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Enabling Sustainable and Technology-Driven Health Systems: A Fuzzy Quality Function Deployment Approach for Advancing Healthcare 4.0
No full textHealthcare 4.0 can support SDG 3 and SDG 9 by using Industry 4.0 technologies to improve care delivery, operational efficiency, and environmental performance. In practice, hospitals face two persistent barriers: high uncertainty when prioritizing transformation initiatives and strict constraints related to data protection, interoperability, and legacy systems. This study addresses the need for a transparent, requirement-driven way to identify and rank the critical success factors of sustainable Healthcare 4.0, and to translate those priorities into implementable technical actions. A hybrid framework combining Interval-Valued Pythagorean Fuzzy AHP (IVPF-AHP) and Quality Function Deployment (QFD) is proposed. IVPF-AHP is used to weight sustainability-oriented success factors under uncertainty, and QFD maps the weighted requirements to technical and managerial responses. The framework is demonstrated through a hospital case study in Istanbul with five Industry 4.0 experienced decision-makers. Eleven sub-factors across economic, environmental, and social dimensions are evaluated. The results show that the economic dimension carries the highest importance (48.0%), followed by the environmental (42.4%) and social (9.6%) dimensions. The highest-priority sub-factors are effective data source management and security (15.3%) and a digital strategy for sustainable transformation (14.6%), with circular waste management and enabling technological infrastructure also ranking among the leading requirements. The proposed approach supports decision-makers by clarifying where to invest first to achieve a secure, measurable, and sustainability-aligned Healthcare 4.0 transition
DENETİM KOMİTESİ YAPISI VE FİNANSAL PERFORMANS ARASINDAKİ İLİŞKİ: BIST-100 FİRMALARI ÜZERİNE BİR PANEL VERİ ANALİZİ
No full text“Horses out of the barn”: pancreatic ductal adenocarcinoma frequently extends beyond the grossly visible tumour, requiring microscopic rectification for accurate T-staging
No full textAims: Accurate determination of tumour size is critical for pT staging in pancreatic ductal adenocarcinoma (PDAC), yet gross measurement alone often underestimates the true tumour extent because of the tumour's ill-defined and infiltrative nature. This study aimed to evaluate the diagnostic and prognostic value of incorporating microscopic rectification into tumour size assessment in PDAC. Methods and results: A total of 342 therapy-naïve pancreatoduodenectomies were analysed using a grossing protocol that includes separate sampling of anterior and posterior soft tissues via the ‘orange-peeling’ technique to retrieve lymph nodes and document soft tissue involvement. Peripancreatic soft tissue involvement was present in 91% of cases, and isolated microscopic foci distant from the main mass in 48%. Of the 266 tumours grossly classified as pT1/T2 (≤4 cm), 39 (14%) showed carcinoma in both anterior and posterior soft tissues, and were reclassified as pT3. This subset showed significantly worse survival (P = 0.04) and higher nodal positivity (87% versus 69%, P = 0.02) than the remaining pT2 cases, comparable to conventional pT3 tumours (86%, P = 0.77). Multivariable Cox regression adjusted for age, sex, nodal status, margin, and lymphovascular/perineural invasion confirmed the survival disadvantage of this subgroup. Reclassification yielded a more balanced distribution of T categories (pT2 66% → 52%, pT3 22% → 34%) and modestly improved prognostic discrimination (C-index: 0.592 versus 0.574). Conclusions: This study elucidates that PDAC frequently extends beyond the visible mass (‘horses out of the barn’ phenomenon); peripancreatic soft tissue involvement is common, and gross size often underestimates the true tumour extent, making microscopic correction crucial. Approximately one in six pT1/T2 tumours (≤4 cm) shows carcinoma in both anterior and posterior soft tissues and behave like pT3 in outcomes and nodal status. Therefore, gross-micro rectification is essential to avoid understaging, particularly for T2 tumours. The orange-peeling protocol should classify tumours with foci in both anterior and posterior soft tissues as pT3, while other approaches may employ mapping techniques to enable microscopic reconstruction and biologically accurate staging
Exploring waste cooking oils as renewable feedstock for alkyd resin production
No full textThe increasing demand for environmentally sustainable materials has increased interest in renewable raw materials for polymer synthesis. Among these sources, waste cooking oil (WCO) has been considered a promising alternative due to its abundance, low cost and rich triglyceride content suitable for polymeric applications. This review examines the use of WCO in the synthesis of alkyd resins, highlighting significant improvements in raw material processing, resin formulation development and resulting physicochemical properties. The addition of WCO not only addresses waste disposal concerns but also offers a path toward the development of high-performance, bio-based coating materials. The effects of oil pretreatment, polyol selection and reaction parameters on resin properties are discussed in this study. Comparison with conventional alkyds shows that WCO-derived resins exhibit competitive drying behavior, mechanical stability and adhesion properties, although they have some limitations in oxidative resistance. The review also examines recent innovations aimed at improving the quality and durability of WCO-based alkyds, with the aim of positioning them as sustainable candidates in the coatings industry
Optimization of Sustainable Hybrid Natural–Waste Adsorbent Compositions for Mixed Dye Removal from Aqueous Solutions
No full textIn this study, the removal of a synthetic dye mixture containing anionic (Telon Blue AGLF), cationic (Astrazon Blue BG-200%), and nonionic (Dianix Blue S-BG) dyes from aqueous solutions was investigated using the adsorption method. As an alternative to commonly used commercial adsorbents, three low-cost, naturally abundant, and renewable materials magnolia cone (MC), beidellite (BD), and fly ash (FA) were selected. Unlike many previous studies in the literature, these adsorbents were used simultaneously to explore the potential advantages of combined adsorption. Batch adsorption experiments were conducted by varying the operational parameters, including pH (4–11), contact time (5–60 min), and the individual dosages of three different adsorbents (within the range of 0.01–0.04 g), while keeping the initial dye concentrations constant. A synthetic dye solution was prepared by mixing the three dyes in equal concentrations and volumes. The effects of the selected parameters on dye and total organic carbon (TOC) removal efficiencies were evaluated and optimized using Response Surface Methodology (RSM) based on Central Composite Design (CCD). To assess the structural and surface characteristics of the adsorbents before and after adsorption, Brunauer–Emmett–Teller (BET) surface area analysis and Scanning Electron Microscopy (SEM) were employed. BET analysis revealed surface areas of the adsorbents ranging from 18 to 158.5 m2/g. SEM images demonstrated that dye molecules were successfully adsorbed onto the surface and within the pores of the adsorbents. The findings indicate that the simultaneous use of natural and waste-derived materials can offer a sustainable, efficient, and cost-effective approach for the removal of mixed dyes from wastewater
Some new classes of fuzzy contraction defined by means of fuzzy negations and related fixed point theorems
No full textUsing the notion of fuzzy negation functions which naturally arises in the theory and applications of fuzzy logic, we enlarge the class of fuzzy ψ-contractions of (Formula presented.) type as well as the class of fuzzy (Formula presented.) contractions and generalize corresponding fixed point theorems. We show that strict negations, strong negations and Archimedean t-norms play a central role in the aforesaid fixed point theorems. Appropriate examples that illustrate the exposed theory are provided. In the process, we obtain a new type of topology (as well as convergence and completeness) for the fuzzy metric spaces that suggesting a potential new research avenue to explore the subject
Attachment Styles, Resilience, and Parenting Attitudes Among Adolescents Exposed to Interparental Intimate Partner Violence
No full textThis study aimed to investigate the relationship among the resilience levels, attachment styles, and the parenting attitudes of adolescents who did and did not witness interparental intimate partner violence (IPV). The study included adolescents and their mothers who presented to the Child-Adolescent Psychiatry clinics. The case and control group consisted of adolescents who had and had not witnessed interparental IPV, respectively. Data were collected using the K-SADS-PL-DSM-5-T, a sociodemographic data form, the Child and Youth Resilience Measure, the Three-Dimensional Attachment Style Scale, and the Parental Attitude Research Instrument. Resilience levels were significantly lower in the case group. In the control group, secure attachment style was observed more frequently, while avoidant and anxious-ambivalent attachment styles were more prevalent in the case group. Resilience was positively related to secure attachment and negatively related to avoidant and anxious-ambivalent attachment in both groups. Regarding parenting attitudes, the case group scored higher on the Rejection of the Housewife Role and Marital Discord subscales. In conclusion, the adjustment of children exposed to interparental IPV depends not only on traumatic experiences but also on resilience, attachment styles, and parental attitudes. Therefore, intervention programs should integrate trauma-focused approaches with strategies that strengthen parent-child relationships and foster protective factors enhancing resilience
Prognostic Significance of C-PLAN Index in Patients Treated with Immunotherapy for Non-Small-Cell Lung Cancer
No full textBackground/Objectives: Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to assess the prognostic significance of the C-PLAN index, which includes performance status (PS) and C-reactive protein (CRP). Methods: A total of 560 patients were included in this multicenter study. Patients had been diagnosed with NSCLC and had received nivolumab therapy. The C-PLAN index, defined in 2022, is a score derived from the combination of PS, CRP, lactate dehydrogenase (LDH), albumin, and neutrophil–lymphocyte ratio (NLR). Patients were classified into good-, moderate-, and poor-prognosis groups according to the C-PLAN score. Results: The median metastatic overall survival was 25 months in the group with a C-PLAN score < 2 and 6 months in the group with a C-PLAN score ≥ 2 (p < 0.001). The median metastatic progression-free survival was 11 months in the group with a C-PLAN score < 2 and 3 months in the group with a C-PLAN score ≥ 2. Conclusion: This is the first comprehensive study demonstrating that the C-PLAN index can be used for prognostic purposes in immunotherapy. This score, which can be easily, economically, and practically calculated in outpatient clinics, can predict patient prognosis and determine who should receive longer durations of immunotherapy
Calix[4]arene-Pyrene Based On–Off–On Fluorescent Sensor for Sensitive Detection of Triazole Pesticides in Food and Environmental Samples
No full textIn this study, a new fluorescent sensor was occurred from pyrene-substituted calix[4]arene derivatives and its usability in the detection of Cu2+ ions and triazole-based pesticides was investigated. Calix[4]arene derivatives formed complexes that exhibited an "on–off-on" fluorescence response by interacting with pesticides containing triazole groups and showed significant changes in their optical properties. This innovative sensor plays an effective binding role especially for Cu2+ ions and the change in the fluorescence properties of the complexes formed with these ions can be used for the detection of pesticides. In the study, "turn-on–off-on" fluorescence responses were observed as a result of the interaction of calix[4]arene-pyrene complex with triazole-based pesticides (tebuconazole, tetraconazole, penconazole and difenoconazole). In addition, it is emphasized that the sensor is a potential tool for the rapid and sensitive detection of pesticides, which are important in terms of environmental pollution and food safety. The results obtained show that calix[4]arene derivatives have great potential in the detection of environmental pollutants and in the development of optical sensors sensitive to these pollutants
