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Background: This study aims to determine alterations in the antibiotic resistance status of Acinetobacter baumannii strains isolated from lower respiratory tract samples of patients in intensive care units over the years. Methods: In this comprehensive study, A. baumannii strains isolated from aspirate and sputum samples of patients hospitalized in intensive care units of a second-stage state hospital between January 2018 and December 2022 were meticulously and retrospectively investigated and analyzed for antimicrobial resistance. Results: The rate of aspirate and sputum samples in the study was 18.1% (754/4151); The positivity rate of cultures was 51.7% (390/754); The rate of those associated with A. baumannii was found to be 65.6% (256/390).. 90.2% of the isolates were isolated from the general intensive care unit (231/256). The rates of A. baumannii isolated from aspirate and sputum samples were 67.4% (213/316) and 58.1% (43/74), respectively. The carbapenem resistance rate in A. baumannii isolates grown in aspirate samples was 96.5%, fluoroquinolone resistance was 91.7%; The carbapenem resistance rate in sputum samples was 96.1% and fluoroquinolone resistance was 90.9%. The most effective antibiotics against A. baumannii strains isolated from both aspirate and sputum samples were colistin 100% (n=256), TMP/SXT 55.8% (143/256), tigecycline 50.3% (129/256), respectively. Conclusion: Our study reveals a concerning trend-a high frequency of multidrug-resistant A. baumannii isolates are being identified in the Central Anatolia region of our country. This high prevalence, which is a cause for immediate concern, underscores the urgent and immediate need for robust infection control measures to curb the spread of A. baumannii in hospitals.

Introduction: Cortical windows in the proximal femur are used in musculoskeletal tumor surgery for both biopsy and curettage purposes. This study aimed to evaluate the effect of cortical windows on the weakening of the proximal femur under axial and rotational loading using finite element analysis and determine the safe widths, levels, and axial positions. Methods: The proximal femurs of a healthy 37-year-old male and an osteoporotic 76-year-old female were 3D modeled using computed tomography scans. A total of 192 different models were created with 225 mm-long oblong windows with widths of 10, 12.5, 15, and 17.5 mm at 8 different levels and 3 different axial locations. Each model was tested for axial and rotational loading up to failure point. Results: The safe maximum width for all levels and both bones was found to be 10 mm (p0.05). Conclusion: The study quantitatively shows that keeping the width of the cortical window below 15 mm and proximal to the lesser trochanter is an important factor in keeping the fracture risk low during biopsy procedures. Additionally, anterolateral or posterolateral placement of cortical windows does not offer any biomechanical advantages. The findings of this study can help clinicians to avoid iatrogenic fractures during biopsy and curettage procedures.

PURPOSE: We aim to examine the long-term outcomes of patients who underwent multiparametric prostate magnetic resonance imaging (mp-MRI) for suspected prostate cancer (PCa), specifically based on their initial Prostate Imaging Reporting and Data System (PI-RADS) categories and various clinical factors. Our secondary aim is to evaluate the prognostic value of the PI-RADS through the National Comprehensive Cancer Network (NCCN) risk group distribution. METHODS: This research was conducted as a single-center retrospective cohort study in a tertiary care hospital. A total of 1,359 cases having at least one histopathological examination after the initial mp-MRI and/or adequate clinical/radiological follow-up data were included in the clinically significant PCa (cs-PCa) diagnosis-free survival analysis. Initial mp-MRI dates were accepted as the start of follow-up for the time-to-event analysis. The event was defined as cs-PCa diagnosis (International Society of Urological Pathology ≥2). Patients who were not diagnosed with cs-PCa during follow-up were censored according to predefined literature-based criteria at the end of the maximum follow-up duration with no reasonable suspicion of PCa and no biopsy indication. The impact of various factors on survival was assessed using a log-rank test and multivariable Cox regression. Subsequently, 394 cases diagnosed with PCa during follow-up were evaluated, based on initial PI-RADS categories and NCCN risk groups. RESULTS: Three main risk factors for cs-PCa diagnosis during follow-up were an initial PI-RADS 5 category, initial PI-RADS 4 category, and high MRI-defined PSA density (mPSAD), with average hazard ratios of 29.52, 14.46, and 3.12, respectively. The PI-RADS 3 category, advanced age group, and biopsy-naïve status were identified as additional risk factors (hazard ratios: 2.03, 1.54–1.98, and 1.79, respectively). In the PI-RADS 1–2 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 99.1%, 96.5%, and 93.8%, respectively. For the PI-RADS 3 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 94.9%, 90.9%, and 89.1%, respectively. For the PI-RADS 4 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 56.6%, 55.1%, and 55.1%, respectively. These rates were found to all be 24.2% in the PI-RADS 5 cohort. Considering the 394 cases diagnosed with PCa during follow-up, PI-RADS ≥4 cases were more likely to harbor unfavorable PCa compared to PI-RADS ≤3 cases (P < 0.001). In the PI-RADS 3 subgroup analysis, a low mPSAD (

Objective: The present study aimed to evaluate the knowledge level of health personnel working in pre-hospital emergency health services in the Konya province regarding the coronavirus disease 2019 (COVID-19) infection and the use of personal protective equipment (PPE) during the pandemic. Material and Methods: A total of 410 health personnel working in emergency health services in the Konya province were included in the study. The data were collected through a questionnaire developed by the researcher inquiring about the demographic data, whether they contracted (COVID-19), knowledge about COVID-19, and knowledge and attitudes regarding the use of PPE. Results: The rate of individuals who experienced mild infection was 27.1% and the rate of individuals who experienced severe infection was 5.6%. Of the subjects who experienced COVID-19 infection, 73.8% had fatigue, 67.9% had bone and muscle ache, 47.7% had fever, 42.5% had a cough and 27% had loss of taste, smell, and gastrointestinal symptoms and 25.3% had dyspnea. Of the health personnel, 83.7% were detected to use PPE. The most commonly used PPE was seen to be gloves (90.8%) and the least was visors and eyeglasses (43.8%). When the symptom frequency was analyzed according to age, the symptoms were found to be most frequent in the age group of 40 years and above and the symptom frequency was seen to increase with age. Conclusion: It was concluded that the health personnel had received in-service training about COVID-19 and had sufficient knowledge. The rate of PPE use was found to be high. There was no difference between males and females in contracting COVID-19 infection.

Objective: Differences in individual muscle/fat volumes may change the effectiveness of chemotherapy. In this study, the relationship between trunkal muscle and fat volume and body mass index (BMI) obtained before receiving neoadjuvant chemotherapy (NCT) in patients with breast cancer and complete pathological response (pCR) was investigated. Materials and Methods: The volumes of psoas, abdominal and paraspinal muscles, and trunkal subcutaneous and visceral fat were calculated using CoreSlicer AI 2.0 opensource program from the F-18 fluorodeoxyglucose positron emission tomography/computed tomography (CT) and CT images before NCT and postoperative pCR rates to NCT were recorded. Muscle/fat volumes and BMI prior to NCT were compared in terms of pathological pCR rates. Patients were followed up regularly for recurrence and survival. Results: Ninety-three patients were included with median (range) values for age, BMI, and body weights of 48 (28–72) years, 27 (16.8–51.6) kg/m2, and 71.94 (43–137) kg, respectively. The median follow-up time was 18.6 (6.7–59.6) months. No significant correlation was found between total muscle or fat volumes of patients with and without pCR. BMI [26.2 (16.8–51.6) kg/m2 vs. 24.6 (20.3–34.3) kg/m2, p = 0.03] and pCR rates in patients with low right-psoas muscle volume [11.74 (7.03–18.51) vs. 10.2 (6.71–13.36), p = 0.025] were significantly greater. A significant relationship was found between right psoas muscle volume and disease-free survival (DFS) (11.74 cm3 (7.03–18.51) vs. 10.2 cm3 (6.71–13.36), p = 0.025). However, no significant relationship was detected between total muscle-fat volume, BMI and overall survival and DFS (p>0.05). Conclusion: This is the first published study investigating the relationship between the pCR ratio and body muscle and fat volume measured by CoreSlicer AI 2.0 in patients with breast cancer who received NCT. No correlation was found between the pCR ratio and total muscle plus fat volume. However, these results need to be validated with larger patient series.

On yedinci yüzyıldan itibaren Avrupa'nın en yakınındaki “öteki” olan Osmanlı İmparatorluğu'na duyduğu merak ve bu ülkeyle gelişen ilişkileri, Avrupalı elçileri, temsilcileri, tüccarları ve gezginleri bu toprakları ziyaret etmeye teşvik etti. Doğu'ya yapılan yolculuklar ve bu yolculuklara dair anlatıların yayınlanması, Doğu'ya dair bir bilgi birikimi ve temsillerin temellerini attı. Akdeniz'de gelişen bir ticaret merkezi olarak İzmir, Avrupalı seyyahların Doğu'ya yaptıkları yolculuklarda güzergahlarına dahil ettikleri bir yer haline geldi. Seyahatnamelerde İzmir'in kentsel yaşamı, günlük rutini, demografisi ve sosyal yapısının yanı sıra fiziksel çevresi, coğrafi özellikleri ve mimari manzarası da betimlenmiştir. Bu çalışma, on yedinci yüzyıla ait bu anlatıları, özellikle de İngiliz ve Fransız seyyahların anlatılarını, ortak yönlerinin yanı sıra bireysel ve özgün bakış açıları açısından ortaya koymayı amaçlamaktadır. Buna ek olarak, çalışmada, on yedinci yüzyıldaki Doğu'ya bakışın - İzmir'in bu seyahatnamelerdeki metinsel ve görsel temsillerinin kanıtladığı üzere - on sekizinci ve on dokuzuncu yüzyıl Oryantalizminin bir başlangıcı olarak görülüp görülemeyeceği sorgulanmaktadır.

In our study, it was observed that the EPR signals of table sugar irradiated with gamma rays at 3 kGy, 5 kGy, 10 kGy increased in proportion to the increasing dose. The fading in the signals was investigated by taking into account the peak-to-peak heights (Ipp) in the EPR spectra of table sugar. The stability of radicals was monitored by performing EPR measurements on sugar samples irradiated with high doses of gamma rays (Co-60) on 29.06.2020, 23.03.2021, 28.06.2021, 05.08.2021. Suitability evaluation was made with Z score, which is a statistical test to determine fading. It was observed that there was almost no loss in the EPR signals of sugar for 14 months. Also table sugar; Similarities have been shown by comparing the EPR spectra of the fruits used in the TS EN 13708 Foodstuffs - Standard for determining whether foodstuffs containing crystal sugars are irradiated by ESR spectroscopy. Thanks to these similarities, it has been suggested that fruits can also be used as dosimeters, depending on the sugar they contain.

The aim of this study is to investigate the effects of wearable local vibration therapy (VT) on muscle soreness, joint position sense, and dynamic balance in recovery after squat exercise. Twenty males (age: 22.25±1.97 years) participated in the study. Muscle soreness, joint position sense, and dynamic balance were evaluated before exercise, 24 and 48 hours after exercise. All participants performed six sets of 10 repetitions of squat exercises. VT was applied to one thigh of the participants randomly for 10 minutes after exercise, and the other thigh was determined as the control. The muscle soreness increased significantly for VT (p.05). No significant difference was found between VT and control (p>0.05). No significant difference was found after exercise at knee joint position sense for both conditions (p>.05). No significant difference was observed between VT and control (p>.05). There was a significant difference between before exercise and 48 hours after exercise at anterior direction of the modified Star Excursion Balance Test for VT (p=.033). A significant difference was found between before exercise and 24 hours after exercise at posteromedial (p=.012) direction for VT. There was only significant difference at posteromedial (p=.028) direction at 24 hours after exercise between VT and control. The wearable local VT after squat exercise did not affect muscle soreness and knee joint position sense. However, local VT contributed to the improvement of dynamic balance.

Osmanlı döneminin meşhur seyyahı Evliya Çelebi, ömrünün yarım asrı aşan süresini seyahat ederek geçirmiştir. Bu seyahatler esnasında gözlem, izlenim ve müşahedelerinden elde ettiği bilgileri on cilt halinde Seyahatnâme adıyla yayınlamıştır. Bu eser, devletin resmi kayıt ve kaynaklarında bulunmayan 17. yüzyıl geniş Osmanlı coğrafyasının sosyal, kültürel ve ekonomik alanlarıyla ilgili bilgiler vermektedir. Diğer bir ifade ile eser, Anadolu, Balkanlar, Kafkaslar ve Arap Yarımadasının tarihî ve mimarîsinin yanında toplum yapısı, ticarî ilişkileri, kültür seviyesi, siyasî yapısı gezdiği mekânın şehircilik açısından önemi ile genel özellikleri hakkında değerli bir kaynaktır. Evliya Çelebi, gezdiği ve gördüğü şehirler hakkında detaylı bilgi vermenin yanı sıra devlet erkânı ile olan yakın ilişkileri sebebiyle dönemin padişahının, vezirlerinin, paşalarının gerek özel hayatları ve gerek dâhil oldukları siyasi meseleler hakkında başka kaynaklarda bulunmayan bilgiler aktarmaktadır. Seyyahın Anadolu coğrafyasında gittiği şehirlerden birisi de Kayseri’dir. Şehir Evliya Çelebi’nin gezdiği ve şehircilik açısından dikkat çeken bilgiler verdiği önemli yerler arasında göze çarpmaktadır. Kayseri tarih boyunca ticari, kültürel ve eğitim kurumlarının zenginliği ile Anadolu’nun en önemli merkezlerinden biri olmuştur. Bu çalışmamızda büyük önem arz eden şehrin 17. yüzyıldaki durumunu Evliya Çelebi’nin gözüyle mekân açısından ele alacağız ve Seyahatnâme’de şehrin tarihi, mimarisi, mahalleleri, coğrafyası, ibadethaneleri, eğitim kurumları ve ticari yapıları gibi alanlarda verdiği bilgileri tahlil ederek değerlendirmeye çalışacağız.

Abstract Background Surgery remains a priority for breast cancer treatment. This study aimed to compare the cosmetic outcomes of oncoplastic patients who had undergone breast-conserving surgery, mini-LDF (latissimus dorsi flap), and immediate implant reconstruction using both the Japanese scale and the BCCT.core (The Breast Cancer Conservative Treatment cosmetic results software) program and to validate this program. Patients and methods Patients who underwent surgery for breast cancer between 1997 and 2021 were retrospectively studied. Patients were divided into three groups: 1-those who had undergone breast-conserving surgery (245 patients, 71.3%), 2-those who had undergone mini-LDF after lumpectomy (38 patients, 11.02%), and 3- those who underwent reconstruction with implants after nipple-sparing mastectomy (61 patients, 17.68%). The patients were called for a follow-up examination, and their photos were taken. The photographs were shown to an independent breast surgeon and a plastic surgeon who was not included in the surgeries, and they were asked to evaluate and rate them according to the Japanese cosmetic evaluation scale. The same images were transferred to the computer and scored using BCCT.core. Results The plastic and breast surgeon evaluation results showed no significant difference between the three cosmetic techniques (p = 0.99, 0.98). The results of BCCT.core software measurements were similar to the results of plastic and breast surgeons (p: 0.43). Conclusion Patients are more knowledgeable about cosmetic outcomes and expect more objective data. In this study, we used 3 different cosmetic evaluation scales. We found that these techniques give results that are compatible with each other in terms of evaluating the work done in a more concrete way. For this reason, we recommend the use of such software, which offers objective results in a subjective field such as aesthetics and is very easy to apply.

Objective: In this study, we investigated the effects of calreticulin (CALR) and JAK2V617F mutational status on clinical course and disease outcomes in Turkish patients with essential thrombocythemia (ET). Materials and Methods: Seventeen centers from Türkiye participated in the study and CALR- and JAK2V617F-mutated ET patients were evaluated retrospectively. Results: A total of 302 patients were included, of whom 203 (67.2%) and 99 (32.8%) were JAK2V617F- and CALR-positive, respectively. CALR-mutated patients were significantly younger (51 years vs. 57.5 years, p=0.03), with higher median platelet counts (987x109/L vs. 709x109/L, p

The purpose of this study was to examine the effects of cognitive strategies and metacognitive functions of students with learning disabilities (LD), students with low-achieving (LA), and students with average-achieving (AA) over their math problem-solving performance. The study sample consisted of 150 students with 50 students from each group. Study data were collected through Think-Aloud Protocols, Metacognitive Experiences Questionnaire, Math Problem Solving Assessment-Short Form, and 10 math problems. Study findings revealed that the significant predictors of math problem-solving performance were metacognitive strategies and experiences regarding students with LD, metacognitive strategies and knowledge considering students with LA, and metacognitive strategies in students with AA. A statistically significant relationship was found between problem-solving performance of students with LD and their metacognitive strategies and metacognitive experiences. Problem-solving performance and metacognitive strategies of students with LA were found to be close to a high level, and their metacognitive knowledge had a moderate relationship. It was also observed to be moderately related to problem-solving performance and metacognitive strategies in students with AA. The findings were discussed within the relevant literature scope, and suggestions were made for teachers in terms of implementation and researchers for further studies.

The purpose of this research is to determine the effect of course material developed with augmented reality (AR) technology in teaching subjects related to coding on students' academic achievement, their level of permanence in learning and their opinions on the process. The mixed method was used in the study. In the quantitative dimension of the research, semi-experimental design with pretest-posttest control group, and in qualitative dimension phenomenology pattern were preferred. The quantitative data of the research were collected with the achievement test and the qualitative data were collected with a semi-structured interview form. The study group consists of 64 students attending a university in Computer Programming department in Turkey. There are 34 students in the experimental group and 30 students in the control group. The prepared achievement test was applied to the students as pretest, posttest and permanence test. After the application, interviews were made with 15 students selected from the experimental group. As a result of the research, it is seen that the academic achievement and permanence levels of students in the experimental group using AR course material for teaching coding education are higher than the students in the control group. According to the results obtained from the qualitative dimension of the research, it has been determined that AR technology provides many advantages such as efficiency, permanence, comprehensibility and convenience on learning; accordingly, it has been suggested that it should be expanded in different courses and fields.

Abstract Background The comprehensive understanding of microRNAs (miRNAs) in sheep milk during various lactation periods and their impact on milk yield and composition remains limited. Objectives This study aimed to investigate the expression patterns of four highly expressed miRNAs in sheep milk and their association with milk composition and yield parameters during peak and late lactation stages. Methods A total of 40 healthy 4‐year‐old Akkaraman (n = 20) and Awassi (n = 20) ewes registered with the Ministry of Agriculture and Forestry of the Republic of Türkiye were used in the present study. For miRNA isolation from milk, the Qiagen miRNeasy Serum/Plasma Advanced Kit was utilised following the manufacturer's instructions. The expression levels of miRNAs were assessed using Qiagen miRNA PCR Assays. Results The significant fold changes in the expression levels of oar‐miR‐30a‐5p, oar‐miR‐148a and oar‐miR‐181a were observed between peak and late lactation periods in the Awassi sheep breed. Conversely, only oar‐miR‐30a‐5p and oar‐miR‐148a exhibited statistically significant changes in the Akkaraman sheep breed during the same lactation periods. Furthermore, oar‐miR‐21‐5p demonstrated a significant fold change exclusively in peak lactation compared to Akkaraman and Awassi ewes. Conclusions The findings suggest that the expression of the analysed miRNAs is influenced by both the lactation stage and different sheep breeds. This study offers valuable insights into the relationship between key miRNA expressions in sheep milk and milk composition and yield parameters during peak and late lactation, contributing to the existing knowledge in this field.

Agricultural crop affected preliminary and the most prominent by the adverse effects of global climate change have to adapt to various abiotic factors that will occur as a result of climate fluctuations in the near-future and struggle to survive. Among abiotic factors, the one of the greatest impact on plant stress is high temperature. Therefore, the most important step to take action against the global threat is the development of new temperature tolerant varieties. Barley, which is the fourth most important cereal in the world after wheat, maize, and rice are affected by high ambient temperatures. In this work, the effects of their alone and in double, triple combinations of ten various plant growth regulators (PGRs) on mitotic activity and chromosome behaviors in root meristems of barley exposed to high temperature (30°C) were investigated. In the experiments, Hordeum vulgare L. cv. Bülbül 89 variety and GA3, KIN, BA, E, EBR, TRIA and PAs (Spm, Spd, Put, Cad) as growth regulators were used. The results obtained were compared with each other and with those of the seeds germinated at optimum temperature (20°C). Consequently; it has been determined that most of the PGRs studied, especially the GA3 and their combinations with GA3, exhibit a very successful performance on mitotic activity and cytogenetic aberrations in barley seeds germinated under high temperature stress- HTS conditions. The effects of these PGRs (except for EBR) and their combinations on mitotic activity and chromosome behaviors under HTS have been presented in this study for the first time.

Environmental knowledge and awareness of individuals affect their attitudes and behavior toward the environment. In this regard, it is essential to specify how environmental issues are interpreted in individuals' cognitive structures. This study aims to investigate preservice science teachers' cognitive structures on environmental issues. The study was conducted with 78 third-year preservice science teachers. The data were collected through a word association test that contains eight stimulus words about environmental problems and protecting the environment. "Global warming," "greenhouse effect," "radiation," and "acid rain" were chosen for environmental problems; "recycling," "waste disposal," "sustainability," and "solar energy" were selected for protecting the environment. Besides, preservice science teachers were asked to write a sentence for each stimulus word. Two concept networks were created based on the cut-off point method for the word association test, and content analysis was used for sentences. Besides, by comparing the data obtained from the concept networks and sentence analysis, an attempt was made to obtain more in-depth information. It is concluded that preservice science teachers focused on daily life rather than scientific facts about environmental issues. In this respect, new courses such as Green Chemistry may effectively eliminate alternative conceptions and raise awareness on environmental issues.

This study aims to compare the perceptions of pre-service elementary mathematics teachers on the experiences provided by teacher training institutions on a national and an international level. The participants in the study were 1386 pre-service teachers from 21 universities in twelve regions of Turkey. The Learning Opportunities Scales developed by the TEDS-M Project were translated into Turkish by the researchers and used to collect the data. According to the results, the pre-service teachers perceived that they had more opportunities to learn about mathematics pedagogy than about mathematics or general pedagogy. Furthermore, the variations between regions were most pronounced in mathematics pedagogy. Lastly, it can be inferred that there was generally a positive relationship between development level of a region and pre-service teachers' learning opportunities.

This study aims to explore the impact of critical thinking skills on promotion of intercultural competence among student teachers of an English language teaching program. The participants were 34 student teachers studying English language teaching at BA level. They were equally assigned to two groups as treatment (n=17) and non-treatment (n=17). The student teachers recruited for the experimental group received a 10-week teacher training on the cultivation of critical in intercultural contexts. The data were collected through online tests, rating scales, and a set of reflections. The statistical differences between the experimental and the control groups were confirmed with appropriate effect size calculations to scrutinize the effect of the training. How critical thinking skills and intercultural competence exert an impact on the personal and professional development of teacher candidates were analysed and reported qualitatively through the content analysis of the reflections. According to statistical analysis and student teachers' reflections, critical thinking skills played a complementary and crucial role in fostering intercultural knowledge, awareness, and sensitivity in second language teacher education.

The present study aimed to investigate the statistical literacy perceptions of instructors who teach undergraduate statistics courses in different disciplines. Participants of the study were consisted of nine instructors of the introductory statistics course from nine different undergraduate programs. Data were collected by the help of the interviews. Instructors were asked to answer the questions about statistical literacy definitions, organization of the course content, "issues" emphasized or avoided by instructors in teaching statistics, "and" instructors' post-course expectations from their students. Qualitative data was categorized under five main themes based on the interview questions and data was analyzed through statistical literacy components and their aspects. The instructors' ultimate expectations from the students and the issues they emphasized during the courses are mostly stated in relation with statistical literacy. They provided less information related statistical literacy about two themes: course content and the issues they avoid. Recommendations from this study include reviewing and revising statistics course content and methods to reveal the components of statistical literacy.

Due to the significantly increased consumption of energy drinks worldwide, reports of toxicity and adverse events related to these beverages are emerging in the literature. We report a 40-year-old male patient who consumed eight to ten cans (2000 to 2500 mL) of taurine-containing energy drinks per day during the two weeks prior to hospitalization. The patient applied at the hospital with loss of consciousness and in the physical examination, petechia is detected in whole body. Laboratory values except platelet count were normal. We applied the plasmapheresis with a platelet count of 1300 mm3. On the fourth day, we extubated the patient whose clinical findings improved. On the sixth day, we measured the platelet count was 136,000 mm3, and transferred the patient to the hematology service. In conclusion, clinicians need to be aware of any potential side effects from using energy drinks.

Estradiol (E2), a follicle-stimulating hormone (FSH), AMH, and inhibin B levels, along with AFC and MOV, are used to determine ovarian reserve in pre-menopausal women. Studies have shown that AMH levels are more sensitive than those of E2, FSH, and inhibin B and that AFC and MOV can be used to evaluate ovarian reserve. AMH, AFC, and MOV measurements were performed before and after adjuvant SC in 3-month periods for one year. Patients were classified as experiencing chemotherapy-induced amenorrhea (CIA) if they did not have menstrual cycles for a period of six months or longer following the conclusion of their chemotherapy treatment. We aimed to evaluate the factors affecting chemotherapy-induced amenorrhea in breast cancer patients treated with adjuvant chemotherapy and the performance of baseline measurements of AMH, AFC, and MOV to predict chemotherapy-induced amenorrhea. The effects of different chemotherapy regimens on the AMH level, AFC, and MOV in CIA patients were investigated. Seventy-one patients were eligible for this study, and the median age was 38 years (range: 23–45). The median follow-up was 37 months (range: 20–51), and CIA developed in 62% of the patients. The AMH level and AFC were significantly decreased one year after SC (p < 0.0001), whereas MOV was not (p = 0.507). AMH levels before chemotherapy (median: 1.520 vs. 0.755, p = 0.001) and at the end of the first year (median: 0.073 vs. 0.010, p = 0.030) and pre-treatment AFC (median: 12 vs. 4.50, p = 0.026) were lower in patients with CIA compared to those without CIA. The AMH levels before SC were the most valuable and earliest factor for predicting CIA development. In addition, there was no difference between the chemotherapy regimens (including or not including taxane) in terms of CIA development.

Objective:This study aimed to evaluate the relationship between PREDICT tool overall survival (OS) scores and high-risk patients according to TAILORx risk categorization in elderly hormone reseptor (HR) positive human epidermal growth factor negative early breast-cancer patients.Materials and Methods:We conducted a retrospective study, extracting data from medical records of 64 patients diagnosed with breast cancer. A retrospective analysis was performed on all patients who had Oncotype Dx Recurrence Scores across five medical centers between 2017 and 2022. PREDICT scores were defined as calculated 10-year OS rates via PREDICT tool.Results:The median age of the patients was 67, with a range between 65–75 years. Low-risk patients had a slightly higher two PREDICT scores compared to high-risk patients (78% vs. 73%), (81% vs. 77%), which were statistically significant. The progesterone receptor (PR) level was significantly lower in the high-risk group (3.5% vs. 80%). A unit decrease in the PREDICT scores was associated with a 11% increase in the odds of being in the high-risk group. However, these effects weren’t statistically significant in the multivariate analysis. A unit decrease in the PR level was significantly associated with increased odds (by 5% in the multivariate analysis) of being in the high-risk group.Conclusion:Our study underscores the importance of using a combination of tools, including the PREDICT tool, PR levels, and TAILORx risk categorization, for a comprehensive risk assessment in these patients, especially in the older population. Accurate risk assessment is crucial for tailoring the treatment and optimizing outcomes in this vulnerable population. Future studies are warranted to further validate these findings in larger cohorts and to explore additional biomarkers and genomic signatures that may aid in the risk assessment and management of breast cancer in older patients.

Ça&gbreve;lar Ünal,1 Tolga Özmen,2,3 Ahmet Serkan &Idot;lgün,4 Çetin Ordu,5 Enver Özkurt,6 Naziye Ak,7 Gül Alço,8 Zeynep Erdo&gbreve;an &Idot;yigün,9 Sevgi Kurt,10 Tomris Duymaz,11 Mehmet Alper Öztürk,12 Filiz Elbüken Çelebi,13 Kanay Yararba&scedil;,14 Gürsel Soybir,15 Fatma Aktepe,16 Vahit Özmen17 1Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi K&inodot;rdar City Hospital, &Idot;stanbul, Turkey; 2Division of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Boston, MA, USA; 3Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA; 4Department of Surgery, Mater Dei Hospital, Msida, Malta; 5Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, &Idot;stanbul, Turkey; 6Department of General Surgery, Istanbul Florence Nightingale Hospital, &Idot;stanbul, Turkey; 7Division of Medical Oncology, Department of Internal Medicine, Istanbul Florence Nightingale Hospital, &Idot;stanbul, Turkey; 8Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, &Idot;stanbul, Turkey; 9Department of Physical Therapy and Rehabilitation, Göztepe Medical Park Hospital, &Idot;stanbul, Turkey; 10Department of Plastic Surgery, Istanbul Florence Nightingale Hospital, &Idot;stanbul, Turkey; 11Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey; 12Department of General Surgery, Biruni Hospital, &Idot;stanbul, Turkey; 13Department of Radiology, Yeditepe University Hospital, &Idot;stanbul, Turkey; 14Department of Medical Genetics, Demiroglu Bilim University, Istanbul, Turkey; 15Department of General Surgery, Memorial &Scedil;i&scedil;li Hospital, &Idot;stanbul, Turkey; 16Department of Pathology, Memorial &Scedil;i&scedil;li Hospital, &Idot;stanbul, Turkey; 17Department of General Surgery, Istanbul University Istanbul School of Medicine, &Idot;stanbul, TurkeyCorrespondence: Ça&gbreve;lar Ünal, Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi K&inodot;rdar City Hospital, &Idot;stanbul, Turkey, Email caglarunal5@gmail.comBackground: The minichromosome maintenance protein-2 (MCM-2) is a more sensitive proliferation marker than Ki-67. This study aimed to evaluate the relationship between MCM-2 and Oncotype DX recurrence score (ODX-RS) and determine an MCM-2 cutoff value in high-risk patients according to TAILORx risk categorization.Methods: Hormone receptor (HR) positive HER-2 negative early-stage breast cancer patients (pT1-2, pN0-N1, M0) who had ODX-RS were included in the study. According to the TAILORx trial, patients were divided into two groups with high (ODX-RS ≥ 26) and low risk (ODX-RS < 26) in terms of ODX-RS. Formalin-fixed-paraffin-embedded tissues of patients were re-evaluated, and 3 μm sections were prepared for MCM-2 immuno-histochemical staining. The relationship between ODX-RS and the percentage of MCM-2 staining was evaluated in two groups. The ROC curve analysis was performed to determine the MCM-2 cut-off value for the TAILORx high-risk group (ODX-RS ≥ 26).Results: The mean MCM-2 value was significantly higher in the high-risk group [(60.2 ± 11.2 vs 34.4 ± 13.8, p < 0.001)]. In the multivariate analysis, MCM-2 (OR: 1.27, 95% CI: 1.08– 1.49, p = 0.003) and progesterone receptor (PR) levels ≤ 10% (OR: 60.9, 95% CI: 4.1– 89.7, p = 0.003) were found to be independent factors indicating a high-risk group. A one-unit increase in MCM-2 level increased the likelihood of being in the high-risk group by 1.27 times. In the ROC curve analysis, the optimal MCM-2 cut-off level was 50 (AUC: 0.921, sensitivity: 86.7%, specificity: 96.0%, p < 0.001).Conclusion: Our study is the first study in the literature to investigate the relationship between ODX-RS and MCM-2 levels in HR-positive HER-2 negative early breast-cancer patients. In this study, MCM-2 was an independent risk factor in identifying high-risk patients according to TAILORx risk classification. MCM 2 cut-off value (50) may help the decision on adjuvant chemotherapy in patients where the Oncotype DX test cannot be performed.Keywords: breast cancer, MCM-2, Oncotype DX recurrence score, TAILORx risk categorization

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) that is the third leading cause of death in the world is one of the main economic burden. The cost is primarily due to COPD exacerbations and hospitalizations. We aimed to determine the factors associated with increasing costs in severe COPD exacerbation. MATERIAL AND METHODS: It was a multicenter and prospective observational recording study. 294 patients who severe COPD exacerbation were included in the study. An amount of more than 429.58 euros was accepted as increasing costs (IC). Factors associated with IC were determined by regression analysis. RESULTS: Mean age was 69.90 ± 9.79/years (minimum: 40 maximum: 95), mean costs were 594.9 ± 70.9 euros. About 83.7% of the patients were male, 24.1% (71) were active smokers, and 81% (238) had at least 1 comorbidity. Factors associated with IC in the regression analysis were delay of discharge (due to prolonged consultation), antibiotic use longer than 7 days, need to enteral/parenteral feeding, application of pulmonary rehabilitation (physiotherapy) at hospitalization, and refusal to be discharged. CONCLUSION: The increasing costs in severe COPD exacerbation depends not only treatment but also the patient’s social status and hospital-related factors. We think that the cost of severe COPD exacerbation can be reduced by interventions on interchangeable factors such as patient's social status and hospital-related factors.

Metin anlama becerisi; okuyucunun okuma öncesi, okuma sırası ve okuma sonrasında bilişsel ve üstbilişsel stratejilerin kullanımını gerektirir. Bu araştırmada Öğrenme Güçlüğü (ÖG) olan ve Ortalama Başarı (OB) gösteren ortaokul öğrencilerinin metin anlama strateji bilgilerinin üstbilişsel görüşme aracılığıyla belirlenmesi ve kullandıkları stratejiler bakımından farklılıklarının ortaya konması amaçlanmıştır. Çalışmaya 5, 6, 7 ve 8. sınıflara devam eden 30 ÖG olan ve 30 OB gösteren öğrenci katılmıştır. Araştırma verilerinin toplanması amacıyla üstbilişsel görüşme yapılmıştır. Araştırma sonuçları; ÖG olan öğrencilerin OB gösteren öğrencilere göre yetersiz ve etkisiz metin anlama strateji bilgisine sahip olduklarını göstermektedir. OB gösteren öğrencilerin ise okuma öncesi ve okuma sonrası bilişsel strateji bilgisinin bir kısmına sahip oldukları buna karşın okuma sırasında kullanılan bilişsel ve üstbilişsel stratejiler konusunda sınırlılıkları olduğu bulunmuştur.