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The radiologic and FDG uptake findings of osseous lesions incidentally detected on 18F-FDG-PET/CT imaging
No full textBackground: In routine clinical practice, incidental solitary bone lesions are commonly seen on various imaging modalities. 18F-FDG-positron emission tomography (PET)/computed tomography (CT) imaging provides functional and morphological information in oncology patients, and incidental bone lesions are often detected during the scan. Purpose: To evaluate the metabolic characteristics and CT morphological findings of incidental bone lesions detected in patients undergoing 18F-FDG-PET/CT imaging. Material and Methods: SUVmax values and CT characteristics of incidental osseous lesions reported in 86 patients undergoing 18F-FDG-PET/CT imaging between 2019 and 2023 were evaluated. In addition, the SUVmax values of the lesions were compared with bone areas without adjacent/contralateral density/FDG changes. CT characteristics of incidental osseous lesions were evaluated. Results: The study group included 52 women and 34 men (age range = 26–89?years). CT identified typical bone haemangioma lesions in 45/86 (52%) cases. Non-haemangioma lesions were mainly benign bone pathologies: fibrous dysplasia; Paget's disease; perineural cyst; osteonecrosis; and osteoma. The mean SUVmax value of 41 non-haemangioma bone lesions (4.27 ± 3.71) was significantly higher than that in adjacent/contralateral normal density areas (2.31 ± 1.27; P = 0.01). Conclusion: 18F-FDG-PET/CT imaging shows varying FDG uptake in incidental osseous lesions. Morphological features on CT play a critical role in diagnosis and avoiding unnecessary imaging or interventions. © 2025 Elsevier B.V., All rights reserved
The Role of a Smartphone Application in Monitoring the Risk of Hearing Loss Associated with Personal Listening Devices in Young Adults
No full textBackground Exposure to loud music has been reported to affect high-frequency hearing thresholds in adults. This study aimed to use a mobile application to assess the risk of hearing loss associated with personal listening devices (PLDs) in young adults. Methods A cross-sectional study was conducted on 99 healthy iPhone Operating System (iOS) smartphone users aged 17 to 31 years. Based on their weekly, monthly, 6-month, and annual listening data from the Health application, participants were classified into at-risk or non-risk groups. Six individuals in the at-risk group underwent audiological assessments. The Speech, Spatial, and Qualities of Hearing Scale (SSQ) was given to all participants. SSQ scores were compared between groups using the Mann-Whitney U test. The correlation between average PLD sound levels and SSQ scores was analyzed using the Spearman's test. Results The weekly, monthly, 6-month, and annual listening data showed that 16, 14, 12, and 12 participants were at risk, respectively. All six participants who underwent audiological assessment exhibited normal hearing thresholds. However, a pattern of decline at high frequencies was noted. A significant difference was found between the groups in terms of overall SSQ score (z = -2.74, P = 0.00), speech perception score (z = -3.25, P = 0.00), and hearing quality score (z = -2.01, P = 0.04) based on the 6-month and annual listening data. A weak positive correlation was found between the SSQ scores across all subscales and monthly sound-level data. Exposure duration was negatively correlated with speech perception (r = -0.32, P < 0.05), spatial perception (r = -0.26, P < 0.05), and overall score (r = -0.29, P < 0.05) in weekly data, as well as with hearing quality (r = -0.21; P < 0.05) and overall score (r = -0.21, P < 0.05) in annual data. Conclusions The immediate effects of loud music exposure were absent; however, prolonged exposure resulted in reduced speech perception and hearing-quality levels. Data from the iOS Health application indicated that some individuals were at risk of hearing loss, suggesting the need to modify their listening habits to prevent long-term decline in hearing function.TUBITAK (The Scientific and Technological Research Council of Turkiye) [2209-A]Supported by TUBITAK (The Scientific and Technological Research Council of Turkiye) 2209-A University Students Research Projects Support Program
Sistemik skleroz tanılı olgularda pan-immün inflamatuar değerin akciğer tutuluşu ile ilişkisinin değerlendirilmesi
No full textBu çalışma, sistemik skleroz (SSc) tanılı olgularda pan-immün inflamatuar değer (PIV) ile interstisyel akciğer hastalığ (İAH) varlığı ve hastalık progresyonu arasındaki ilişkiyi değerlendirmek amacıyla gerçekleştirilmiştir. Ege Üniversitesi Romatoloji Polikliniği'nde takip edilen 69 sistemik skleroz hastası retrospektif olarak incelenmiştir. PIV değeri, nötrofil, monosit ve trombosit sayılarının çarpımının lenfosit sayısına bölünmesiyle hesaplanmıştır. Bulgulara göre; tanı anında PIV, nötrofil, trombosit, CRP ve ESH düzeyleri İAH (+) olan grupta anlamlı düzeyde yüksek, FVC değerleri ise daha düşük bulunmuştur. Ancak 1. ve 5. yıllar arasındaki PIV değişimi ile İAH progresyonu, FVC, DLCO ve Rodnan skoru arasında anlamlı bir ilişki saptanmamıştır. Çalışma sonuçları, PIV'nin sistemik sklerozda tanı anında inflamatuar yükü yansıtabilen bir biyobelirteç olabileceğini, ancak zaman içerisindeki değişimlerinin hastalık progresyonunu öngörmede sınırlı kaldığını göstermektedir. Bu nedenle PIV, özellikle tanı aşamasında yardımcı bir gösterge olarak kullanılabilir; ancak hastalık takibinde tek başına yeterli olmayabilir.This study aimed to evaluate the relationship between the pan-immune inflammatory value (PIV) and the presence and progression of interstitial lung disease (ILD) in patients diagnosed with systemic sclerosis (SSc). A total of 69 SSc patients followed at Ege University Rheumatology Clinic were retrospectively analyzed. PIV was calculated by dividing the product of neutrophil, monocyte, and platelet counts by the lymphocyte count. The findings showed that, at baseline, PIV, neutrophil, platelet, CRP, and ESR levels were significantly higher in patients with ILD, while FVC values were significantly lower. However, no significant relationship was observed between changes in PIV over 1 and 5 years and ILD progression, FVC, DLCO, or Rodnan score. These results suggest that PIV may reflect the inflammatory burden at diagnosis in SSc but has limited predictive value for long-term disease progression. As an easily accessible and low-cost parameter, PIV may be useful in early disease assessment, though insufficient as a standalone follow-up tool
Advancing analytical solutions: Novel wave insights and methodologies for beta fractional Kuralay-II equations
No full textThis article investigates new analytical wave solutions within the beta (?) fractional framework (F?IIAE and F?IIBE) of the Kuralay II equations, which are significant in the field of nonlinear optics. To achieve this, we employ the improved Kudryashov method, the R method, and the Sardar sub-equation method. The study successfully derives a variety of soliton solutions, including dark, bright, singular, and others, some of which are illustrated through 2D and 3D graphics. For the first time, this research graphically demonstrates the impact of the beta fractional derivative on these solutions. The findings provide valuable insights that may aid in the advancement of future models. The methodologies applied here are not only effective and straightforward to implement but also robust for addressing other fractional, nonlinear partial differential equations. © 2025 Elsevier B.V., All rights reserved
Enhanced photodegradation of perfluorocarboxylic acids (PFCAs) using carbon quantum dots (CQDs) doped TiO2 photocatalysts: A comparative study between exfoliated graphite and mussel shell-derived CQDs
No full textRemediation of perfluorocarboxylic acids (PFCAs) is crucial due to their widespread distribution, persistence, and harmful effects on aquatic life, especially as short-chain fluorinated compounds are increasingly used as substitutes after the global ban on long-chain PFCAs. This pioneering study explores the photodegradation of perfluorooctanoic acid (PFOA-C8) and several short-chain PFCAs using carbon quantum dot (CQD)-doped TiO2. We synthesized CQDs via two innovative methods: electrochemical exfoliation of graphite rods (Exfol.CQD) and a hydrothermal process using mussel shell biomass (MCQD). The structural and morphological properties of CQDs, TiO2, and CQD/TiO2 composites were characterized. Photodegradation tests showed that Exfol.CQD/TiO2 significantly improved PFOA degradation under visible light, achieving a twofold increase compared to pure TiO2. Degradation rates for C3-C6 short-chain PFCAs with Exfol.CQD/TiO2 ranged from 22 % to 40 %. PFOA decomposed stepwise into shorter-chain PFCAs and F- ions, maintaining excellent reusability after three cycles. In contrast, the MCQD/TiO2 photocatalyst needed further optimization due to decreased performance. Our research has shown that using pure water and ethanol as electrolytes facilitates the synthesis of high-purity CQDs without the need for chemical additives. This study sheds light on the previously underexplored area of photodegradation of PFCAs via CQD/TiO2 composites, highlighting their potential applications in wastewater treatment.Scientific and Technological Research Council of Turkiye (TUBITAK) [121C069]This work is based on research supported by the Scientific and Technological Research Council of Turkiye (TUBITAK) under project number 121C069
SACREDNESS IN SECULARITY: THE USE OF DANCE FORMS IN ST. MATTHEW PASSION
No full textJohann Sebastian Bach tarafından 1727’de bestelenen Matthäuspassion (Latince: Passio Domini nostri J. C. secundum Evangelistam Matthaeum, BWV 244), batı müziği tarihindeki en etkili kutsal oratoryolardan biri olarak öne çıkmaktadır. Orta Çağ'da gelişen ve yaygınlaşan basmakalıp Gregoryen tarzı ilahilerden farklı olarak (ki bu eserde esas olarak Evanjelik bölümlerde hala kullanılmaktadır), Matthäuspassion büyük ölçüde ‘seküler’ ezgileri, özellikle de dans formlarını kutsal bir bağlamda kullanmıştır. Bu alışılmadık düzenin nedenleri üzerine şekillenen sorular doğrultusunda, makalem öncelikle Erken Hristiyanlık dönemindeki müziğe dair tarihsel düşünceleri ve Lutherci reformun dini müzik üzerindeki etkisini ele alacaktır. Ardından, Matthäuspassion’daki dans formlarına odaklanan kısa bir analiz sunarak bu olağanüstü eserin müzikal, felsefi ve estetik değerini daha iyi anlamayı amaçlamaktadır. Bunun yanı sıra, Erken Modern (Protestan) Almanya'da müzik ve din arasındaki genel düşünce akımlarını da daha kapsamlı bir şekilde değerlendirecektir.Written by Johann Sebastian BACH in 1727, St. Matthew Passion (Latin: Passio Domini nostri J. C. secundum Evangelistam Matthaeum, BWV 244) is arguably the most influential sacred oratorio during the Western music history. Unlike the stereotypical Gregorian-style hymns that flourished in the Middle Ages (which is still used in this passion mainly for the Evangelical parts), St. Matthew Passion largely applied ‘secular’ tunes, notably the dance forms, into a sacred religious context. With such question about this seemingly unusual layout, my essay will mainly describe the historical thoughts of music on Early Christian period, the Lutheran reformation on religious music, then followed by a brief analysis of St Matthew passion with the emphasis of its dance forms, in order to further understand the musical, philosophical and aesthetics value of this remarkable composition, and furthermore, the understanding of the general trend of thoughts on music and religion in Early Modern (Protestant) Germany
Sofokles’in Antigone tragedyasında kadın edimleri
Get PDFBu çalışma, Antik Yunan tragedyasında, özellikle Sofokles’in Antigone adlı eserinde kadın temsillerini incelemektedir. Kadın karakterlerin nasıl temsil edildiği, bu temsillerin dönemin toplumsal, politik ve ritüel yapılarıyla nasıl ilişkilendiği ve kadın edimlerinin (yas tutma, evlenme, etik karar alma) tragedya sahnesindeki işlevi araştırmanın temel sorularını oluşturmaktadır. Bu bağlamda çalışma, tarihsel süreçte kadının sistematik biçimde dışlanışını ve günümüzdeki toplumsal eşitsizliklerin tarihsel temellerini sorgulamayı amaçlamaktadır. Metodolojik olarak Helene Foley’nin Female Acts in Greek Tragedy adlı eserindeki yaklaşım benimsenmiş; kadın edimlerinin tarihsel ve ritüel bağlamlar içinde değerlendirilmesi hedeflenmiştir. Çözümleme hem metinsel incelemeyi hem de tarihsel-kültürel bağlamın yorumlanmasını içermektedir. Antigone tragedyasındaki kadın karakterlerin eylemleri, dönemin toplumsal normları, ritüel pratikleri ve politik yapıları çerçevesinde ele alınmıştır. Çalışma üç bölümden oluşmaktadır. İlk bölümde tragedya, kolektif kimliğin üretildiği politik ve ritüel bir pratik olarak ele alınmış; George Thomson’ın yaklaşımı doğrultusunda tragedyanın totemci klan ritüellerinden Atina demokrasisine uzanan toplumsal dönüşümle ilişkisi gösterilmiştir. Ayrıca Aristoteles’in Poetika’sındaki tragedya kuramı tartışılmış; tragedyanın epistemik ve felsefi boyutları değerlendirilmiştir. İkinci bölümde Sofokles’in tragedya anlayışı ve eserlerindeki kadın temsilleri incelenmiştir. Sofokles’in, kadın karakterleri diğer tragedya yazarlarına kıyasla daha karmaşık, çatışmalı ve çok boyutlu biçimlerde sahneye taşıdığı ortaya konmuştur. Antigone, Elektra ve Deianeira gibi karakterler, toplumsal normları sorgulayan figürler olarak değerlendirilmiştir. Üçüncü bölümde Antigone tragedyasında kadın edimlerinin temsili analiz edilmiştir. Foley’nin yaklaşımı temel alınarak bu edimlerin yalnızca bireysel tercihler değil; yasa, töre ve etik arasında kurulan ilişkilerin ritüel ifadeleri olduğu gösterilmiştir. Antigone’nin kardeşi için gerçekleştirdiği gömme eylemi, kişisel bir görev olmanın ötesinde, polis düzenine ve devlet yasasına karşı etik bir direniş pratiği olarak ele alınmıştır. Sonuç olarak bu çalışma, Antik Yunan tragedyasındaki kadın temsillerini dönemin politik, toplumsal ve ritüel bağlamı içinde ele alan bütüncül bir yaklaşım geliştirerek literatüre katkıda bulunmayı hedeflemiştir. Kadın figürlerinin kültürel düzenin hem dönüştürücüsü hem de çatlak yaratan özneleri olarak sahneye taşındığı bu tez, yalnızca geçmişe yönelik bir çözümleme değil; aynı zamanda günümüzün toplumsal eşitsizliklerini sorgulamak ve dönüştürmek adına eleştirel bir perspektif sunmayı amaçlamaktadır.This study examines the representations of women in Ancient Greek tragedy, with a particular focus on Sophocles’ Antigone. It explores how female characters are portrayed, how these representations relate to the social, political, and ritual structures of the period, and what functions female acts4such as mourning, marriage, and ethical decision-making-serve within the tragic framework. In this context, the study aims to trace the roots of women’s systematic exclusion throughout history and to question the historical foundations of contemporary gender inequalities. Methodologically, the study adopts the approach of Helene Foley as outlined in her work Female Acts in Greek Tragedy. It seeks to analyze female acts within their historical and ritual contexts through both textual analysis and an evaluation of the broader historicalcultural framework. The actions of female characters in Antigone are examined in relation to the social norms, ritual practices, and political structures of the time. The thesis is composed of three main chapters. The first chapter treats tragedy as a political and ritual practice in which collective identity is produced. Following George Thomson’s approach, it demonstrates how tragedy evolved in connection with social transformations, from totemic clan rituals to the democratic institutions of Athens. This section also engages with Aristotle’s theory of tragedy as articulated in the Poetics, discussing its epistemic and philosophical dimensions. The second chapter investigates Sophocles’ tragic vision and the representation of women in his works. It argues that Sophocles portrays female characters in more complex, conflicted, and multi-layered ways compared to other tragedians. Characters such as Antigone, Electra, and Deianeira emerge as figures who challenge the boundaries of social norms. The third chapter analyzes the representation of female acts in Antigone. Drawing on Foley’s methodology, it demonstrates that these acts are not merely personal choices but ritualized expressions of the tensions between law, custom, and ethics. Antigone’s act of burial for her brother is interpreted not only as a familial duty but also as an ethical gesture of resistance against the order of the polis and the authority of the state. In conclusion, this study offers a comprehensive approach to the representation of women in Ancient Greek tragedy by contextualizing them within the political, social, and ritual structures of the period. By framing female figures as both transformative agents and disruptive subjects of cultural order, the thesis contributes to the existing literature and aims to develop a critical perspective that not only deepens our understanding of the past but also interrogates and challenges present-day social inequalities
Dentofacial Findings and Management of two Pediatric Patients With Bainbridge-Ropers Syndrome: A Case Report
No full textBainbridge-Ropers Syndrome(BPRS) is a rare autosomal dominant genetic disorder resulting from heterozygous mutations in the ASXL3(Additional Sex Comb-Like 3) gene located on chromosome 18q12. To date, only 45 cases have been documented in the literature. BPRS is characterized by a range of clinical features, including feeding difficulties, hypotonia, distinctive dysmorphic facial features, high-arched palate, and intellectual disability. This case report aims to present two pediatric patients diagnosed with BPRS, emphasize newly identified oro-dental manifestations, and propose a comprehensive dental management plan. In Case #1, a 10-year-old female patient presented to the clinic with concerns of developmental delay and spinal deformity. Physical examination revealed trigonocephaly, thoracic kyphosis, strabismus, hirsutism, bitemporal narrowing, and bilateral coxa valga. Additionally, the patient exhibited failure to thrive, language difficulties, and mild intellectual disability. Oral examination identified a high-arched palate, fibrotic frenulum, narrow maxilla, and posterior crossbite. In Case #2, a 6-year-old female patient presented with developmental delay, language difficulties, and mouth breathing. Physical findings included trigonocephaly, bitemporal narrowing, strabismus, hirsutism, and arched eyebrows. Oral examination revealed a high-arched palate, narrow maxilla, and open bite. For both cases, preventive dental interventions were implemented, including the application of fissure sealants, fluoride varnishes, dietary regulation, and the use of interceptive orthodontic appliances. Children diagnosed with BPRS require ongoing medical and dental management through a multidisciplinary approach to address the complex and varied manifestations of the disorder effectively
Farklı organik gübre uygulamalarının Mentha Piperita'nın verim, kalite parametreleri ve yağ içeriği üzerine etkilerinin belirlenmesi
No full textBu tez çalışması, Türkiye'nin İzmir ili Bayındır ilçesi iklim ve toprak koşullarında yetiştirilen Mentha piperita L. (nane) bitkisinde farklı organik gübre uygulamalarının bitki büyümesi, verimi ve uçucu yağ bileşenleri üzerindeki etkilerini kapsamlı bir şekilde değerlendirmek amacıyla gerçekleştirilmiştir. Araştırma, bölgeye özgü çevresel faktörlerin tarımsal uygulamalar üzerindeki etkisini anlamayı ve organik gübrelerin sürdürülebilir tarımda oynadığı rolü ortaya koymayı amaçlamıştır. Deneme, üç yıl boyunca yürütülmüş olup, ilk yıl dikimden önce, ikinci ve üçüncü yıllar hasat sonrası parsellere saf olarak 5,75 kg N/da, 2,16 kg P₂O₅/da ve 5,75 kg K₂O/da olacak şekilde N-P-K içerikli sıvı organik gübre uygulanmıştır. Bunun yanı sıra sıvı vermikompost, mikrobiyal gübre, sıvı deniz yosunu, enzim içerikli gübre, K içerikli ve N içerikli organik sertifikalı gübreler 8 L/da/yıl dozunda, Mart, Nisan, Mayıs ve Haziran aylarında olmak üzere dört farklı periyotta uygulanmıştır. Araştırmada, azot (N), potasyum (K), yosun, sıvı vermikompost, mikrobiyal ve enzim destekli gübrelerin bitki metabolizması üzerindeki biyokimyasal ve fizyolojik etkileri detaylı olarak incelenmiştir. Bulgular, yosun ve mikrobiyal uygulamaların özellikle mentol oranını artırmada etkili olduğunu, azot ve potasyum uygulamalarının ise menton gibi monoterpenlerin üretimini optimize ettiğini ortaya koymuştur. Kontrol grubuna kıyasla, organik gübre uygulamaları uçucu yağ verimi ve bileşenlerinde dikkate değer artışlar sağlamış ve ekonomik değeri yüksek bileşenlerin oranlarını artırmıştır. Mentol ve menton gibi bileşiklerin artışı, organik gübrelerin metabolik süreçler üzerindeki olumlu etkilerini açıkça ortaya koymaktadır. Bunun yanı sıra, bölge koşullarının ve uygulama stratejilerinin uçucu yağ bileşimleri üzerinde belirgin etkiler yarattığı tespit edilmiştir. Bu bulgular, Bayındır gibi iklim özelliklerine sahip bölgelerde organik gübrelerin, kimyasal gübrelerin olumsuz etkilerini minimize etmek ve sürdürülebilir tarım uygulamalarını desteklemek açısından güçlü bir alternatif sunduğunu göstermektedir. Organik gübreler, sadece ürün verimini ve kalitesini artırmakla kalmayıp çevresel sürdürülebilirliği de desteklemekte ve sera gazı emisyonlarının azaltılmasına katkı sağlamaktadır. Araştırma, bu yönleriyle organik tarımın ekonomik, çevresel ve sosyal açıdan avantajlarını vurgulamaktadır.This thesis study was conducted to comprehensively evaluate the effects of different organic fertilizer applications on plant growth, yield, and essential oil components of Mentha piperita L. (peppermint) cultivated under the climatic and soil conditions of Bayındır district, İzmir province, Turkey. The research aimed to understand the impact of region-specific environmental factors on agricultural practices and to reveal the role of organic fertilizers in sustainable agriculture. The experiment was carried out over three years. In the first year, before planting, and in the second and third years after harvest, liquid organic fertilizer containing N-P-K was applied to the plots at a rate of 5.75 kg N/da, 2.16 kg P₂O₅/da, and 5.75 kg K₂O/da. Additionally, liquid vermicompost, microbial fertilizer, liquid seaweed extract, enzyme-enriched fertilizer, K-enriched organic fertilizer, and N-enriched organic-certified fertilizers were applied at a dose of 8 L/da/year in four different periods: March, April, May, and June. The study thoroughly examined the biochemical and physiological effects of nitrogen (N), potassium (K), seaweed extract, liquid vermicompost, microbial, and enzyme-supported fertilizers on plant metabolism. The findings revealed that seaweed and microbial applications were particularly effective in increasing menthol content, while nitrogen and potassium applications optimized the production of monoterpenes such as menthone. Compared to the control group, organic fertilizer applications significantly increased essential oil yield and composition, enhancing the proportions of economically valuable components. The increase in compounds such as menthol and menthone clearly demonstrated the positive effects of organic fertilizers on metabolic processes. Furthermore, the regional conditions and application strategies were found to have a significant impact on essential oil compositions. These findings suggest that in regions with climatic characteristics similar to Bayındır, organic fertilizers provide a strong alternative for minimizing the adverse effects of chemical fertilizers and promoting sustainable agricultural practices. Organic fertilizers not only enhance yield and quality but also support environmental sustainability and contribute to the reduction of greenhouse gas emissions. In this regard, the study highlights the economic, environmental, and social benefits of organic farming
Blood transfusion knowledge and practice among nurses in Turkey: A scenario sample
No full textBACKGROUND: In the maintenance of this important application, it is very important to ensure safety and to prevent complications. Therefore, it must be careful in the transfusion of blood and blood component. AIM: The aim of the study was to define nurses’ blood transfusion?related knowledge levels and applications. STUDY SETTINGS AND DESIGN: The study sample consisted of nurses who worked in a medical faculty hospital, two education and research hospitals and two state hospitals in Turkey. The study was performed with 116 nurses. MATERIALS AND METHODS: “Nurse Information Form”, “The Blood Transfusion Knowledge Questionnaire” and “The scenario form and a video taken on the errors and drawbacks related to blood transfusion” were used as data collection instruments. STATISTICAL ANALYSIS USED: The statistical analysis was performed using SPSS for Windows version 17.0. The sociodemographic data obtained from the study were assessed by numbers frequency and percentage distribution. The blood transfusion knowledge scores of the independent variables and, the relationship between knowledge scores and units were analysis by chi?square, Mann Whitney?U and, Kruskal–Wallis tests. RESULTS: The nurses’ mean scores for the blood transfusion knowledge level were 61.81 ± 10.18 (ranging between 0 and 79) for the overall scale. There was a significant relationship between the clinics and questions on pre?transfusion patient preparation knowledge and their mean total knowledge score. The nurses’ mean scores for the blood transfusion?related scenario knowledge levels were 36.42 ±15.42 for the overall scenario scores. CONCLUSIONS: Based on this, the nurses’ knowledge levels about blood transfusion are partly adequate in terms of their mean knowledge scores, and insufficient in terms of their mean scenario knowledge scores. © 2025 Elsevier B.V., All rights reserved