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ONKOPLASTİK MEME CERRAHİSİNİN TEKNİKLERİNİN TEMELLERİ
No full textTRAINING IN ONCOPLASTIC BREAST SURGERYNuh Zafer Cantürk1 Sue Kim Down2 Yazan Masannat31Kocaeli University, Faculty of Medicine, Department of General Surgery, Kocaeli, Türkiye 2James Paget University Hospital, Department of Breast Surgery, Great Yarmouth, United Kingdom 3Broomfield Hospital, Mid and South Essex NHS Trust Chelmsford, Department of Oncoplastic Surgeon, Essex, United KingdomABSTRACTBreast cancer management has evolved significantly over the past century, with a shift towards breast-conserving surgery (BCS) and oncoplastic breast surgery (OPBS) to balance oncologic and cos-metic outcomes. While most breast surgeons can perform basic OPBS techniques, collaboration with plastic surgeons or specialized training is often necessary for complex cases. Emerging academies such as the European Academy of Senology offer structured curriculums combining theoretical education with hands-on surgical practice, aiming to equip surgeons with the necessary skills to manage breast cancer effectively. Recognizing the importance of ongoing education and specialization, efforts are underway to standardize breast surgery training across Europe and advocate for formal recognition of breast surgery as a distinct specialty. Multidisciplinary teamwork and specialized training programs play a key role in delivering high-quality care to breast cancer patients and advancing research and innovation in the field. Despite challenges in OPBS training, international efforts and specialized pro-grams in countries like Turkey are enhancing education and promoting breast preservation techniques. Further research and training initiatives are needed to standardize methods and outcomes in OPBS, ensuring optimal care for breast cancer patients.</div
Virtual reality headsets for employee training in enterprises: fuzzy SRP data-driven framework for a comprehensive evaluation
No full textVirtual reality (VR) is progressively transforming employee training in companies by offering immersive and engaging learning experiences. Nevertheless, the selection of an appropriate VR headset is vital for optimizing training effectiveness. This paper addresses this issue by proposing a novel hybrid fuzzy multi-criteria decision-making model that integrates the improved fuzzy stepwise weight assessment ratio analysis (IF-SWARA) with the fuzzy simple ranking process (F-SRP). The IF-SWARA methodology is employed to compute the relative weights of the selection criteria for VR headsets utilized in employee training, whereas the newly developed F-SRP is implemented to rank the various VR headsets. By employing the IF-SWARA method, the model offers a more nuanced understanding of criteria weights, thereby reflecting the differing significance of various headset features. The research's novelties and contributions are as follows: (1) This study is the first to select VR headsets by applying multi-criteria methods. (2) The F-SRP model is developed for the first time in the literature. (3) The introduced F-SRP methodology allows for a comprehensive ranking of the available VR headsets, facilitating informed decision-making. The paramount indicators for selecting VR headset options for training in enterprises consist of technical specifications, comfort and ergonomics, and screen specifications. The results obtained from the fuzzy SRP indicate that the Apple Vision Pro surpasses the other alternatives. Finally, the robustness and applicability of the proposed model are evaluated through an exhaustive sensitivity analysis. This research possesses broader implications for VR training in enterprises by providing a robust and reliable framework, ultimately contributing to the development of more effective and impactful VR training programs
Comment on: Can artificial intelligence pass the written European Board of Hand Surgery exam?
No full textDoes responsible leadership via voice behavior promote green behavior?
No full textPurpose: This study, which utilizes the job demands-resources (JD-R) theory, aims to explicate the relationship between responsible leadership (RL), green behavior (GB) and the mediating role of voice behavior (VB). Design/methodology/approach: This study used a quantitative research design. The research sample consists of 260 participants who work in five-star hotels in Izmir. The research data were collected through face-to-face and online survey methods. Confirmatory factor analysis (CFA) in AMOS was performed to assess the measurement model. The research hypotheses were tested with structural equation modeling (SEM). Findings: The results determined that RL affects GB and VB positively and significantly. In addition, VB has a significant positive link with GB. Furthermore, this study discovered that VB acts as a mediator in the relationship between RL and GB, indicating that RL indirectly promotes GB through implementing VB. Research limitations/implications: This study has limitations, such as its dependence on self-reported data, cross-sectional design and exclusive emphasis on participants from a single nation. When RL encourages employees to take GB, they are more likely to engage in GB. This study contributes to the field by evaluating the structures discussed with the JD-R theory. In the management practice of organizations, RL should be strengthened, and training should be provided to enhance RL. Originality/value: The literature analysis revealed that, while studies have been undertaken using RL, the idea has not been tested using VB or has it been investigated in the hotel business, which has grown vital to the global economy. With these aspects, the work stands apart and serves as a source of motivation for researchers
A critical and updated review on advanced oxidation processes for micropollutants in aquatic systems: Insights into metal–organic frameworks, mixed metal oxides, effluent toxicity, and cost
No full textMicropollutants (MPs), such as pharmaceuticals, pesticides, endocrine disruptors, dyes, and industrial chemicals, persist through conventional wastewater treatment, necessitating advanced oxidation processes (AOPs) that can generate high-valence radicals (radOH, SO4rad−, Clrad). This review provides an updated and critical synthesis of AOP developments from 2019 to 2025, with explicit emphasis on mechanistic insights, electrode/catalyst innovations, hybrid AOP synergies, effluent toxicity, and economic feasibility. A key novelty of this work lies in its integrated comparison of standalone versus hybrid AOPs, as well as its inclusion of emerging systems such as metal-organic frameworks (MOFs), mixed-metal oxides (MMOs), bio-electrochemical systems (BES), and microwave-assisted AOPs, all evaluated together for the first time. Electrochemical processes (electro-Fenton, electro-persulfate, and electro-oxidation) demonstrated superior mineralization efficiency and stability, supported by advanced electrodes such as boron-doped diamond (BDD), Ti/SnO2-RuO2, and CO2-modified biochar. Photochemical, sono-chemical, and hybrid processes achieved >90% MP removal, with hybrid systems consistently outperforming standalone methods due to multi-pathway radical generation. A structured toxicity analysis using EC50/LC50 frameworks confirmed significant detoxification, though ozonation-based AOPs require careful by-product control. Economic comparison highlights the feasibility of solar-driven and modular AOPs, particularly for low- and middle-income regions. Critical research gaps are identified in scale-up, cost, by-product fate, and long-term catalyst durability, offering pathways for future sustainable AOP deployment
Diagnostic yield of pre- versus post-biopsy bronchial washing in endobronchial cancer: Impact of procedural sequence
No full textBACKGROUND: Fiberoptic bronchoscopy is a crucial diagnostic tool in the evaluation of lung cancer, particularly in tumors with endobronchial involvement. While forceps biopsy, bronchial brushing, and bronchial washing are commonly used, the diagnostic value and optimal timing of bronchial washing remain debatable. OBJECTIVES: To evaluate the effect of pre- and post-biopsy bronchial washing on cytological diagnostic yield in patients with visible endobronchial lesions. DESIGN: Prospective diagnostic study. SETTINGS: Single tertiary university hospital. MATERIALS AND METHODS: Between April 2018 and April 2021, 55 patients with bronchoscopically visible endobronchial lesions underwent flexible bronchoscopy. Patients with invisible or submucosal tumors were excluded. Bronchial washings were obtained before and after 4-6 forceps biopsies. Cytological analyses were conducted blindly on all specimens. Statistical analysis included Chi-square and McNemar tests, with P<.05 considered significant. MAIN OUTCOME MEASURES: Cytological diagnostic positivity rates in pre- and post-biopsy bronchial washings. SAMPLE SIZE: Fifty-five patients. RESULTS: Forceps biopsy alone achieved a diagnostic yield of 95%, which increased to 96% when combined with bronchial washing. Post-biopsy washing demonstrated a significantly higher cytological positivity rate (47%) than pre-biopsy washing (22%) (P=.002). No complications were observed. CONCLUSIONS: Bronchial washing after forceps biopsy significantly improves cytological diagnostic yield in endobronchial lung lesions. Its simplicity, low cost, and additional diagnostic yield support its routine use in bronchoscopic evaluation. LIMITATIONS: Single-center design and relatively small sample size; other cytologic methods such as brushing orendobronchial ultrasound (EBUS) were not evaluated
Li-ALLOYED Mg-Zn-Ca Systems' Phase Structure Modification, Mechanical Properties and Corrosion Performance
No full textMagnesium-lithium (Mg-Li) binary alloys have attracted significant attention in recent years due to their exceptionally low density and high specific strength. Lithium, with a density of 0.58 g/cm3, is lighter than magnesium, making Mg-Li alloys highly attractive for aerospace, defense, and additive manufacturing applications where weight reduction is critical. The mechanical properties of Mg-Li alloys are strongly dependent on their crystal structure, which varies with lithium content and can exist in hexagonal close-packed (HCP), body-centered cubic (BCC), or dual-phase (HCP + BCC) forms. Additional alloying with calcium (Ca) and zinc (Zn), either individually or in combination, can further enhance mechanical performance. In the present study, three Mg-Li-Zn-Ca alloys-LZX110, LZX420, and LZX920-were produced via permanent mold casting following ASTM standards, with fixed Zn and Ca contents. LZX110 consisted solely of the alpha-Mg(Li) HCP phase, while LZX920 was composed entirely of the beta-Li(Mg) BCC phase. X-ray diffraction (XRD) and scanning electron microscopy with energy-dispersive spectroscopy (SEM-EDS) analyses revealed that LZX420 exhibited a dual-phase structure containing both alpha-Mg(Li) and beta-Li(Mg) phases. Zn and Ca were found to dissolve within the matrix phases, contributing to solid solution strengthening without forming distinct secondary phases. Hardness increased with Li content, with average values of 50.92 HV, 66.68 HV, and 73.56 HV for LZX110, LZX420, and LZX920, respectively. LZX920 exhibited the highest yield strength (195 MPa) and ultimate tensile strength (196 MPa), whereas LZX420 demonstrated the greatest ductility (13.5%). Overall, the dual-phase LZX420 alloy provided an optimal balance of strength and ductility, making it a promising candidate for lightweight structural applications
Digital Inclusion of Migrants in Türkiye: Emotional, Linguistic, and Structural Barriers
No full textThis study uses a bibliometric review of international research and 27 in‐depth interviews to investigate digital disparities among migrant groups in Türkiye. We aim to understand how gender, as well as emotional, linguistic, and structural factors influence digital inclusion. The interviews demonstrate how these problems manifest across Türkiye’s varied migrant communities, while the bibliometric analysis identifies global themes such as digital literacy, access, trust, and language barriers. The primary obstacles, which are frequently exacerbated by gender and legal status, are monolingual e‐government platforms, low digital trust, and reliance on family for online access. The results show that social and emotional aspects of digital inclusion are involved, requiring institutions to be sensitive, build trust, and ensure linguistic accessibility. The study integrates infrastructure with lived experience‐based policies, proposing culturally sensitive, linguistically inclusive, and emotionally sensitive strategies. For other areas with sizable migrant populations, this strategy offers a scalable model.</p
MULTIPLICATIVE TEMPERED FRACTIONAL INTEGRALS IN G-CALCULUS AND ASSOCIATED HERMITE–HADAMARD-TYPE INEQUALITIES
No full textThis paper introduces the first theory of tempered fractional integrals within the framework of G-calculus, a multiplicative non-Newtonian system for positive-valued functions with positive arguments. We begin by formulating the multiplicative Riemann–Liouville integral in its pure multiplicative form and extend it to include an exponential tempering parameter. A new multiplicative λ-incomplete Gamma function is defined to characterize these operators. Furthermore, we introduce and analyze multiplicative convexity in G-calculus, along with novel multiplicative formulations of the classical midpoint and trapezoidal quadrature rules. We then establish the Hermite–Hadamard inequalities for GG-convex functions and derive two novel multiplicative integral identities, leading to midpoint- and trapezium-type bounds. Numerical examples with graphical illustrations, applications to quadrature rules, and connections to special means validate our results. The proposed framework fills a critical gap in non-Newtonian analysis and provides new tools for modeling scale-invariant phenomena in economics, biology, and signal processing