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Shedding Light on the Prognostic and Predictive Value of Circulating Tumor DNA for Management of Patients with Early-Stage Colon Cancer
No full textThe management of early-stage colon cancer involves surgical resection of the primary tumor with or without chemotherapy, depending on pathological staging. The benefit of adjuvant chemotherapy for stage II and III colon cancer is approximately 5% and 15%, indicating the need for optimization for risk stratification and patient selection. Several studies have revealed that current clinicopathological factors lack precision. Circulating tumor DNA (ctDNA) is cell-free DNA originating from cancer cells and can be detected even in the absence of radiologically detectable disease among patients with colon cancer. Recent cohort studies revealed that ctDNA is one of the most significant prognostic factors for patients with early-stage colon cancer, surpassing pathological and clinical risk factors. Prospective cohort studies also suggest there may be a predictive role for ctDNA on the decision for consideration of adjuvant therapy. Currently, randomized clinical trials are enrolling to better define this role. In this review article, we review recent literature on ctDNA and its role in patients with colon cancer. We also elaborate on the future clinical utility of ctDNA in clinical practice and the unmet need for research to optimize currently available ctDNA assays
Re: The Effects of Various Approaches to Lobectomies on Respiratory Muscle Strength, Diaphragm Thickness, and Exercise Capacity in Lung Cancer Re: Enhancing Respiration Function Evaluation and Recovery in Lung Cancer: The Interdisciplinary Approach to Postoperative Management
No full textA Survey on Internet of Medical Things (IoMT): Enabling Technologies, Security and Explainability Issues, Challenges, and Future Directions
No full textInternet of Medical Things (IoMT) paradigm refers to the process of collection, transmission and analysis of healthcare data using communication and information systems over the internet. IoMT consist of medical devices that can link to the internet or other networks, including wearables, sensors, monitoring tools and other medical appliances. IoMT data can be utilised to lower costs, increase the effectiveness of healthcare delivery and improve the patient health status. In addition to the potential benefits IoMT may provide, the impact of COVID19 pandemic has also strengthened the desire to collect patient data remotely and pushed a lot of medical professionals to utilise IoMT applications such as telemedicine, telehealth, remote patient monitoring, remote patient diagnostics and distant consultations etc. The expectation is that IoMT market size and the usage will increase dramatically and IoMT will change the conventional healthcare systems significantly in the upcoming years. Motivated with that growth expectation, this study aims to analyse the IoMT, its components, enabling technologies and applications by emphasising the fundamental pillars (sensing, communication, data analytics, and security) essential for developing a reliable, dependable, and secure IoMT ecosystem. Furthermore, this study conducts a detailed analysis of recent major cyberattacks targeting the healthcare industry, evaluating their impact and discussing the key lessons derived from these incidents by employing DOTMLPFI approach. Additionally, this survey offers a concise overview of the emerging technologies that complement IoMT in the development of smart healthcare systems and explores potential future directions within this evolving field
Children with Auditory Brainstem Implants: Language Proficiency and Reading Comprehension Process
No full textIntroduction: Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABIs) throughout the first 3 years of life are difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI. Method: In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development-Third Edition (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language. Results: Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order. Conclusion: Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model, and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area
Comparison of trauma and diabetes mellitus-induced transtibial amputees in terms of gait parameters and functional capacity
No full textBACKGROUND: The aim of this study was to compare gait parameters, balance, weight-bearing symmetry, functional capacity, functional mobility, prosthesis satisfaction, and quality of life between individuals with diabetes mellitus-induced and traumatic transtibial amputations (TTAs). METHODS: Ten individuals with traumatic transtibial amputation and 10 individuals with diabetes mellitus-induced transtibial amputation were included in the study. All participants in both the trauma and diabetes groups used a vacuum-assisted suction suspension system (VASS) and a carbon composite foot transtibial prosthesis. Gait analysis and weight-bearing symmetry were assessed using a computerized gait analysis system. Balance was evaluated with the Biodex Balance System (BBS), functional capacity with the Six- Minute Walk Test (6MWT), functional mobility with the Timed Up and Go Test (TUG) and the Stair Climbing Test (SCT), prosthesis satisfaction with the Trinity Amputation and Prosthesis Experience Scale (TAPES), and quality of life with the Short Form-36 (SF-36). RESULTS: When comparing the traumatic and diabetic groups, significant differences favoring the trauma group were found in the following parameters: stride length (SL) (p=0.004), amputated limb step length (ASL) (p=0.019), non-affected limb step length (NSL) (p=0.005), balance assessment parameters of general postural stability (p=0.000), anteroposterior (A-P) postural stability (p=0.000), mediolateral (M-L) postural stability (p=0.007), SCT performance (p=0.000), and the activity restriction subsection of TAPES (p=0.029). No significant differences were observed in gait velocity, cadence, step width, weight-bearing percentage of the amputated and non-affected limbs, TUG performance, SF-36 scores, or the psychosocial adjustment, prosthesis satisfaction, and daily use time subsections of the TAPES. CONCLUSION: In this study, the use of a VASS prosthesis in both traumatic and diabetic amputees had a positive effect on outcomes in the diabetic group, resulting in comparable results to those of the traumatic group. The fact that diabetic amputees used their prostheses as frequently as traumatic amputees, remained active, and benefited from the choice of prosthesis and suspension system provides valuable insights for healthcare professionals as a facilitating factor in rehabilitation
Causal mechanisms of ontological (In)security in Turkish politics and foreign policy: anxiety transmittance from Sèvres to Lausanne
No full textIn the 'age of anxiety,' research on trauma, memory, and syndromes in politics and foreign policy is growing. This article examines Turkey's unique case, focusing on anxieties over the Treaties of S & egrave;vres and Lausanne. It explores how both generate anxiety, using an interdisciplinary approach to ontological (in)security, trauma, and memory with a Discourse-Historical Approach. It identifies two processes: anxiety informing policy choices and policies rationalized through collective anxiety. Tracing Turkey's history shows how anxiety is amplified and mitigated. The findings highlight anxiety's role in policymaking, revealing how elites use trauma and memory to shape politics and foreign policy
A Crash-Energy Distribution Technique for Seats to Improve Neck Protection in Rear-End Impacts
No full textIn this study, a state-of-the-art whiplash-mitigating passive seat is retrofitted with a pro-active head-restraint, an auxiliary damper at the recliner and a firmer layer of seat back suspension and foam in the seat back structure so as to provide improved neck protection for rear-end impacts having delta-V's between 13 km/h and 35 km/h. The retrofitted seat proposed in this study is designed by using a biofidelic occupant model which is a 50th percentile male. Virtual sled tests are performed in accordance with the EuroNCAP dynamic whiplash assessment protocol. The crash energy to be absorbed by the seat components are distributed to provide balanced protection for all severities. The proposed forward-facing retrofitted seat earns maximum points from the EuroNCAP whiplash rating even for a rear-end impact having 35 km/h of delta-V. This paper draws attention to designing seats that can withstand very high severity rear-end impacts and provide sufficient neck protection to limit whiplash associated disorders considerably
Histopathological Diagnosis of Mycosis Fungoides
No full textMycosis fungoides (MF) is a neoplastic proliferation characterized by cutaneous infiltration of atypical T-lymphocytes. MF often shows diagnostic difficulties. Histopathology, immunochemistry, and clonality determination may be an auxiliary diagnostic method but they are not always sufficient and the final diagnosis should be made with correlation of clinical findings, routine histopathology, immunohistochemistry, and gene rearrangement studies. Histopathological findings may also vary in different stages of the disease. In this article, the histopathological findings of classical MF and its variants are reviewed together with their immunohistochemical features
School participation, supports and barriers of children with and without attention deficit hyperactivity disorder
No full textObjectives To investigate the differences in participation patterns, environmental barriers and supports across specific activities typically done at school between children with attention deficit hyperactivity disorder (ADHD) and without ADHD.Design Prospective cross-sectional study.Setting The children and adolescents with ADHD were selected from those routinely referred to the Health Sciences University Research and Training Hospital's child and adolescent psychiatry department, which is a reference centre for the region.Participants A total of 365 children (n children with ADHD =175, n children without ADHD =190, mean age 11.66 years, SD 2.96 years) and their primary caregivers were included in the study.Primary outcome measures Participation and Environment Measure for Children and Youth was used to evaluate children.Results The mean frequency of participation in five different school activities was significantly lower in children with ADHD than in children without ADHD, with moderate to large effect sizes. Children with ADHD were less likely to be involved in any activity type than children without ADHD, with moderate to large effect sizes. The characteristics of the school environment typically made it more challenging for children with ADHD to participate than for children without ADHD, with moderate effect sizes.Conclusions Children with ADHD have challenges in classroom activities and with socialising with peers outside class, cognitive demands, sensorial qualities and safety. Relationships with friends, cultural acceptance and support could improve the school participation of children with ADHD