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One-Year Patient Reported Outcomes and Lymphedema in Node-Positive Breast Cancer in the Prospective Multicenter Neosenti-Turk/MF-18-03 study: Is there any benefit of Targeted Axillary Dissection over Sentinel Lymph Node Biopsy?
No full textMeeting Abstract : 1988509...
Optimization of inventory replenishment under assymmetric stock-out and inventory holding costs
No full textPerishable products are an essential part of commerce. Shelf-life characteristics are usually not modeled in traditional inventory models. This study proposes an inventory replenishment model for perishable products with an asymmetric cost structure for holding and stock-out costs. The modeling phase involves the shelf-life characteristics of products. Shelf life is essential due to sustainability concerns, costs, and service levels due to perished products. In contrast to classical safety stock models, where stock-out costs increase linearly, the proposed model utilizes incrementally increased fixed costs for holding costs in a conflicting cost structure. It incorporates the shelf-life of the products, calculates the probability of perishing, and formulates accurate waste and total costs using an asymmetrical cost structure. The model is applied to a real dataset to assess the performance and compare it with the traditional approach. The performance of the proposed model is better, with a total cost reduction of 45.33%. Additionally, the model demonstrated a 17.21% increase in service level. The sensitivity analysis further underlined the robustness of the proposed model across various demand scenarios and shelf-life conditions. The main research gap addressed by this study is the lack of consideration for shelf-life characteristics and asymmetric cost structures in traditional inventory models. By integrating these factors, this research provides a more accurate and cost-effective approach to inventory management for perishable products, enhancing sustainability and service levels. This study's findings can help businesses optimize inventory strategies, reduce waste, and improve operational efficiency
A systematic review on the roles of remote diagnosis in telemedicine system: Coherent taxonomy, insights, recommendations, and open research directions for intelligent healthcare solutions
No full textBackground: The term 'remote diagnosis' in telemedicine describes the procedure wherein medical practitioners diagnose patients remotely by using telecommunications technology. With this method, patients can obtain medical care without having to physically visit a hospital, which can be helpful for people who live in distant places or have restricted mobility. When people in the past had health issues, they were usually sent to the hospital, where they received clinical examinations, diagnoses, and treatment at the facility. Thus, hospitals were overcrowded because of the increase in the number of patients or in the death of some very ill patients given that the completion of medical operations required a significant amount of time.
Objective: This research aims to provide a literature review study and an in-depth analysis to (1) investigate the procedure and roles of remote diagnosis in telemedicine; (2) review the technical tools and technologies used in remote diagnosis; (3) review the diseases diagnosed remotely in telemedicine; (4) compose a crossover taxonomy among diseases, technologies, and telemedicine; (5) present lists of input variables, vital signs, data and output decisions already applied in remote diagnosis; (6) Summarize the performance assessment measures utilized to assess and validate remote diagnosis models; and (7) identify and categorize open research issues while providing recommendations for future advancements in intelligent remote diagnosis within telemedicine systems.
Methods: A systematic search was conducted using online libraries for articles published from 1 January 2016 to 13 September 2023 in IEEE, PubMed, Science Direct, Springer, and Web of Science. Notably, searches were limited to articles in the English language. The papers examine remote diagnosis in telemedicine, the technologies employed for this function, and the ramifications of diagnosing patients outside hospital settings. Each selected study was synthesized to furnish proof about the implementation of remote diagnostics in telemedicine.
Results: A new crossover taxonomy between the most important diagnosed diseases and technologies used for this purpose and their relationship with telemedicine tiers is proposed. The functions executed at each tier are elucidated. Additionally, a compilation of diagnostic technologies is provided. Additionally, open research difficulties, advantages of remote diagnosis in telemedicine, and suggestions for future research prospects that require attention are systematically organized and presented.
Conclusions: This study reviews the role of remote diagnosis in telemedicine, with a focus on key technologies and current approaches. This study highlights research challenges, provides recommendations for future directions, and addresses research gaps and limitations to provide a clear vision of remote diagnosis in telemedicine. This study emphasizes the advantages of existing research and opens the possibility for new directions and smart healthcare solutions
A comparative analysis of the liver retraction with long surgical gauze in three-port sleeve gastrectomy and the four-port nathanson retractor technique
Full text linkBackground: This study evaluated the long surgical gauze (SurG) technique as a liver retraction method in laparoscopic sleeve gastrectomy (LSG). Traditional methods involve the Nathanson retractor, associated with ischemia and necrosis complications. In addition, these techniques require an additional trocar with an incision that increases postoperative pain. Our aim, therefore, was to reduce such complications through the use of SurG and evaluate recovery and outcome implications.
Methods: In this retrospective study, patients who underwent laparoscopic sleeve gastrectomy (LSG) between January and December 2023 were divided into two groups based on the liver retraction method used: NR or SurG. Demographic data, surgery times, postoperative liver enzyme levels (AST, ALT), C-reactive protein (CRP), pain scores, and analgesic use (VAS) were collected from medical records and statistically analyzed.
Results: The SurG group demonstrated significantly lower postoperative pain scores and reduced analgesic use compared to the NR group (p < 0.001). Additionally, liver enzyme levels (AST, ALT, CRP) were lower in the SurG group, indicating less liver stress. Early mobilization was achieved more quickly in the SurG group, aligning with Enhanced Recovery After Surgery (ERAS) protocols. However, the SurG method showed some limitations during the dissection of the greater curvature due to the narrower field of view.
Conclusions: The long surgical gauze method provides a viable alternative to the Nathanson retractor, offering advantages such as less postoperative pain, reduced liver stress, and quicker mobilization. Despite some technical limitations, this method can improve patient outcomes in sleeve gastrectomy
Reinforcement Neural Network-Based Grid-Integrated PV Control and Battery Management System
No full textA reinforcement neural network-based grid-integrated photovoltaic (PV) system with a battery management system (BMS) was developed to enhance the efficiency and reliability of renewable energy systems. In such a setup, the PV system generates electricity, which can be used immediately, stored in batteries, or fed into the grid. The challenge lies in dynamically optimizing the power flow between these components to minimize energy costs, maximize the use of renewable energy, and maintain grid stability. Reinforcement learning (RL) combined with NNs offers a powerful solution by enabling the system to learn and adapt its energy management strategy in real time. By using the proposed techniques, the convergence time was decreased with lower complexity compared with existing approaches. The RL agent interacts with the environment (i.e., the grid, PV system, and battery), continuously improving its decisions regarding when to store energy, draw from the battery, and supply power to the grid. This intelligent control approach ensures optimal performance, contributing to a more sustainable and resilient energy system
HawkFish Optimization Algorithm: A Gender-Bending Approach for Solving Complex Optimization Problems
No full textInspired by the gender transition behavior seen in hawkfish, this paper introduces the HawkFish optimization algorithm, a nature-inspired optimization technique modeled on the unique gender transition behavior of hawkfish. By leveraging this biological phenomenon, the proposed method addresses optimization problems through dual fitness functions, combining an original and inverse fitness function to drive search space exploration while avoiding local minima. The algorithm’s performance is rigorously evaluated against benchmark problems, including the CEC/GECCO 2019 suite, and applied to real-world engineering challenges like welded beam and tension/compression spring design. The proposed method consistently outperforms existing algorithms in terms of convergence rate, accuracy, and solution quality. The results underscore the algorithm’s efficiency in exploring unknown search spaces and solving complex optimization tasks, making it a promising tool for various domains requiring high precision and optimization efficiency
The Psychometric Properties of Autism Mental Status Examination (AMSE) in Turkish Sample
No full textAutism Spectrum Disorder (ASD) is a prevalent neurodevelopmental disorder, and early diagnosis plays a pivotal role in prognosis and management. This study aims to examine the psychometric properties of the Autism Mental Status Exam (AMSE), a tool that shows great promise in terms of clinical utility, within the Turkish population. This study conducted in a cohort of 307 Turkish children aged 17 to 120 months with suspected ASD. Participants underwent a multidisciplinary assessment based on DSM-5 criteria for diagnosis and were categorized into ASD and non-ASD groups. Subsequently, the research team conducted blinded administrations of the AMSE and Childhood Autism Rating Scale (CARS). Additionally, a subset of 61 children underwent retesting for AMSE and CARS after three weeks for temporal stability. The results revealed an optimal cut-off score of 4 for AMSE, yielding sensitivity and specificity rates of 84% and 97%, respectively. Internal consistency, indicated by a Cronbach’s alpha of 0.80, was very good. The test-retest reliability, assessed using the Intraclass Correlation Coefficient (ICC), was excellent (ICC = 0.959). The inter-rater reliability also showed excellent agreement (ICC = 0.997). Furthermore, a significant correlation was observed between the AMSE and CARS scores (r = 0.94, p < 0.001). Notably, the AMSE scores were significantly different between the ASD and non-ASD groups (p < 0.001) with a large effect size (Cohen’s d = 1.40). The findings of this study underscore the utility of AMSE as a valid and reliable tool for Turkish children with robust psychometric properties.Funding agency: İstanbul Medeniyet Universit
Online simulation versus traditional classroom learnings in clinical pharmacy education: effect on students' knowledge, satisfaction and self-confidence
Full text linkBackground: Over the course of the past few years, the area of medical education has experienced a substantial movement towards the establishment of online learning platforms and resources. This study aimed to to evaluate the efficacy of an online simulation learning intervention, MyDispense®, compared to traditional classroom learning in terms of enhancing knowledge, satisfaction, and self-confidence among participants.
Methods: A multicentre randomized controlled study was conducted among pharmacy students who were assigned either intervention MyDispense® or control traditional classroom learning groups. They were eligible if they previously had experience with online simulation learning. A previously validated questioner were used to measure the outcome of knowledge, satisfaction and self-confidence.
Results: Both the intervention and control groups revealed significant improvement in knowledge, the P value for pre-post knowledge scores for each group was 0.05) between the intervention and control groups on knowledge gain, satisfaction, or self-confidence. This represents comparable outcomes irrespective of the group's exposure to intervention.
Conclusion: The study evaluated the efficacy of online simulation learning intervention MyDispense® in comparison to traditional classroom learning. While both strategies effectively improved knowledge, satisfaction, and self-confidence, the findings demonstrated that the online simulation yielded equivalent learning benefits. MyDispense® could be an alternative to traditional education in situations where face to face learning is not feasible, with comparable learning outcomes.
Clinical trial number: not applicable
Cognitive impairment in kidney transplanted patients
No full textChronic kidney disease affects almost all of the organs. Recently, more attention has been paid to the kidney and the central nervous system connections. In patients on kidney replacement therapy, including kidney transplantation, there is an increased prevalence of cognitive impairment, and depression and other neurological complications, such as cerebrovascular disorders and movement disorders. Kidney transplant recipients need an assessment for the risk factors and the pattern of cognitive impairment (memory, attention and executive function decline). This enables an accurate diagnosis to be made at an earlier stage. Partial post-transplant cognitive impairment recovery is also important. Finally, doctors and patients alike face numerous ethical concerns and challenges regarding the transplantation of kidneys and other solid organs. In this review, we examined some key issues regarding cognitive impairment in kidney transplant patients. We focused on the mechanism of cognitive impairment in kidney transplant recipients, patterns of cognitive impairment; evaluation of patients with cognitive impairment for kidney transplantation, the potential impact of cognitive impairment on waitlisted and transplanted patients on patient care, non-pharmacological interventions and unmet medical needs, psychological and ethical issues in kidney transplantation, and unmet needs. As cognitive impairment in kidney transplant recipients is an underestimated, underrecognized but clinically relevant problem, screening for cognitive function before and after kidney transplantation would be worth considering in standard routine practice.Funding sponsor: European Cooperation in Science and Technology
Funding number: CA1912
3D modelling and x-ray depth analysis map of the pulp with computer software via digital periapical radiography and cone beam computed tomography
Full text linkObjective: Periapical radiographs (PAR) offer information about the pulp and periodontal health of teeth. However, intraoral radiographs are insufficient for diagnosing buccolingual anomalies and variations such as bifid canals due to their two-dimensional nature. Cone beam computed tomography (CBCT) is the gold standard for 3D imaging in the clinic but requires additional radiation. The aim of this study was to create a software (XPAR) which obtains x-ray depth analysis and 3D modelling of the pulps of single-rooted teeth by converting the grey values in the original radiographs into numerical data.
Materials and methods: Two single-rooted teeth were included in the experimental part of the study. Chicken fibula bone was preferred for alveolar bone simulation because it could simulate cortical and trabecular structures due to similarity. A total of four images (60kVp & 70kVp; single alveolar bone & double alveolar bone) were obtained. The aim of this experimental part is to test the repeatability and realism of the algorithm to be created for pulp modelling. Retrospectively, 31 single-rooted teeth with both periapical radiography and cone-beam computed tomography imaging were included in the retrospective part of the study. According to XPAR, depth increase areas were interpreted as root resorption and accessory canal. Depth decrease areas were evaluated as the transformation of the pulp from an elliptical to an oval form, pulp stone, bifid canal formation and the presence of thick alveolar bone. The diagnostic accuracy of XPAR application on pathological and morphological changes was evaluated by comparing the obtained results with CBCT.
Results: 80% of the analyses diagnosed as bifurcation by XPAR application were supported by CBCT. This rate decreased to 27% in the diagnosis of transitions from elliptical to oval form. A total of 5 and 19 linear formations observed in the form of depth decrease and increase, respectively, were accepted as image errors in XPAR.
Conclusion: Buccolingual bifid canal formations and pulp obliterations can be diagnosed with a rate of nearly 50% with the depth decrease finding obtained in XPAR application. Imaging errors caused by deformed detectors are typically observed as linear formations