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A Novel Ensemble Framework for Comprehensive Early-Stage Colorectal Cancer Diagnosis, Prognosis, and Treatment: Integration of Gastroenterology-Specific Transformer Language Models and Multiple Decision Trees
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Doğumsal Brakiyal Pleksus Yaralanmasında 9-Delikli Peg Testi: Total Palsiden Üst Trunkus Yaralanmalarına Kadar Ne Anlama Gelebilir?
No full textAmaç: Çalışmamızın amacı, farklı yaralanma tiplerine sahip doğumsal brakiyal pleksus yaralanmalarında 9-delikli peg testinin öz bakım aktiviteleri ve motor fonksiyon ile ilişkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya, yaşları 5-16 arasında değişen, 18'inde total brakiyal pleksus ve 73'ünde üst trunkus hasarı olan 91 çocuk dahil edilmiştir. Tüm çocuklar 9-delikli peg testi, aktif hareket ölçeği ve Wee-FIM öz bakım bölümü ile değerlendirilmiştir. 9-delikli peg testi, aktif hareket ölçeği ve Wee-FIM skorları arasındaki ilişki Spearman korelasyon katsayısı hesaplanarak incelenmiştir. Sonuçlar: Üst trunkus yaralanması olan 73 çocukta, 9-delikli peg testi ile öz bakım aktiviteleri skoru arasında güçlü bir negatif korelasyon (p<0.01, r=-0.73) ve toplam üst ekstremite fonksiyonu ile orta düzeyde negatif korelasyon (p<0.01, r=-0.68) vardı. Aktif hareket ölçeği ile değerlendirilen 15 eklem hareketi ile 9-delikli peg testi arasında orta derecede negatif korelasyon vardır (p<0.01, -0.59<r<-0.37), bununla birlikte en yüksek korelasyon omuz, parmak ve başparmak hareketlerinde mevcuttur. Total brakiyal pleksus hasarı olan birçok çocuk 9-delikli peg testini tamamlayamadı. Tartışma: Üst trunkus yaralanmalarında, 9- delikli peg testi sonucu öz bakım aktiviteleri ve üst ekstremitenin toplam fonksiyonunu yansıtabilir, ancak bu test total pleksus yaralanması olan çocuklarda aktif el bileği ve parmak hareketlerine bağlı olarak uygun olmayabilir.Purpose: The aim of our study is to investigate the relationship of the 9-hole-peg test with self-care activities and motor function in brachial plexus birth injury with different injury types. Material and Methods: The study included 91 children aged 5-16 years, 18 had total brachial plexus injury and 73 had upper trunk injury. All children were assessed with the 9-hole-peg test, active movement scale (AMS) and Wee-FIM self-care section. The relationship between 9-hole-peg test, AMS and Wee-FIM scores were examined by calculating Spearman correlation coefficient. Results: In 73 children with upper trunk injury, there was a strong negative correlation between the 9-hole-peg test and self-care activities (p<0.01, r=-0.73), and a moderate negative correlation between the 9-hole-peg test and total upper limb function (p<0.01, r=-0.68). There was a moderate negative correlation between all 15 joint movements assessed AMS and the 9-hole peg test (p<0.01, -0.59<r<-0.37), moreover the highest correlation was with shoulder, finger and thumb movements. Many children with total brachial plexus injury were unable to complete the 9-hole-peg test. Conclusion: The performance of children with upper trunk injuries on the 9-hole peg test may reflect performance in self-care activities and overall function of the upper limb, but this test may not be appropriate for children with total brachial plexus injuries based on active finger and wrist movements
The pathogenesis, clinical presentations and treatment of monogenic systemic vasculitis
No full textMany monogenic autoinflammatory diseases, including DADA2 (deficiency of adenosine deaminase 2), HA20 (haploinsufficiency of A20), SAVI (STING-associated vasculopathy with onset in infancy), COPA syndrome, LAVLI (LYN kinase-associated vasculopathy and liver fibrosis) and VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, present predominantly with vasculitis and constitute a substantial subgroup of vasculitic conditions associated with a 'probable aetiology'. The spectrum of monogenic vasculitis encompasses all sizes and types of blood vessel, ranging from large vessels to medium-size and small vessels, and from the arterial side to the venous side of the vasculature. Monogenic vasculitis typically starts early in life during infancy or childhood; VEXAS syndrome, which presents in late adulthood, is an exception. The activation of myeloid cells via inflammasome and nuclear factor-kappa B pathways, type I interferon-enhanced autoimmune mechanisms and/or dysregulated adaptive immune responses have an important role in the development of immune-mediated endothelial dysfunction and vascular damage. Genetic testing is essential for the diagnosis of underlying monogenic autoinflammatory diseases; however, the penetrance of genetic variants can vary. Increased awareness and recognition of distinctive clinical findings could facilitate earlier diagnosis and allow for more-targeted treatments
Privacy for Process Mining: A Systematic Literature Review
No full textProcess mining is an emerging scientific discipline focused on discovering, inspecting, and enhancing process models using event data collected from information systems, automating the detailed modeling work without the need for extensive manual labor. However, privacy preservation issues arise when handling such data. Although various process mining methods, models, and tools exist to support the Business Process Management life cycle, no systematic review has been conducted to evaluate these methods and models under the lens of privacy. This work aims to fill this gap by analyzing the applicability of privacy-enhanced methods for process mining. Through a systematic literature review, we identified 39 relevant papers, examining them to understand demographic trends, challenges, characteristics, and implementations related to privacy in process mining. Our findings indicate that privacy-preserving process mining approaches have gained significant attention, especially post-2018, with a predominant focus on anonymizing event logs rather than developing privacy-compliant methodologies for process mining. Most approaches aim to prevent linkage attacks while adhering to privacy regulations, with many utilizing noise addition techniques for anonymization. Despite several issues in defining and using privacy in process mining, this review provides valuable insights for researchers and practitioners, marking the first comprehensive analysis in this domain and highlighting areas for future research
Tannic acid-based bio-MOFs with antibacterial and antioxidant properties acquiring non-hemolytic and non-cytotoxic characteristics
No full textTannic acid (TA) based bio-metal phenolic networks (bio-MPNs) were prepared by using Cu(II), Zn(II), Bi(III), Ce(III), La(III), and Ti(IV) metal ions. TA-based bio-MPNs exhibited wedge-shaped pores between 16.4 and 25.8 nm pore size ranges. The higher gravimetric yield% was achieved for TA-Bi(III), and TA-Ti(IV) bio-MPNs with more than 90 %, and higher surface area was observed for TA-La(IIII) bio-MPNs as 56.2 m(2)/g with 17.3 nm average pore sizes. All TA-based MPNs are non-hemolytic with less than 5 % hemolysis ratio, whereas TA-based Bio-MPNs do not affect blood clotting with > 90 % blood clotting indexes except for TA-Cu(II) Bio-MPNs at 0.1 mg/mL concentration. Moreover, TA-Bi(III) and TA-Ce(III) Bio-MPNs were found to be safer materials showing no significant toxicity on L929 fibroblast cells at 100 mu g/mL concentration, along with TA-based Bio-MPNs prepared with Cu(II), Zn(II), La(III), and Ti(IV) metal ions that could be safely used in in vivo applications at 1 mu g/mL concentration. It has been proven by 2 different antioxidant tests that the prepared TA-based Bio-MPNs show antioxidant properties even if their TA-derived antioxidant properties decrease. Furthermore, all types of TA-based Bio-MPNs show great antimicrobial activity depending on the metal ion or microorganism types and the highest antibacterial/antifungal effect was determined for TA-Cu(II), and TA-Zn(II) Bio-MPNs with the lowest MBC/MFC values against Pseudomonas aeruginosa ATCC 10145, Bacillus subtilis ATCC 6633, and Candida albicans ATCC 10231
Evaluating headache referral trends and practices across different settings in neurology clinics: insights from an international cross-sectional multicenter study
No full textBackground: Misdiagnoses often lead to suboptimal therapeutic approaches, making early and accurate diagnoses by experts crucial for effective headache management. This study primarily aims to investigate the referred patient profiles with headaches to optimize diagnostic and referral approaches. Methods: In this cross-sectional multicenter international study, sixty-nine neurologists from 13 countries evaluated headache patients referred to neurology clinics (NCs). Researchers recruited patients on different weekdays selected by the research randomizer program for five consecutive weeks in April and May 2022. The clinicians collected data on various factors such as age, sex, headache characteristics and accompanying symptoms using the Head-MENAA study questionnaire and the International Classification of Headache Disorders-3 (ICHD-3) criteria. Patients were grouped according to the settings as emergency services (ESs), other specialty clinics (OSCs) and private offices (POs) in which they were evaluated. Results: A total of 3722 individuals out of 12043 evaluated in NCs had headache complaints. Among them, 15.07% consisted of patients referred to neurology by these three different settings. 14.8% of them were referred from ESs, 16.58% from OSCs, and 68.64% were applied to POs. While there was not a significant difference between groups regarding the mean age, the proportion of male patients in the ESs (49.4%) was higher than those in OSCs (26.9%) and POs (23.1%) (p < 0.001). Headache severity was higher in the ESs and POs than in the OSCs and Neurology Outpatient Clinics (NOCs) (p < 0.001). Primary headaches were the reason for consultation in 89.2% of patients in the ESs, 90.3% of patients OSCs and 93.5% of patients in POs, migraine without aura being the most common headache type in all groups. Conclusions: This study suggests that preferences for admission and referral may vary based on demographic characteristics, types and severity of the headache, as well as accessibility and availability of different settings
Phosphorus-nitrogen compounds. Part 78. Design, synthesis, crystallographic and spectral properties, free radical scavenging and bioactivity studies of tetrakis(alkylamino)monoferrocenyl-(N/N)-spiro-cyclotriphosphazenes
No full textHerein, new hybrid inorganic/organic heterocyclic cyclotriphosphazenes were synthesized to investigate their spectral/crystallographic properties and bioactivity. For this purpose, ferrocenyl units containing diamines with proven biological activity and primary amino groups were incorporated on the basis of robust trimeric phosphazene ring, a biocompatible material. Tetrachloromonoferrocenyl-(N/N)-spirocyclotriphosphazenes (1-3) were synthesized from the reactions of hexachlorocyclotriphosphazene, N3P3Cl6 (HCCP), with ferrocenyldiamines. Nucleophilic substitution reactions of tetrachloro-phosphazenes (1-3) with n-propyl and n-butyl amines gave tetrakis(n-propylamino) (1a, 2a, and 3a) and tetrakis(n-butylamino) (1b, 2b, and 3b) monoferrocenyl-(N/N)-spirocyclotriphosphazenes, respectively. Elemental analysis, FTIR, 1H, 13C, 31P NMR, HSQC and QTOF-MS methods were used for the characterization of these phosphazenes. Structural evaluations proved that fully (n-alkylamino)cyclotriphosphazenes were obtained by nucleophilic substitution reactions. The crystal structure of tetrakis(n-butylamino)monoferrocenyl-(N/N)-spirocyclotriphosphazene (2b) was elucidated crystallographically. The phosphazene ring is in flattened-boat conformation with a total puckering amplitude QT of 0.2390. However, the cytotoxic, antimicrobial and antioxidant activities of the compounds and their interactions with DNA were also evaluated. All compounds were more potent than chloramphenicol against B. subtilis G(+) and (except for 1a) had higher antifungal activity than ketoconazole against C. albicans. Tetrakis(n-butylamino)monoferrocenyl-(N/N)-spirocyclotriphosphazenes had much superior activity against C. tropicalis considering their MIC values. In particular, 1b, 2b, 3a, and 3b exhibited remarkable antimicrobial properties positioning them as strong candidates to combat the increasing challenge of antimicrobial resistance. In addition, 2a was concluded to be a good anticancer agent based on in vitro cytotoxic activity studies
The effect of dose reduction of CDK4/6 inhibitors on survival in postmenopausal HR+HER2-negative metastatic breast cancer
No full textBackgroundThis study aimed to evaluate the effect of dose reduction of CDK4/6 inhibitors on survival outcomes in postmenopausal patients with HR+HER2-negative metastatic breast cancer (mBC).MethodsA retrospective cohort study was conducted involving 164 postmenopausal patients with HR+ HER2-negative mBC who received CDK4/6 inhibitors between 2021 and 2024. Clinical parameters were systematically analyzed. Progression-free survival (PFS) and overall survival (OS) were evaluated based on dose reduction status. Survival outcomes were estimated using the Kaplan-Meier method, and independent prognostic factors were identified through multivariate Cox regression analysis.ResultsThe median age was 61 years, with a median follow-up of 23.5 months. The median PFS was 23.3 months, while median OS was not reached. Dose reduction occurred in 45 patients (27%), who exhibited significantly worse survival (PFS HR: 1.67, 95% CI: 1.02-2.72, p = 0.042; OS HR: 2.54, 95% CI:1.34-4.83, p = 0.004). Dose reduction and liver metastases were independent risk factors for shorter PFS and OS, while treatment in later lines was associated with shorter PFS.ConclusionDose reductions in CDK4/6 inhibitors were associated with worse survival outcomes in postmenopausal HR+ HER2- mBC patients. Future biomarker-driven studies are needed to guide personalized dose adjustments and optimize treatment efficacy