Search Results (146)

In order to improve the microstructure and corrosion resistance of entropy alloy in the FeCrNi system, laser melting deposition technology was used as a preparation method to study the effects of different contents of Al and Ti on the microstructure and corrosion resistance of entropy alloy in FeCrNi(AlTi)_x (x = 0.17, 0.2, and 0.24). The results show that the addition of Al and Ti elements can change the phase structure of the alloy from a single FCC phase structure to an FCC + BCC biphase structure. The BCC phase volume fraction of FeCrNi(AlTi)_0.2 is the highest among the three alloys, reaching 37.5%. With the addition of Al and Ti content, the grain of the alloy will be refined to a certain extent. In addition, the dual-phase structure will also improve the corrosion resistance of the alloy. In 3.5 wt.% NaCl solution, the increase of Al and Ti content can effectively improve the protection of the passivation film on the surface of the entropy alloy in FeCrNi(AlTi)_x, effectively inhibit the large-scale corrosion phenomenon on the alloy surface, and thus improve the corrosion resistance of the alloy. In a certain range, increasing the content of Al and Ti elements in the FeCrNi(AlTi)_x system can improve the corrosion resistance of the alloy. Full article

Establishing a sustainable production system requires a more efficient utilization of resources and the adoption of cleaner production methodologies. Specifically, industrial symbiosis promotes collaboration among interconnected industries by exchanging waste, byproducts, and utilities, thereby providing innovative ways to enhance the efficiency of production processes. However, the sustainability of agricultural products and agro-based industries is essential for human survival. This study proposed an integrated symbiotic production system that targets agro-based industries. The system includes seven plants: a sugar production plant, a corn-integrated industrial plant, an alcohol production plant, a feed production plant, a fertilizer plant, a bioethanol production plant, and a wastewater treatment plant. The study aimed to design a sustainable industrial system that shares byproducts, waste, and water reuse. Symbiotic relations between production plants are designed in a provided multi-objective optimization model that considers both the mitigation of CO₂ emissions and the maximization of system profit. The multi-objective model with the epsilon-constraint method results in Pareto-efficient solutions that address the tradeoff between the objectives. This allows decision makers to select a suitable one among the solution set that prioritizes conflicting objectives. We developed ten scenarios to assess costs, revenue, profit, and CO₂ emissions, offering significant insights into how model parameters affect managerial knowledge. This study also addresses environmental and economic concerns, thereby making the development of agro-based industries more sustainable. Full article

Background and Objectives: Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking agents in cancer therapy; however, their immune-related adverse effects, especially pulmonary toxicity, significantly limit their use. This study aimed to determine the incidence and risk factors associated with ICI-induced pulmonary toxicity. Materials and Methods: We conducted a prospective observational study involving 126 patients aged ≥18 years with malignancies treated with ICIs between April 2022 and April 2024. Patients were followed every six months over a two-year period. Clinical, laboratory, and radiological data were collected to assess pulmonary toxicity. Results: The mean age of our patients was 62.93 ± 12.94 years, and 81% were male. The ICI-related pulmonary toxicity rate was 16.7%, and the all-cause mortality rate was 68.3%. In the analysis, the conditions associated with pulmonary toxicity were the type of malignancy, the presence of lung cancer, COPD, long-term ICI use, dyspnea, cough and sputum, the pre-ICI lung nodule mass, and high blood monocyte levels. Our regression analysis results for the determination of risk factors showed a 7.70-fold increase in the presence of cough symptoms, a 4.57-fold increase in the presence of COPD, a 0.998-fold increase for every 1 unit decrease in lymphocyte count, and an 11.75-fold increase in risk for a monocyte count of 130 or less. Conclusions: Our study’s findings suggest that patients with identifiable risk factors for pulmonary toxicity should undergo closer monitoring and early diagnostic evaluation during ICI therapy to reduce morbidity and mortality. Full article

Background/Objectives: Vancomycin-induced nephrotoxicity (VIN) remains a significant clinical challenge, with no effective nephroprotective agent currently established. This study aimed to evaluate the protective effects of the sodium–glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin (DAPA) against VIN in a Wistar albino rat model. Methods: Rats were randomly assigned to four groups: control, VA (vancomycin), DAPA (dapagliflozin), and VA+DAPA. Renal function was assessed by measuring serum urea and creatinine. Oxidative stress markers [malondialdehyde (MDA), total oxidant status (TOS), and myeloperoxidase (MPO)], antioxidant enzyme activities [total antioxidant status (TAS), glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD)], apoptotic mediators (Bax, Bcl-2, and caspase-3), and pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6)] were evaluated. Histopathological and immunohistochemical analyses of kidney tissues were also performed. Results: Administration of VA led to significant renal dysfunction, increased oxidative stress, heightened apoptotic activity, and notable histopathological damage. Co-administration of DAPA with VA significantly reduced serum urea and creatinine levels and decreased caspase-3 activity and was associated with a trend toward reduction in both MDA levels and TNF-α expression, as well as the amelioration of histopathological renal injury. However, reductions in IL-1β and IL-6 levels were not statistically significant. Overall, these findings indicate that DAPA exerts nephroprotective effects against VIN by modulating oxidative stress, inflammation, and apoptotic pathways. Conclusions: Dapagliflozin may serve as a potential protective agent against vancomycin-induced nephrotoxicity. Further long-term and large-scale clinical studies are warranted to validate these preclinical findings and explore their therapeutic implications. Full article

Analyzing the prevalence of neurological disorders (NDs) is crucial to understand health expenditures and economic outcomes as they change over time and have significant economic effects. Diseases, particularly those involving neuron damage, can have an economic impact. This study aims to quantify the effects of NDs on health expenditure and economic output for OECD countries from 2000 to 2021 using a dual-model dynamic panel data approach. Also, this study uniquely highlights the dual economic burden of neurological disorders by examining their simultaneous impact on both health expenditures and economic output using dynamic panel data methods. We used both Arellano–Bond and Blundell–Bond estimation methods. The results indicate that an increase in ND prevalence significantly impacts both health expenditures and economic output. While NDs substantially raise health expenditures, they also decrease income levels, underscoring their dual economic burden. Overall, the rise in NDs in society drives up healthcare spending and underscores their significant economic burden. Policymakers should prioritize preventive strategies and early interventions for neurological disorders to mitigate their rising economic and healthcare costs on a societal level. Full article

Background: Colorectal cancer (CRC) remains a significant global health burden, with early detection and intervention crucial for improving patient outcomes. This study aims to develop and evaluate a novel proof-of-concept ensemble framework combining transformer-based language models and decision tree-based models for early-stage CRC screening, diagnosis, and prognosis. Methods: The ensemble framework consists of four key components: (1) GastroGPT, a transformer-based language model for extracting relevant data points from patient histories; (2) a decision tree-based model for assessing CRC risk and recommending colonoscopy; (3) GastroGPT for extracting data points from early CRC patients’ histories; and (4) a suite of decision tree-based models for predicting survival outcomes in early-stage CRC patients. The study employed a retrospective, observational, methodological design using simulated patient cases. Results: GastroGPT demonstrated high accuracy in extracting relevant data points from patient histories. The decision tree-based model for CRC risk assessment achieved an area under the receiver operating characteristic curve (AUC-ROC) of 0.85 (95% CI: 0.78–0.92) in predicting the need for colonoscopy. The decision tree-based models for survival prediction showed strong performance, with C-indices ranging from 0.71 to 0.75 for overall survival and disease-free survival at 24, 36, and 48 months. Conclusions: The novel ensemble framework demonstrates promising performance in early-stage CRC screening, diagnosis, and prognosis. Further research is needed to validate the models using larger, real-world datasets and to assess their clinical utility in prospective studies. Full article

Objectives: Inflammation plays an important role in cancer development, and various inflammation parameters are used as potential prognostic markers. This study aimed to evaluate the effectiveness of the combined use of HALP and H index in predicting pathological response to neoadjuvant therapy in patients with HER2-positive early-stage breast cancer. Method: This retrospective cohort study was conducted on 146 HER2-positive breast cancer patients treated in two centers. To stratify patients by their predicted probability of pathological response, HALP and H index values were combined into a composite biomarker score called the combined response score (CRS). Patients were classified into three groups based on biomarker levels: 0 = low CRS (low predictive score), 1 = intermediate CRS, and 2 = high CRS (high predictive score). These groups reflect predicted response likelihood and do not represent actual pathological outcomes. Pathological response results were evaluated according to the combined response score. Pathological complete response (pCR) was defined as residual cancer burden (RCB) 0, indicating no residual invasive tumor in breast or lymph nodes. Results: The mean age of 146 early-stage breast cancer patients included in our study was 52.3 ± 11.3 (min: 29-max: 83). In the ROC analysis, the optimum cut-off value for the HALP score in pathological response classification was found to be 36 (AUC = 0.608, sensitivity = 76.29%, specificity = 44.9%, PPV = 73%, NPV = 47.89%) and 2.3 for the H index (AUC = 0.641, sensitivity = 65.98%, specificity = 51.02%, PPV = 72.73%, NPV = 43.1%). While the pathological complete response rate was 66.4% in all patients, it was 81.8% in those with a combined score of 2, 51% in those with a score of 1, and 58.6% in those with a score of 0 (p < 0.001). In the logistic regression analysis, the probability of pathological response in patients in the combined score = 2 group is 3.77 times higher than in group 0. In the Fagan nomogram, the pretest probability of pathological response is 66%, while the post-test probability for combined response score group 2 is 81.5%, and for the low-H index < 2.3 and the high-HALP ≥ 36 patient group, our estimate for pathological complete response increases to 82%. Conclusions: The HALP-H index combined score is an important predictor of pathological response in early-stage HER2-positive breast cancer patients, independent of histological type and stage. This new score may enable personalized approaches in treatment planning. Full article

Background/Objectives: Acute pancreatitis (AP) is an illness that requires prompt diagnosis and treatment since it has the potential to become life-threatening. The American College of Gastroenterology 2024 (ACG24) guidelines offer a framework for diagnosis, severity, and treatment criteria. To assess Google Gemini application of ACG24 guidelines to Medical Information Mart for Intensive Care-III AP cases for risk, nutrition, and complication management. Methods: This observational cross-sectional study was based on 512 patients with AP who were treated in the Medical Information Mart for Intensive Care-III database from 2001 to 2012. The study compared the efficiency of Gemini in relation to the ACG24 guidelines in the three main areas of risk stratification, enteral nutrition timing, and necrotizing pancreatitis management. Enteral nutrition, according to the ACG24 guidelines, should be started within 48 h for patients who are capable, and antibiotics should only be used for confirmed infected necrosis. Results: The study included 512 patients who were divided into two groups: 213 patients with mild pancreatitis (41.6%) and 299 patients with severe pancreatitis (58.4%). The model achieved 85% accuracy for mild cases and 82% accuracy for severe cases of pancreatitis. The Acute Physiology and Chronic Health Evaluation II and Ranson scores matched the predictions of Gemini for both mild cases (p = 0.28 and p = 0.33, respectively) and severe cases (p = 0.31 and p = 0.27, respectively). The recommendations for early enteral nutrition and delayed feeding in mild cases were correct for 78% of patients, but the system suggested oral intake prematurely in 8% of severe cases. The antibiotic guideline compliance reached 82% among 156 patients with necrotizing pancreatitis, and the procedure for draining infected necrosis was correct 85% of the time. Conclusions: The Gemini model achieved 78–85% accuracy in determining pancreatitis severity and adherence to treatment guidelines but showed lower accuracy in nutrition timing compared to other parameters. Core Tip: This study evaluated the Google Gemini model in applying the American College of Gastroenterology 2024 guidelines for acute pancreatitis across 512 Medical Information Mart for Intensive Care-III cases. Results demonstrated 85% accuracy in severity classification, precise prediction of Acute Physiology and Chronic Health Evaluation II and Ranson scores, and 78–85% compliance with nutritional and necrotizing pancreatitis management guidelines. These findings suggest that artificial intelligence-based clinical decision support systems can provide rapid, consistent, and guideline-concordant recommendations, which are particularly valuable in settings with limited specialist expertise. Full article

Objective: This study aimed to evaluate the prognostic utility of systemic inflammatory markers, such as the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Neutrophil–Lymphocyte Ratio (NLR), Monocyte–Lymphocyte Ratio (MLR), and Platelet–Lymphocyte Ratio (PLR), to identify patients at risk of developing surgically treated postpericardiotomy syndrome (PPS). Methods: A total of 150 patients were retrospectively analyzed. In total, 75 patients who developed postpericardiotomy syndrome requiring surgical drainage constituted the postpericardiotomy group, whereas 75 age- and surgically matched non-PPS patients served as the control group. Blood samples were collected at four time points: preoperative (T1), 24 h postoperative (T2), 7 days postoperative (T3), and 24 h before secondary intervention in the PPS group and the closest matched outpatient follow-up (T4) in the control group. Inflammatory marker values were compared within and between the groups at the four defined time points. Logistic regression and receiver operating characteristic (ROC) analyses were used to determine the diagnostic and predictive accuracy of each marker. Results: Significant increases in the SIRI, MLR, and CRP levels were observed in patients who developed PPS and required surgical intervention. MLR on postoperative day 7 had the highest sensitivity (84%) with a cut-off of 0.575, whereas SIRI demonstrated the highest specificity (81.3%) at a cut-off of 3.34. SII increased significantly only in the late stage, indicating disease progression. The NLR lacked predictive power across all time points. Conclusions: The SIRI and MLR are promising early-stage biomarkers for identifying patients at high risk of developing PPS. Their integration into routine postoperative follow-up could facilitate earlier diagnosis and reduce surgical burden. A multi-marker approach may enhance the diagnostic precision of PPS beyond that of traditional inflammatory measures. Full article

Task scheduling for multiple humanoid robot manipulators in industrial and collaborative settings remains a significant challenge due to the complexity of coordination, resource sharing, and real-time decision-making. In this study, we propose a framework for modeling task scheduling for multiple humanoid robot manipulators by using the symbolic discrete controller synthesis technique. We encode the task scheduling problem as discrete events using parallel synchronous dataflow equations and apply our synthesis algorithms to manage the task scheduling of multiple humanoid robots via the resulting controller. The control objectives encompass the fundamental behaviors of the system, strict rules, and mutual exclusions over shared resources, categorized as the safety property, whereas the optimization objectives are directed toward maximizing the throughput of robot-processed products with optimal efficiency. The humanoid robots considered in this study consist of two pairs of six-degree-of-freedom (6-DOF) robot manipulators, and the inverse kinematics problem of the 6-DOF arms is addressed using metaheuristic approaches inspired by biomimetic principles. Our approach is experimentally validated, and the results demonstrate high accuracy and performance compared to other approaches reported in the literature. Our approach achieved an average efficiency improvement of 40% in 70-robot systems, 20% in 30-robot systems, and 10% in 10-robot systems in terms of production throughput compared to systems without a controller. Full article

Objectives: Evisceration is a rarely performed surgical procedure, and literature information regarding the characteristics of patients undergoing this surgery is limited. This study aims to evaluate the demographic features and etiological factors of patients who underwent evisceration surgery in a tertiary clinic over 10 years. Methods: This descriptive study comprised the data of 134 patients who underwent evisceration surgery at the Department of Ophthalmology, Faculty of Medicine, Çukurova University, Adana, Türkiye, between 2011 and 2022. Demographic data of all patients, including age, sex, surgical indication, etiology, primary disease location, pathology results, and follow-up periods, were recorded and analyzed. Results: The mean age of the 134 patients included in the study was 56.18 ± 22.71 (min: 8–max: 91), with a male-to-female ratio of 65.2% to 34.8%. Evisceration etiologies included trauma (37%), endophthalmitis (37%), absolute blind eye (12.6%), and spontaneous perforation (11.9%). Endophthalmitis cases were more common in older ages and females, trauma patients in younger ages and males, and spontaneous perforation in older ages and males. Progression to panophthalmitis was observed in 6.6% of all cases, and all were found to originate from endophthalmitis. Culture growth was positive in 18.5% of the cases, with the most commonly grown microorganisms in culture being Pseudomonas aeruginosa, Streptococcus dysgalactiae and Aspergillus fumigatus. Escherichia coli and Staphylococcus epidermidis rates were significantly higher in cases progressing to panophthalmia. Acute inflammation was more prevalent in cases of endophthalmitis and spontaneous perforation, while chronic inflammation was in cases of trauma and absolute blind eyes. Conclusions: Trauma was the main etiology of evisceration in young males and endophthalmitis in older females. Considering trauma prevention measures is important for public health in terms of eyeball saving. Full article

Background and Objectives: This study aims to evaluate the adequacy of the liberal transfusion strategy applied in patients undergoing endoscopy-assisted Metopic, Coronal, or Sagittal craniosynostosis surgery according to the Pre-Transfusion and Post-Transfusion Estimated Red Blood Cell Mass (ERCM) ratios. Materials and Methods: This retrospective cohort study, conducted at the Pamukkale University Faculty of Medicine (2017–2023), utilized anesthesia, surgical records, and hospital electronic data of patients undergoing endoscopic craniosynostosis surgery. The primary endpoints were the rates of Post-Transfusion 1st-hour ERCM/Pre-Transfusion ERCM (%) and Post-Transfusion 24th-hour ERCM/Pre-Transfusion ERCM (%). The secondary endpoints were determined as Hemoglobin (Hb) and Hematocrit (Hct) values at the 1st and 24th hours after surgery, Calculated Blood Loss (CBL) during surgery (%), total 24 h CBL (%), ERCM (%), and Estimated Blood Loss (EBV) during surgery and total 24 h transfusions, Packed Red Blood Cells (PRBCs) (mL/kg) amounts during surgery, and total 24 h transfusions. Results: A total of 86 pediatric craniosynostosis cases were evaluated and categorized into Metopic (n = 38), Sagittal (n = 33), and Coronal (n = 15) groups, with Post-Transfusion evaluation conducted across these groups. Post-Transfusion 1st-hour ERCM/Pre-Transfusion ERCM ratios were found to have median values of 90.70% in the Metopic group, 91.61% in the Sagittal group, and 93.09% in the Coronal group. Post-Transfusion 24th-hour ERCM/Pre-Transfusion ERCM ratios were found to be median values of 94.05% in the Metopic group, 88.3% in the Sagittal group, and 87.08% in the Coronal group. Conclusions: The liberal transfusion strategy provided adequate transfusion, maintaining ERCM ratios within the 85–115% range across all groups. Significant decreases in Hb and Hct levels were observed from preoperative to postoperative measurements at 1 and 24 h. Changes in CBL, ERCM, EBV, and PRBC volumes were noted between the postoperative 1 h and 24 h measurements across all groups. Full article

Analyzing the transmission dynamics of airborne disease spores is crucial for advancing early warning and control strategies for crop diseases. This study introduces a novel approach utilizing the HYSPLIT-5 model to investigate the spore transmission patterns and pathways of airborne crop diseases. By employing the Lagrangian particle trajectory method of HYSPLIT-5 in conjunction with MeteInfoMap 3.5, the spatiotemporal frequency of cucumber downy mildew spore trajectories over extended periods was examined. The results indicate that the transmission trajectory of cucumber downy mildew spores is heavily influenced by atmospheric circulation, with spores spreading along air currents to surrounding areas. These trajectories frequently intersect, resulting in a broad transmission range, and the observed transmission patterns exhibit a degree of universality. Which provided a basis for the subsequent study of a large-scale prediction model of cucumber downy mildew. Full article

Background/Objectives: Renal cell carcinoma (RCC) accounts for 2–3% of all cancers, with approximately 25% of patients being detected at the metastatic stage. This study aimed to determine the prognostic significance of co-evaluating two risk parameters: one, the HALP score based on haemoglobin, albumin, lymphocyte, and platelet counts, and the other, albumin-to-alkaline phosphatase ratio (AAPR) in patients with metastatic RCC treated with targeted therapy. Methods: This retrospective cohort study included 147 patients with metastatic RCC. The HALP score and AAPR values were calculated from pre-treatment blood test results, and followingly, the cut-off value was determined by using ROC analysis. Patients were categorised into three groups with a low, moderate or high combined risk score based on this cut-off value. The effect of these risk groups on survival was evaluated. Results: The mean age of patients was 64.1 ± 11.9. The median follow-up time was 38.3 months, and the mortality rate was 53.7% in all groups. Kaplan–Meier survival analysis showed a statistically significant difference between the combined scores of the risk groups: the median survival time was 51.6 months in the low-risk group, 20.7 months in the medium-risk group, and 10.4 months in the high-risk group (p < 0.001), with 5-year survival rates being 38.8% in the low-risk group, 30% in the intermediate-risk group, and 19% in the high-risk group. When compared to the low-risk group, Cox regression analysis revealed that the mortality risk, i.e., HR (hazard ratio), was 2.42 times higher in the intermediate-risk group and 3.76 times higher in the high-risk group. A nephrectomy operation decreased the mortality risk (HR = 0.24) by 4.16 times. Conclusions: This new combined risk scoring, obtained from co-evaluating the HALP score and AAPR, was found to be an independent prognostic factor in metastatic RCC patients. This combined risk scoring is expected to help clinicians in treatment decisions. Full article

In this study, the total phenolic and anthocyanin contents, antioxidant activity, color, pH, serum separation, water holding capacity (WHC), rheology, texture and viscosity of cranberry (Cornus mas L.)-enriched yogurt were determined. The addition of cranberries (5–15%) to yogurt resulted in a proportional increase in antioxidant activity, total anthocyanin and phenolic contents. In yogurt samples to which cranberries were added, the WHC increased, while the serum separation values decreased. Due to the red color of the cranberry fruits, the L* (lightness) and b* (yellowness) values decreased, and the a* (redness) values increased (p < 0.05). The sensory evaluation showed that the 10% (w/w) cranberry-added yogurt had the highest general acceptability score when compared to the other samples. Also, it was found that the addition of 10% (w/w) cranberries to the yogurt samples contributed positively to the physicochemical (textural properties, rheological behavior, color and serum separation) and biochemical (antioxidant activity, phenolics and anthocyanins) properties of the samples. The addition of cranberries to yogurt influenced the growth of microbial populations. The number of starter bacteria (counts for Lactobacillus delbrueckii subsp. bulgaricus) in the yogurt samples with cranberries was slightly lower than in the control sample; but was at an acceptable level. E. coli and coliform bacteria were not detected in either the control yogurt sample or the samples with added cranberries. In conclusion, the addition of 10% (w/w) cranberries to yogurt can be recommended in order to achieve acceptable physical and sensory properties as well as the enrichment of yogurt with nutritional and functional aspects. Full article