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Is there a role for reinforcing soft-tissue repairs or flaps for patients who have abductor deficiency?
No full textIs there a role for reinforcing soft-tissue repairs or flaps for patients who have abductor deficiency? Response/Recommendation: Reinforcing soft-tissue repairs, either alone or in combination with muscle flaps, may provide mild to moderate improvement in clinical outcomes in patients who have abductor deficiency undergoing revision total hip arthroplasty (THA). Patients should be informed regarding persistent limping after surgery. Level of Evidence: Limited. Expert Vote: agree 87.4%, disagree 7.4%, abstain 5.2%
Flow-diverting stents in the management of extracranial carotid artery aneurysms
No full textPURPOSE This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections. METHODS A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow-up assessments included digital subtraction angiography or computed tomography angiography at 6–12 months and clinical evaluations to monitor symptom resolution and complications. RESULTS Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period. CONCLUSION The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes. CLINICAL SIGNIFICANCE The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications
Integrated information system based on q-learning algorithm and multi-objective particle swarm optimization with molecular fuzzy-based decision-making for corporate environmental investments
No full textDetermining the most important criteria is a great necessity to increase the environmental performance of renewable energy projects. This situation helps to reach cost efficiency and effective use of limited resources. However, there are very few studies in the literature where priority analysis is made for these factors. This condition indicates an important gap in the literature on this subject. Accordingly, this study aims to identify the most convenient investment strategies to increase the environmental performance of renewable energy projects. First, the balanced expert dataset is generated via Q-learning algorithm and multi-objective particle swarm optimization. In the following step, selected criteria are weighted with molecular fuzzy cognitive maps approach. The final stage consists of ranking the alternatives with fuzzy molecular ranking (MORAN). The contribution of this study to the literature is to define the most appropriate investment strategies to increase the environmental performance of these projects by generating a new decision-making model. Integrating molecular geometry into decision-making processes increases both the originality and effectiveness of the model. Thus, it is possible to calculate the degrees with a more scientific infrastructure. Integrating Q-learning and swarm optimization techniques into the decision-making model also increases the superiority of the model. In this context, the optimization technique is used to obtain the importance weights of the experts. The findings denote that energy capacity expansion plays the most important role in improving the environmental performance of businesses because it has the greatest weight (0.2563). Return on investment is another factor that plays an important role in increasing this performance with the weight of 0.2559. Geothermal and hydropower are found as the most successful renewable energy types regarding environmental performance improvement since they have the highest aggregated values (0.534 and 0.620). Carbon tax is an important policy application to increase renewable energy capacity. With the help of this tax, fossil fuels lose their competitive advantage significantly. As a result, this situation has a positive contribution to the increase of the renewable energy projects
Comparison of diagnoses made by dentistry students and by artificial intelligence dentists
No full textObjectives: The introduction of artificial intelligence (AI) about great changes in the field of dentistry, but it has not yet been fully determined in which areas it will make a positive contribution to dentistry students. The objective of our study was to compare the diagnostic accuracy of undergraduate students (fourth-year dentistry students [4DS] and final-year dentistry students [5DS]) and AI when examining panoramic radiographs. Methods: Fifty panoramic radiographs and 1602 teeth were examined by 50 4DS who had not received a clinical practice internship, 50 5DS, and an AI application. The participants and the AI application evaluated the teeth seen in each radiograph one by one in terms of caries, fillings, teeth with root canal treatment, periodontal loss, extractions, crowns, teeth with apical lesions, and impacted and extracted teeth. Findings were recorded in an Excel chart. Chi-square analysis was used to compare diagnostic success between the groups. Results: The results indicate that there was a statistically significant difference in the identified accuracy of caries, fillings, and extractions between the AI application and undergraduate students (p 0.05). Conclusion: AI exhibited better results than undergraduate students especially in the detection of caries and fillings. AI could improve undergraduates’ accuracy in detecting caries, fillings, and extractions and help them make accurate treatment decisions. In cases where dentistry students are examining patients using panoramic radiographs, employing AI programs during their clinical training to confirm and strengthen the student's diagnosis may be a promising new development
What are the contraindications, if any, for the use of tranexamic acid during knee or hip arthroplasty?
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Triz-driven assessment of sector-wise investment decisions in renewable energy projects through a novel integrated q-rof-dematel-srp model
No full textNecessary actions should be taken to improve renewable energy investments to minimize the carbon emission problem. In this process, the most significant determinants should be identified for some reasons, such as using human and financial resources more effectively. However, there are limited studies in the literature that prioritize the analysis of these items. This situation can be accepted as a missing gap in the literature. Accordingly, this study evaluates sector-wise investment decisions in renewable energy projects. To do so, a novel integrated q-rung orthopair fuzzy set (q-ROFS) decision-making model has been generated. Firstly, the weights of the theory of the solution of inventive problems (TRIZ)-driven criteria are computed via the q-ROF decision-making trial and evaluation laboratory (DEMATEL) methodology. The second stage of the proposed model consists of selecting the most appropriate investment alternatives with the help of the q-ROFS-based simple ranking process (q-ROF SRP). The main contribution of this study is that key sector-wise investment decisions in renewable energy projects can be identified by establishing a novel decision-making model. The main superiority of the proposed model is that the DEMATEL method is extended to the q-ROFS context to determine the weights of the factors. With the help of this issue, uncertainties and subjective randomness in the decision-making process can be minimized. In addition to this situation, causal directions between these indicators can be taken into consideration for this condition. The findings indicate that possible extension with modularity is the most critical indicator for this situation. Similarly, resource efficiency is also found to be the most influencing item. In addition to them, the ranking results demonstrate that waste-to-energy technologies and energy storage systems are the most critical investment alternatives
Sodium glucose cotransporter 2 inhibitors improve long-term atrial fibrillation-free survival after catheter ablation
No full textAbstract:Although sodium-glucose cotransporter 2 inhibitors (SGLT2i) are known to reduce the incidence of atrial fibrillation (AF) and AF-related adverse events, evidence on their prognostic effect in patients undergoing catheter ablation (CA) for AF is limited. In a single center, 614 patients (mean age 58.1 ± 9.9 years, 42.2% female) who underwent CA for AF were retrospectively divided into 2 groups according to SGLT2i treatment after the index procedure and followed up for 24 months. The primary outcome of the study was AF recurrence after the first 90-day blanking period after CA. Two separate Cox regression models were constructed to determine the predictors of AF recurrence. Rates of the primary outcome were 19.4% and 35.7% in the SGLT2i and non-SGLT2i groups, respectively. According to the multivariable model 1, which was established among the clinically relevant variables that were found to be statistically significant in univariable analysis, left atrial diameter (adjusted HR: 1.087, 95% CI, 1.054-1.122, P < 0.001), SGLT2i therapy (adjusted HR: 0.436, 95% CI, 0.286-0.665, P < 0.001), and nonparoxysmal AF (adjusted HR: 1.549, 95% CI, 1.039-2.309, P = 0.032) were independent predictors of recurrence after ablation. In model 2, SGLT2i treatment remained an independent predictor of AF recurrence along with significant variables such as age, heart failure with reduced ejection fraction, and previous stroke (adjusted HR: 0.315, 95% CI, 0.214-0.461, P < 0.001). The favorable efficacy of SGLT2i on the primary outcome was maintained in subgroup analyses. SGLT2i treatment is associated with lower recurrence after CA for AF in subgroups with and without diabetes or heart failure with reduced ejection fraction and in the overall patient population, independent of AF phenotype
Dietary satisfaction and quality of life in individuals following diet programs satisfaction of diet programs
No full textPurpose: The purpose of this study was to assess individuals’ satisfaction with their diet programs and evaluate the impact of their diet on their quality of life (QOL). Design/methodology/approach: This cross-sectional study was conducted with 812 females and 334 males (n = 1,046) aged 18–65 years, all of whom were following a diet program under the guidance of a dietitian. The questionnaire included personal information as well as items related to dietary satisfaction and QOL, measured using the SF-36 scale. Findings: Of the participants, 38.4% were aged 18–24, and 32.6% were aged 25–40. The mean score for dietary satisfaction was 3.0 ± 0.9 (out of 5), while the mean scores for the mental and physical components of the QOL scale were 62.0 ± 17.8 and 74.3 ± 19.2, respectively. Factors such as age, BMI and duration of the diet were associated with dietary satisfaction, whereas age, gender, health status, diet type and BMI impacted QOL (p < 0.05). Dietary satisfaction scores showed a weak positive correlation with QOL scores (r = 0.125; p < 0.01). Originality/value: Dietary satisfaction and QOL are influenced by demographic characteristics, health status, diet type and the duration of the diet program. Additionally, there is a correlation between dietary satisfaction and QOL. To ensure the sustainability and suitability of long-term dietary plans, it is crucial to monitor patients’ dietary satisfaction. In this context, assessing the QOL in individuals on diet programs, using a newly validated diet satisfaction scale, adds originality and value to the study
Efficacy of chitosan powder in reducing vaginal bleeding following a loop electrosurgical excision procedure: a randomized control trial
No full textObjective: To evaluate the efficacy of topical chitosan powder in reducing postoperative vaginal bleeding following a loop electrosurgical excision procedure (LEEP). Methods: In this randomized controlled trial, patients who underwent LEEP were randomly assigned (1:1) to the chitosan group, in which the wound area was sprayed with chitosan powder using a spray pump, or the control group. The primary outcome was the median quantity of vaginal blood lost in the early postoperative period (defined as within 6 h of the procedure). Results: The 124 women enrolled in the study were randomly divided into control (n = 61) and chitosan (n = 63) groups. The median amount of vaginal blood loss during the early postoperative period was significantly lower in the chitosan group than in the control group (198.85 [64.4–388.57] mL vs. 250.60 [67.7–552.87] mL; P < 0.001). The rate of late postoperative bleeding requiring hemostatic intervention was also lower in the chitosan group than in the control group (3.2% vs. 16.4%; P = 0.013). Superior cervical wound healing in the chitosan group compared to the control group was also observed. Conclusion: The application of chitosan powder to the cervical wound bed can improve surgical outcomes by decreasing post-LEEP vaginal bleeding and facilitating the healing of cervical wounds
Innovative financial solutions for sustainable investments using artificial intelligence-based hybrid fuzzy decision-making approach in carbon capture technologies
No full textHigh 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