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Purpose: To provide a structured macroscopic overview of the characteristics and advances in research related to the Enhancing Recovery after Surgery (ERAS) protocol., Design: A bibliometric analysis., Methods: Web of Science was selected as the search engine for the bibliometric analysis study, and data up to January 25, 2024 were included in the scan. The analysis was conducted using the "biblioshiny" application available in the Bibliometrics R package., Findings: A total of 769 studies were included in the review between 1991 and 2024. China produced the most publications on the subject, while the United States received the highest number of citations. A total of 213 global collaborations were identified, with the most frequent collaboration being between the United States and Canada (8 collaborations). The author Li K. contributed the most papers and the Journal of Perianesthesia Nursing published the most nursing papers on the topic. "Enhanced recovery" was the most frequently used keyword in the articles. In addition, China led in the number of publications, while the United Kingdom, China, Canada, and Sweden had the highest number of citations of all countries., Conclusions: This bibliometric study provided comprehensive information on global trends and hotspots in ERAS protocol care research. Developed countries were the most productive in this area of research. It was noted that publications in this study area did not meet the Lodka and Bradford laws., Competing Interests: Declaration of Competing Interest None to report., (Copyright © 2025 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Purpose: This original study aimed to examine the relationship of emotional intelligence and passion to decision-making in surgical nurses., Design: It is a descriptive, relational study., Methods: This study was conducted with 166 surgical nurses. Data for the study were collected using the Descriptive Characteristics Form, Passion Scale, Emotional Intelligence Scale, and Nurse Decision-Making Scale., Findings: The decision-making level of 85.6% of the surgical nurses was found to be at the third level. There was a 0.265 U increase in decision-making score for a 1 U increase in nursing experience. A 1 U increase in the standard deviation of the Emotional Intelligence Scale increased the standard deviation of the Nursing Decision-Making Scale by 0.322 U, and a 1 U increase in the standard deviation of the Passion Scale increased the standard deviation of the Nursing Decision-Making Scale by 0.268 U., Conclusions: Surgical nurses' passion, emotional intelligence, and decision-making levels were found to be high. A positive relationship was also found between the passion and emotional intelligence levels of surgical nurses and their decision-making. Decision-making is crucial in nursing, particularly in the surgical setting where passion and emotional intelligence play a significant role. This study highlights how passion, associated with professional growth and emotional intelligence and empathy and situational awareness, influence surgical nurses' decision-making processes., Competing Interests: Declaration of Competing Interest None to report., (Copyright © 2025 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Importance: Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC)., Objective: To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)-positive breast cancer and patients whose disease became cN negative after NAC (ycN negative)., Design, Setting, and Participants: In the NEOSENTITURK MF-1803 prospective cohort registry trial, patients from 37 centers with cT1-4N1-3M0 disease treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) alone or with ypN-negative or ypN-positive disease after NAC were recruited between February 15, 2019, and January 1, 2023, and evaluated., Exposure: Treatment with SLNB or TAD after NAC., Main Outcomes and Measures: The primary aim of the study was axillary, locoregional, or distant recurrence rates; disease-free survival; and disease-specific survival. Number of axillary lymph nodes removed was also evaluated., Results: A total of 976 patients (median age, 46 years [range, 21-80 years]) with cT1-4N1-3M0 disease underwent SLNB (n = 620) or TAD alone (n = 356). Most of the cohort had a mapping procedure with blue dye alone (645 [66.1%]) with (n = 177) or without (n = 468) TAD. Overall, no difference was found between patients treated with TAD and patients treated with SLNB in the median number of total lymph nodes removed (TAD, 4 [3-6] vs SLNB, 4 [3-6]; P = .09). Among patients with ypN-positive disease, those who underwent TAD were more likely to have a lower median lymph node ratio (TAD, 0.28 [IQR, 0.20-0.40] vs SLNB, 0.33 [IQR, 0.20-0.50]; P = .03). At a median follow-up of 39 months (IQR, 29-48 months), no significant difference was found in the rates of ipsilateral axillary recurrence (0.3% [1 of 356] vs 0.3% [2 of 620]; P ≥ .99) or locoregional recurrence (0.6% [2 of 356] vs 1.1% [7 of 620]; P = .50) between the TAD and SLNB groups, with an overall locoregional recurrence rate of 0.9% (9 of 976). The initial clinical tumor stage, pathologic complete response, and use of blue dye alone as a mapping procedure were not associated with the outcome. Even though patients with TAD demonstrated an increased disease-free survival rate compared with the SLNB group, this difference did not reach statistical significance (94.9% vs 92.6%; P = .07). Factors associated with decreased 5-year disease-specific survival were cN2-3 axillary stage (cN1, 98.7% vs cN2-3, 96.8%; P = .03) and nonluminal type tumor pathologic characteristics (luminal, 98.9% vs nonluminal, 96.9%; P = .007)., Conclusions and Relevance: The short-term results suggest very low rates of axillary and locoregional recurrence in a select group of patients with cN-negative disease after NAC treated with TAD alone or SLNB alone followed by regional nodal irradiation regardless of the SLNB technique or nodal pathology. Whether TAD might provide a clear survival advantage compared with SLNB remains to be proven in studies with longer follow-up.

Prosthetic valve thrombosis (PVT) is a critical and life-threatening condition driven by multifactorial etiologies, including genetic predispositions. The study was designed as a single-center retrospective manner. Echocardiographic features and genetic test including factor II/prothrombin (G20210A), factor V Leiden (G1691A), factor V R2 (A4070G), apolipoprotein (Apo) B-100 (G10708A), ApoE (C112R), ApoE (R158C), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C, factor XIII G103T (V34L), β-fibrinogen (455G>A), PAI-1 4G/5G, and HPA-1 GPIIIa (T196C) genotyping variations were assessed. We performed genetic tests on 175 patients with PVT (biologically women [n = 124, 70.9%], with a mean age of 49.8 ± 13.1 years) and 101 patients (biologically women [n = 57, 56.4%], with a mean age of 54.7 ± 13.6 years) without thrombus formation. The thrombosis group was significantly younger compared with controls (p = 0.004). The percentage of patients with mechanical aortic valves was significantly lower in the thrombosis group compared with controls (22.3% vs 34.7%, p = 0.025). A significant difference was observed between the thrombosis and control groups regarding the genotype ratios of factor II/prothrombin (G20210A) (heterozygous, 6.8% vs 1%, p = 0.043) and HPA-1 GPIIIa (T196C) (homozygous mutant, 7.8% vs 0%, p = 0.034). In addition, there was a significant association of heterozygous MTHFR (A1298C) variation with obstructive thrombosis compared with nonobstructive thrombosis (46.9% vs 29.2%, p = 0.046). In conclusion, this is the first study to report a potential association between genetic variants, including HPA-1 GPIIIa (T196C), factor II/prothrombin (G20210A), MTHFR (A1298C), and PVT, necessitating extensive further research and additional clinical consideration., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Cerebral cortex development in humans is a highly complex and orchestrated process that is under tight genetic regulation. Rare mutations that alter gene expression or function can disrupt the structure of the cerebral cortex, resulting in a range of neurological conditions 1 . Lissencephaly ('smooth brain') spectrum disorders comprise a group of rare, genetically heterogeneous congenital brain malformations commonly associated with epilepsy and intellectual disability 2 . However, the molecular mechanisms underlying disease pathogenesis remain unknown. Here we establish hypoactivity of the mTOR pathway as a clinically relevant molecular mechanism in lissencephaly spectrum disorders. We characterized two types of cerebral organoid derived from individuals with genetically distinct lissencephalies with a recessive mutation in p53-induced death domain protein 1 (PIDD1) or a heterozygous chromosome 17p13.3 microdeletion leading to Miller-Dieker lissencephaly syndrome (MDLS). PIDD1-mutant organoids and MDLS organoids recapitulated the thickened cortex typical of human lissencephaly and demonstrated dysregulation of protein translation, metabolism and the mTOR pathway. A brain-selective activator of mTOR complex 1 prevented and reversed cellular and molecular defects in the lissencephaly organoids. Our findings show that a converging molecular mechanism contributes to two genetically distinct lissencephaly spectrum disorders., Competing Interests: Competing interests: N.S. is a co-founder and shareholder of Bexorg, Inc. All the other authors declare no competing interests., (© 2025. The Author(s).)

Although complementary feeding (CF) and maternal attitudes towards infant feeding are known to affect the nutritional status of infants during the neonatal period, studies in this field remain limited. The present study aimed to determine CF practices for infants aged 6-12 months who live in Turkey and maternal attitudes towards infant feeding. In addition, the effects of CF practices and maternal attitudes on the nutritional status of infants were examined. This study included 720 infants, of whom 289 were aged 6-8 months and 431 were aged 9-12 months. CF status was assessed using the CF index (CFI), and maternal attitudes towards infant feeding were measured using the Iowa infant feeding attitude scale (IIFAS). The weight and length measurements of infants were categorized using z-scores. Infants with weight-for-age z-score (WAZ) and weight-for-length z-score (WLZ) of less than -2 standard deviation were categorized as malnourished. Mothers of malnourished infants were found to have lower CFI and IIFAS scores (p < 0.05). Consistency of fruit feeding and complementary foods in the first 3 days of CF was associated with WAZ. The mothers' level of knowledge about CF and appropriate CF practices significantly affects the nutritional status of infants. The tools used in the present study to monitor CF practices should be incorporated into public health programmes., (© 2024 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Innovative technology and methods are crucial for making pure and refreshing water. Two main methods are present to delete soluble salts from water: membrane processes and thermal processes. A beneficial membrane technique is reverse electrodialysis. This research used molecular dynamics (MD) simulation to investigate how channel roughness affected particle diffusion and permeability in carbon nanotubes (CNTs) via the reverse electrodialysis process. The results indicate that adding roughness in the CNT duct increased the force between the primary fluid and the duct. Using an armchair-edged CNT structure maximized the electric current in the sample. Furthermore, the roughness increased the intensity of force in the channel, which was due to gravity, leading to a decrease in the mobility of fluid particles. Additionally, several broken hydrogen bonds inside the simulation box increased from 116 to 128 in the duct sample with roughness., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Advancements in materials science, synthetic biology, and nanomaterial engineering are revolutionizing renewable energy technologies, creating new pathways for sustainable energy production. Biohybrid devices-systems combining biological components with engineered synthetic materials-are emerging as powerful platforms for harnessing solar energy to drive hydrogen production, photovoltaics, catalysis, and biosensing. This collection of articles presents leading-edge research in biohybrid energy systems, where photosynthetic mechanisms are redeployed to develop eco-friendly, high-efficiency alternatives to conventional solar technologies. Central to these biohybrid designs are diverse organisms, from cyanobacteria and algae to purple bacteria and archaea, enabling researchers to employ a broad range of bioengineered proteins and photosynthetic complexes. By integrating advances in synthetic biology with precision nanomaterial fabrication, scientists can improve protein functionality and device stability at the nanoscale, optimizing these systems for light absorption, energy conversion, and resilience. This convergence allows exploring unique photoactive pigments, including type I and type II reaction centers, specialized light-harvesting and retinal-binding proteins. Through protein engineering and careful selection of photoactive components, biohybrid devices offer promising solutions for sustainable energy applications, positioning photosynthetic organisms as critical contributors to innovative energy technology., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The omission of axillary lymph node dissection (ALND) remains controversial for patients with residual axillary disease after neoadjuvant chemotherapy (NAC), regardless of the residual burden. This study evaluated the oncologic safety and factors associated with outcomes in patients with residual axillary disease. These patients were treated solely with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD), without ALND, after NAC., Methods: A joint analysis of two different multicenter cohorts-the retrospective cohort registry MF18-02 and the prospective observational cohort registry MF18-03 (NCT04250129)-was conducted between January 2004 and August 2022. All patients received regional nodal irradiation., Results: Five hundred and one patients with cT1-4, N1-3M0 disease who achieved a complete clinical response to NAC underwent either SLNB alone (n = 353) or TAD alone (n = 148). At a median follow-up of 42 months, axillary and locoregional recurrence rates were 0.4% (n = 2) and 0.8% (n = 4). No significant difference was found in disease-free survival (DFS) and disease-specific survival (DSS) rates between patients undergoing TAD alone versus SLNB alone, those with breast positive versus negative pathologic complete response, SLN methodology, total metastatic LN of one versus ≥2, or metastasis types as isolated tumor cells with micrometastases versus macrometastases. In the multivariate analysis, patients with nonluminal pathology were more likely to have a worse DFS and DSS, respectively, without an increased axillary recurrence., Conclusions: The omission of ALND can be safely considered for patients who achieve a complete clinical response after NAC, even if residual disease is detected by pathologic examination. Provided that adjuvant radiotherapy is administered, neither the SLNB method nor the number of excised LNs significantly affects oncologic outcomes., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA., Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process., Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit., Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines., Competing Interests: The authors have nothing to disclose., (Copyright © 2025 Korean Society for Sexual Medicine and Andrology.)

Biohybrid devices that generate an electrical signal under the influence of light due to photochemical reactions in photosynthetic pigment-protein complexes have many prospects. On the one hand, the oxygen-evolving complex of photosystem II allows the use of ubiquitous water as a source of electrons for photoinduced electron transfer in such devices; on the other hand, it is the most vulnerable part of the photosynthetic apparatus. From the perspective of sustainable operation of bio-based hybrid devices, it is helpful to analyze how removing or modifying the Mn cluster will affect the performance of the bio-hybrid device. This work analyzed photocurrent generation in a liquid three-electrode solar cell based on manganese-depleted and reactivated thylakoid membranes. Membranes lacking Mn could not produce any significant photocurrent until manganese chloride was added. After adding MnCl 2 , the cell could produce current when exposed to light. This current was about a few percent from cells with intact thylakoid membranes. However, the photoactivation procedure made it possible to restore up to 75 % of the photocurrent of cells based on intact thylakoid membranes. The main objective of this work is to answer the question about the possibility of photocurrent generation in a biohybrid system based on thylakoid membranes using artificial analogs of the native oxygen-evolving complex. Photoactivation with manganese chloride is the simplest way to obtain preparations devoid of the native Mn cluster, but capable of oxidizing water., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Suleyman I. Allakhverdiev reports financial support was provided by Russian Science Foundation. Barry D. Bruce reports a relationship with National Science Foundation that includes: funding grants. Barry D. Bruce, Special Guest Editor, Applied Photosynthesis BBA- Bioenergetics Suleyman I. Allakhverdieve, Special Guest Editor, Applied Photosynthesis BBA- Bioenergetics If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Nutritional profiles and guidelines are determined by various associations to ensure optimum health of cats and provide pet food manufacturers nutritional recommendations to ensure the well-balanced and nutritionally adequate pet food., Objectives: It was aimed to determine some trace elements and macro minerals in prescription and non-prescription dry cat foods and compare the contents with the suggested guidelines to evaluate the potential in-compliance., Methods: A total of 96 dry cat foods were evaluated. Cu, Fe, Mn, Se, Zn, Mg, Ca and P concentrations were analysed in prescription dry cat foods developed for gastrointestinal diseases-GI (n = 18), renal diseases-R (n = 15), urinary diseases-U (n = 8), obesity-O (n = 10) and non-prescription-N-P (n = 45) foods from different flavours and brands by ICP-OES., Results: Ten precent of the O group exceeded the upper limit, and 15.5% of the N-P group failed to provide a nutritional minimum level. 4.44% of prescription foods were below the minimum recommended Mn level according to the European Pet Food Industry Federation (FEDIAF), and 66% of N-P foods were below the minimum adult maintenance value recommended by the Association of American Feed Control Officials (AAFCO). One hundred percent non-compliance with the guidelines in the GI and U groups was recorded. 22.2% of the GI group was lower, and 5.55% of the GI group was higher than the recommended levels by FEDIAF, which reflects the 27.7% in compliance. While all the prescription foods have 100% compliance with the determined minimum level of guidelines, 11.1% of N-P foods were below the minimum recommended level. In compliance with the guidelines for Ca was noted in the O and U groups (10% and 12.5%, respectively). The P ratio in all prescription food groups except for GI was below the minimum level determined by AAFCO., Conclusions: In all food groups, mean Cu, Fe, Mn, Mg, Ca and P concentrations were between the minimum and maximum limits recommended by FEDIAF. However, the mean Se level was above the upper legal limit in all food groups, and the Zn level was below the minimum recommended level in the N-P food group. Besides the mean values, a high number of foods in each group show a broad in-compliance with the guidelines., (© 2024 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

This study considers Timoshenko beam theory and the isogeometric analysis method to investigate the free vibration and buckling of axially functionally graded (AFG) tapered beams. The governing equations are obtained from the kinematic assumptions of Timoshenko beam theory and Hamilton's principle. The isogeometric analysis approach is implemented to solve the motion equations. One-dimensional B-spline basis functions are used to estimate the displacement field, describe the geometry, and illustrate the deformed shapes of the beam. Due to suffering the isogeometric approach from the shear locking phenomenon, the selectively reduced integration is applied. It is shown that this method can mitigate the effect of shear locking. In this attempt, the effect of material non-homogeneity parameters, mass density, Young's modulus, and taper ratio on the critical buckling loads and natural frequencies are considered for various boundary conditions. Several numerical examples show the accuracy and reliability of this method. The obtained results are in accord with the ones in the related articles and can be adopted as future reference solutions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Malnutrition is a critical clinical condition that requires early intervention due to its potential for causing preventable fatalities and complications. This study aims to assess the impact of outpatient enteral nutrition support (ENS) as a therapeutic intervention on anthropometric measurements, intolerance, and micronutrient values in malnourished children., Methods: This observational study included 344 patients in ages 1 to 18 treated with standard enteral nutrition (1.5 kcal/mL energy with fiber). Patient data recorded at admission, in 3 and 6 months, including weight, height, body mass index (BMI), intolerance symptoms, and micronutrient levels. Data were also compared by age groups (1-2, 3-5, 6-12, and 13-18 years of age)., Results: Malnutrition was prevalent in the 1- to 5-year age group (63.6%). Age-based analysis showed significant height and BMI z-score improvement in all age groups ( P = .009 and P < .001, for all age groups, respectively), except the 13- to 18-year age group ( P = .102 and P = .091, respectively). Micronutrient values remained within healthy ranges with minimal fluctuations. The ENS was well tolerated by 62.5% of patients, and the most common intolerance symptoms were constipation (15.4%), vomiting (8.1%), and nausea (7.3%)., Conclusion: This study demonstrates that outpatient ENS therapy for 6 months significantly improved anthropometric measurements in malnourished children and was well tolerated. The 1 to 2 age group exhibited the most substantial response to treatment, whereas the 1 to 5 age group required at least 6 months of nutritional therapy to prevent stunting. However, the effect of ENS therapy on height and BMI z-scores in the 13 to 18 age group appeared insufficient after 3 months., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: This study aims to compare the clinical outcomes of patients treated for complex anal fistulas using standard laser fistula closure (FiLaC) versus FiLaC combined with an advancement flap (+FLAP)., Methods: A retrospective review was conducted on patients treated for complex anal fistulas between January 2022 and December 2023. Treatments included standard FiLaC and FiLaC combined with an advancement flap. Main outcome measures included operation duration, hospital stay, postoperative pain [Visual Analog Scale (VAS) score], complications, and success rate., Results: A total of 47 patients were included in the study, with 25 in the standard FiLaC group and 22 in the +FLAP group. The +FLAP group had significantly longer operation times (29.7 ± 4.7 min versus 18.7 ± 4.0 min, p < 0.001) and hospital stays (16.2 ± 5.04 h versus 3.9 ± 2.3 h p < 0.001). Postoperative pain scores were similar between groups. The mean follow-up periods for the FILAC and +FLAP groups were 10.5 ± 3.5 months and 8.4 ± 4.0 months, respectively. The success rate was significantly higher in the +FLAP group (95.5% versus 72%, p = 0.03)., Conclusion: In this study, we found that, compared with FiLAC alone, combining FiLaC with an advancement flap may significantly improve primary success rates in the treatment of complex anal fistulas, and we believe this approach could be a valuable option for enhancing treatment outcomes in complex cases. The increased operation and hospital stay durations appear to be balanced by the higher success rates., Competing Interests: Declarations. Conflict of interest: The authors declare that they did not receive any financial and non-financial interest. Ethical approval: Institutional ethics committee approved the study design (108–24). Since the study was retrospective, no additional intervention was performed other than routine patient care. Human ethics and consent to participate declaration: Not applicable., (© 2024. Springer Nature Switzerland AG.)

Purpose: This systematic review and meta-analysis aimed to systematically evaluate and enhance the understanding of optimal management strategies for serpentine aneurysms., Methods: A systematic search was conducted in Medline, Scopus, and Cochrane databases up to July 8, 2024, using relevant keywords. Studies included were case series, prospective or retrospective cohorts, or randomized controlled trials with data on clinical and angiographic outcomes of intracranial serpentine aneurysms. Data extraction and quality assessment were performed independently by two authors. Statistical analysis was conducted using R, with pooled estimates under a random-effects model., Results: Ten studies comprising 70 patients with 71 serpentine aneurysms were included. The majority (92.9%) were giant aneurysms. The overall rate of procedure-related complications was 33%, morbidity was 13%, and mortality was 13%. Good neurological outcomes were achieved in 76% of cases. For unruptured aneurysms, the complication rate was 34%, while no complications were observed in ruptured aneurysms. Comparative analysis between ruptured and unruptured aneurysms showed no significant differences in outcomes or complications. The technical success rate was 91%. Reconstructive methods showed a slightly higher rate of good neurological outcomes (77%) compared to deconstructive methods (70%), though complication rates were similar., Conclusion: Both reconstructive and deconstructive endovascular treatments for serpentine aneurysms are effective, with high rates of good neurological outcomes and acceptable complication rates., Competing Interests: Conflict of interest C. Cinar, A. Elek, I. Allahverdiyev, K.K. Ozcinar, A.C. Yazici, M. Kusbeci, E. Ozturk and I. Oran declare that they have no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Each year, millions face natural disasters, encountering mass fatalities and severe medical issues such as crush injuries and crush syndrome. Crush syndrome, marked by acute kidney injury (AKI) and hyperkalemia, correlates with mortality. This study focuses on presenting epidemiological data on kidney disease resulting from the February 6, 2023 earthquakes centered in Kahramanmaras., Methods: This retrospective analysis included patients diagnosed with crush syndrome after the 2023 Kahramanmaras earthquakes, treated in regional hospitals or referred elsewhere in Turkey. Patient data were documented using the web-based system developed by the Turkish Nephrology Association Renal Disaster Working Group., Results: Of the 1024 analyzed patients from 46 centers, 515 (50.3%) were women. The mean age was 41 ± 16 years, with a median duration of 12 h under rubble, and the median presentation time to the first health facility was 4 h after extrication from the rubble. Upon admission, 79.8% received intravenous fluid therapy, all potassium-free. Initial serum creatinine, K + , and creatinine kinase levels averaged 2.59 ± 2 mg/dl, 5.1 ± 1 mmol/L 38,305 ± 54,303 U/L, respectively. Intensive care unit (ICU) admissions were 53.6%, with mean hospital and ICU stays of 20 and 11 days, respectively. Compartment syndrome occurred in 40.8% of patients, with 75.8% undergoing fasciotomy. Acute kidney injury developed in 67.9% of patients, with 70.3% undergoing hemodialysis, totaling 3016 sessions on 488 patients. The overall in-hospital mortality rate was 9.8%., Conclusion: Earthquakes have a significant impact on kidney health. Although our study indicates some progress compared to previous earthquake responses, there remains a crucial need for drills emphasizing post-earthquake initial response, fluid-electrolyte balance management, and emergency dialysis protocols., Competing Interests: Declarations. Conflict of interest: The authors declare no conflict of interest. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed and approved by Istanbul University Istanbul Faculty of Medicine Clinical Research Ethics Committee (Decision date/no: 17.02.2023/04). Human and animal rights: This study does not contain any studies with animals performed by any of the authors. Informed consent: For this type of study, formal consent is not required., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)

Objective: We aimed to investigate whether the Pan-Immune-Inflammation-Value/Hemoglobin (PIV/Hb) index could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal cancer (LA-NPC)., Materials and Methods: This retrospective analysis included LA-NPC patients who underwent CCRT and pre-CCRT oral exams at our institution's Departments of Radiation Oncology and Dentistry between January 2010 and December 2022. The relationship between ORN rates and PIV-Hb levels was explored using receiver operating characteristic curve analysis. The primary objective was to establish a correlation between pre-CCRT PIV-Hb levels and ORN rates, while the secondary objective was to identify other risk factors for ORN., Results: Of 249 eligible patients, 21 (8.4 %) were diagnosed with ORN. The optimal pre-CCRT PIV/Hb cutoff was 73.8, which divided patients into two subgroups with distinctive ORN risk estimates: Group 1: PIV/Hb < 73.8 (N = 206), and Group 2: PIV/Hb ≥ 73.8 (N = 43). The results of the comparative analysis indicated that the cohort with PIV/Hb ≥ 73.8 exhibited substantially higher rates of ORN than the PIV/Hb < 73.8 cohort (44.2 % vs. 1.0 %; P < 0.001). The multivariate logistic regression analysis indicated that the pretreatment PIV/Hb ≥ 73.8 was independently associated with higher ORN rates (P < 0.001)., Conclusion: The results of our current investigation indicate that higher levels of pretreatment PIV/Hb were associated with a significant independent increase in ORN rates in LA-NPC patients who received CCRT., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Widespread adoption for substitutes of artificial bone grafts based on proper bioceramics has been generated in recent years. Among them, calcium-silicate-based bioceramics, which possess osteoconductive properties and can directly attach to biological organs, have attracted substantial attention for broad ranges of applications in bone tissue engineering. Approaches exist for a novel strategy to promote the drawbacks of bioceramics such as the incorporation of Zn 2+ , Mg 2+ , and Zr 4+ ions into calcium-silicate networks, and the improvement of their physical, mechanical, and biological properties. Recently, hardystonite (Ca 2 ZnSi 2 O 7 ) bioceramics, as one of the most proper calcium-silicate-based bioceramics, has presented excellent biocompatibility, bioactivity, and interaction. Due to its physical, mechanical, and biological behaviors and ability to be shaped utilizing a variety of fabrication techniques, hardystonite possesses the potential to be applied in biomedical and tissue engineering, mainly bone tissue engineering. A notable potential exists for the newly developed bioceramics to help therapies supply clinical outputs. The promising review paper has been presented by considering major aims to summarize and discuss the most applicable studies carried out for its physical, mechanical, and biological behaviors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Current treatment approaches cannot exactly regenerate cartilage tissue. Regarding some problems encountered with cell therapy, exosomes are advantageous because of their "cell-free" nature. This study examines the relationship between IL-10 and TGF-β and Canonical Wnt/β-catenin signal pathways in human adipose tissue-derived MSCs exosomes (hAT-MSCs-Exos) after in vitro chondrogenic differentiation. Human adipose tissue-derived mesenchymal stem cells (hAT-MSCs) and, as a control group, human fetal chondroblast cells (hfCCs) were differentiated chondrogenically in vitro. Exosome isolation and characterization analyses were performed. Chondrogenic differentiation was shown by Alcian Blue and Safranin O stainings. The expression levels of IL-10, TGF-β/SMAD signaling pathway genes, and Canonical Wnt/β-catenin signaling pathway genes, which play an essential role in chondrogenesis, were analyzed by RT-qPCR. Conditioned media cytokine levels were measured by using the TGF-β and IL-10 ELISA kits. IL-10 expression was upregulated in both chondrogenic differentiated hAT-MSC-Exos (dhAT-MSC-Exos) (p < 0.0001). In the TGF-β signaling pathway, TGF-β (p < 0.0001), SMAD2 (p < 0.0001), SMAD4 (p < 0.001), ACAN (p < 0.0001), SOX9 (p < 0.05) and COL1A2 (p < 0.0001) expressions were upregulated in dhAT-MSC-Exos. SMAD3 expression was upregulated in non-differentiated hAT-MSC-Exos. In the Canonical Wnt/β-catenin signaling pathway, WNT (p < 0.0001) and CTNNB1(p < 0.0001) expressions were upregulated in dhAT-MSC-Exos. AXIN (p < 0.0001) expression was upregulated in non-differentiated hAT-MSC-Exos. TGF-β and IL-10 levels were higher in dhAT-MSCs) (p < 0.0001). Related to these results, IL-10 may induce TGF-β/SMAD and Canonical Wnt/β-catenin signaling pathways in hAT-MSC exosomes obtained after chondrogenic differentiation. Therefore, using these exosomes for cartilage regeneration can lead to the development of treatment methods., Competing Interests: Compliance with Ethical Standards Conflict of interest The authors declare that they have no conflict of interest. Consent for Publication All the authors approved the publication., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Special low protein foods (SLPF) that are phenylalanine (Phe)-free or have a low Phe content are an integral part of PKU diet therapy. Aim: The aim of this study is to determine the nutritional profiles of SLPFs used in Turkey and to compare their contents with equivalent products in the "regular" category, in order to evaluate nutritional and metabolic risks. Methods: Between February and March 2022, the information concerning the nutritional contents of "special low protein products" recommended for PKU and available in Turkey were obtained from the websites of producers/suppliers. Results: A total of 148 SLPFs were identified in Turkey. Compared to regular products, SLPFs were determined to contain less sugar and high carbohydrate content in the Turkish market (p < 0.001). Overall, SLPF products had higher dietary fiber compared to products with regular protein content (p < 0.001). In SLPF subgroups, meat substitutes, rice and pasta, and soup products had significantly less total fat than regular products; low protein bread, sweet snacks, and salted crackers were found to contain less saturated fat (p < 0.05). Moreover, all SLPFs contained significantly more salt than regular products, especially the salt content of subgroups of low protein bread, flour, pasta, and rice was significantly higher than regular products (p < 0.05). Conclusion: Including detailed nutritional information on the Turkish SLPFs' food labels will be effective for patients with PKU to follow themselves on their own., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The relationship between diet, inflammation and mental health has been receiving increasing interest. However, limited data are available on the inflammatory role of diet in university students, among whom depression is commonly observed. Aim: The aim of our study is to investigate the relationship between dietary inflammatory index (DII) and depression among female students of nutrition and dietetics department, whom we assume to be conscious about health. Methods: DII scores were determined by averaging the 3-day dietary records. Depression status of the students was determined by using Beck Depression Inventory (BDI). Results: Our study was conducted with 122 female university students. The mean total BDI score of the students in the first tertile (more anti-inflammatory effect) was found significantly lower than those of the students in the second and third tertiles ( p  = 0.001). In addition, there were no significant difference between the depression scores of the students and their grade level ( p  = 0.114) and place of residence ( p  = 0.866). We found a positive association between DII and depressive symptoms (Model 1, B  = 0.512, %95 CI: 0.236-0.789, p  = 0.000). This relationship was also found when adjusting for age, weight, body mass index, smoking status, and presence of chronic disease (Model 2, B  = 0.496, %95 CI: 0.217-0.776, p  = 0.006; Model 3, B  = 0.493, %95 CI: 0.210-0.777, p  = 0.024. Conclusion: Supporting that the inflammatory burden of diet is associated with mental health, our findings are of significance for the development of anti-inflammatory nutritional approaches among students who are prone to depression., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: This is a structured scoping review to assess whether there is a relationship between stress-induced hyperglycemia (SIH), cytokine interactions, and mortality in trauma patients in comparison to non-diabetic normoglycemia [NDN], diabetic normoglycemia [DN], and diabetic hyperglycemia [DH]., Methods: We conducted a literature search of MEDLINE (PubMed) databases from 2000 to 2022 using a search strategy to identify observational studies. Initially, 2879 articles were retrieved. Of these, 2869 were excluded due to insufficient variables, and non-trauma focuses., Results: Nine studies on the interaction between SIH and proinflammatory cytokines were analyzed. SIH was associated with the highest mortality rate (21.3%), followed by DH (5.4%), DN (2.8%), and NDN (2.3%) ( p < 0.001). Furthermore, SIH patients exhibited an 11.28-fold higher likelihood of mortality compared to NDN patients (95% CI [9.13-13.93]; p < 0.001) and a 4.72-fold higher likelihood compared to DH patients (OR 4.72; 95% CI [3.55-6.27]; p < 0.001)., Conclusions: SIH patients had elevated IL-6 concentrations relative to NDN, DN, and DH patients. SIH is linked to higher mortality in trauma, with greater odds than NDN. However, the robustness of this association is still being determined due to statistical and clinical variability. Uncertainties about injury severity and IL-6 level similarities between SIH and DH patients require further investigation.

Background: This meta-analysis aims to evaluate and compare the clinical and angiographic outcomes of different management strategies for partially thrombosed intracranial aneurysms (PTIAs)., Methods: A systematic review was conducted using MEDLINE, Scopus, and Web of Science databases up to September 2024. Studies providing clinical and angiographic outcomes of PTIAs were included. Favorable outcomes were defined as those reported directly in the studies or, when the modified Rankin Scale (mRS) was available, as an mRS score of 0-2. Statistical analysis was conducted using R, with pooled estimates under a random-effects model., Results: Eighteen studies involving 362 patients with 363 PTIAs were analyzed. Favorable neurological outcomes were observed in 76% of patients, while 20% experienced procedure-related complications. Recurrence occurred in 36% of cases, and retreatment was required in 23%. Mortality was low at 0.8%. Subgroup analysis revealed that reconstructive approaches were associated with higher rates of favorable outcomes (72%) and lower complication rates (21%) compared with deconstructive methods (60% and 28%, respectively). Among the reconstructive techniques, flow diverter stenting showed the highest rate of favorable outcomes (82%), while simple coiling had the lowest (71%). Additionally, unruptured PTIAs had a significantly better prognosis, with 69% achieving favorable outcomes, fewer complications (22% vs 51% for ruptured), and lower mortality (0.8% vs 27%) compared with ruptured aneurysms. Among the reconstructive techniques, flow diverter stenting showed the best outcomes., Conclusion: PTIAs treated with reconstructive approaches that are unruptured, non-giant, and located in the anterior circulation show higher rates of favorable neurological outcomes with acceptable complications. However, outcomes, complications, and occlusion rates are slightly worse compared with typical non-thrombotic saccular aneurysms, indicating that these aneurysms pose a greater challenge., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

CCR5 is a class A GPCR and serves as one of the coreceptors facilitating HIV-1 entry into host cells. This receptor has vital roles in the immune system and is involved in the pathogenesis of different diseases. Various studies were conducted to understand its activation mechanism, including structural studies in which inactive and active states of the receptor were determined in complex with various binding partners. These determined structures provided opportunities to perform molecular dynamics (MD) simulations and to analyze conformational changes observed in the protein structures. The atomic-level dynamic studies allow us to explore the effects of ionizable residues on the receptor. Here, our aim was to investigate the conformational changes in CCR5 when it forms a complex with either the inhibitor maraviroc (MRV), an approved anti-HIV drug, or HIV-1 envelope protein GP120, and compare these changes to the receptor's apo form. In our simulations, we considered both ionized and protonated states of ionizable binding site residue GLU283 7.39 in CCR5 as the protonation state of this residue was considered ambiguously in previous studies. Our molecular simulations results suggested that in fact, the change in the protonation state of GLU283 7.39 caused interaction profiles to be different between CCR5 and its binding partners, GP120 or MRV. We observed that when the protonated state of GLU283 7.39 was considered in complex with the envelope protein GP120, there were substantial structural changes in CCR5, indicating that it adopts a more active-like conformation. On the other hand, CCR5 in complex with MRV always adopted an inactive conformation regardless of the protonation state. Hence, the CCR5 coreceptor displays conformational heterogeneity not only depending on its binding partner but also influenced by the protonation state of the binding site binding site residue GLU283 7.39 . This outcome is also in accordance with some studies showing that GP120 binding could activate signaling pathways. This outcome could also have significant implications for discovering novel CCR5 inhibitors as anti-HIV drugs using in silico methods such as molecular docking, as it may be necessary to consider the protonated state of GLU283 7.39 .

The impact of Bariatric Surgery (BS) on maternal and neonatal outcomes among pregnant women is not fully understood, especially in comparison to different weight categories. The primary aim of this study is to assess the factors associated to women who have undergone BS. The study also investigates the maternal and neonatal outcomes amongst this group in comparison to the three Body Mass Index (BMI) groups (women with obesity, overweight and normal weight). A 12-month population-based retrospective study was conducted using registry data from the PEARL-Peristat Study at the Women's Wellness and Research Center (WWRC) in Qatar from January 1, 2017, through December 31, 2017. Both univariate and multivariable regression analyses were employed to scrutinize risk factors and maternal and neonatal outcomes. The study included 6212 parturient women, of which 315 had a history of BS, while 5897 with no BS history. Qatari women, aged 35 and higher, with parity > 1, diabetes, and hypertension were more likely to be in the post-BS group. Women in the post-BS group were found to be more likely to have a cesarean delivery (37.5% vs. 24%, Adjusted Odds Ratio (aOR) = 1.59, CI 1.18-2.14), preterm babies (10% vs. 7%, aOR = 1.66, CI 1.06-2.59), and stillbirth (1.6% vs. 0.4%, aOR = 4.53, CI 1.33-15.50) compared to the normal weight women group. Moreover, post-BS women had a higher risk of low-birth-weight neonates than women with obesity (15% vs. 8%, aOR = 1.77, CI 1.153-2.73), overweight (15% vs. 7%, aOR = 1.63, CI 1.09-2.43), and normal weight (15% vs. 8%, aOR = 1.838, CI 1.23-2.75). Finally, women in the post-BS group were more likely to have low-birth-weight neonates amongst term babies than women with obesity and overweight. Pregnancies with post-BS should be considered a high-risk group for certain medical outcomes and should be monitored closely. These findings may guide the future clinical decisions of antenatal and postnatal follow-up for post-BS women., (© 2024. The Author(s).)

Background: The systemic immune-inflammation index (SII) is an effective tool for predicting the prognosis of patients with cancer. However, its value in patients with locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) undergoing definitive chemoradiotherapy has yet to be addressed. Therefore, we aimed to retrospectively investigate the prognostic significance of the pretreatment SII on the survival outcomes of patients with unresectable LA-PDAC treated with concurrent chemoradiotherapy (C-CRT)., Methods: The study included 163 patients with LA-PDAC who had received C-CRT. Using receiver operating characteristic (ROC) curve analysis, the utility of a pre-C-CRT cutoff that could stratify survival results was investigated. The primary and secondary endpoints were the correlations between SII levels and overall survival (OS) and progression-free survival (PFS)., Results: At a median follow-up period of 15 months (range: 3.2-94.5), the median OS and PFS rates for the entire group were 15.7 months (95% confidence interval [CI]: 13.4-17.9), and 7.8 months (95% CI: 6.1-9.4), respectively. We divided the patients into 2 SII cohorts based on the ROC curve analysis (area under the curve [AUC]: 71.9%; sensitivity: 68.9%; specificity: 66.7%): SII < 538 (N = 70) and SII ⩾ 538 (N = 93). Comparative survival analysis showed significantly inferior median OS (13.0 vs 25.4 months; P  < .001) and PFS (7.0 vs 15.2 months; P  = .003) in patients with SII ⩾ 538 compared with those with SII < 538 before treatment. In multivariate analyses, the Eastern Cooperative Oncology Group (ECOG) performance of 2, N1-2 lymph node, CA 19-9 > 90 U/mL, and SII ⩾ 538 status emerged as independent prognosticators of inferior OS and PFS., Conclusions: Present results indicate that patients with unresectable LA-PDAC who underwent C-CRT and had a pretreatment SII ⩾ 538 had significantly worse OS and PFS outcomes compared with those with lower SII values., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: The efficacy of various supervision methods for stabilization exercises in patients with chronic low back pain (CLBP) remains uncertain., Objective: To evaluate the impact of supervised and unsupervised stabilization exercises in patients with CLBP., Methods: Sixty-six participants were assigned to the in-person-supervised, tele-supervised, or unsupervised groups. All participants received a 20-30-minute exercise program three times a week for 4 weeks. We assessed functionality (Oswestry Disability Index), pain intensity (Numeric Rating Scale), and kinesiophobia (Tampa Scale of Kinesiophobia) before and after the 4 weeks. The outcomes were analyzed using effect size, minimum clinically important difference (MCID), minimal detectable change (MDC), Wilcoxon test, and post hoc analyses., Results: While the unsupervised group improved in all measures ( p  < .05) both the tele-supervised ( p  = .001) and in-person-supervised ( p  < .001) groups achieved superior functionality exceeding MDC. The in-person-supervised group demonstrated greater functionality ( p  < .001) than the tele-supervised group, exceeding MCID. Pain intensity decreased in the tele-supervised ( p  = .011) and in-person-supervised groups ( p  < .001) compared to the unsupervised group, exceeding MCID and MDC. No significant difference was found in post-treatment NRS score changes between the supervised groups ( p  = .071). The in-person-supervised group displayed a greater reduction in kinesiophobia than the tele-supervised ( p  < .001) and unsupervised groups ( p  < .001) but not exceeding MCID or MDC. Effect sizes were large within and between groups except for a small effect size between the tele-supervised and unsupervised groups in kinesiophobia., Conclusion: While tele-supervised stabilization exercises alleviate pain and enhance functionality, in-person-supervised exercises may be more effective in improving functionality and reducing kinesiophobia in patients with CLBP.

Aluminum nanosheets are a form of Al nanoparticle that have been recently manufactured on an industrial scale and have a variety of uses. Al nanoparticles are extensively used in a variety of sectors, including aerospace, construction, medical, chemistry, and marine industries. Crack propagation in various constructions must be investigated thoroughly for structural design purposes. Cracks in nanoparticles may occur during the production of nanosheets (NSs) or when different mechanical or thermal pressures were applied. In this work, the effect of a continuous electric field on the fracture formation process of aluminum nanosheets was investigated. For this study, molecular dynamics simulation and LAMMPS software were used. The effects of various electric fields on several parameters, including as stress, velocity (Velo), and fracture length, were explored, and numerical data were retrieved using software. The results show that the amplitude of the electric field parameter affected the atomic development of modeled Al nanosheets throughout the fracture operation. This effect resulted in atomic resonance (amplitude) fluctuations, which affected the mean interatomic forces and led the temporal evolution of atoms to converge to certain specified initial conditions. The crack length in our modeled samples ranged from 22.88 to 32.63 Å, depending on the electric field parameter (0.1-1 V/Å). Finally, it was determined that the crack growth of modeled Al nanosheets may be controlled using CEF parameters in real-world situations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Neutrophil response is critical in inflammatory regulation and immune response to bacterial infections. During periodontal disease, pathogenic bacteria lead to exaggerated neutrophil responses. We hypothesized that low-level laser application (LLLT), therapeutic strategy for dampening inflammatory processes, will regulate neutrophil activity in response to periodontopathogens., Materials and Methods: The impact of LLLT on neutrophil responses was measured by light delivered at wavelength of 850 nm. The direct effect of LLLT on P. gingivalis A7436 was determined by flow cytometry using LIVE/DEADTM Cell Vitality kit. The phagocytosis of P. gingivalis A7436 by human neutrophils was measured using flow cytometry. Superoxide generation was measured by cytochrome-C-reduction in the presence of N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP; 1 mM). Cytokine release by neutrophils was measured by multiplex immunoassay., Results: The phagocytosis of P. gingivalis by primary human neutrophils was significantly reduced in response to LLLT (p < 0.05). While LLLT led to increased superoxide production in neutrophils that were not challenged by P. gingivalis, it dampened the increased superoxide and IL-6 release by the neutrophils in response to P. gingivalis. LLLT did not directly affect the viability of P. gingivalis., Conclusion: These results suggested that LLLT can provide therapeutic strategy in periodontal disease, regulating the neutrophil response to P. gingivalis., (© 2024 Wiley Periodicals LLC.)

Understanding the mechanical properties of porous carbon-based materials can lead to advancements in various applications, including energy storage, filtration, and lightweight structural components. Also, investigating how silicon doping affects these materials can help optimize their mechanical properties, potentially improving strength, durability, and other performance metrics. This research investigated the effects of atomic doping (Si particle up to 10 %) on the mechanical properties of the porous carbon matrix using molecular dynamics methods. Young's modulus, ultimate strength, radial distribution function, interaction energy, mean square displacement and potential energy of designed samples were reported. MD outputs predict the Si doping process improved the mechanical performance of porous structures. Numerically, Young's modulus of the C-based porous matrix increased from 234.33 GPa to 363.82 GPa by 5 % Si inserted into a pristine porous sample. Also, the ultimate strength increases from 48.54 to 115.93 GPa with increasing Si doping from 1 % to 5 %. Silicon doping enhances the bonding strength and reduces defects in the carbon matrix, leading to improved stiffness and load-bearing capacity. This results in significant increases in mechanical performance. However, excess Si may disrupt the optimal bonding network, leading to weaker connections within the matrix. Also, considering the negative value of potential energy in different doping percentages, it can be concluded that the amount of doping added up to 10 % does not disturb the initial structure and stability of the system, and the structure still has structural stability. So, we expected our introduced atomic samples to be used in actual applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)