High costs,technical difficulties,and policy uncertainties are the main challenges in carbon capture technology investments.Therefore,innovative financial products are required to develop projects that overcome these ...High costs,technical difficulties,and policy uncertainties are the main challenges in carbon capture technology investments.Therefore,innovative financial products are required to develop projects that overcome these difficulties.Some issues must be considered when developing innovative financial products.An important problem in this process is that these features cannot possibly exist together in the new financial product,because each of these features incurs some costs.Therefore,identifying the most important features of innovative financial products is necessary.Accordingly,this study develops a new and innovative financial product to increase the effectiveness of investments in carbon capture technologies.For this purpose,a novel artificial intelligence(AI)-based fuzzy decision-making model is constructed.First,the weights of the experts were calculated by considering AI methodology.Second,the factors affecting investment in carbon capture technologies were weighted using a spherical fuzzy DEMATEL.Finally,the financial features required for investments were ranked using the spherical fuzzy ARAS method.This study’s main contribution is its creation of a novel fuzzy decision-making model by integrating AI methodology with fuzzy decision-making theory.In this process,the weights of the experts are calculated using an AI approach.It is concluded that cost-effectiveness must be prioritized in the development of new financial products.Technological competence is another aspect that should be considered in this process.However,innovative financial products should include risk management and flexible financing.展开更多
A recent study in the World Journal of Diabetes by Yang et al explored how Rheb1 signaling influenced pancreaticβcell fate and its potential as a therapeutic target.This invited commentary by a senior diabetes resear...A recent study in the World Journal of Diabetes by Yang et al explored how Rheb1 signaling influenced pancreaticβcell fate and its potential as a therapeutic target.This invited commentary by a senior diabetes researcher discussed the findings of Yang et al in the context of current knowledge onβcell biology,providing critical insight into the role of Rheb1 inβcell survival and function and the prospects for diabetes treatment.Key outcomes of the study were interpreted alongside established literature on Rheb1-mechanistic target of rapamycin signaling in islet cells.Rheb1 emerges as a pivotal regulator ofβcell growth and insulin secretory function,aligning with evidence thatβcell-specific Rheb1 deletion impairsβcell mass and glucose-stimulated insulin secretion.The commentary highlighted how modulating this pathway could preserve or restore theβcell population in diabetes while cautioning about potential off-target effects(e.g.inαcells).Targeting Rheb1 signaling represents a promising new frontier in diabetes therapy to enhanceβcell resilience;however,a balanced approach addressing both its benefits and risks is essential.This letter discussed the scientific implications and future research directions needed to translate Rheb1 modulation into clinical application for diabetes.展开更多
Neoliberal economic policies implemented by the Justice and Development Party(AKP)in Turkey empowered the modernization process which is one of the main dynamics of transforming traditional societies.As a result of th...Neoliberal economic policies implemented by the Justice and Development Party(AKP)in Turkey empowered the modernization process which is one of the main dynamics of transforming traditional societies.As a result of this socio-economic transformation,new institutions and technical developments evolved,without any relation to religion or its institutions(Zubaida,2011).In fact,this course has accelerated the individualization process of the religiously educated Generation Z in Turkey,whereas the significance of collective religious identity shrank(Kara,2014).The expansion of social media platforms has influenced young people’s relationship with religion and faith.However,after the Gezi Parki protests in 2013,the government started using a more populist discourse with regard to religious and nationalist symbols.This type of political communication had a crucial impact on the political arena.This research sheds light on the result of a qualitative analysis,based on interviews conducted with Imam Hatip school students in Turkey.The results of these in-depth interviews show how digital media is creating a new ecosystem based on self-identity(Giddens,1991).展开更多
The gut microbiota(GM)is a highly dynamic ecology whose density and com-position can be influenced by a wide range of internal and external factors.Thus,“How do GM,which can have commensal,pathological,and mutualisti...The gut microbiota(GM)is a highly dynamic ecology whose density and com-position can be influenced by a wide range of internal and external factors.Thus,“How do GM,which can have commensal,pathological,and mutualistic rela-tionships with us,affect human health?”has become the most popular research issue in recent years.Numerous studies have demonstrated that the trillions of microorganisms that inhabit the human body can alter host physiology in a variety of systems,such as metabolism,immunology,cardiovascular health,and neurons.The GM may have a role in the development of a number of clinical disorders by producing bioactive peptides,including neurotransmitters,short-chain fatty acids,branched-chain amino acids,intestinal hormones,and secondary bile acid conversion.These bioactive peptides enter the portal circulatory system through the gut-liver axis and play a role in the development of chronic liver diseases,cirrhosis,and hepatic encephalopathy.This procedure is still unclear and quite complex.In this study,we aim to discuss the contribution of GM to the development of liver diseases,its effects on the progression of existing chronic liver disease,and to address the basic mechanisms of the intestinal microbiota-liver axis in the light of recent publications that may inspire the future.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
BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future a...BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future anxiety,defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future,may further influence these outcomes.AIM To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship.METHODS A cross-sectional study was conducted with 659 participants aged 18 to 65 years.Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale,the Dark Future Scale,and the European Health Interview Survey-Quality of Life 8.Correlation analyses were performed,followed by Structural Equation Modeling to test the proposed mediation model.RESULTS The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety.Future anxiety was negatively correlated with HRQoL.Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety.Additionally,future anxiety negatively affected HRQoL,mediating the relationship between knowledge and HRQoL.The mediation effect was significant,as confirmed by bootstrapping(bootstrap coefficient=0.068,95%CI:0.046-0.093).CONCLUSION The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL.These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.展开更多
Small-scale wind turbines are essential energy sources for hospitals because they have several advantages,such as lower maintenance costs and the possibility of customization.However,small-scale wind energy projects o...Small-scale wind turbines are essential energy sources for hospitals because they have several advantages,such as lower maintenance costs and the possibility of customization.However,small-scale wind energy projects often have high capital requirements.Many factors affect the performance of financial products to be developed for financing small-scale wind turbines.Nevertheless,applications to improve each of these variables lead to increased costs.Owing to this situation,it is necessary to determine the more important factors and to prioritize these issues.The purpose of this study is to identify the essential factors that have the greatest impact on the performance of financial products considered for small-scale wind turbine projects.First,a unique criteria list is evaluated via the T-Spherical fuzzy TOP-DEMATEL technique.Another analysis is also performed to define which of the financial products are suitable for smallscale wind turbine projects with RATGOS.The main contribution of this study is that a priority evaluation has been conducted to identify the most critical determinants of effective financial products for small-scale wind turbine projects.Current decisionmaking models called RATGOS and TOP-DEMATEL are used to increase methodological specificity and minimize uncertainty.One of the theoretical contributions of this study is that it provides a strategic roadmap for financing such projects.The findings indicate that financial efficiency is the most significant factor in increasing the performance of financial innovation.Moreover,green bonds can be a viable option for financing wind energy projects,as they are generally long-term and have low interest rates.展开更多
Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The trigly...Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The triglycerideglucose(TyG)index,a marker of insulin resistance,has shown promise in various cancers,but its role in GC remains unclear.Yao et al investigated its prognostic value in 300 patients with advanced GC receiving immunotherapy and chemotherapy.Their model,which integrates the TyG index,programmed death-ligand 1 expression,and Eastern Cooperative Oncology Group performance status,underscores the impact of metabolic dysfunction on immune response and treatment efficacy.This letter examines the TyG index’s potential as a prognostic tool in GC and its implications for treatment strategies guided by metabolic and immune factors,as demonstrated in Yao et al research.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
BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surg...BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS,both in the short and long term.METHODS This prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria:Surgical and conservative.The conservative group received a supervised physical therapy and exercise program for 45 minutes,five days a week,for one month.The surgery group underwent micro endoscopic decompression surgery based on their LSS levels.Assessments,conducted before treatment and at one-month and one-year intervals,included the participants'walking distance,pain level using the visual analog scale,func tionality using the Istanbul low back pain disability index(ILBDI)and Swiss Spinal Stenosis Questionnaire(SSS)Scale,and activities of daily living level using the Nottingham Extended Activities of Daily Living.RESULTS The study comprised 40 participants,equally divided into surgical and conservative treatment groups,with no significant demographic differences.After one year,both groups exhibited similar changes in walking distance and pain levels.However,the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS.After one year,the surgical group showed greater functionality,as assessed by ILBDI,and superior improvement in activities of daily living compared to the conservative group.CONCLUSION Both treatments showed comparable efficacy in core outcomes(pain,walking distance).However,complementary advantages were observed:Conservative management demonstrated superior improvement in SSS functional subscales,while surgery yielded greater gains in daily living activities and low-back-pain-related disability.展开更多
BACKGROUND Post-transplant diabetes mellitus(PTDM)is a common metabolic adverse event following kidney transplantation,negatively impacting graft function and patient outcomes.AIM To evaluate the frequency of PTDM and...BACKGROUND Post-transplant diabetes mellitus(PTDM)is a common metabolic adverse event following kidney transplantation,negatively impacting graft function and patient outcomes.AIM To evaluate the frequency of PTDM and to determine predictive factors in living donor individuals who have undergone kidney transplantation.METHODS A retrospective analysis was conducted on 1200 living donor kidney transplant recipients treated between 2016 and 2023.Demographic,clinical,and treatment data were collected,and PTDM was identified based on American Diabetes Association criteria.Statistical analysis included logistic regression analysis to determine independent predictors of PTDM.RESULTS PTDM was diagnosed in 162 patients(13.5%).Risk factors included older age[odds ratio(OR)1.03,P=0.03],increased body mass index(OR 1.08,P=0.02),a genetic predisposition to diabetes(OR 1.95,P=0.001),and corticosteroid use(OR 1.30,P=0.04).Most PTDM cases(61.7%)occurred during the initial 6 months after transplant.Tacrolimus-based regimens were more commonly associated with PTDM compared to other protocols.Renal function at 12 months was com-parable between PTDM and non-PTDM groups.CONCLUSION PTDM remains a significant concern in kidney transplantation,particularly among patients with modifiable risk factors.Optimizing immunosuppressive regimens,implementing early metabolic monitoring,and addressing modifiable risks such as BMI may help reduce PTDM incidence.Additional research is required to evaluate extended-term results and refine preventive strategies.展开更多
We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis,a rare clinical condition in pediatric patients presenting to the emergency department.As...We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis,a rare clinical condition in pediatric patients presenting to the emergency department.As emergency medicine clinicians,we frequently encounter diverse and complex cases,and such rare conditions pose significant challenges in the diagnostic process.This article will discuss the management and diagnostic approach of such cases encountered in the emergency department.展开更多
Pension fund must consider some significant issues when making renewable energy project investment decisions.It is necessary to determine the most important factors and prioritize the indicators.Accordingly,the purpos...Pension fund must consider some significant issues when making renewable energy project investment decisions.It is necessary to determine the most important factors and prioritize the indicators.Accordingly,the purpose of this study is to conduct a priority analysis of the determinants of investment in renewable energy projects by pension funds.This study constructs a novel fuzzy decision-making model.First,five indicators for this process are weighted using an entropy methodology based on sine trigonometric Pythagorean fuzzy sets.The CRITIC methodology is also considered to make a comparative evaluation.Second,five different clean energy investment alternatives for pension funds are ranked using the RATGOS methodology.Similarly,this ranking analysis is also made by considering TOPSIS technique to check the reliability of the results.The main contribution of this study is the creation of a new and comprehensive fuzzy decision-making model to identify the most important factors in renewable energy project investments for pension funds.The proposed model uses the RATGOS technique to rank clean energy investment alternatives for pension funds.By considering the geometrical mean in the RATGOS calculation process,criticisms related to existing ranking techniques can be overcome.The use of sine trigonometric Pythagorean fuzzy numbers provides significant benefits to the quality of the proposed decision-making model.The defuzzification process can be implemented appropriately using these sets.Therefore,this study’s findings pave the way for investors to make investment decisions under these circumstances.It is concluded that the most important criterion is risk minimization.Effective regulations are another critical issue.Furthermore,the ranking results indicate that the most suitable renewable energy alternative is green bonds.The comparative results with STPFY-TOPSIS show that the proposed model generates coherent and reliable findings.展开更多
The objective of this article is to delve into the digital financial asset(DFA)portfolio price of institutional investors,such as hedge funds.The aim is to make a significant contribution by providing methods(statisti...The objective of this article is to delve into the digital financial asset(DFA)portfolio price of institutional investors,such as hedge funds.The aim is to make a significant contribution by providing methods(statistical methods and fuzzy logic)for investors to identify and select the best long-term portfolio from the pool of 218 digital financial assets that are available in the Russian market.Importantly,companies listed as digital financial asset operators often offer multiple classes of these assets for trading,and as such,investors are only able to trade floating digital financial assets.By the time we reach the conclusion of the year 2024,it has been estimated that the total volume of the Russian DFA market that is currently in circulation will amount to a staggering 1.54 billion USD.Additionally,it is worth noting that 708 different issues are currently actively circulating in the market,showcasing a rather extensive array of options for potential investors.In December alone,an impressive total of 147 new DFAs were introduced and successfully placed,contributing a notable 0.7 billion USD to the market,which is certainly a remarkable feat.The sustainability of the price premium remains uncertain,a consequence of the digital asset market’s inherent volatility and relatively short history.When this volatility is considered,the observed premium lacks statistical significance for the sample period.Therefore,the novelty of this study is the creation of new effective tools for researching the effectiveness of portfolio management for time series,which includes 416 daily observations for the period March 2022–October 2023.展开更多
Semisubmersible naval ships are versatile military crafts that combine the advantageous features of high-speed planing crafts and submarines.At-surface,these ships are designed to provide sufficient speed and maneuver...Semisubmersible naval ships are versatile military crafts that combine the advantageous features of high-speed planing crafts and submarines.At-surface,these ships are designed to provide sufficient speed and maneuverability.Additionally,they can perform shallow dives,offering low visual and acoustic detectability.Therefore,the hydrodynamic design of a semisubmersible naval ship should address at-surface and submerged conditions.In this study,Numerical analyses were performed using a semisubmersible hull form to analyze its hydrodynamic features,including resistance,powering,and maneuvering.The simulations were conducted with Star CCM+version 2302,a commercial package program that solves URANS equations using the SST k-ωturbulence model.The flow analysis was divided into two parts:at-surface simulations and shallowly submerged simulations.At-surface simulations cover the resistance,powering,trim,and sinkage at transition and planing regimes,with corresponding Froude numbers ranging from 0.42 to 1.69.Shallowly submerged simulations were performed at seven different submergence depths,ranging from D/LOA=0.0635 to D/LOA=0.635,and at two different speeds with Froude numbers of 0.21 and 0.33.The behaviors of the hydrodynamic forces and pitching moment for different operation depths were comprehensively analyzed.The results of the numerical analyses provide valuable insights into the hydrodynamic performance of semisubmersible naval ships,highlighting the critical factors influencing their resistance,powering,and maneuvering capabilities in both at-surface and submerged conditions.展开更多
Rare earth(RE)doped ferrites with the chemical formula Cu_(0.3)Zn_(0.3)Mg_(0.4)T_(x)Fe_(2-x)O_(4)(x=0,0.1;T=La,Ce,Sr)were synthesized by chemical co-precipitation method.The structural,optical,electrical and humidity ...Rare earth(RE)doped ferrites with the chemical formula Cu_(0.3)Zn_(0.3)Mg_(0.4)T_(x)Fe_(2-x)O_(4)(x=0,0.1;T=La,Ce,Sr)were synthesized by chemical co-precipitation method.The structural,optical,electrical and humidity sensing properties of Cu-Mg-Zn ferrites with rare earth element doping were investigated.Single-phase cubic spinel structure was confirmed via X-ray diffraction(XRD),and the crystal size ranges fro m 22.12 to 63.17 nm according to the Scherrer formula and from 25.66 to 67.46 nm according to the Williamson-Hall method.Po rous structure and elemental characterization of the samples were investigated by scanning electron microscopy(SEM).The optic band gap varies between 2.21 and 2.49 eV.Electrical measurements were conducted in the frequency range of 1 Hz-20 MHz and temperature range of 25-400℃.It has been determined that the dielectric results are consistent with the Maxwell-Wagner method and exhibit a non-Debye relaxation model,as observed from the Nyquist plots.At a minimum frequency value of 1 Hz,the dielectric constants for pure,Ce,Sr,and La samples are 9×10^(4),5×10^(4),1×10^(8),and 2×10^(5) at 25℃,and 1.85×10^(8),1.34×10^(8),1.15×10^(10),and 4.4×10^(8)at 400℃.In the same order,for the maximum frequency value of 20 MHz,the dielectric constants at 25℃are 169,166,3799,and 60,while at 400℃they are 734,624,12108,and 774.The La doped sample's low dielectric loss makes it suitable for high-frequency applications.Humidity measurements were performed at room temperature and in the 5%-95%relative humidity range.The humidity properties of the samples were investigated through humidity mapping,sensitivity,hysteresis,and long-term stability tests.Compared to other samples,the results indicate that Ce exhibits better humidity performance with 99%sensitivity and the highest repeatability(91.2%).These results show that Ce-doped ferrite can be used as a low-cost,high-performance humidity sensor.展开更多
Soil development may be impacted by periglacial processes that take place in regions where freezing and thawing episodes predominate.Mount Ilgar(2918 m a.s.l.)is a volcanic mass located on the Lesser Caucasus(4090 m a...Soil development may be impacted by periglacial processes that take place in regions where freezing and thawing episodes predominate.Mount Ilgar(2918 m a.s.l.)is a volcanic mass located on the Lesser Caucasus(4090 m a.s.l.).The objectives of this study were to assess how climate influenced the formation of periglacial landforms in Mount Ilgar,identify the morphological characteristics of each patterned ground by periglacial landforms,and investigate the pedological processes,physicochemical,biological,and mineralogical characteristics of the soils that developed on each of them.Non-sorted steps,mud circles,and stony earth circles are examples of periglacial landforms found on the slopes of the hills?küzkoku(2804 m a.s.l.)and Misikan(2674 m a.s.l.)to the north of Mount Ilgar.In terms of soil physical characteristics,the average aggregate stability and clay content of soils created on non-sorted steps are 43.52%and 8.9%,respectively;these values,however,rise dramatically in soils formed on mud circles and stony earth circles.Chemically,the soils generated on the mud and stony earth circles have lower pH values than the soils formed on the non-sorted steps,but they have higher levels of organic matter.The microbial biomass carbon and basal respiration values of the soils generated on mud circles and stony earth circles are high due to the low pH values and high organic matter contents of these soils,which also have an impact on biological activity.The rate at which soils weather is also influenced by variations in their physical,chemical,and biological characteristics.It is found that the quartz mineral is more prevalent in the soils developed on mud circles landforms,despite the fact that the distribution of the basic clay minerals in the soils is essentially the same.Additionally,smectite clay minerals with a 2:1 layer are present,according to clay mineral analysis,especially in soils that are produced from mud circle formations.One may argue that the influence of local microtopographic landforms on soil formations were the primary cause of the differences in soils on periglacial landforms developed on identical geological material and at similar elevations.展开更多
This letter to the editor critically appraises the study by Luo et al.While the study provides valuable insights into imaging-pathology correlations in pancreatic can-cer,we identify several opportunities for enhancin...This letter to the editor critically appraises the study by Luo et al.While the study provides valuable insights into imaging-pathology correlations in pancreatic can-cer,we identify several opportunities for enhancing its clinical relevance.Notably,the exclusion of magnetic resonance cholangiopancreatography and positron emission tomography/computed tomography imaging limits the study’s diag-nostic scope,as these modalities offer superior capabilities in differentiating benign from malignant lesions and assessing metabolic tumor activity.Addi-tionally,the retrospective,cross-sectional design restricts the potential for dyna-mic insights into disease progression.We also highlight the untapped potential of radiomics-based analyses,which could significantly improve diagnostic accuracy and prognostic assessments.We recommend integrating these advanced imaging modalities,adopting longitudinal study designs,and leveraging radiomics app-roaches in future research to enhance the diagnostic frameworks in pancreatic cancer imaging.展开更多
BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents si...BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents significantly increase the risk of acute kidney injury(AKI).Identifying perioperative risk factors plays a critical role in preserving renal function.AIM To evaluate postoperative renal outcomes in patients with PC who underwent CRS+HIPEC.METHODS Patients who underwent CRS+HIPEC for PC between 2017 and 2024 were included in this retrospective cohort study.Demographic data,preoperative estimated glomerular filtration rate,HIPEC agents used(cisplatin,mitomycin C,oxaliplatin),intraoperative fluid management,vasopressor use,and postoperative creatinine levels were recorded.AKI was defined according to the 2012 Kidney Disease:Improving Global Outcomes criteria.Independent predictors were identified through multivariate logistic regression analysis.RESULTS AKI developed in 61 of 445 patients(13.7%).Among them,62.0%were stage I,24.6%were stage II,and 13.1%were stage III.The highest AKI rate was observed in the cisplatin group(21.4%),with lower rates in the oxaliplatin group(9.6%)and the mitomycin C group(6.5%).Independent risk factors included cisplatin use[odds ratio(OR)=2.8;95%confidence interval:1.6-4.9;P<0.001),intraoperative fluid administration<6000 mL(OR=2.1;P=0.02),vasopressor requirement(OR=1.9;P=0.03),and preoperative estimated glomerular filtration rate<75 mL/minute/1.73 m2(OR=2.3;P=0.01).AKI was associated with a prolonged hospital stay.Three patients(0.7%)progressed to chronic kidney disease.CONCLUSION Independent risk factors such as cisplatin use,inadequate fluid replacement,vasopressor requirement,and preoperative renal function should be considered during perioperative planning to reduce AKI risk following CRS+HIPEC.展开更多
BACKGROUND In the treatment of rectal cancer,a temporary loop ileostomy(TLI)is created after low anterior resection to protect bowel function in the postoperative period.Dehydration and kidney failure are significant ...BACKGROUND In the treatment of rectal cancer,a temporary loop ileostomy(TLI)is created after low anterior resection to protect bowel function in the postoperative period.Dehydration and kidney failure are significant potential complications in loop ileostomies.Compared to late closure(3-6 months),early closure(10-14 days)of the TLI may facilitate faster patient recovery and shorter hospital stays.AIM To compare early and late closure of TLIs and demonstrate that early stoma closure can be performed without increasing morbidity.METHODS This study included patients who underwent TLI for rectal cancer,with data collected prospectively between June 2016 and October 2024 and analyzed retrospectively.Patients whose stomas were closed in the late period(3-6 months)between June 2016 and October 2022(group A)were compared with those who underwent early closure(10-14 days)between October 2022 and 2024(group B),with the primary outcome being complication rate and the secondary outcome being quality of life.RESULTS A total of 270 TLIs were created(70.9%).Of these,120(44.4%)were closed in the late period(group A),and 150(55.6%)were closed in the early period(group B).There was no statistically significant difference between group A and group B in terms of demographic and clinicopathological characteristics(P>0.05).Perioperative(anesthesia management,operative time,blood loss,surgical technique)and postoperative findings(anastomotic leak,infection)were similar between the two groups and were not statistically significant(P>0.05).There were no statistically significant differences in complication rates as the primary outcome between the two groups.Quality of life as a secondary outcome was significantly higher in the early closure group(P<0.05).CONCLUSION No statistically significant difference was found between early and late loop ileostomy closure in terms of perioperative and postoperative morbidity.Early closure accelerated patients’psychological and social recovery.展开更多
文摘High costs,technical difficulties,and policy uncertainties are the main challenges in carbon capture technology investments.Therefore,innovative financial products are required to develop projects that overcome these difficulties.Some issues must be considered when developing innovative financial products.An important problem in this process is that these features cannot possibly exist together in the new financial product,because each of these features incurs some costs.Therefore,identifying the most important features of innovative financial products is necessary.Accordingly,this study develops a new and innovative financial product to increase the effectiveness of investments in carbon capture technologies.For this purpose,a novel artificial intelligence(AI)-based fuzzy decision-making model is constructed.First,the weights of the experts were calculated by considering AI methodology.Second,the factors affecting investment in carbon capture technologies were weighted using a spherical fuzzy DEMATEL.Finally,the financial features required for investments were ranked using the spherical fuzzy ARAS method.This study’s main contribution is its creation of a novel fuzzy decision-making model by integrating AI methodology with fuzzy decision-making theory.In this process,the weights of the experts are calculated using an AI approach.It is concluded that cost-effectiveness must be prioritized in the development of new financial products.Technological competence is another aspect that should be considered in this process.However,innovative financial products should include risk management and flexible financing.
文摘A recent study in the World Journal of Diabetes by Yang et al explored how Rheb1 signaling influenced pancreaticβcell fate and its potential as a therapeutic target.This invited commentary by a senior diabetes researcher discussed the findings of Yang et al in the context of current knowledge onβcell biology,providing critical insight into the role of Rheb1 inβcell survival and function and the prospects for diabetes treatment.Key outcomes of the study were interpreted alongside established literature on Rheb1-mechanistic target of rapamycin signaling in islet cells.Rheb1 emerges as a pivotal regulator ofβcell growth and insulin secretory function,aligning with evidence thatβcell-specific Rheb1 deletion impairsβcell mass and glucose-stimulated insulin secretion.The commentary highlighted how modulating this pathway could preserve or restore theβcell population in diabetes while cautioning about potential off-target effects(e.g.inαcells).Targeting Rheb1 signaling represents a promising new frontier in diabetes therapy to enhanceβcell resilience;however,a balanced approach addressing both its benefits and risks is essential.This letter discussed the scientific implications and future research directions needed to translate Rheb1 modulation into clinical application for diabetes.
文摘Neoliberal economic policies implemented by the Justice and Development Party(AKP)in Turkey empowered the modernization process which is one of the main dynamics of transforming traditional societies.As a result of this socio-economic transformation,new institutions and technical developments evolved,without any relation to religion or its institutions(Zubaida,2011).In fact,this course has accelerated the individualization process of the religiously educated Generation Z in Turkey,whereas the significance of collective religious identity shrank(Kara,2014).The expansion of social media platforms has influenced young people’s relationship with religion and faith.However,after the Gezi Parki protests in 2013,the government started using a more populist discourse with regard to religious and nationalist symbols.This type of political communication had a crucial impact on the political arena.This research sheds light on the result of a qualitative analysis,based on interviews conducted with Imam Hatip school students in Turkey.The results of these in-depth interviews show how digital media is creating a new ecosystem based on self-identity(Giddens,1991).
文摘The gut microbiota(GM)is a highly dynamic ecology whose density and com-position can be influenced by a wide range of internal and external factors.Thus,“How do GM,which can have commensal,pathological,and mutualistic rela-tionships with us,affect human health?”has become the most popular research issue in recent years.Numerous studies have demonstrated that the trillions of microorganisms that inhabit the human body can alter host physiology in a variety of systems,such as metabolism,immunology,cardiovascular health,and neurons.The GM may have a role in the development of a number of clinical disorders by producing bioactive peptides,including neurotransmitters,short-chain fatty acids,branched-chain amino acids,intestinal hormones,and secondary bile acid conversion.These bioactive peptides enter the portal circulatory system through the gut-liver axis and play a role in the development of chronic liver diseases,cirrhosis,and hepatic encephalopathy.This procedure is still unclear and quite complex.In this study,we aim to discuss the contribution of GM to the development of liver diseases,its effects on the progression of existing chronic liver disease,and to address the basic mechanisms of the intestinal microbiota-liver axis in the light of recent publications that may inspire the future.
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.
文摘BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals'health behaviors and perceptions,potentially impacting their health-related quality of life(HRQoL).Future anxiety,defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future,may further influence these outcomes.AIM To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship.METHODS A cross-sectional study was conducted with 659 participants aged 18 to 65 years.Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale,the Dark Future Scale,and the European Health Interview Survey-Quality of Life 8.Correlation analyses were performed,followed by Structural Equation Modeling to test the proposed mediation model.RESULTS The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety.Future anxiety was negatively correlated with HRQoL.Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety.Additionally,future anxiety negatively affected HRQoL,mediating the relationship between knowledge and HRQoL.The mediation effect was significant,as confirmed by bootstrapping(bootstrap coefficient=0.068,95%CI:0.046-0.093).CONCLUSION The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL.These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.
文摘Small-scale wind turbines are essential energy sources for hospitals because they have several advantages,such as lower maintenance costs and the possibility of customization.However,small-scale wind energy projects often have high capital requirements.Many factors affect the performance of financial products to be developed for financing small-scale wind turbines.Nevertheless,applications to improve each of these variables lead to increased costs.Owing to this situation,it is necessary to determine the more important factors and to prioritize these issues.The purpose of this study is to identify the essential factors that have the greatest impact on the performance of financial products considered for small-scale wind turbine projects.First,a unique criteria list is evaluated via the T-Spherical fuzzy TOP-DEMATEL technique.Another analysis is also performed to define which of the financial products are suitable for smallscale wind turbine projects with RATGOS.The main contribution of this study is that a priority evaluation has been conducted to identify the most critical determinants of effective financial products for small-scale wind turbine projects.Current decisionmaking models called RATGOS and TOP-DEMATEL are used to increase methodological specificity and minimize uncertainty.One of the theoretical contributions of this study is that it provides a strategic roadmap for financing such projects.The findings indicate that financial efficiency is the most significant factor in increasing the performance of financial innovation.Moreover,green bonds can be a viable option for financing wind energy projects,as they are generally long-term and have low interest rates.
文摘Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The triglycerideglucose(TyG)index,a marker of insulin resistance,has shown promise in various cancers,but its role in GC remains unclear.Yao et al investigated its prognostic value in 300 patients with advanced GC receiving immunotherapy and chemotherapy.Their model,which integrates the TyG index,programmed death-ligand 1 expression,and Eastern Cooperative Oncology Group performance status,underscores the impact of metabolic dysfunction on immune response and treatment efficacy.This letter examines the TyG index’s potential as a prognostic tool in GC and its implications for treatment strategies guided by metabolic and immune factors,as demonstrated in Yao et al research.
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.
文摘BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS,both in the short and long term.METHODS This prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria:Surgical and conservative.The conservative group received a supervised physical therapy and exercise program for 45 minutes,five days a week,for one month.The surgery group underwent micro endoscopic decompression surgery based on their LSS levels.Assessments,conducted before treatment and at one-month and one-year intervals,included the participants'walking distance,pain level using the visual analog scale,func tionality using the Istanbul low back pain disability index(ILBDI)and Swiss Spinal Stenosis Questionnaire(SSS)Scale,and activities of daily living level using the Nottingham Extended Activities of Daily Living.RESULTS The study comprised 40 participants,equally divided into surgical and conservative treatment groups,with no significant demographic differences.After one year,both groups exhibited similar changes in walking distance and pain levels.However,the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS.After one year,the surgical group showed greater functionality,as assessed by ILBDI,and superior improvement in activities of daily living compared to the conservative group.CONCLUSION Both treatments showed comparable efficacy in core outcomes(pain,walking distance).However,complementary advantages were observed:Conservative management demonstrated superior improvement in SSS functional subscales,while surgery yielded greater gains in daily living activities and low-back-pain-related disability.
文摘BACKGROUND Post-transplant diabetes mellitus(PTDM)is a common metabolic adverse event following kidney transplantation,negatively impacting graft function and patient outcomes.AIM To evaluate the frequency of PTDM and to determine predictive factors in living donor individuals who have undergone kidney transplantation.METHODS A retrospective analysis was conducted on 1200 living donor kidney transplant recipients treated between 2016 and 2023.Demographic,clinical,and treatment data were collected,and PTDM was identified based on American Diabetes Association criteria.Statistical analysis included logistic regression analysis to determine independent predictors of PTDM.RESULTS PTDM was diagnosed in 162 patients(13.5%).Risk factors included older age[odds ratio(OR)1.03,P=0.03],increased body mass index(OR 1.08,P=0.02),a genetic predisposition to diabetes(OR 1.95,P=0.001),and corticosteroid use(OR 1.30,P=0.04).Most PTDM cases(61.7%)occurred during the initial 6 months after transplant.Tacrolimus-based regimens were more commonly associated with PTDM compared to other protocols.Renal function at 12 months was com-parable between PTDM and non-PTDM groups.CONCLUSION PTDM remains a significant concern in kidney transplantation,particularly among patients with modifiable risk factors.Optimizing immunosuppressive regimens,implementing early metabolic monitoring,and addressing modifiable risks such as BMI may help reduce PTDM incidence.Additional research is required to evaluate extended-term results and refine preventive strategies.
文摘We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis,a rare clinical condition in pediatric patients presenting to the emergency department.As emergency medicine clinicians,we frequently encounter diverse and complex cases,and such rare conditions pose significant challenges in the diagnostic process.This article will discuss the management and diagnostic approach of such cases encountered in the emergency department.
文摘Pension fund must consider some significant issues when making renewable energy project investment decisions.It is necessary to determine the most important factors and prioritize the indicators.Accordingly,the purpose of this study is to conduct a priority analysis of the determinants of investment in renewable energy projects by pension funds.This study constructs a novel fuzzy decision-making model.First,five indicators for this process are weighted using an entropy methodology based on sine trigonometric Pythagorean fuzzy sets.The CRITIC methodology is also considered to make a comparative evaluation.Second,five different clean energy investment alternatives for pension funds are ranked using the RATGOS methodology.Similarly,this ranking analysis is also made by considering TOPSIS technique to check the reliability of the results.The main contribution of this study is the creation of a new and comprehensive fuzzy decision-making model to identify the most important factors in renewable energy project investments for pension funds.The proposed model uses the RATGOS technique to rank clean energy investment alternatives for pension funds.By considering the geometrical mean in the RATGOS calculation process,criticisms related to existing ranking techniques can be overcome.The use of sine trigonometric Pythagorean fuzzy numbers provides significant benefits to the quality of the proposed decision-making model.The defuzzification process can be implemented appropriately using these sets.Therefore,this study’s findings pave the way for investors to make investment decisions under these circumstances.It is concluded that the most important criterion is risk minimization.Effective regulations are another critical issue.Furthermore,the ranking results indicate that the most suitable renewable energy alternative is green bonds.The comparative results with STPFY-TOPSIS show that the proposed model generates coherent and reliable findings.
文摘The objective of this article is to delve into the digital financial asset(DFA)portfolio price of institutional investors,such as hedge funds.The aim is to make a significant contribution by providing methods(statistical methods and fuzzy logic)for investors to identify and select the best long-term portfolio from the pool of 218 digital financial assets that are available in the Russian market.Importantly,companies listed as digital financial asset operators often offer multiple classes of these assets for trading,and as such,investors are only able to trade floating digital financial assets.By the time we reach the conclusion of the year 2024,it has been estimated that the total volume of the Russian DFA market that is currently in circulation will amount to a staggering 1.54 billion USD.Additionally,it is worth noting that 708 different issues are currently actively circulating in the market,showcasing a rather extensive array of options for potential investors.In December alone,an impressive total of 147 new DFAs were introduced and successfully placed,contributing a notable 0.7 billion USD to the market,which is certainly a remarkable feat.The sustainability of the price premium remains uncertain,a consequence of the digital asset market’s inherent volatility and relatively short history.When this volatility is considered,the observed premium lacks statistical significance for the sample period.Therefore,the novelty of this study is the creation of new effective tools for researching the effectiveness of portfolio management for time series,which includes 416 daily observations for the period March 2022–October 2023.
文摘Semisubmersible naval ships are versatile military crafts that combine the advantageous features of high-speed planing crafts and submarines.At-surface,these ships are designed to provide sufficient speed and maneuverability.Additionally,they can perform shallow dives,offering low visual and acoustic detectability.Therefore,the hydrodynamic design of a semisubmersible naval ship should address at-surface and submerged conditions.In this study,Numerical analyses were performed using a semisubmersible hull form to analyze its hydrodynamic features,including resistance,powering,and maneuvering.The simulations were conducted with Star CCM+version 2302,a commercial package program that solves URANS equations using the SST k-ωturbulence model.The flow analysis was divided into two parts:at-surface simulations and shallowly submerged simulations.At-surface simulations cover the resistance,powering,trim,and sinkage at transition and planing regimes,with corresponding Froude numbers ranging from 0.42 to 1.69.Shallowly submerged simulations were performed at seven different submergence depths,ranging from D/LOA=0.0635 to D/LOA=0.635,and at two different speeds with Froude numbers of 0.21 and 0.33.The behaviors of the hydrodynamic forces and pitching moment for different operation depths were comprehensively analyzed.The results of the numerical analyses provide valuable insights into the hydrodynamic performance of semisubmersible naval ships,highlighting the critical factors influencing their resistance,powering,and maneuvering capabilities in both at-surface and submerged conditions.
基金supported by the Ondokuz Mayis University Project Number PYO.MUH.1901.21.001。
文摘Rare earth(RE)doped ferrites with the chemical formula Cu_(0.3)Zn_(0.3)Mg_(0.4)T_(x)Fe_(2-x)O_(4)(x=0,0.1;T=La,Ce,Sr)were synthesized by chemical co-precipitation method.The structural,optical,electrical and humidity sensing properties of Cu-Mg-Zn ferrites with rare earth element doping were investigated.Single-phase cubic spinel structure was confirmed via X-ray diffraction(XRD),and the crystal size ranges fro m 22.12 to 63.17 nm according to the Scherrer formula and from 25.66 to 67.46 nm according to the Williamson-Hall method.Po rous structure and elemental characterization of the samples were investigated by scanning electron microscopy(SEM).The optic band gap varies between 2.21 and 2.49 eV.Electrical measurements were conducted in the frequency range of 1 Hz-20 MHz and temperature range of 25-400℃.It has been determined that the dielectric results are consistent with the Maxwell-Wagner method and exhibit a non-Debye relaxation model,as observed from the Nyquist plots.At a minimum frequency value of 1 Hz,the dielectric constants for pure,Ce,Sr,and La samples are 9×10^(4),5×10^(4),1×10^(8),and 2×10^(5) at 25℃,and 1.85×10^(8),1.34×10^(8),1.15×10^(10),and 4.4×10^(8)at 400℃.In the same order,for the maximum frequency value of 20 MHz,the dielectric constants at 25℃are 169,166,3799,and 60,while at 400℃they are 734,624,12108,and 774.The La doped sample's low dielectric loss makes it suitable for high-frequency applications.Humidity measurements were performed at room temperature and in the 5%-95%relative humidity range.The humidity properties of the samples were investigated through humidity mapping,sensitivity,hysteresis,and long-term stability tests.Compared to other samples,the results indicate that Ce exhibits better humidity performance with 99%sensitivity and the highest repeatability(91.2%).These results show that Ce-doped ferrite can be used as a low-cost,high-performance humidity sensor.
基金supported by Ardahan University,Scientific Research Projects Office(Project No:2020-001)。
文摘Soil development may be impacted by periglacial processes that take place in regions where freezing and thawing episodes predominate.Mount Ilgar(2918 m a.s.l.)is a volcanic mass located on the Lesser Caucasus(4090 m a.s.l.).The objectives of this study were to assess how climate influenced the formation of periglacial landforms in Mount Ilgar,identify the morphological characteristics of each patterned ground by periglacial landforms,and investigate the pedological processes,physicochemical,biological,and mineralogical characteristics of the soils that developed on each of them.Non-sorted steps,mud circles,and stony earth circles are examples of periglacial landforms found on the slopes of the hills?küzkoku(2804 m a.s.l.)and Misikan(2674 m a.s.l.)to the north of Mount Ilgar.In terms of soil physical characteristics,the average aggregate stability and clay content of soils created on non-sorted steps are 43.52%and 8.9%,respectively;these values,however,rise dramatically in soils formed on mud circles and stony earth circles.Chemically,the soils generated on the mud and stony earth circles have lower pH values than the soils formed on the non-sorted steps,but they have higher levels of organic matter.The microbial biomass carbon and basal respiration values of the soils generated on mud circles and stony earth circles are high due to the low pH values and high organic matter contents of these soils,which also have an impact on biological activity.The rate at which soils weather is also influenced by variations in their physical,chemical,and biological characteristics.It is found that the quartz mineral is more prevalent in the soils developed on mud circles landforms,despite the fact that the distribution of the basic clay minerals in the soils is essentially the same.Additionally,smectite clay minerals with a 2:1 layer are present,according to clay mineral analysis,especially in soils that are produced from mud circle formations.One may argue that the influence of local microtopographic landforms on soil formations were the primary cause of the differences in soils on periglacial landforms developed on identical geological material and at similar elevations.
文摘This letter to the editor critically appraises the study by Luo et al.While the study provides valuable insights into imaging-pathology correlations in pancreatic can-cer,we identify several opportunities for enhancing its clinical relevance.Notably,the exclusion of magnetic resonance cholangiopancreatography and positron emission tomography/computed tomography imaging limits the study’s diag-nostic scope,as these modalities offer superior capabilities in differentiating benign from malignant lesions and assessing metabolic tumor activity.Addi-tionally,the retrospective,cross-sectional design restricts the potential for dyna-mic insights into disease progression.We also highlight the untapped potential of radiomics-based analyses,which could significantly improve diagnostic accuracy and prognostic assessments.We recommend integrating these advanced imaging modalities,adopting longitudinal study designs,and leveraging radiomics app-roaches in future research to enhance the diagnostic frameworks in pancreatic cancer imaging.
文摘BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents significantly increase the risk of acute kidney injury(AKI).Identifying perioperative risk factors plays a critical role in preserving renal function.AIM To evaluate postoperative renal outcomes in patients with PC who underwent CRS+HIPEC.METHODS Patients who underwent CRS+HIPEC for PC between 2017 and 2024 were included in this retrospective cohort study.Demographic data,preoperative estimated glomerular filtration rate,HIPEC agents used(cisplatin,mitomycin C,oxaliplatin),intraoperative fluid management,vasopressor use,and postoperative creatinine levels were recorded.AKI was defined according to the 2012 Kidney Disease:Improving Global Outcomes criteria.Independent predictors were identified through multivariate logistic regression analysis.RESULTS AKI developed in 61 of 445 patients(13.7%).Among them,62.0%were stage I,24.6%were stage II,and 13.1%were stage III.The highest AKI rate was observed in the cisplatin group(21.4%),with lower rates in the oxaliplatin group(9.6%)and the mitomycin C group(6.5%).Independent risk factors included cisplatin use[odds ratio(OR)=2.8;95%confidence interval:1.6-4.9;P<0.001),intraoperative fluid administration<6000 mL(OR=2.1;P=0.02),vasopressor requirement(OR=1.9;P=0.03),and preoperative estimated glomerular filtration rate<75 mL/minute/1.73 m2(OR=2.3;P=0.01).AKI was associated with a prolonged hospital stay.Three patients(0.7%)progressed to chronic kidney disease.CONCLUSION Independent risk factors such as cisplatin use,inadequate fluid replacement,vasopressor requirement,and preoperative renal function should be considered during perioperative planning to reduce AKI risk following CRS+HIPEC.
文摘BACKGROUND In the treatment of rectal cancer,a temporary loop ileostomy(TLI)is created after low anterior resection to protect bowel function in the postoperative period.Dehydration and kidney failure are significant potential complications in loop ileostomies.Compared to late closure(3-6 months),early closure(10-14 days)of the TLI may facilitate faster patient recovery and shorter hospital stays.AIM To compare early and late closure of TLIs and demonstrate that early stoma closure can be performed without increasing morbidity.METHODS This study included patients who underwent TLI for rectal cancer,with data collected prospectively between June 2016 and October 2024 and analyzed retrospectively.Patients whose stomas were closed in the late period(3-6 months)between June 2016 and October 2022(group A)were compared with those who underwent early closure(10-14 days)between October 2022 and 2024(group B),with the primary outcome being complication rate and the secondary outcome being quality of life.RESULTS A total of 270 TLIs were created(70.9%).Of these,120(44.4%)were closed in the late period(group A),and 150(55.6%)were closed in the early period(group B).There was no statistically significant difference between group A and group B in terms of demographic and clinicopathological characteristics(P>0.05).Perioperative(anesthesia management,operative time,blood loss,surgical technique)and postoperative findings(anastomotic leak,infection)were similar between the two groups and were not statistically significant(P>0.05).There were no statistically significant differences in complication rates as the primary outcome between the two groups.Quality of life as a secondary outcome was significantly higher in the early closure group(P<0.05).CONCLUSION No statistically significant difference was found between early and late loop ileostomy closure in terms of perioperative and postoperative morbidity.Early closure accelerated patients’psychological and social recovery.
