Search

Introduction: Locoregional gastric cancer is a still serious problem and perioperative treatments may improve the success of management. Different regimens were examined. The present study purposed to compare the efficacy of fluorouracil-leucovorin-oxaliplatin-docetaxel (FLOT) and docetaxel-cisplatin-fluorouracil (DCF) regimens., Methods: A retrospective multicenter study assessed the patients with locoregional gastric cancer. There are 240 patients (137 DCF, 103 FLOT). Survival rates were compared., Results: Demographic features were similar between the two groups, but the time period was different. The FLOT group had 7.8% pathological complete response, while the DCF group did not. Disease-free survival was longer in the FLOT than in the DCF group (median not reached - 13.94 months, respectively). Median overall survival was similar (30.9 vs. 37.8 months), but median follow-up affected the analysis. Survival for 36 months was 63% for the FLOT group and 40% for the DCF group (log-rank; p = 0.015)., Conclusion: FLOT regimen was superior to DCF regimen for response and survival rates. DCF is a historical approach. Long-term follow-up period is needed for FLOT treatment., (© 2024 S. Karger AG, Basel.)

Objective: The general approach to malignant biliary obstruction (MBO) is to provide drainage in all patients with jaundice. However, the procedure is often palliative, and its contribution to survival is debated. This study aimed to investigate prognostic factors in patients undergoing percutaneous transhepatic biliary drainage (PTBD) for MBO., Patients and Methods: All laboratory values were divided into two groups based on median values: low and high. Chi-square analysis was performed for dichotomous data. The time from the PTBD procedure to the date of death or last follow-up was considered overall survival (OS). Univariate and multivariate analyses were calculated using the Cox regression model., Results: A total of 152 patients were included in the study, of whom 84 (55.3%) were male. The median OS was 71 ± 12.6 days (95% CI: 46.3-95.7). The 1, 3, 6, and 12-month OS rates were 74.3%, 45.2%, 29.2%, and 13%, respectively. In the multivariate analysis, comorbidity (p=0.029), Eastern cooperative oncology group performance status (ECOG PS) (p=0.007), pre-PTBD albumin (p=0.025), post-PTBD aspartate aminotransferase (p=0.025), chemo naive (p<0.001), and post-PTBD chemotherapy (CT) (p=0.01) were found to be independent prognostic factors., Conclusions: In patients with poor prognosis MBO, the decision for PTBD should be made multidisciplinarily, taking into consideration ECOG PS, comorbidities, albumin levels, and prior CT status.

In recent years, there has been an increasing interest in producing new materials that use renewable resources and halogen-free flame retardants with nonleaching properties. This research focuses on designing and synthesizing phosphorus-nitrogen-based biopolyols for use in polyurethane (PU) foam production. Polyol (ESBO-DYM) with dual functionalities, renewability, and nonflammability is synthesized through the epoxy ring-opening reaction of epoxidized soybean oil with phosphorus and nitrogen-containing tetraol products (DYM). The mechanical and flame retardant properties of PU foams with the addition of an ESBO-DYM were investigated. Increasing the amount of phosphorus in the PU foams increased the thermal stability properties. Using 100% ESBO-DYM as a polyol in the foam formulation increased the limiting oxygen index (LOI) value to 22.9% and resulted in the highest char yield according to the thermal gravimetric analysis (17% at 600 °C). Additionally, the introduction of ESBO-DYM polyol into the formulation resulted in a decrease in the compression strength of the foams. The foam density decreased as the amount of ESBO-DYM polyol in the formulation increased. The foam with the highest amount of ESBO-DYM had a foam density of 29.1 kg/m 3 . The morphology of the foams was characterized using a scanning electron microscope (SEM). As a result of this study, flame retardant polyurethane foams were formulated using a renewable source, polyol, along with commercial compounds., (© TÜBİTAK.)

Background: The lymph node ratio (LNR), defined as the number of positive lymph nodes (LN) divided by the total number of harvested LN, has been demonstrated to be an independent factor in the prognosis of surgically treated colorectal cancer (CRC) patients. This study aims to establish the prognostic value of LNR in stage III CRC patients with high numbers of LN removed., Methods: Stage III CRC patients who underwent curative resections over an 8-year period were included to the study. Demographics, clinicopathological features, surgical as well as recurrence and survival outcomes were recorded and statistically analyzed. Calculations for LNR were carried out as a function of percentage rates and Cox proportional hazards regression analyses were performed to determine its effect on disease-free and overall survival., Results: Among a total of 493 surgically treated CRC cases, 104 patients were included to the study consisting of 68 (65.4%) men and 36 (34.6%) women with a median age of 64 (inter-quartile range: 55-74) years. The mean number of harvested LN was 31.6 ± 21.0 (range: 12-103). Multivariate Cox regression analyses proved LNR to be a significant factor in both disease-free and overall survival ( p  = 0.007 and p  = 0.003, respectively). Forward elimination analyses showed that a 1% increase in LNR resulted with a 2% increase in both the risks of recurrence and mortality., Conclusions: The LNR may be assessed as an adjunct to the current staging systems for the prediction of oncological outcomes and survival of surgically treated stage III CRC patients.

Background: In recent years, many studies have proven that percutaneous thermal ablation is an effective second-line treatment method with low complication rates in early-stage non-small cell lung carcinoma and lung metastases. Radiofrequency ablation and microwave ablation are commonly used for this purpose., Purpose: To evaluate the factors affecting the success of the percutaneous thermal ablation treatment with technical success, complication rates, and long-term follow-up results in metastatic lung lesions., Material and Methods: Computed tomography (CT)-guided percutaneous ablation was performed for 70 metastatic lung lesions in 35 patients (22 men, 13 women; mean age = 61.34 years; age range = 41-75 years). Radiofrequency ablation was performed in 53/70 (75.7%) lesions and microwave ablation in 17/70 (24.3%) lesions., Results: The technical success rate was 98.6%. Median overall survival, progression-free survival, and local recurrence-free survival of the patients were 33.9 months (range=25.6-42.1 months), 12 months (range=4.9-19.2 months), and 24.2 months (range=8.2-40.1 months), respectively. One- and two-year overall survival rates were 84% and 74%, respectively. Median progression-free survival times were 20.3 months and 11.4 months, respectively, according to the number of metastatic lung lesions being single and multiple, and the difference was statistically significant ( P  = 0.046). According to the number of lesions ≤3 and >3, the difference was also found statistically significant ( P  = 0.024) (14.3 months and 5.7 months, respectively)., Conclusion: In conclusion, CT-guided percutaneous thermal ablation is a safe and effective treatment method in metastatic lung lesions. The number of lesions is the most important factor in predicting treatment success.

Difficulty in accessing resources and increasing environmental concerns encourage industrial manufacturing enterprises to establish a symbiosis network. The identification of symbiotic relationships contributes to the more sustainable development of industrial activities. However, businesses operating in industrial parks are diversified by sector. In order to establish a sustainable symbiosis network in industrial parks, the symbiotic relations of each sector in industrial parks should be evaluated separately. Thus, the installation process of the symbiosis network will be easier and more sustainable. In this context, this study aims to prioritize the sector in which a symbiosis network will be established by presenting an innovative approach for the evaluation of symbiosis potentials. For this purpose, criteria for the implementation process affecting the establishment of the symbiosis network were determined. Multi-criteria decision-making methods were used to solve the problem. Considering the uncertainties in the process, fuzzy multi-criteria decision-making methods were used. As a result, a decision-making model has been proposed to determine the priority sector in order to establish a symbiosis network in industrial parks. According to the results obtained with the multi-criteria decision-making methods, the number of enterprises that will evaluate the waste, that is, the number of customers with waste, has been determined as the criterion with the highest level of importance. While evaluating the alternatives, the casting sector was chosen as a priority. This sector is followed by the petro and chemical sector as the second alternative., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To determine the comparative efficacy of taxane-based treatment and 5-FU-based treatment as second-line chemotherapy regimens in advanced gastric cancer patients, as measured by overall survival (OS) and progression-free survival (PFS)., Study Design: Observational study. Place and Duration of the Study: Department of Medical Oncology, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from January 2008 and December 2020., Methodology: Patients aged 18 years and older, diagnosed with gastric cancer, who received at least one line chemotherapy were included. Patients who received FOLFIRI, FOLFOX, and capecitabine in the second-line therapy were grouped as those who received 5-FU-based treatment, while those who received docetaxel and paclitaxel were grouped as those who received taxan-based treatment. The primary outcome measures, OS and PFS, were assessed and compared between the treatment groups using the Kaplan-Meier method., Results: A total of 172 patients were included in this analysis, among whom 73 (42.4%) received second-line chemotherapy. Among the patients who received the second-line treatment, 50 (68.5%) were males. The median age of the cohort was 60 years (23-86), with 37 (50.7%) patients falling into the <60 age group. The overall response rates (ORR) were 8% (2/25) in the taxane group and 16.7% (8/48) in the 5-FU-based treatment group. The median overall survival (OS) for all patients receiving second-line therapy was 7.52 months (standard error: 0.97; 95% confidence interval [CI]: 5.62-9.43). Specifically, the median OS was 5.16 months (standard error: 1.07; 95% CI: 3.07-7.25) in the taxane group and 8.02 months (standard error: 1.40; 95% CI: 5.28-10.75) in the group receiving 5-FU-based therapy (p=0.11)., Conclusion: The superiority of chemotherapy regimens to each other could not be demonstrated. However, the second-line treatment demonstrated clear superiority over the best supportive care. Therefore, it is recommended that all patients with good performance status (PS) should be offered second-line treatment., Key Words: Gastric cancer, Second-line chemotherapy, Taxanes, Treatment efficacy, 5-Fluorouracil.

Phosphorous is an essential element for the life of organisms, and phosphorus-based compounds have many uses in industry, such as flame retardancy reagents, ingredients in fertilizers, pyrotechnics, etc. Ionic liquids are salts with melting points lower than the boiling point of water. The term "polymerized ionic liquids" (PILs) refers to a class of polyelectrolytes that contain an ionic liquid (IL) species in each monomer repeating unit and are connected by a polymeric backbone to form macromolecular structures. PILs provide a new class of polymeric materials by combining some of the distinctive qualities of ILs in the polymer chain. Ionic liquids have been identified as attractive prospects for a variety of applications due to the high stability (thermal, chemical, and electrochemical) and high mobility of their ions, but their practical applicability is constrained because they lack the benefits of both liquids and solids, suffering from both leakage issues and excessive viscosity. PILs are garnering for developing non-volatile and non-flammable solid electrolytes. In this paper, we provide a brief review of phosphonium-based PILs, including their synthesis route, properties, advantages and drawbacks, and the comparison between nitrogen-based and phosphonium-based PILs. As phosphonium PILs can be used as polymer electrolytes in lithium-ion battery (LIB) applications, the conductivity and the thermo-mechanical properties are the most important features for this polymer electrolyte system. The chemical structure of phosphonium-based PILs that was reported in previous literature has been reviewed and summarized in this article. Generally, the phosphonium PILs that have more flexible backbones exhibit better conductivity values compared to the PILs that consist of a rigid backbone. At the end of this section, future directions for research regarding PILs are discussed, including the use of recyclable phosphorus from waste.

In this study, silane and quaternary ammonium functional methacrylate monomers were synthesized and used to construct a copolymer using an emulsion polymerization technique to control the reaction rate. The copolymer was then designed using different ratios of silane and quaternary ammonium groups to investigate the relationship between the structure and properties. The presence of the ethoxy silane group in the copolymer series provided covalent bonding through the silanol group onto cotton fabric. The presence of cationic groups also helped to cover the fabric surface. After coating the cotton textile fabric, the resistance of the dye on the fabric surface to friction was assessed and tests were conducted on washing, rubbing, water, and light fastness. Finally, the textile surfaces were investigated for their antibacterial activity against Staphylococcus aureus and Escherichia coli . It was observed that the copolymer series showed >99% killing efficiency against S. aureus but had no effect on E. coli ., (© TÜBİTAK.)

In this study, the shift scheduling problem of the personnel who maintain the 324 trains operating on the lines of the Ankara Metro, which carry approximately 10 million passengers per month, is discussed. In the problem, daily personnel needs and personnel qualifications are evaluated together according to the fault prediction. Firstly, a total of 1721 fault data for 181 days is analyzed, and the prediction is made according to 8 prediction methods. Then, a 30-day fault prediction is made with the prediction method, which has the least error rate. According to the number of faults obtained as a result of the prediction, the daily personnel requirement is determined. Then, according to the type of fault, the personnel are classified as electronics, electromechanics, and mechanics. It is aimed at distributing the personnel evenly to the shifts. The goal programming model is used to solve the problem, allowing us to add more than one goal to the model. When the solution results of the problem are compared with the current schedule, it is seen that the monthly total working hours are distributed equally, and the shifts are distributed fairly, and a necessary balance is achieved in the shifts according to the personnel qualifications. It is thought that this study, in which personnel qualifications and fault prediction are evaluated together, will contribute to the literature on railway maintenance personnel scheduling., Competing Interests: Conflict of interestThere is no conflict of interest in the study., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

When it comes to choosing the best option among multiple alternatives with criteria of different importance, it makes sense to use multi criteria decision making (MCDM) methods with more than 200 variations. However, because the algorithms of MCDM methods are different, they do not always produce the same best option or the same hierarchical ranking. At this point, it is important how and according to which MCDM methods will be compared, and the lack of an objective evaluation framework still continues. The mathematical robustness of the computational procedures, which are the inputs of MCDM methods, is of course important. But their output dimensions, such as their capacity to generate well-established real-life relationships and rank reversal (RR) performance, must also be taken into account. In this study, we propose for the first time two criteria that confirm each other. For this purpose, the financial performance (FP) of 140 listed manufacturing companies was calculated using nine different MCDM methods integrated with step-wise weight assessment ratio analysis (SWARA). İn the next stage, the statistical relationship between the MCDM-based FP final results and the simultaneous stock returns of the same companies in the stock market was compared. Finally, for the first time, the RR performance of MCDM methods was revealed with a statistical procedure proposed in this study. According to the findings obtained entirely through data analytics, Faire Un Choix Adéquat (FUCA) and (which is a fairly new method) the compromise ranking of alternatives from distance to ideal solution (CRADIS) were determined as the most appropriate methods by the joint agreement of both criteria., Competing Interests: Željko Stević is an Academic Editor for Peerj. All other authors declare that they have no competing interests., (© 2023 Baydaş et al.)

In this paper, the properties of organic-inorganic hybrid polymer materials, which were synthesized from an aluminosilicate inorganic matrix with the addition of brushite and aminosilane grafted on one side and PEI covalently bonded composites on the other side, were examined. The synthesized organic-inorganic hybrid polymers were examined in terms of a structural, morphological, thermo-gravimetric, and adsorption-desorption analysis and also as potential CO 2 capturers. The structural and phase properties as well as the percentage contents of the crystalline and amorphous phase were determined by the X-ray diffraction method. The higher content of the amorphous phase in the structure of hybrid polymers was proven in metakaolin and metakaolin-brushite hybrid samples with the addition of amino silane and with 1,000,000 PEI in a structure. The DRIFT method showed the main band changes with the addition of an organic phase and inorganic matrix. Microstructural studies with the EDS analysis showed a uniform distribution of organic and inorganic phases in the hybrid geopolymers. The thermo-gravimetric analysis showed that organic compounds are successfully bonded to inorganic polymer matrix, while adsorption-desorption analysis confirmed that the organic phase completely covered the surface of the inorganic matrix. The CO 2 adsorption experiments showed that the amine-modified composites have the higher capture capacity, which is 0.685 mmol·g -1 for the GM10 sample and 0.581 mmol·g -1 for the BGM10 sample, with 1,000,000 PEI in the structure.

Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based)., Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy., Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months., Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET., (© 2023. The Author(s).)

In this paper, we consider the problem of automobile selection for transportation in inner city using a hybrid multicriteria decision making approach. The electric automobiles that are a relatively new concept in the world of the automotive industry, are widely viewed as attractive among its alternatives day by day. Fuel-vehicles produce a lot of carbon emissions that are ejected into our natural atmosphere, leaving us vulnerable to things like pollution and greenhouse gases. So, electric vehicle and automobiles have emerged as a more efficient alternative and these vehicles have been a great step forward to help positively the environment with zero emissions and total energy consumption in their lifecycle. Many companies focus on electric vehicle production with the development of electric vehicle technology. Therefore, the selection process emerges among the various electric automobile technologies for the users. The selection process includes several conflicting factors which are such as economic, technical and technological factors. In the present study, we propose a hybrid approach for electric automobile selection that combines analytic hierarchy process (AHP), technique for order of preference by similarity to ideal solution (TOPSIS) and goal programming (GP) is used to determine the weights to assign to the factors that go into these selection decisions and TOPSIS method is used for preference ranking. These weights founded by AHP are inputted into a GP model to determine the best alternative among the electric automobiles. Finally, the study used three methods TOPSIS, AHP- TOPSIS and AHP-GP for better comparison and evaluation. The most suitable electric automobile is selected among their alternatives by using analytic methods and goal programming., Competing Interests: Conflict of interestThe authors declare they have no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objective: Percutaneous transhepatic cholangiography (PTC) is an invasive procedure used in patients with obstructive jaundice in the progress of some malignancies, and its most common complication is infection. We aimed to evaluate the patients who underwent PTC regarding their cultures, prophylaxis, and antibiotics used for treatment., Materials and Methods: In this cross-sectional study, patients who underwent PTC and were followed up in a medical oncology outpatient clinic between 2010-2017 were evaluated retrospectively. Patients' data were obtained from the hospital record system (FONET), epicrisis forms, and patient progress files., Results: A total of 93 patients were included in the study. Prophylaxis was given in 50% of the cases. Complications developed in 68% of the cases after the intervention, and the infectious disease clinic consulted all. Blood cultures were obtained from 89% of the febrile patients; however, bile cultures were obtained only from 29%. The rate of resistant Gram-negative enteric bacteria in growing microorganisms was 52% (n=13). It was determined that 65% of the initiated empirical treatments were appropriate for the growth of microorganisms., Conclusion: The growth rate was significantly higher in blood cultures than in bile cultures. The lower growth rate in bile culture was attributed to the low number of bile cultures. There was no significant difference regarding the growth rate and drug resistance of the microorganisms. Therefore, we think giving antibiotics as treatment rather than prophylaxis is more appropriate. Taking cultures will ensure that patients receive appropriate antibiotic therapy for the causative agent., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Background/aim: Lenalidomide (LND) is an oral anticancer drug used to treat various malignant hematologic diseases, including multiple myeloma. The most common adverse events with LND are myelosuppression, thrombosis and pneumonia. Myelosuppression is reversible, and thrombosis can be treated with prophylactic administration of antithrombotic drugs. Pneumonia is less common and its incidence profile in clinical studies is unclear. This study aimed to evaluate the incidence and onset timing of LND-related lung toxicity and outcome details using the Japanese Adverse Drug Event Report (JADER) database., Patients and Methods: Adverse events with LND reported between April 2004 and March 2021 were selected. Data on lung adverse drug reactions (ADRs) were analyzed, and safety signals were estimated using reported odds ratios (RORs) and 95% confidence intervals (CIs). We also estimated the timing of onset of lung toxic signs., Results: A total of 10,929 ADRs were attributed to LND. Of these, 908 were lung toxicities. The most frequently reported ADRs with significantly high RORs were pneumonia (559 cases, ROR=3.89, 95% CI=3.57-4.24) and bacterial pneumonia (38 cases, ROR=2.02, 95% CI=1.46-2.78). Median onset of pneumonia and bacterial pneumonia were 84 and 74 days, respectively. Prognoses of patients who received LND and had pneumonia and bacterial pneumonia were poor, with 10-20% non-recovery and deaths., Conclusion: The findings indicate that pneumonia and bacterial pneumonia, among all LND-related lung toxicities, may be associated with immunosuppression, suggesting the importance of monitoring respiratory symptoms within the first 3 months of treatment., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Industrial symbiosis (IS) is an approach that aims to use resources efficiently by cooperating between independent enterprises in raw materials, energy, and similar sectors. As a result of cooperation, businesses gain economic, environmental, and social benefits. Especially in recent years, IS applications have become widespread due to the problems experienced in the supply of resources. The presence of more than one enterprise in cooperation creates a complex network structure in IS applications. In this complex system, many decision problems are encountered in establishing and effectively maintaining the industrial symbiosis network. Operations research techniques are at the forefront of the methods used to solve decision problems. This study examined studies using operations research techniques in industrial symbiosis. Studies were divided into four classes according to the methods they used: exact methods, heuristic methods, multi-criteria decision-making, and simulation. In the literature review, the studies in the Web of Science (WOS) database are systematically presented by scanning with the determined keywords. As a result of the study, it was analyzed which method was preferred and where the methods could be applied in industrial symbiosis., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Stage III colorectal cancer (CRC), which accounts for approximately one third of all CRC cases, is associated with worsened prognosis. The aim of this study was to compare the preoperatively measured systemic inflammatory markers and to define the most significant marker in terms of its prognostic value in stage III CRC., Methods: Surgically treated stage III CRC patients were included. Demographics, preoperatively measured Glasgow prognostic score (GPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/C-reactive protein ratio (LCR) and C-reactive protein/albumin ratio (CAR) values, clinicopathological features, surgical, oncological and survival outcomes were recorded and statistically analysed., Results: The study group of 102 patients consisted of 65 (63.7%) men and 37 (36.3%) women with a median age of 64 (range: 26-89). The mean follow-up period was 42.8 ± 30.5 (range: 6-107) months. Overall survival (OS) and disease-free survival (DFS) rates were 71.6%, and 67.7%, respectively. Elevated CRP, GPS 2, LCR ≤ 0.530, CAR ≥ 0.080, higher numbers of metastatic lymph nodes and N2b nodal status were detected to impair DFS (P = 0.001, P = 0.015, P = 0.001, P = 0.001, P = 0.001 and P = 0.043, respectively). Variables including GPS 2, PLR≥190.83, CAR≥0.045, LCR≤0.684, surgical site infection and longer hospital stay decreased OS (P = 0.004, P = 0.002, P = 0.005, P = 0.001, P = 0.001 and P = 0.001, respectively). According to multivariate analysis; PLR ≥ 190.83 was associated with three times [HR: 2.892 (95% CI: 1.100-7.602), P = 0.031], and LCR ≤ 0.684 was associated with four times [HR: 3.919 (95% CI: 1.130-13.592), P = 0.031] greater risk of cancer-related mortality., Conclusion: As an independent prognostic factor, LCR had the highest impact on predicting survival after curative resection for stage III CRC., (© 2022 Royal Australasian College of Surgeons.)

The rapidly increasing population causes an increase in consumption amounts day by day. This leads to negative effects such as the reduction of limited resources. In order to eliminate or reduce such negative effects, sustainable approaches are adopted for the future. Industrial symbiosis is one of these sustainable approaches. Industrial symbiosis is when two or more economic enterprises operating independently of each other form beneficial partnerships. In this study, the factors affecting industrial symbiosis collaboration were determined by literature review and by analyzing these factors; it is aimed to eliminate inefficiencies and to ensure the sustainability of established relations. The criteria determined are weighted with the Analytical Network Process method, which is one of the multi-criteria decision-making methods, and it is aimed to calculate the degree of importance and priority., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The relationship of the ABO blood group system with the immune response is known, but its relationship with immune checkpoint inhibitors (ICIs) has not been clearly investigated until now., Objective: In this study, the relationship between different blood groups and nivolumab treatment response in patients with advanced malignant melanoma was investigated., Methods: The data of patients who used nivolumab for advanced malignant melanoma between April 2018 and April 2021 were retrospectively reviewed., Results: A total of 73 patients were included in the study. In the progression-free survival (PFS) analysis according to blood groups, it was 3.9 months, 16.1 months, 20.0 months and 3.0 months for A, B, AB and O, respectively (p= 0.1). Overall survival (OS) analysis according to blood groups was 5.1 months, 25.0 months, 20.0 months and 9.3 months for A, B, AB and O, respectively (p= 0.1). The B antigen group (B or AB) had significantly longer PFS and OS than the non-B antigen group (A or O) (16.1 vs. 3.5 months for PFS, respectively, p= 0.03; 20.0 vs. 7.4 months for OS, respectively, p= 0.02)., Conclusions: The presence of B antigen provides a significant advantage in terms of survival in patients using ICIs for advanced melanoma.

Aim: To evaluate the immunogenicity and safety of the CoronaVac vaccine in patients with cancer receiving active systemic therapy. Methods: This multicenter, prospective, observational study was conducted with 47 patients receiving active systemic therapy for cancer. CoronaVac was administered as two doses (3 μg/day) on days 0 and 28. Antibody level higher than 1 IU/ml was defined as 'immunogenicity.' Results: The immunogenicity rate was 63.8% (30/47) in the entire patient group, 59.5% (25/42) in those receiving at least one cytotoxic drug and 100% (five of five) in those receiving monoclonal antibody or immunotherapy alone. Age was an independent predictive factor for immunogenicity (odds ratio: 0.830; p = 0.043). Conclusion: More than half of cancer patients receiving active systemic therapy developed immunogenicity.

Computational complexity is one of the drawbacks of orthogonal frequency division multiplexing (OFDM)-index modulation (IM) systems. In this study, a novel IM technique is proposed for OFDM systems by considering the null subcarrier locations (NSC-OFDM-IM) within a predetermined group in the frequency domain. So far, a variety of index modulation techniques have been proposed for OFDM systems. However, they are almost always based on modulating the active subcarrier indices. We propose a novel index modulation technique by employing the part of the transmitted bit group into the null subcarrier location index within the predefined size of the subgroup. The novelty comes from modulating null subcarriers rather than actives and reducing the computational complexity of the index selection and index detection algorithms at the transmitter and receiver, respectively. The proposed method is physically straightforward and easy to implement owing to the size of the subgroups, which is defined as a power of two. Based on the results of our simulations, it appeared that the proposed NSC-OFDM-IM does not suffer from any performance degradation compared to the existing OFDM-IM, while achieving better bit error rate (BER) performance and improved spectral efficiency (SE) compared to conventional OFDM. Moreover, in terms of computational complexity, the proposed approach has a significantly reduced complexity over the traditional OFDM-IM scheme.

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey., Materials and Methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively., Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78)., Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence., Competing Interests: None

Purpose: Colorectal cancer is the third leading diagnosis accounting for nearly 10% of all new cancers worldwide. The distinct features among BRAF mutant colorectal cancers make these tumor groups hard to treat for oncologists. The median overall survival (OS) of these types of cancers is reported to be 9 to 14 months., Methods: The study was declared on the Turkish Oncology Study Group Conference and approved. The patients' data was received from the centers who confirmed to participate. The BRAF-mutated patients were included in the study. The demographic features (age, gender, etc.), type of mutation, tumor localizations, histology, microsatellite instability (MSI) status, metastasis patterns chemotherapeutic agents and progression, and death times were recorded., Results: Thirty-nine patients were enrolled in the study. Sixteen patients had concurrent KRAS mutations, while 7 had NRAS mutations. Most of the patients received doublet chemotherapies in combination with anti-VEGF agents in the first and second line of the treatment. There was a significant difference in OS according to the stage which showed a decreased survival in stage IV patients at the time of diagnosis. Concurrent KRAS mutation resulted in increased OS. The median OS was 47 and 24 months favoring the KRAS mutant group. The patients whose primary tumor operated had better survival when compared with other patients. The median OS of the operated group was 47 months, while the non-operated group was 24 months. Liver metastasis was related to worse prognosis at the time of diagnosis in univariate analysis., Conclusion: In our study we found a high concurrent RAS mutation ratio in a BRAF mutant patient group which was different from prior studies. The concurrent mutations resulted in a favorable outcome in terms of OS which is also different from the current knowledge. More prospective studies are needed especially BRAF-mutated patient population and especially with concurrent RAS mutations., (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Neoadjuvant treatment is a widely accepted approach for locally advanced rectum cancer. Efforts to explore a surrogate endpoint for clinical trials revealed a new prognostic scoring system which is named as neoadjuvant rectal score (NAR) in patients who received neoadjuvant treatment for rectal cancer., Material and Methods: 88 patients who met inclusion criteria were included in the study. The optimal cutoff value of the NAR score was 17.6 with 71% sensitivity and 63% specificity. Patients with NAR score > 17.6 (n: 48, 54%) were defined as the high-risk group and those with NAR score ≤ 17.6 (n: 40, 56%) as the low-risk group., Result: Survival analysis according to the NAR score group (low-risk vs high-risk) revealed that there was a statistically significant difference between groups regarding OS and DFS. The median OS for high-risk patients was 27.3 months (95% CI, 15.0-39.6); it was 76.6 months (47.3-106.0) for low-risk patients (p < 0.0001). The median DFS was 15.1 months (11.8-18.4) for high-risk patients; it was 44.3 months (95% CI, 4.1-84.6) in the low-risk group (p = 0.002)., Discussion: As a result, we interpreted our findings as supporting data about the utility of NAR score not only as a surrogate endpoint for the clinical trial of rectal cancer but also as a prognostic marker in patients with gastric cancer who received neoadjuvant treatment., (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)

There is growing interest in the detection of bacteria in consumables, for example, in the food and water sectors. In this study, the aim was to produce a polymer-based bacteria biosensor via ROMP (ring opening metathesis polymerization). In the first part of the study, block and random copolymers were synthesized, and their biocidal activities were tested on the glass surface. Interdigitated electrode arrays coated with the polymers possessing the highest activity were used to screen the affinity towards different bacterial strains by monitoring impedance variations in real-time. The polymer-coated electrode could detect gram-positive and gram-negative bacteria strains at a concentration of 10 7 cfu/mL. The results show that ROMP-based polymer offers bacterial detection and can be used in developing biosensor devices for efficiently detecting pathogenic bacteria., Competing Interests: CONFLICT OF INTEREST: none declared, (Copyright © 2021 The Author(s).)

Purpose: COVID-19 will continue to disrupt the diagnosis-treatment process of cancer patients. Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital has been considered as a 'non-pandemic' center ('clean') in Ankara, the capital city of Turkey. The other state hospitals that also take care of cancer patients in Ankara were defined as 'pandemic' centers. This study aimed to evaluate hospital admission changes and the precautionary measures in clean and pandemic centers during the pandemic. The effect of these measures and changes on COVID-19 spreading among cancer patients was also evaluated., Methods: The patients admitted to the medical oncology follow-up, new diagnosis, or chemotherapy (CT) outpatient clinics during the first quarter of pandemic period (March 15-June 1, 2020) of each center were determined and compared with the admissions of the same frame of previous year (March 15-June 1, 2019). COVID-19 PCR test results in clean and pandemic centers were compared with each other. Telemedicine was preffered in the clean hospital to keep on follow-up of the cancer patients as 'noninfected'., Results: In the clean hospital, COVID-19-infected patients that needed to be hospitalized were referred to pandemic hospitals. COVID-19 test positivity rate was eight-fold higher for outpatient clinic admissions in pandemic hospitals (p < 0.001). The number of patients admitted new diagnosis outpatient clinics in both clean and pandemic hospitals decreased significantly during the pandemic compared with the previous year., Conclusion: We consider that local strategic modifications and defining 'clean' hospital model during infectious pandemic may contribute to protect and treat cancer patients during pandemic.

Background: Lymph node metastasis is a predominant prognostic indicator in colorectal cancer. Number of lymph nodes removed surgically was demonstrated to correlate with staging accuracy and oncological outcomes. However, number of lymph nodes removed depends on uncontrolled variables. Therefore, a more reliable prognostic indicator is needed. Calculation of ratio of positive lymph nodes to total number of removed lymph nodes may be an appealing solution., Materials and Methods: We retrospectively analyzed data of 156 Stage III colorectal cancer patients whom underwent surgery between 2008 and 2015. Patients' demographic characteristics, tumor grade, location, vascular-perineural invasion status, number of removed lymph nodes, and ratio of positive lymph nodes to number of removed lymph nodes were recorded. Spearman correlation analysis was used to determine the correlation coefficient while Kaplan-Meier method and Cox proportional hazard regression model were performed for the prediction of survival and multivariate analysis, respectively., Results: Number of removed lymph nodes did not correlate with survival, but it was inversely correlated with number of positive lymph nodes. Multivariate analysis showed that ratio of removed positive lymph nodes to the total number of lymph nodes was a significant prognostic factor for survival for a ratio equal or above 0.31 was a poor prognostic indicator (108 months vs. 34 months, hazard ratio: 4.24 [95% confidence interval: 2.15-8.34]; P < 0.019). Tumor characteristics failed to demonstrate any prognostic value., Conclusions: This study showed that positive lymph node ratio (PLNR) is an important prognostic factor for Stage III colorectal cancer. Although 0.31 can be taken as threshold for "PLNR," prospective trials including larger patient groups are needed to validate its role as a prognostic indicator., Competing Interests: None

Objective: To investigate the genetic causes of colorectal cancers (CRCs); and to determine the genotype-phenotype correlation., Study Design: Descriptive study., Place and Duration of Study: Department of Medical Genetics, Diskapi Yildirim Beyazit Training and Research, Hospital, Ankara, Turkey, between January 2018 and January 2020., Methodology: 59 cancer susceptibility genes of 41 patients, included in the study and diagnosed with CRC, were examined using next generation sequencing (NGS) technique. Statistical analysis of the possible relationships among the mutation carrier status of the patients and the parameters of gender, age at diagnosis, and family cancer history, were performed., Results: The mean age at diagnosis of all CRC patients was 48.7 years (range 28-74). Mutations in MLH1, MSH6, CHEK2, PMS2 and MUTYH genes were detected in 10 patients (24.4%). The mean age at diagnosis of CRC was 46.2 years in those who carried the mutation, while it was 49.5 years in those without. Carriers and non-mutation carriers, when compared in terms of age at diagnosis, gender, family cancer history, no significant difference was observed., Conclusion: Genes that may cause susceptibility to cancer may play a role in the etiopathogenesis of the CRC. NGS-based multigene panels allow these genes to be detected in the patient and to identify an inherited cancer syndrome. Key Words: Colorectal cancer, Lynch syndrome, Hereditary cancer, Gene, Next generation sequencing.

Background: Surgical procedures applied in the treatment of early breast cancer (EBC) to achieve satisfactory oncological results lie in a wide spectrum. There has been a major shift toward less-invasive treatments during the past decades. We compared the outcomes of oncoplastic breast surgery (OBS), non-oncoplastic breast conserving surgery (NBCS) and mastectomy in the treatment of EBC., Methods: The records of 412 patients with EBC who underwent OBS, NBCS or mastectomy at our institution between January 2012 and June 2019 were retrospectively analyzed. Postoperative complications, local recurrences (LR) and disease-free survival (DFS) were compared between the groups. EBC patients with unilateral stage-I, IIa and IIb tumors were studied. All patients received adjuvant, targeted and/or endocrine therapy according to the tumor characteristics, followed by radiotherapy (all OBS and NBCS cases, and selected mastectomy patients)., Results: Postoperative complications were similar in all groups except for six fat necrosis and partial nipple-areola necrosis in two diabetic patients treated with OBS. Re-excision rate was lower in OBS (6.5%) than NBCS (8%). There was no statistical difference between the groups regarding recurrence ( P =1.000) or DFS ( P =0.937)., Conclusion: OBS, NBCS and mastectomy are equally acceptable procedures in EBC in terms of both oncological and surgical aspects., (© 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Purpose: Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years., Method: Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children's self-reports and parents' proxy reports, using the Wong-Baker FACES Pain Rating Scale., Results: Descriptive characteristics of the children ( n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group ( n = 36; 5.03 ± 3.35) experienced more pain than the children in VR group ( n = 35; 2.34 ± 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 ± 2.46) were found to be lower than those in the control group (4.67 ± 2.56; p < .001)., Conclusions/implications for Practice: VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.

Aim: The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey., Material and Methods: A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires., Results: Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice, Conclusion: This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors., Competing Interests: The authors have no conflicts of interest or funding to disclose., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Introduction: Metabolic syndrome is associated with an increased risk of diabetes mellitus (DM) and coronary heart disease. It may also be associated with a higher risk of some common cancers. The objective of this study was to determine the relationship between metabolic syndrome and breast cancer in postmenopausal women., Methods: We present a prospective cohort study of postmenopausal women. This cohort was divided into two groups: the «benign diagnosis group», including women who were studied after breast cancer screening; and the «malignant tumor group», including patients with breast cancer that had been diagnosed by biopsy. Age, weight, height, body mass index (BMI), abdominal perimeter, serum glucose, LDL, HDL and insulin levels were analyzed as variables under study. The HOMA-IR homeostatic model formula was used to assess insulin resistance. The differences were considered statistically significant when P<.05., Results: Two hundred women with a mean age of 61.5±9.6 (range: 37-93) were enrolled in the study, consisting of 150 (75%) patients with a benign diagnosis and 50 (25%) patients with a malignant tumor. BMI and abdominal perimeter were higher in the group with a malignant tumor (P<.05). The incidence of DM and metabolic syndrome was higher in the malignant tumor group (P<.005). In the malignant tumor group, much higher incidences correlated with fasting glycemic levels >100mg/dL, insulin levels >10mIU/L and HOMA-IR scores >2.7 (P<.05)., Conclusions: There is a relationship between metabolic syndrome and postmenopausal breast cancer. More studies are needed to establish methods for the prevention of breast cancer in women with metabolic syndrome., (Copyright © 2020 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction Colonic wall thickening (CWT) is frequently observed incidentally via abdominal computerized tomography (aCT). Although the general approach to evaluating incidental CWT is a colonoscopic examination, there is a lack of definitive recommendation guidelines. Thus, we aimed to determine neoplasia rates and identify the factors predictive of neoplasia via colonoscopic examinations of patients with CWT incidentally diagnosed via aCT. Methods We retrospectively reviewed 5,300 colonoscopy reports. A total of 122 patients who had CWT incidentally observed via aCT were included in the study. CWT was graded as mild (3-5 mm), moderate (6-12 mm), or severe (≥12 mm). A logistic regression model was used to determine the predictive factors for neoplasia. Results The mean age of the patients was 60 years, and abnormal findings were noted in 52% of the colonoscopies. Neoplastic lesions were detected in 24 patients (19.6%), while colon adenocarcinoma was detected in 8 patients (6.5%). Multivariate analysis showed that moderate-severe, focal, and asymmetric CWT were independent factors for predicting neoplasia (p=0.049, p=0.033, and p=0.018, respectively). Conclusion Pathological findings can be noted via colonoscopic examination in cases of incidental CWT; therefore, patients with moderate-severe, focal, or asymmetric CWT require colonoscopic examination for the purpose of detecting neoplasia., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Karacin et al.)

During the development of effective drugs for the treatment of cancer, one of the most important tasks is to identify effective drug candidates having maximum antiproliferation and minimum side effects. This paper considers the problem of selecting the most promising anticancer agents, showing inhibition at low IC 50 concentration and low releasing lactate dehydrogenase percentage (cytotoxicity). Recently, we prepared quinoline analogs bearing different functional groups and determined their anticancer potential against the HeLa, C6, and HT29 cancer cell lines using different anticancer assays. Experimentally, seven quinoline derivatives consisting of different substituents were determined as promising anticancer agents. We propose a multicriteria recommendation method to identify the most promising anticancer agents against all tested cell lines with an accurate prediction algorithm according to the available input data. A multicriteria decision-making methodology (MCDM) was used for the solution of the relevant problem in this study. Both the experimental results and MCDM method indicated that 5,7-dibromo-8-hydroxyquinoline (2) and 6,8-dibromo-1,2,3,4-tetrahydroquinoline (6) are the most promising anticancer agents against the HeLa, HT29, and C6 cell lines., (© 2020 Wiley Periodicals LLC.)

There is an increase in the amount of resource use due to the rise in population, urbanization, and industrialization. Also, the amount of waste increases due to an increase in consumption and resource use. Countries are developing new policies depending on both decreasing resources and environmental problems caused by waste. The "Zero Waste" project was launched to recycle waste and to reduce environmental pollution in Turkey. The project aims to separate recyclable waste at its source and recycle them. One of the problems encountered in the implementation of the project is collecting the waste from temporary storage areas. In this study, the problem of transportation of wastes from temporary warehouses to the main warehouse was discussed in Kırıkkale/Turkey. A three-step solution approach has been proposed to the solution of the problem. In the first stage, the amounts of waste generated at the addresses to collect were estimated. In the second stage, the addresses to be visited are classified with an approach based on Pareto analysis according to the calculated waste amounts. According to this classification, it is planned which addresses will be visited on which day of the week. At the last stage, the problem is modeled as a heterogeneous multi-vehicle routing problem, which also takes into account the daily working hours and vehicle capacity constraints. According to the result of the mathematical model, the number of vehicles needed for waste collection, the types of vehicles, and the routes of the vehicles were found. Considering the implementation stages of the Zero Waste project, three different case studies are handled for Kırıkkale. These case studies have been solved by considering different waste rates. According to the results, the waste collection plan was made economically by visiting fewer spots in a week.

The immune system plays a fundamental role in the response to neoadjuvant chemotherapy (NAC) of locally advanced breast cancer (LABC) patients. Patients with pathological complete response (pCR) after NAC have a higher survival rate. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are peripheral blood indicators of inflammatory response. This investigates the correlation between NLR, PLR, LMR, and other clinicopathological features of breast cancer patients before receiving NAC and pCR.Data of LABC patients who underwent NAC between 2009 and 2018 were retrospectively reviewed. Each patient's peripheral complete blood count was recorded before starting NAC. The cut-off values for neutrophils, lymphocytes, monocytes, and platelets in the peripheral blood and NLR, PLR, and LMR were determined by receiver operating characteristic curve analyses.The records of 131 patients were analyzed and divided into two groups, pCR (+ve) and pCR (-ve), and their clinicopathological features and laboratory findings were compared. pCR was achieved in 23.6% of patients. The cut-off values of neutrophils, lymphocytes, monocytes, and platelets at the time of diagnosis and NLR, PLR, and LMR were, respectively, 4150 μL, 2000 μL, 635 μL, 271 × 10 μL, 1.95, 119, and 3.35. The pCR rate was higher in patients with low neutrophil count, low NLR, and high lymphocyte count (P = .002, <.001, and .040, respectively).As per the findings of multivariate logistic regression analysis, the independent predictive factors of pCR were clinical tumor size T1 and T2, grade 3, ER negativity, and low NLR (P = .015, .001, .020, .022, and .001, respectively).While NLR was found to be an independent predictive factor of pCR in LABC patients receiving NAC, a similar result was not observed for PLR and LMR. NLR can be a useful biomarker for predicting the response of patients receiving NAC.

Introduction Oxaliplatin-based chemotherapy is the standard treatment in stage III colon cancer. Oxaliplatin may cause sinusoidal damage and sinusoidal obstruction syndrome (SOS) in the liver. Clinical reflections of SOS are splenomegaly and thrombocytopenia. This study aimed to investigate the frequency of splenomegaly development in patients receiving oxaliplatin-based chemotherapy and thrombocytopenia incidence rates related to this condition.  Materials and methods Files of 50 patients having received fluorouracil and oxaliplatin (mFOLFOX6) regimen for stage 3 colon cancer between 2015 and 2017 were retrospectively reviewed. Spleen volumes (SV) of the patients were calculated using pre-and post-chemotherapy tomographic examinations. A 50% increase in the SV after chemotherapy (SV ≥1.5 change) was accepted as chemotherapy-associated splenomegaly. The patients were divided into two groups as having or not having splenomegaly after chemotherapy. Complete blood count was evaluated prior to each treatment cycle, and on the third month of treatment, termination was used for thrombocyte values.  Results Splenomegaly was determined in 50% of the patients. Cumulative oxaliplatin dosage was found higher in those who developed splenomegaly (p = 0.003). Chemotherapy dose reduction was higher in patients who did not develop splenomegaly (p = 0.015). Thrombocytopenia was confirmed higher in patients who developed splenomegaly compared to those who did not (p = 0.047). Lower thrombocyte counts were found in the complete blood count of the patients having developed splenomegaly which was performed during and 3 months after chemotherapy when compared to those that did not develop splenomegaly (p-values, respectively, as 0.005, 0.038). Upon multivariate logistic regression analysis, cumulative oxaliplatin dose was the single independent factor related to splenomegaly (OR: 7.55 (1.90-31.61); p = 0.004). Conclusion Thrombocytopenia was confirmed to be higher in colon cancer patients receiving adjuvant mFOLFOX6 and developing splenomegaly during the post-treatment period. Moreover, splenomegaly was shown to be associated with the cumulative oxaliplatin doses received. Thrombocytopenia seen in patients receiving oxaliplatin for colon cancer should be a warning in terms of splenomegaly and SOS development., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Eren et al.)

Purpose: Whether primary tumor resection (PTR) should be performed in patients with asymptomatic colorectal cancer (CRC) and unresectable synchronous metastasis is controversial. The purpose of this study was to investigate the prognostic impact of initial primary tumor resection in patients with synchronous unresectable metastatic CRC., Methods: The patients with unresectable synchronous metastatic CRC who had undergone primary tumor resection and then received chemotherapy were compared with the patients who received only palliative systemic chemotherapy., Results: Survival analysis showed that median overall survival (OS) for all patients was 22.37 months. Primary tumor resection was associated with a significant survival benefit on unadjusted analysis (median survival 29.56 months vs. 14.25 months; p<0.001). Two-year, 3-year and 5-year survival rates were 57%, 35%, 19% for the PTR group and 30%, 16%, 8% for the non-PTR group and all results were statistically significant and favored surgery., Conclusions: Our study suggests that primary tumor resection improves the survival of patients with metastatic CRC and unresectable synchronous metastasis.

Objective: To explore life experiences of adolescents after cancer diagnosis., Methods: The phenomenological qualitative study was conducted at the paediatric oncology clinic of a university hospital in Edirne, Turkey, from March 15 to April 1, 2016, and comprised semi-structured interviews with adolescents aged 10-18 years diagnosed with different types of cancer. Data was analysed using Colaizzi's method., Results: Of the 12 adolescents, 7(58.3%) were boys and 5(41.7%) were girls. The overall mean age was 14.92}2.19. Mean duration of life post-diagnosis was 2.87}2.94 years (range: 1-11 years), and all (100%) of them had undergone chemotherapy. More adolescents experienced shock, sadness, fear, anxiety, curiosity and uncertainty when they learned their diagnosis. Changes related to family included missing their siblings and parents, and feelings of guilt, anger, and sibling jealousy. Adolescents stated that they missed their schools and friends, feared stigmatisation, abandonment and changes related to future. They wanted a stress-free life, to have an occupation, to continue school, and to be independent., Conclusions: Cancer changed adolescents' relationships with family and peers, and their feelings and thoughts regarding future. It is important that health professionals, especially nurses, recognise and understand such changes to provide quality care.

Introduction:  Tamoxifen treatment has been shown to reduce the recurrence and mortality rates in hormone receptor-positive breast cancers independent from chemotherapy. This benefit increases with the prolongation of the use of tamoxifen but with increasing side effects. In this study, we aim to evaluate the presence of urogenital symptoms in breast cancer patients on tamoxifen and compare them with those who are not on any hormonotherapy., Materials and Methods: This study was performed on patients diagnosed as early-stage breast cancer. The study group consisted of hormone receptor-positive patients given tamoxifen as adjuvant hormonal therapy. The control group consisted of breast cancer patients who had no hormonotherapy. Patients with a complaint of urinary incontinence with onset after tamoxifen usage were evaluated with Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire Short Form (IIQ-7) and Incontinence Quality of Life Questionnaire (I-QOL)., Results: A total of 137 early-stage breast cancer patients were included in this study; 74 estrogen receptor-positive patients on tamoxifen therapy (study group) and 63 hormone receptor-negative patients with no hormonotherapy (control group). The median age was 44 (30-65) years for tamoxifen users and 49 (27-64) years for the control group. The stages of the patients were similar for both groups. 78.4% of the women in the tamoxifen group and 49.2% in the control group were in the premenopausal period. The groups were similar in regard to body mass index and parity. The complaint of urinary incontinence was more frequent in the study group compared to controls (39 (52.7%) vs. 5 (7.9%)). Women with the complaint of urinary incontinence were evaluated with self-reported UDI-6, IIQ-7 and I-QOL forms and the scores were similar for both study and control groups. A statistically significant relation was observed between cigarette smoking and the presence of urinary incontinence. The percentages of smokers were 50% of those with incontinence and 24.7% of those without incontinence., Conclusion: Urinary incontinence is positively correlated with tamoxifen usage in early-stage breast cancer patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2019, Imamoglu et al.)

Aim: Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH)., Methods: In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors., Results: A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group., Conclusion: According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH., Competing Interests: The authors declare that no conflicts of interest exist.