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© 2023, Springer Nature Switzerland AG.Background: Long-term bowel dysfunction after resection for rectal cancer, known as low anterior resection syndrome (LARS), is observed in many patients. The LARS score was developed to assess this syndrome and its impact on the quality of life in Danish patients. Recently versions in English and many other languages have been validated. The aim of this study was to validate the Turkish translation of the LARS score in patients who have undergone treatment for rectal cancer. Methods: Rectal cancer patients who underwent low anterior resection in May 2000- May 2018 in three Turkish centers received the LARS score questionnaire, the European Organisation for Research and Treatment Of Cancer Core Quality of Life questionnaire [Ed.11] (EORTC QLQ-C30), and a single ad hoc quality of life question. The test–retest reliability of the LARS score was evaluated by asking a randomly selected subgroup of patients to repeat the assessment of the LARS score 2 to 4 weeks after their initial response. Results: A total of 326 patients were reviewed and contacted for the study, and 222 (68%) were eligible for the analyses (129 males, 93 females, median age 64 years [range:24–87 years, IQR = 14]) There was a strong association between the LARS score and quality of life (p < 0.01) and the test–retest reliability was high. The intraclass correlation coefficient was 0.78 (95% CI 0.73–0.83) for the whole study group and 0.79 (95% CI 0.68–0.87) for the subgroup, indicating strong reliability. Conclusions: The Turkish translation of the LARS score has psychometric properties comparable with previously published results in similar studies. The Turkish version of the LARS score can be considered a valid and reliable tool for measuring LARS in Turkish rectal cancer patients. Clinical trial registration: NCT05289531.

A successful digital transformation (DT) requires reengineering company processes in line with the strategy and business model, and using multiple technologies simultaneously and harmoniously. This creates multiple challenges. This study identifies and prioritizes emerging DT challenges in Turkish industrial sectors. After conducting the literature review, this exploratory study uses structured interviews in multiple sectors and conducts case studies. Challenges are discussed under technological, organizational, managerial, and human dimensions and results are compared with the existing literature. In Turkey, 29% of challenges are human-related, 28% are organizational, 24% are technological, and 19% are managerial. Findings support the importance of handling the soft aspects during the implementations, and put forward the variability of the results with respect to company size and sector. The study is valuable in providing a comprehensive Turkish perspective, classification, and prioritization of multi-dimensional challenges.

IntroductionChiari malformation type 1 (CM1), a complex pathological developmental disorder of the craniovertebral junction, is typically characterized by herniation of the cerebellar tonsils from the foramen magnum. Treatment using posterior fossa decompression alone without taking the ventral cervico-medullary compression into consideration may lead to unsatisfactory treatment outcomes. The current study evaluated the utility of the modified clivoaxial angle (MCAA) in assessing ventral compression and also examined its effect on treatment outcomes.MethodThis retrospective study included 215 adult patients who underwent surgical treatment for CM1 at one medical center over a 10-year period. The following surgical techniques were used to decompress the posterior fossa: (a) PFD: bone removal only; (b) PFDwD: bone removal with duraplasty; and (c) CTR: cerebellar tonsil resection. The morphometric measurements of the craniovertebral junction (including MCAA) were recorded using preoperative images, and the postoperative clinical status was evaluated using the Chicago Chiari outcome scale (CCOS).ResultsMCAA was positively correlated with the CCOS score and also independently predicted treatment outcome. To enable Receiver operating characteristic (ROC) curve analysis of CCOS scores, the patients were divided into three groups based on the MCAA cut-off values, as follows: (a) severe (n = 43): MCAA ≤ 126; (b) moderate (n = 86): 126 n = 86): MCAA > 138. Group a exhibited severe ventral cervico-medullary compression (VCMC), and their CCOS scores for the PFD, PFDwD, and CTR groups were 11.01 ± 1.2, 11.24 ± 1.3, and 13.01 ± 1.2, respectively (p p 138°) exhibited 78% regression of syringomyelia, and this was significantly greater than that observed in the other groups.DiscussionMCAA can be used in the selection of appropriate surgical techniques and prediction of treatment outcomes, highlighting the importance of preoperative evaluation of ventral clivoaxial compression in patients with CM1.

Plants compete for light by growing taller than their nearest competitors. This is part of the shade avoidance syndrome and is a response to an increase of Far-Red light (FR) reflected from neighboring leaves. The root responds to this shoot-sensed FR cue by reducing lateral root emergence. It is well-established that the plant hormone Gibberellic Acid (GA) is involved in supplemental FR-induced shoot elongation. Although GA is also transported from shoot to root, its role in regulating lateral root growth is unclear. We show via GA manipulations, both chemical and genetic, that GA modulates the lateral root reduction induced by shoot-sensed FR enrichment. Using the FRET-based GA biosensor GPS1, we observed detailed GA changes in the root upon shoot exposure to FR enrichment and when GA was supplied to the shoot. Supplying GA to the shoot also mitigated the FR-enrichment root phenotype, indicating a functional link between GA and changes in root development in response to shoot-sensed FR. The regulatory role of GA in root growth appears to be partially dependent upon the role of ELONGATED HYPOCOTYL 5 (HY5), a light-responsive transcription factor that regulates root growth. Shoot-to-root transported GA4 led to an increase in HY5 protein levels in the lateral root primordia. HY5 then repressed auxin signaling to repress lateral root growth. Our data unveil a novel way in which hormone and light signaling coordinate development across spatial scales by adjusting (lateral) root growth from above-ground FR light signals.

S4. (a) Representative immunostaining of Pt-(GpG) adducts in KP and KPE cell lines after cisplatin exposure (left). Quantification of Pt-(GpG) adduct staining in KP (n = 5) and KPE (n = 6) cells after cisplatin exposure (right). P values were calculated using two-tailed t-test. (b) Clonogenic survival assay of mock-treated KP and cisplatin-treated KP cells, mock-treated KPE and cisplatin-treated KPE cells, mock-treated KPE post cis and cisplatin-treated KPE post cis cells, mock-treated KPE post cis clone 6 (*6) and cisplatin-treated KPE post cis clone 6 (*6). (c) Detailed representation of Fig. 4c.