Durağan Durum Görsel Uyaran Potansiyellerinden Fourier Dönüşümü ile Üç Farklı Frekansın Kestirimi

Durağan durum görsel uyarılmış potansiyeller (DDGUP), diğer beyin bilgisayar ara yüzü (BBA) tekniklerine oranla oldukça yüksek sinyal-gürültü oranları ve bilgi aktarım hızına sahip oldukları için EEG çalışmalarında sıkça kullanılır. Ayrıca durağan durum paradigmaları, dinamik neokorteks süreçlerinde tercih edilen frekansları karakterize etmek için de kullanılır. Kısa eğitim süresine sahip olan DDGUP’lar, pratik uygulamalarda önemli bir rol oynar. Sinyalleri komuta dönüştürmekte kullanılan, sinyal işleme algoritmaları, BBA sistemlerinin performansını arttırmak için kilit öneme sahiptir. Buna ek olarak, DDGUP sinyallerinin birbirinden farklı yöntemlerle sınıflandırılmasını araştıran çok az çalışma vardır. Bu çalışmada, internetten açık erişim ile alınan veri seti (AVI SSVEP Dataset) üzerinde analizler yapılmıştır. Veri setindeki EEG kayıtları, katılımcılar, rengi siyahtan beyaza hızla değişen yedi farklı frekansta yanıp sönen bir kutuya baktıkları durumda kaydedilmiştir. Oksipital bölgeden kaydedilen DDGUP sinyalleri ilk olarak Hızlı Fourier Dönüşümü uygulanarak, sinyal alt bantlarına (delta, teta, alfa, beta ve gama) ayrılmıştır. Alt bantların her biri için enerji ve varyans öznitelik vektörleri çıkarılmıştır. Öznitelikler altı temel sınıflandırıcı (LDA, k-NN, SVM, Naive Bayes, Topluluk Öğrenmesi, Karar Ağacı) ile sınıflandırılmıştır. Sınıflandırma performansları birbirleri ile karşılaştırılmıştır. Sınıflandırma 5-kat çapraz doğrulama modeli ve hata matrisinden doğruluk değerleri çıkarılarak analiz edilmiştir. Katılımcılar ayrı ayrı göz önüne alındığında %100’e varan sınıflandırma başarımı SVM ve k-NN sınıflandırıcılarında elde edilirken, ortalamalara göre en yüksek başarım Topluluk Öğrenmesi sınıflandırıcısında %79,73 olarak elde edilmiştir

Factors threating food security and solutions

Sürekli artış gösteren dünya nüfusu, bugün 7 milyarı geçmiştir. Artan nüfusla beraber, insanların tüketim maddelerine olan talep miktarları da artış göstermektedir. Bu tüketim maddelerinin başında ise, gıda ürünleri gelmektedir. Tarım, insanların yaşamlarını devam ettirebilmeleri için gerekli olan gıda ürünlerini üreten bir sektör olduğundan büyük önem derecesine sahiptir ve gıda güvencesinin sürdürebilirliğini sağlaması gerekmektedir. Gıda güvencesi, Dünya Gıda ve Tarım Teşkilatı tarafından, insanların yaşamlarını sürdürebilmeleri için gerekli olan gıdayı, zamanında ve yeterli miktarda bulup, satın alabilmeleri olarak ifade edilmektedir. Toplumlar, ekonomik etmenler, doğada meydana gelen değişimler, sosyal ve politik bazı etmenler ile gıda güvencesini sağlamada sorunlar yaşamaya başlamışlardır. Son yıllarda hızla değişen iklimin beraberinde getirdiği kuraklık, kullanılabilir suyun azalması, kaynakların aşırı ve hor kullanımı, tarım arazilerinin bilinçsiz kullanımı ile verimsizleşmesi, üretim maliyetlerinin artması ile ürün fiyatlarında meydana gelen artışlar, düşük gelir seviyesi, işsizlik, yetersiz ve kontrolsüz tarımsal destekler gibi birçok faktör toplumları gıda güvencesi sorunu ile karşı karşıya getirmektedir. Bu çalışmada, daha önce konu ile ilgili yapılmış olan çalışmalar ve istatistikler incelenerek, gıda güvencesi ve gıda güvencesi sorununu doğuran etmenler belirtilmiş, gıda güvencesini sağlayabilmek için gerekli yollar tespit edilmeye çalışılmıştır.A world population with constant increase has passed 7 billion today. With increasing population, amount of demand for consumer goods of people has increased. At the beginning of this consumer goods, food products come.Agriculture has great significance, because it is a sector that produces food products people need to survive and required to provide assurance of sustainability of food security. Food security is expressed by the World Food and Agriculture Organization that people finds a sufficient amount of food and buys in time. Community begin to experience problems for ensuring food security factors because of economic factors,changes occuring in nature. Drought brought about by the rapidly changing climate in recent years, the available water depletion, excessive and contempt use of resources, and the irresponsible use of agricultural land and finally infertilation, increases occurred in the price of the product with the increase of production costs, low income, unemployment, many factors such as inadequate and uncontrolled agricultural support are the problems of food security community has been faced. In this study,it has been indicated food security and sources of problems for food security by examining studies conducted before and statistics

Reappraisal of properties soils encountered in the Golden Horn

Haliç üstünde inşa edilen ve edilmekte olan Haliç Köprüsü, Yeni Galata Köprüsü, Haliç Metro Geçiş Köprüsü sondajlarından ve yapım sırasında elde edilen bilgiler, bu bölgedeki zeminlerin özellikleri hakkında ayrıntılı bilgiler elde edilmesini sağlamaktadır. Membadan mansaba doğru bu köprüler Haliç Köprüsü, Haliç Metro Geçiş Köprüsü, Yeni Galata Köprüsü olarak sıralanmaktadır. Yeni Galata Köprüsü kazıklarının girdiği çakıl tabakası, yaklaşık 80 m derinliktedir. Haliç Metro Metro Geçiş Köprüsü ekseninde kaya tabakasının derinliği, Azapkapı tarafında 55 metreden, Unkapanı tarafında 80 metreye alçalmaktadır. Yeni Galata Köprüsü kazıklarının oturduğu çakıl tabakası, Haliç Metro Geçiş Köprüsü yerindeki kaya tabakasına göre yatay olarak kabul edilebilir. Buna karşılık, Haliç Metro Geçiş Köprüsü’nün Unkapanı tarafında taban kayasında derin bir çukur bulunmaktadır. Böyle bir çukurun varlığı, Haliç’te kaya yüzeyinin enine ve boyuna doğrultudaki genel eğimlerine uymayan bir durum oluşturmaktadır. Kaya tabakaları çok yumuşak, kalın kil/silt tabakaları ile örtülüdür. Kıyılarda kalın şehir dolgusu bulunmaktadır. Yumuşak tabakaların üst yüzü hemen hemen yataydır ve bu durum zeminin yüksek su muhtevasını yansıtmaktadır. Likit limit kıvamında tabakalar, bir çanak şeklindeki taban kayasını doldurmaktadır. Haliç’in büyük ekseni boyunca kaya tabakasının derinliği, Haliç’in ağız kısmına doğru büyük bir eğimle alçalmakta ve 80 m kadar derinliğe ulaşmaktadır. Anahtar Kelimeler: Haliç (Golden Horn), yumuşak killi zeminler, çatlaklı ayrışmış kayalar.The Golden Horn is a seven and half kilometres long natural inlet of Boğaziçi Strait. It has a maximum width of about 700 m near its entrance. At its deepest part its  depth is 40 m. The Golden Horn divides historical part of the city from the rest. The geology of the Istanbul area has been studied by many investigators. Penck was first to recognize the shales and graywackes as the oldest of the formations encountered in the area. He named them as the Thrace series. Subsequent investigations indicated the existence of various lithological and paleontological zones in Thrace series, and it is concluded that they belonged to the Early Carboniferous Period of the same era. Over centuries, the detritus brought by Alibey, Kâğıthane, and other creeks, heavy industrial and domestic wastes, and uncontrolled fills have changed drastically almost the entire cross section of the Golden Horn. Along the shores, many valleys have been levelled off by generally uncontrolled fills, and comparatively large areas have been reclaimed.The thickness of the man-made fill is over 40 m along the south shore and over 30 m along the north shore on the axis of the New Galata Bridge. The thickness of the fill decreases with increasing distance from the shore. Man-made fill is underlain by sedimentary deposits consisting of sand, silt and clay in varying proportions. In general it is described as grey-dark organic silty clay of marine origin. On the Eminönü (South) site of the New Galata Bridge, the soft layers are underlain by a few meters thick weathered shale. Over the deeper part of the waterway and towards the Karaköy side soft layers is underlain by cobbly gravel. The design of new bridges over the Golden Horn was subject to severe constraints. The New Galata Bridge is founded on large diameter tubular steel piles. Piles were driven into limestone, diabase and sandstone origined gravel which is encountered between the depths of 76 m and 88 m. Most of the piles of the New Galata Bridge were driven into the shuttered rock bottom. The adoption of a closed end pile having a diameter as large as 2000 mm is well suited to the soil conditions and the design requirements – the damage of the pile tip is prevented, settlement criteria are satisfied. The piles of the New Galata Bridge were designed to carry high working loads (up to 12 000 kN) in end bearing and to comply with severe restrictions on allowable settlement.  A box girder  bridge carried on temporary  supports was constructed over the test pile and was loaded by ingots. Four hydraulic jacks were placed on the head of the test pile to obtain a total reaction of 2000 tonnes. The composite piles of the Metro Crossing Bridge extended to depths over 100 m. They were designed to carry even higher loads (up to 47 000 kN). Osterberg type of loading tests was made on Metro Crossing Bridge. In general dynamic measurements are not considered as a reliable substitute to static pile loading test. On the Metro Crossing Bridge site, dynamic analysis (PDA) is carried out and dynamic response during pile driving is also recorded. Results are found consistent with  the exploration data. Depth of water on the axis of Metro Crossing Bridge is about 34 m. Soil profile is overlain by very soft, almost at liquid consistency, silt clay layer. The thickness of clay layer varied between 30 m and 50 m. Very soft silty clay layer is underlain by sandstone, siltstone and mudstone layers. Depth of rock is 55 m at Azapkapı (North) and 80 m at Unkapanı (South) side of the Bridge. Sea bottom at Golden Horn Bridge site is very shallow. Depth of rock is more than 70 m and is overlain by a gravel layer. The depth of exploration at Metro Crossing Bridge site was well over 100 m. Special attention was given to ascertain the level and characteristics of a suitable stratum. Form the initial data indicated existence of weathered rocks and alternating strong and weak rock formations. Soil investigations and pile driving provided ample information about the rock bottom of the Golden Horn. Rock levels at the site of Golden Horn Bridge and at the site of New Galata Bridge are almost flat in comparison with that of the Metro Crossing Bridge. Furthermore transversal profile of the rock bottom at Metro Crossing Bridge contains a deeper section near Unkapanı (South). Existence of such depression is not confirming with the general slopes of the rock strata. Keywords: Golden Horn, soft clayey soils, soft rocks

Kızıl tilkilerde (vulpes vulpes) testis, penis ve prostat’ın arteriyel vaskülarizasyonu, makroanatomik ve histolojik yapısı

The aim of this study was to examine arterial vascularization and the macroanatomic and histological structures of the testis, penis, and prostate gland in the red fox. Five male red foxes were provided by the Wildlife Rescue and Rehabilitation Center of Kafkas University, Turkey. The arteries supplying the prostate, penis, and testes in the animals were exposed by dissection, the mean length, width, and weight of these organs were measured. After the anatomical features of the testis, penis, and prostate were assessed, tissue samples of each blocked in paraffin then handling standard histological procedures. The internal iliac artery was divided into two branches the caudal gluteal artery, which is the thicker branch and leads dorsally, and the internal pudendal artery, which is the thinner branch and leads ventrally. The testicular artery is asymmetrically separated from both sides of the abdominal aorta at the 5th lumbar vertebra, passes through the spermatic canal, and ends in the testes. It is thought that the findings of this study will contribute information to the literature on artificial insemination, castration, prostate, and urolithiasis surgeries on carnivores.Bu çalışmanın amacı kızıl tilkilerde testis, penis ve prostat’ın arteriyel vaskularizasyonu, makroanatomik ve histolojik yapısını incelemektir. Kafkas Üniversitesi Yaban Hayatı Koruma ve Kurtarma Merkezi’nden 5 adet erkek kızıl tilki temin edildi. Testis, penis ve prostat’ı besleyen arterler diseke edildi. Bu organların ortalama uzunluğu, genişliği, ağırlığı ölçüldü. Testis, penis ve prostat’ın anatomik özellikleri değerlendirildikten doku örneklerine standart histolojik prosedür uygulanarak parafinde bloklandı. İnternal iliac arter, daha kalın dorsal’e yönelen caudal gluteal arter ve daha ince ventral’e yönelen internal pudendal arter olarak ikiye ayrılıyordu. A. testicularis’ler L5 hizasında abdominal aorta’nın iki tarafından asimetrik olarak ayrılıyordu. Spermatik kanal boyunca seyredip testislerde sonlanıyordu. Sunulan çalışmanın bulgularının kızıl tilkiler ve carnivorlarda yapılacak olan suni tohumlama, kastrasyon, prostat ve ürolithiasis operasyonlarına katkıda bulunacağına inanmaktayız

Effect of Modulator Therapies on Nutritional Risk Index in Adults with Cystic Fibrosis:A Prospective Cohort Study

Background: Modulator therapies improve weight and body mass index (BMI) in cystic fibrosis (CF) patients. We aimed to compare the nutritional risk index (NRI) in adult CF patients receiving modulator (MT) or only non-modulator (conventional) therapies (non-MT). Methods: A single-center prospective cohort study was conducted between June and December 2023. The NRI based on weight gain and albumin was calculated at beginning and end of a 12-week period in both groups. This design was pragmatic, since it was based on individual patient access to MT for 12 weeks. Results: In total, 107 patients were included [mean (SD) age: 23.85 (4.98) years, 54.7% male, 46.7% MT]. In the MT group, mean (SD) weight (kg) and albumin (g/dL) increased significantly [changes: +3.09 (2.74) and +0.17 (0.37); p &lt; 0.001]. In the non-MT group, weight and albumin decreased significantly [changes: -0.99 (1.73) and -0.12 (0.30); p &lt; 0.001]. Compared to the MT group, baseline mean (SD) NRI in the non-MT group was significantly higher [100.65 (11.80) vs. 104.10 (10.10); p = 0.044]. At the end of the 12 weeks, mean (SD) NRI in the MT group was higher than in the non-MT group [104.18 (10.40) vs. 102.58 (12.39); p = 0.145]. In the MT group, the NRI category improved in 22 (44%), and worsened in 3 (6%) patients (p &lt; 0.001). In the non-MT group, the NRI category improved in 2 (3.5%), and worsened in 10 (17.5%) patients (p &lt; 0.001). Conclusions: This is the first study reporting on a positive effect of MT on NRIs, based on weight gain and albumin. Personalized nutrition and routine follow-up of adults with CF based on NRI is recommended prior to MT initiation.</p

Different features of lung involvement in Niemann-Pick disease and Gaucher disease

SummaryBackgroundNiemann-Pick disease (NPD) and Gaucher disease (GD) are well-known lysosomal storage diseases. Respiratory system involvement is an important cause of morbidity and mortality in patients with NPD and GD.ObjectivesWe tried to assess the clinical, radiological, and histological features of GD and NPD patients with lung involvement.MethodsWe reviewed medical history, physical examination, radiological, and histological data of 10 NPD and 7 GD patients.ResultsThe most common respiratory symptoms were recurrent lung infection and dyspnea. Although lung examination results in 6 NPD patients were normal, they had lung involvement; 3 patients were diagnosed as NPD directly via lung biopsy during investigation of recurrent lung infection or interstitial lung disease. All GD patients but 1 had respiratory system symptoms at the time of diagnosis. Hepatopulmonary syndrome was present in 4 GD patients. A ground-glass pattern and atelectasis were 2 important high-resolution computed tomography features in the NPD and GD patients. Flexible bronchoscopy and bronchoalveolar lavage were used for emergency extraction of bronchial casts in 1 NPD patient.ConclusionsLung involvement in NPD and GD patients should be included in the differential diagnosis of interstitial lung disease. Besides interstitial appearance on HRCT, atelectasis related to bronchial cast and bronchiectasis are other radiological findings in these group of patients. Analysis of bronchoalveolar fluid and lung biopsy provide very important clues for diagnosis. Hepatopulmonary syndrome is an important vascular complication observed in GD patients

Analysis of GJB2 (Connexin 26) Mutation in Patients with Congenital Non-Syndromic Sensorineural Hearing Loss

Objective:This study was performed to investigate the GJB2 (connexin 26) gene mutations that are the most frequent cause of sensorineural deafness in patients with congenital non-syndromic sensorineural hearing loss in our region.Methods:Sixty patients [35 males (58.3%) and 25 females (41.7%)] between the age of 2-43 years (12.11±9.03) diagnosed with congenital non-syndromic sensorineural hearing loss were included in the study. The control group consisted of 60 individuals with similar demographic features having no hearing problems. 35delG, 167delT, delE120 and 235delC of GJB2 gene mutations and GJB6 gene mutations, and the presence of new mutations were also investigated by analysis of DNA sequences in all individuals.Results:Mutations were identified in 6 (10%) of the 60 patients in the study group. Five of these (8.3% of total) had 35delG and one (1.7%) had a delE120. No mutation was detected in control group individuals. In the study group, a statistically significant correlation was determined between the presence of familial sensorineural hearing loss history and 35delG or delE120 mutation (p=0.011, p=0.034).Conclusion:This is the first study which investigated the GJB2 gene mutation in our region, and our results indicate that 35delG mutation was the most frequent. We believe that our results are noteworthy for the identification of heterozygous or homozygous individuals and the genetic counseling of patients with congenital non-syndromic sensorineural hearing loss and their family

The real-life efficacy of the second line treatment strategy in advanced pancreas cancer

ABS TRACT Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer. Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 patients were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate anal-yses, an Eastern Cooperative Oncology Group performance status ≥2, age ≥65 years, hypoalbuminemia, thrombocytosis, presence of metastatic peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ≥3 were identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prog-nosis. In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and pre-dicting the survival of these patients

Türkiye akademik CAR-T hücre (ISIKOK-19) klinik çalışması ön raporu: Ürün karakterizasyonu ve klinik uygulama sonuçları

Objective: Chimeric antigen receptor T (CAR-T) cell therapies have already made an impact on the treatment of B-cell malignancies. Although CAR-T cell therapies are promising, there are concerns about commercial products regarding their affordability and sustainability. In this preliminary study, the results of the first production and clinical data of an academic CAR-T cell (ISIKOK-19) trial in Turkey are presented. Materials and Methods: A pilot clinical trial (NCT04206943) designed to assess the safety and feasibility of ISIKOK-19 T-cell therapy for patients with relapsed and refractory CD19+ tumors was conducted and participating patients received ISIKOK-19 infusions between October 2019 and July 2021. The production data of the first 8 patients and the clinical outcome of 7 patients who received ISIKOK-19 cell infusions are presented in this study. Results: Nine patients were enrolled in the trial [5 with acute lymphoblastic leukemia (ALL) and 4 with non-Hodgkin lymphoma (NHL)], but only 7 patients could receive treatment. Two of the 3 participating ALL patients and 3 of the 4 NHL patients had complete/ partial response (overall response rate: 72%). Four patients (57%) had CAR-T-related toxicities (cytokine release syndrome, CAR-T-related encephalopathy syndrome, and pancytopenia). Two patients were unresponsive and had progressive disease following CAR-T therapy. Two patients with partial response had progressive disease during follow-up. Conclusion: Production efficacy and fulfillment of the criteria of quality control were satisfactory for academic production. Response rates and toxicity profiles were also acceptable for this heavily pretreated/refractory patient group. ISIKOK-19 cells appear to be a safe, economical, and efficient treatment option for CD19+ tumors. However, the findings of this study need to be supported by the currently ongoing ISIKOK-19 clinical trial.Amaç: Kimerik antijen reseptör T (CAR-T) hücre uygulamaları B-hücreli malignitelerin tedavisinde etkili olmaktadır. CAR-T hücre uygulamalarının sonuçları umut vaadedici olsa da, ticari CAR-T ürünlerinin yükek maliyetleri nedeniyle ulaşılabilirlik açısından ciddi sorunlar yaşanmaktadır. Bu ön raporda, Türkiye’deki ilk akademik CAR-T hücre çalışmasının üretim ve klinik uygulama sonuçları sunulmuştur. Gereç ve Yöntemler: Relaps refrakter CD 19+ hematolojik maligniteli hastalarda ISIKOK-19 T-hücre tedavisinin güvenliği ve etkinliğini değerlendirmek amacıyla yürütülen klinik çalışmaya (NCT04206943) Ekim 2019-Temmuz 2021 tarihleri arasındaki hastalar dahil edilmiştir. Bu raporda ilk 8 hastanın üretim bilgileriyle, ISIKOK-19 hücre infüzyonu yapılan 7 hastanın klinik sonuçları sunulmuştur. Bulgular: Çalışmaya toplam 9 hasta dahil edilmiştir (5 akut lenfoblastik lösemi [ALL] ve 4 non-hodgkin lenfoma [NHL]), ancak sadece 7 hastaya hücre infüzyonu yapılabilmiştir. Hücre infüzyonu alan 3 ALL hastasından 2’sinde ve 4 NHL hastasının 3’ünde tam/kısmi cevap gözlenmiştir (toplam yanıt oranı %72). Dört hastada (%57) CAR-T ilişkili toksisite (sitokin salınım sendromu, immün efektör hücre ilişkili nörotoksisite sendromu ve pansitopeni) tespit edilmiştir. İki hastada ise CAR-T hücre uygulaması sonrası cevapsızlık ve progresif hastalık izlenmiştir. Kısmi cevap veren hastalardan 2’sinde de takip sırasında progresif hastalık tespit edilmiştir. Sonuç: Akademik CAR-T üretimimiz, üretim etkinliği ve kalite kontrol kriterlerinin tam olarak karşılanması açısından tatmin edici sonuçlara sahiptir. Çalışmaya dahil edilen hastaların tedavi yükü hesaba katıldığında tedaviye cevap oranı ve toksisite profili açısından da sonuçlar kabul edilebilir düzeydedir. Bu sonuçlarla, ISIKOK-19 hücrelerinin güvenli, ekonomik ve etkili bir tedavi seçeneği olduğu düşünülebilir. Ancak bu ön sonuçların halen devam eden ISIKOK-19 klinik çalışmasıyla desteklenmesi beklenmektedir

Predictive factor for lymph node metastasis in non-metastatic colorectal adenocarcinomas

Objectives: To evaluate the predictive factors of lymph node involvement in non-metastatic colorectal adenocarcinomas (nmCRC). Methods: A total of 453 patients diagnosed with nmCRC were analyzed regarding T stage, lymphovascular invasion status, tumor grade and proposed risk score (RS), determined by the combination of these three factors for lymph node metastasis. Results: The median age was 62 (25-90 years), M/F ratio was 1.4:1 and majority of the patients had tumors localized on the left colon (70.6%). The number of excised lymph nodes was ≥12 in 77% of the cases. The postoperative pathological assessments revealed that 57.2% of patie,nts had N0 disease, 29.1% had N1 disease, and 13.7% had N2 disease. The T stages (p=0.007), grade (p<0.001), lymphovascular invasion (p=0.002), RS (p<0.001), and number of excised lymph nodes (p=0.029) were significantly different between N0, N1, and N2 patients. Higher RS was associated with lymph node metastasis (p<0.001). Conclusion: The risk score may predict lymph node metastasis in patients with nmCRC and if validated may be helpful in the decision-making of adjuvant chemotherapy, especially in the elderly and patients with inadequate lymph node dissection