 mL of mesenchymal stem cell-derived exosome,comprising 5 billion microvesicles.This exosome was split into four equal volumes of 0.25 mL each and delivered microsurgically to both the proximal and distal stumps using the subepineural pathway.The patient was subjected to a period of 180 d during which they had neurological examination and electrodiagnostic testing.RESULTS The duration of the patient’s follow-up period was 180 d.An increasing Tinel’s sign and sensory-motor recovery were detected even at the 10th wk following nerve grafting.Upon the conclusion of the 6-mo post-treatment period,an evaluation was conducted to measure the extent of improvement in motor and sensory functions of the nerve.This assessment was based on the British Medical Research Council scale and the Mackinnon-Dellon scale.The results indicated that the level of improvement in motor function was classified as M5,denoting an excellent outcome.Additionally,the level of improvement in sensory function was classified as S3+,indicating a good outcome.It is noteworthy that these assessments were conducted in the absence of physical therapy.At the 10th wk post-injury,despite the persistence of substantial axonal damage,the nerve exhibited indications of nerve re-innervation as evidenced by control electromyography(EMG).In contrast to the preceding.EMG analysis revealed a significant electrophysiological enhancement in the EMG conducted at the 6th-mo follow-up,indicating ongoing regeneration.CONCLUSION Enhanced comprehension of the neurobiological ramifications associated with peripheral nerve damage,as well as the experimental and therapy approaches delineated in this investigation,holds the potential to catalyze future clinical progress.展开更多
The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point f...The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point for reporting the results of clinical trials.World Health Organization and Response Evaluation Criteria in Solid Tumors(RECIST)are anatomic response criteria developed mainly for cytotoxic chemotherapy.These criteria are based on the visual assessment of tumor size in morphological images provided by computed tomography(CT)or magnetic resonance imaging.Anatomic response criteria may not be optimal for biologic agents,some disease sites,and some regional therapies.Consequently,modifications of RECIST,Choi criteria and Morphologic response criteria were developed based on the concept of the evaluation of viable tumors.Despite its limitations,RECIST v1.1 is validated in prospective studies,is widely accepted by regulatory agencies and has recently shown good performance for targeted cancer agents.Finally,some alternatives of RECIST were developed as immune-specific response criteria for checkpoint inhibitors.Immune RECIST criteria are based essentially on defining true progressive disease after a confirmatory imaging.Some graphical methods may be useful to show longitudinal change in the tumor burden over time.Tumor tissue is a tridimensional heterogenous mass,and tumor shrinkage is not always symmetrical;thus,metabolic response assessments using positron emission tomography(PET)or PET/CT may reflect the viability of cancer cells or functional changes evolving after anticancer treatments.The metabolic response can show the benefit of a treatment earlier than anatomic shrinkage,possibly preventing delays in drug approval.Computer-assisted automated volumetric assessments,quantitative multimodality imaging in radiology,new tracers in nuclear medicine and finally artificial intelligence have great potential in future evaluations.展开更多
Fog Computing(FC)provides processing and storage resources at the edge of the Internet of Things(IoT).By doing so,FC can help reduce latency and improve reliability of IoT networks.The energy consumption of servers an...Fog Computing(FC)provides processing and storage resources at the edge of the Internet of Things(IoT).By doing so,FC can help reduce latency and improve reliability of IoT networks.The energy consumption of servers and computing resources is one of the factors that directly affect conservation costs in fog environments.Energy consumption can be reduced by efficacious scheduling methods so that tasks are offloaded on the best possible resources.To deal with this problem,a binary model based on the combination of the Krill Herd Algorithm(KHA)and the Artificial Hummingbird Algorithm(AHA)is introduced as Binary KHA-AHA(BAHA-KHA).KHA is used to improve AHA.Also,the BAHA-KHA local optimal problem for task scheduling in FC environments is solved using the dynamic voltage and frequency scaling(DVFS)method.The Heterogeneous Earliest Finish Time(HEFT)method is used to discover the order of task flow execution.The goal of the BAHA-KHA model is to minimize the number of resources,the communication between dependent tasks,and reduce energy consumption.In this paper,the FC environment is considered to address the workflow scheduling issue to reduce energy consumption and minimize makespan on fog resources.The results were tested on five different workflows(Montage,CyberShake,LIGO,SIPHT,and Epigenomics).The evaluations show that the BAHA-KHA model has the best performance in comparison with the AHA,KHA,PSO and GA algorithms.The BAHA-KHA model has reduced the makespan rate by about 18%and the energy consumption by about 24%in comparison with GA.This is a preview of subscription content,log in via an institution to check access.展开更多
Pancreatic head adenocarcinoma(PHAC) is one of the most aggressive malignancies, and it has low long-term survival rates. Surgery is the only option for long-term survival. The difficulties associated with PHAC includ...Pancreatic head adenocarcinoma(PHAC) is one of the most aggressive malignancies, and it has low long-term survival rates. Surgery is the only option for long-term survival. The difficulties associated with PHAC include higher frequencies of regional or distant lymph node metastases and vascular involvement, and positive resection margins in pancreatic and retroperitoneal tissues. Radical resections increase margin negativity and life expectancy;however, the extend of the surgery applied is controversial. Thus, western and eastern centers may use different approaches. Multiorgan, peripancreatic nerve plexus, and vascular resections have been discussed in relation to radical surgery for pancreatic cancer as have the roles of neoadjuvant and adjuvant therapy regimens. Determining the appropriate limits for surgery, standardizing definitions and surgical techniques according to guidelines, and centralizing pancreatic surgery within high-volume institutions to reduce mortality and morbidity rates are among the most important issues to consider. In this review,we evaluate the basic concepts underlying and the roles of radical surgery for PHAC, and lymphadenectomy, nerve plexus, retroperitoneal tissue, vascular,and multivisceral resections, total pancreatectomy, and liver metastases are discussed.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Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients aged 65 years and over,who were admitted to the Emergency Department of Baskent University Ankara Hospital between January 2011 and January 2015 and diagnosed with vertebral trauma.The information of the patients was obtained from the medical records.The clinical characteristics of patients including localizafions and types of fracture,presence of additional system injuries and treatment options were investigated.Results:The most common cause was fall,accounting for 51 (79.7%),with 7 (10.9%) due to intra-vehicle traffic accident,and 6 (9.4%) due to out-of-vehicle pedestrian injury.The most common site of trauma was the lumbar region.Of the fractures,46.9% (n=30) were in the lumbar region,37.5% (n=24) in the thoracic region and 15.6% (n=10) were in the cervical vertebra region.Fourteen (21.9%) patients had an additional injury.Given the fracture types,47 fractures (74.6%) were compression,14 fractures (22.2%) were spinous process and 2 fractures (3.2%) were burst fractures.Twenty patients (31.2%) had multilevel vertebral fractures.Conclusions:The results of our study demonstrated the importance of vertebral fractures in the geriatric age group.In this age group,falls and motor vehicle accidents are the leading causes of vertebral traumas.Taking the necessary measures to prevent the risk factors which increase with aging is the most important step in preventing the mortality and morbidity that may occur as a result of vertebral fracture.
文摘BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.
文摘Metabolic dysfunction-associated steatotic liver disease(MASLD)and inflam-matory bowel disease(IBD)are chronic conditions with complex aetiologies,in which environmental factors and interactions between the gut and liver play a key role.Both conditions are characterised by disturbances in the gut microbiota,which can affect local and systemic inflammatory responses.In particular,inc-reased intestinal permeability promotes the translocation of bacterial components into the portal circulation,contributing to the development of inflammation in the liver.There is growing evidence that modulation of the gut microbiota and imp-roved intestinal barrier function may be of therapeutic importance.The purpose of this review is to discuss the pathogenetic mechanisms that link MASLD and IBD,with a particular emphasis on the influence of the microbiota and environ-mental factors on the development of these diseases.
文摘BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better short-term outcomes,including less postoperative pain,shorter operative time,faster return to work,and higher patient satisfaction.However,there is a risk-benefit debate surrounding SH due to significant complications from the procedure,such as anal stenosis,rectovaginal fistula,fecal incontinence,and recurrence.AIM To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.METHODS This retrospective,single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis.Early(less than 7 days after SH)and late(7 or more days after SH)complications were analyzed.Recurrence rates were calculated as well.RESULTS Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups.Recurrence was observed in 4 patients(23.6%)with grade IV hemorrhoids,and no recurrence was noted in patients with grade III hemorrhoids.Postoperative bleeding,incomplete defecation,urgent defecation,incontinence,skin tags,and anal fissure were complications reported by both groups.CONCLUSION Due to the high recurrence rate,SH is not an appropriate treatment option for patients with grade IV hemorrhoids.Open surgery may be a more suitable option for these patients.
基金partially supported by the National Natural Science Foundation of China under Grant No.11988101。
文摘In this article,a well-known anisotropic solution,the Tolman-Finch-Skea(TFS)solution,is studied using the gravitational decoupling approach within the framework of 4D Einstein-Gauss-Bonnet(EGB)gravity.The radial metric potential is modified linearly through the minimal geometric deformation approach,while the temporal component of the metric remains unchanged.The system of EGB field equations is decomposed into two distinct sets of field equations:one corresponding to the standard energy-momentum tensor and the other associated with an external gravitational source.The first system is solved using the aforementioned known solution,while the second is closed by imposing the mimic constraint on pressure.Moreover,the junction conditions at the inner and outer surfaces of the stellar object are examined,considering the Boulware-Deser 4D space-time as the external geometry.The physical properties of the stellar model are analyzed using parameters such as energy conditions,causality conditions,compactness,and redshift.
文摘The Internet has been enhanced recently by blockchain and Internet of Things(IoT)networks.The Internet of Things is a network of various sensor-equipped devices.It gradually integrates the Internet,sensors,and cloud computing.Blockchain is based on encryption algorithms,which are shared database technologies on the Internet.Blockchain technology has grown significantly because of its features,such as flexibility,support for integration,anonymity,decentralization,and independent control.Computational nodes in the blockchain network are used to verify online transactions.However,this integration creates scalability,interoperability,and security challenges.Over the last decade,several advancements in blockchain technology have drawn attention fromresearch communities and industries.Blockchain technology helps IoT networks become more reliable and enhance security and privacy.It also removes single points of failure and lowers the cost.In recent years,there has been an increasing amount of literature on IoT and blockchain technology applications.This paper extensively examines the current state of blockchain technologies,focusing specifically on their integration into the Internet of Things.Additionally,it highlights the benefits,drawbacks,and opportunities of recent studies on security issues based on blockchain solutions into categories.The survey examined various research papers fromdifferent types of publications.Also,a review of the other IoT applications has been included,focusing on the security requirements and challenges in IoT-based systems.Future research directions are gathered for the effective integration of Blockchain and IoT.
基金supported in part by the National Natural Science Foundation of China under Grant 62171228in part by the National Key R&D Program of China under Grant 2021YFE0105500in part by the Program of China Scholarship Council under Grant 202209040027。
文摘Changes in the Atmospheric Electric Field Signal(AEFS)are highly correlated with weather changes,especially with thunderstorm activities.However,little attention has been paid to the ambiguous weather information implicit in AEFS changes.In this paper,a Fuzzy C-Means(FCM)clustering method is used for the first time to develop an innovative approach to characterize the weather attributes carried by AEFS.First,a time series dataset is created in the time domain using AEFS attributes.The AEFS-based weather is evaluated according to the time-series Membership Degree(MD)changes obtained by inputting this dataset into the FCM.Second,thunderstorm intensities are reflected by the change in distance from a thunderstorm cloud point charge to an AEF apparatus.Thus,a matching relationship is established between the normalized distance and the thunderstorm dominant MD in the space domain.Finally,the rationality and reliability of the proposed method are verified by combining radar charts and expert experience.The results confirm that this method accurately characterizes the weather attributes and changes in the AEFS,and a negative distance-MD correlation is obtained for the first time.The detection of thunderstorm activity by AEF from the perspective of fuzzy set technology provides a meaningful guidance for interpretable thunderstorms.
基金supported in part by the National Natural Science Foundation of China under Grant 62171228in part by the National Key R&D Program of China under Grant 2021YFE0105500in part by the Program of China Scholarship Council under Grant 202209040027。
文摘Thunderstorm detection based on the Atmospheric Electric Field(AEF)has evolved from time-domain models to space-domain models.It is especially important to evaluate and determine the particularly Weather Attribute(WA),which is directly related to the detection reliability and authenticity.In this paper,a strategy is proposed to integrate three currently competitive WA's evaluation methods.First,a conventional evaluation method based on AEF statistical indicators is selected.Subsequent evaluation approaches include competing AEF-based predicted value intervals,and AEF classification based on fuzzy c-means.Different AEF attributes contribute to a more accurate AEF classification to different degrees.The resulting dynamic weighting applied to these attributes improves the classification accuracy.Each evaluation method is applied to evaluate the WA of a particular AEF,to obtain the corresponding evaluation score.The integration in the proposed strategy takes the form of a score accumulation.Different cumulative score levels correspond to different final WA results.Thunderstorm imaging is performed to visualize thunderstorm activities using those AEFs already evaluated to exhibit thunderstorm attributes.Empirical results confirm that the proposed strategy effectively and reliably images thunderstorms,with a 100%accuracy of WA evaluation.This is the first study to design an integrated thunderstorm detection strategy from a new perspective of WA evaluation,which provides promising solutions for a more reliable and flexible thunderstorm detection.
文摘Reconfiguration,as well as optimal utilization of distributed generation sources and capacitor banks,are highly effective methods for reducing losses and improving the voltage profile,or in other words,the power quality in the power distribution system.Researchers have considered the use of distributed generation resources in recent years.There are numerous advantages to utilizing these resources,the most significant of which are the reduction of network losses and enhancement of voltage stability.Non-dominated Sorting Genetic Algorithm II(NSGA-II),Multi-Objective Particle Swarm Optimization(MOPSO),and Intersect Mutation Differential Evolution(IMDE)algorithms are used in this paper to perform optimal reconfiguration,simultaneous location,and capacity determination of distributed generation resources and capacitor banks.Three scenarios were used to replicate the studies.The reconfiguration of the switches,as well as the location and determination of the capacitor bank’s optimal capacity,were investigated in this scenario.However,in the third scenario,reconfiguration,and determining the location and capacity of the Distributed Generation(DG)resources and capacitor banks have been carried out simultaneously.Finally,the simulation results of these three algorithms are compared.The results indicate that the proposed NSGAII algorithm outperformed the other two multi-objective algorithms and was capable of maintaining smaller objective functions in all scenarios.Specifically,the energy losses were reduced from 211 to 51.35 kW(a 75.66%reduction),119.13 kW(a 43.54%reduction),and 23.13 kW(an 89.04%reduction),while the voltage stability index(VSI)decreased from 6.96 to 2.105,1.239,and 1.257,respectively,demonstrating significant improvement in the voltage profile.
文摘BACKGROUND Traumatic spinal cord injury(SCI)is a life-altering condition that results in long-term complications,including progressive neurodegeneration and cord atrophy.It presents a significant unmet medical need with extensive social and economic burdens.AIM To evaluate the safety and preliminary efficacy of allogeneic mesenchymal stem cells derived from Wharton’s jelly(WJ-MSCs)in patients with chronic complete SCI.The primary objective was to assess whether WJ-MSCs could facilitate neurological recovery and improve the quality of life in this patient population.METHODS This open-label,multicenter phase I study investigated the effects of administering WJ-MSCs via three delivery routes:Intrathecal(for localized spinal targeting);intramuscular(for targeting end organ);and intravenous(for systemic immunomodulation).While all three routes were used concurrently to enhance therapeutic synergy,neurological,sensory,and functional scales were used to assess overall efficacy.Participants with chronic SCI(duration of at least 6 months)who had significant impairment and disability were eligible for inclusion.WJ-MSCs were administered twice monthly for 2 months,with each route receiving a dose of 1×10^(6)cells/kg.Patients were closely monitored for 1 year following treatment.RESULTS At baseline,participants displayed considerable functional deficits,as indicated by the following scores:Functional independence measure of 77.5±2.26;Modified Ashworth Scale of 15.83±4.83;American Spinal Injury Association(ASIA)Motor score of 1.67±2.66;ASIA Light Touch and Pin-Prick scores of 62±18.42 each;Wexner Incontinence Score of 20;and Qualiveen Short Form,a validated questionnaire specifically designed to assess the impact of urinary dysfunction on quality of life in individuals with SCI,score of 32.Following WJ-MSC therapy,significant improvements were observed in all neurological functions over the 1-year follow-up.Notably,the ASIA Motor score improved significantly(χ^(2)=23.938,P<0.001),and Qualiveen Short Form scores demonstrated a substantial enhancement in quality of life(z=-2.214,P<0.05).CONCLUSION This phase I study,conducted without a control group,suggests that the administration of WJ-MSCs through multiple routes is both safe and potentially effective in patients with chronic complete SCI.However,the observed neurological improvements cannot be solely attributed to WJ-MSC therapy,as concurrent pharmacological and rehabilitative interventions were not controlled.These findings indicated that WJ-MSC therapy may offer a promising approach for enhancing neurological function and quality of life in this challenging patient population.Further research with larger cohorts and extended follow-up is necessary to validate these preliminary results.
文摘The field of photocatalysis has witnessed a significant advancement in the development of bioinspired and biomimetic photocatalysts for various biomedical applications,including drug delivery,tissue engineering,cancer therapy,and bioimaging.Nature has evolved efficient light-harvesting systems and energy conversion mechanisms,which serve as a benchmark for researchers.However,reproducing such complexity and harnessing it for biomedical applications is a daunting task.It requires a comprehensive understanding of the underlying biological processes and the ability to replicate them synthetically.By utilizing light energy,these photocatalysts can trigger specific chemical reactions,leading to targeted drug release,enhanced tissue regeneration,and precise imaging of biological structures.In this context,addressing the stability,long-term performance,scalability,and costeffectiveness of these materials is crucial for their widespread implementation in biomedical applications.While challenges such as complexity and stability persist,their advantages such as targeted drug delivery and personalized medicine make them a fascinating area of research.The purpose of this review is to provide a comprehensive analysis and evaluation of existing research,highlighting the advancements,current challenges,advantages,limitations,and future prospects of bioinspired and biomimetic photocatalysts in biomedicine.
基金the Ethics Committee of the Liv Hospital Affiliated to University of I˙stinye,Turkey(2018-003/015).
文摘Background:Intrahepatic cholestasis of pregnancy(ICP)increases the risk of adverse pregnancy outcomes.This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinatal outcome as well as the responses to the treatment of ursodeoxycholic acid(UDCA).Methods:This prospective,case control study included 88 pregnant women(44 women with ICP and 44 healthy controls).The primary end points were the perinatal outcome and the response to UDCA therapy.A logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes and reduced response to UDCA therapy.Results:Women with ICP had significantly higher serum syndecan-1(1.27±0.36 ng/m L vs.0.98±0.50 ng/m L;P=0.003),glypican-3(1.78±0.13 ng/m L vs.1.69±0.16 ng/m L;P=0.004),AST(128.59±1.44 vs.13.29±1.32 U/L;P<0.001),and ALT(129.84±1.53 vs.8.00±3.67 U/L;P<0.001)levels compared with the controls.The increased levels of syndecan-1(OR=4.715,95%CI:1.554–14.310;P=0.006),glypican-3(OR=8.465,95%CI:3.372–21.248;P=0.007),ALT(OR=1.382,95%CI:1.131–1.690;P=0.002),and postprandial bile acid(PBA)(OR=3.392,95%CI:1.003–12.869;P=0.026)were correlated to ICP.The adverse neonatal outcome was related to increased glypican-3(OR=4.275,95%CI:2.726–5.635;P=0.039),and PBA(OR=3.026,95%CI:1.069–13.569;P=0.037).Increases of syndecan-1(OR=7.464,95%CI:2.130–26.153,P=0.017)and glypican-3(OR=6.194,95%CI:2.951–13.002;P=0.025)were the risk factors of decreased response to UDCA treatment.Conclusion:Syndecan-1 and glypican-3 might be powerful determinants in predicting adverse perinatal outcome in patients with ICP,and they can be used to predict the response to the UDCA treatment.
文摘Today,self-healing graphene-and MXene-based composites have attracted researchers due to the increase in durability as well as the cost reduction in long-time applications.Different studies have focused on designing novel self-healing graphene-and MXenebased composites with enhanced sensitivity,stretchability,and flexibility as well as improved electrical conductivity,healing efficacy,mechanical properties,and energy conversion efficacy.These composites with self-healing properties can be employed in the field of wearable sensors,supercapacitors,anticorrosive coatings,electromagnetic interference shielding,electronic-skin,soft robotics,etc.However,it appears that more explorations are still needed to achieve composites with excellent arbitrary shape adaptability,suitable adhesiveness,ideal durability,high stretchability,immediate self-healing responsibility,and outstanding electromagnetic features.Besides,optimizing reaction/synthesis conditions and finding suitable strategies for functionalization/modification are crucial aspects that should be comprehensively investigated.MXenes and graphene exhibited superior electrochemical properties with abundant surface terminations and great surface area,which are important to evolve biomedical and sensing applications.However,flexibility and stretchability are important criteria that need to be improved for their future applications.Herein,the most recent advancements pertaining to the applications and properties of self-healing graphene-and MXene-based composites are deliberated,focusing on crucial challenges and future perspectives.
文摘BACKGROUND Hypoxic-ischemic encephalopathy(HIE)is one of the leading causes of death and long-term neurological impairment in the pediatric population.Despite a limited number of treatments to cure HIE,stem cell therapies appear to be a potential treatment option for brain injury resulting from HIE.AIM To investigate the efficacy and safety of stem cell-based therapies in pediatric patients with HIE.METHODS The study inclusion criteria were determined as the presence of substantial deficit and disability caused by HIE.Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)were intrathecally(IT),intramuscularly(IM),and intravenously administered to participants at a dose of 1×10^(6)/kg for each administration route twice monthly for 2 mo.In different follow-up durations,the effect of WJ-MSCs administration on HIE,the quality of life,prognosis of patients,and side effects were investigated,and patients were evaluated for neurological,cognitive functions,and spasticity using the Wee Functional Independence Measure(Wee FIM)Scale and Modified Ashworth(MA)Scale.RESULTS For all participants(n=6),the mean duration of exposure to hypoxia was 39.17+18.82 min,the mean time interval after HIE was 21.83±26.60 mo,the mean baseline Wee FIM scale score was 13.5±0.55,and the mean baseline MA scale score was 35±9.08.Three patients developed only early complications such as low-grade fever,mild headache associated with IT injection,and muscle pain associated with IM injection,all of which were transient and disappeared within 24 h.The treatment was evaluated to be safe and effective as demonstrated by magnetic resonance imaging examinations,electroencephalographies,laboratory tests,and neurological and functional scores of patients.Patients exhibited significant improvements in all neurological functions through a 12-mo follow-up.The mean Wee FIM scale score of participants increased from 13.5±0.55 to 15.17±1.6 points(mean±SD)at 1 mo(z=-1.826,P=0.068)and to 23.5±3.39 points at 12 mo(z=-2.207,P=0.027)post-treatment.The percentage of patients who achieved an excellent functional improvement(Wee FIM scale total score=126)increased from 10.71%(at baseline)to 12.03%at 1 mo and to 18.65%at 12 mo posttreatment.CONCLUSION Both the triple-route and multiple WJ-MSC implantations were safe and effective in pediatric patients with HIE with significant neurological and functional improvements.The results of this study support conducting further randomized,placebo-controlled studies on this treatment in the pediatric population.
文摘Familial gastrointestinal stromal tumor(GIST)is a rare autosomal dominant disorder associated with mutations in the KIT gene in the majority of cases.Although,exon 11 appears to be the hot spot region for approximately 95%of germline mutations,pathogenic variations have also been identified in exon 8,13 and 17.Exon 13 germline mutations are extremely rare amongst familial GISTs and seven families with a germline mutation have been reported to date.Moreover,the role of imatinib mesylate in this rare familiar settings is not completely known so far.We describe here clinical,imaging,pathological and genetic findings of a family with four affected members;grandmother,his son and two grand-sons having a germline gain-of-function mutation of KIT in exon 13 and discuss the imatinib mesylate treatment surveillance outcomes towards disease management.
基金approved by the medical ethics committee of the authors’institution(protocol number:56733164-203-E.5863).
文摘BACKGROUND Peripheral nerve injury can result in significant clinical complications that have uncertain prognoses.Currently,there is a lack of effective pharmacological interventions for nerve damage,despite the existence of several small compounds,Despite the objective of achieving full functional restoration by surgical intervention,the persistent challenge of inadequate functional recovery remains a significant concern in the context of peripheral nerve injuries.AIM To examine the impact of exosomes on the process of functional recovery following a complete radial nerve damage.METHODS A male individual,aged 24,who is right-hand dominant and an immigrant,arrived with an injury caused by a knife assault.The cut is located on the left arm,specifically below the elbow.The neurological examination and electrodiagnostic testing reveal evidence of left radial nerve damage.The sural autograft was utilized for repair,followed by the application of 1 mL of mesenchymal stem cell-derived exosome,comprising 5 billion microvesicles.This exosome was split into four equal volumes of 0.25 mL each and delivered microsurgically to both the proximal and distal stumps using the subepineural pathway.The patient was subjected to a period of 180 d during which they had neurological examination and electrodiagnostic testing.RESULTS The duration of the patient’s follow-up period was 180 d.An increasing Tinel’s sign and sensory-motor recovery were detected even at the 10th wk following nerve grafting.Upon the conclusion of the 6-mo post-treatment period,an evaluation was conducted to measure the extent of improvement in motor and sensory functions of the nerve.This assessment was based on the British Medical Research Council scale and the Mackinnon-Dellon scale.The results indicated that the level of improvement in motor function was classified as M5,denoting an excellent outcome.Additionally,the level of improvement in sensory function was classified as S3+,indicating a good outcome.It is noteworthy that these assessments were conducted in the absence of physical therapy.At the 10th wk post-injury,despite the persistence of substantial axonal damage,the nerve exhibited indications of nerve re-innervation as evidenced by control electromyography(EMG).In contrast to the preceding.EMG analysis revealed a significant electrophysiological enhancement in the EMG conducted at the 6th-mo follow-up,indicating ongoing regeneration.CONCLUSION Enhanced comprehension of the neurobiological ramifications associated with peripheral nerve damage,as well as the experimental and therapy approaches delineated in this investigation,holds the potential to catalyze future clinical progress.
文摘The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point for reporting the results of clinical trials.World Health Organization and Response Evaluation Criteria in Solid Tumors(RECIST)are anatomic response criteria developed mainly for cytotoxic chemotherapy.These criteria are based on the visual assessment of tumor size in morphological images provided by computed tomography(CT)or magnetic resonance imaging.Anatomic response criteria may not be optimal for biologic agents,some disease sites,and some regional therapies.Consequently,modifications of RECIST,Choi criteria and Morphologic response criteria were developed based on the concept of the evaluation of viable tumors.Despite its limitations,RECIST v1.1 is validated in prospective studies,is widely accepted by regulatory agencies and has recently shown good performance for targeted cancer agents.Finally,some alternatives of RECIST were developed as immune-specific response criteria for checkpoint inhibitors.Immune RECIST criteria are based essentially on defining true progressive disease after a confirmatory imaging.Some graphical methods may be useful to show longitudinal change in the tumor burden over time.Tumor tissue is a tridimensional heterogenous mass,and tumor shrinkage is not always symmetrical;thus,metabolic response assessments using positron emission tomography(PET)or PET/CT may reflect the viability of cancer cells or functional changes evolving after anticancer treatments.The metabolic response can show the benefit of a treatment earlier than anatomic shrinkage,possibly preventing delays in drug approval.Computer-assisted automated volumetric assessments,quantitative multimodality imaging in radiology,new tracers in nuclear medicine and finally artificial intelligence have great potential in future evaluations.
文摘Fog Computing(FC)provides processing and storage resources at the edge of the Internet of Things(IoT).By doing so,FC can help reduce latency and improve reliability of IoT networks.The energy consumption of servers and computing resources is one of the factors that directly affect conservation costs in fog environments.Energy consumption can be reduced by efficacious scheduling methods so that tasks are offloaded on the best possible resources.To deal with this problem,a binary model based on the combination of the Krill Herd Algorithm(KHA)and the Artificial Hummingbird Algorithm(AHA)is introduced as Binary KHA-AHA(BAHA-KHA).KHA is used to improve AHA.Also,the BAHA-KHA local optimal problem for task scheduling in FC environments is solved using the dynamic voltage and frequency scaling(DVFS)method.The Heterogeneous Earliest Finish Time(HEFT)method is used to discover the order of task flow execution.The goal of the BAHA-KHA model is to minimize the number of resources,the communication between dependent tasks,and reduce energy consumption.In this paper,the FC environment is considered to address the workflow scheduling issue to reduce energy consumption and minimize makespan on fog resources.The results were tested on five different workflows(Montage,CyberShake,LIGO,SIPHT,and Epigenomics).The evaluations show that the BAHA-KHA model has the best performance in comparison with the AHA,KHA,PSO and GA algorithms.The BAHA-KHA model has reduced the makespan rate by about 18%and the energy consumption by about 24%in comparison with GA.This is a preview of subscription content,log in via an institution to check access.
文摘Pancreatic head adenocarcinoma(PHAC) is one of the most aggressive malignancies, and it has low long-term survival rates. Surgery is the only option for long-term survival. The difficulties associated with PHAC include higher frequencies of regional or distant lymph node metastases and vascular involvement, and positive resection margins in pancreatic and retroperitoneal tissues. Radical resections increase margin negativity and life expectancy;however, the extend of the surgery applied is controversial. Thus, western and eastern centers may use different approaches. Multiorgan, peripancreatic nerve plexus, and vascular resections have been discussed in relation to radical surgery for pancreatic cancer as have the roles of neoadjuvant and adjuvant therapy regimens. Determining the appropriate limits for surgery, standardizing definitions and surgical techniques according to guidelines, and centralizing pancreatic surgery within high-volume institutions to reduce mortality and morbidity rates are among the most important issues to consider. In this review,we evaluate the basic concepts underlying and the roles of radical surgery for PHAC, and lymphadenectomy, nerve plexus, retroperitoneal tissue, vascular,and multivisceral resections, total pancreatectomy, and liver metastases are discussed.
