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Aim: To demonstrate the prognostic importance of glucose-to-lymphocyte ratio (GLR) and uric acid (UA) in patients with metastatic breast cancer (MBC) receiving Cdk 4/6 inhibitors. Materials & methods: Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, GLR, UA and CA15-3 were analyzed to assess their prognostic value using Kaplan–Meier curves and Cox regression analysis in 101 patients with MBC, retrospectively. Results: Importantly, both progression-free survival and overall survival were shorter in the group with high neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), GLR and UA. In the multivariate analysis, GLR and UA levels were independent prognostic factors for both progression-free survival and overall survival. Conclusion: In patients with MBC, GLR and UA are independent factors that predict survival times.

Environmental education amid Coronavirus Disease 2019 (COVID-19) pandemic requires innovation. The pandemic situation need to improving student attitudes in maintaining the environment need an improvement by conducting various innovations and one of them is ILMIZI learning model utilization. The research aim was to improve student attitudes with the ILMIZI model. The research method is experimental without a control class. Samples involved in the research consist of 61 students with a treatment of environmental learning using the ILMIZI model. The Instrument used in this research was the attitude instrument with a scale of 1-5. The research results suggest that t-value (.231) > t-statistic (1.67) indicating that the ILMIZI model is not yet effective in improving the students’ attitudes in maintaining the environment. The pretest score (83.80) and post-test score (83.62) are not significantly different. The conclusion drawn from the research is that the ILMIZI model has not effective in improving student attitudes in maintaining the environment during COVID-19.

Giriş:Adolesanlardaki sağlıklı yaşam becerileri ile okul başarısı, sosyodemografik özellikler ve aile tutumunun ilişkisini değerlendirmek için bu çalışmanın yapılması planlanmıştır. Gereç ve Yöntem:Araştırma bir lisede 8-15.12.2017 tarihlerinde arasında yapılmıştır. Evrenini lisenin 10. Sınıf öğrencileri oluşturmaktadır. (n=374) . 349 öğrenciye ulaşılmış (%93,3) ve kesitsel tipte epidemiyolojik bir araştırma yapılmıştır. Değişkenler; sosyodemografik özellikler, ailenin sağlığı geliştirme davranışları, Adolesanların Sağlığı Geliştirme Ölçeği (Adolescent Health Promotion Scale-AHPS)(40 soru), vücut kitle indeksleri(Z-skorlaması), okul başarısı, anne-babaları hakkındaki vücut algıları, cep telefonu, bilgisayar ve TV başında geçirilen süredir.Bulgular:Araştırmada erkek öğrencilerin bilgisayar/tablet kullanma ve televizyonu izleme süresi kızlardan daha fazladır. Ayrıca kız öğrenciler erkek öğrencilere göre daha başarılı çıkmıştır. Adolesan Sağlığını Geliştirme Ölçeği puanları ile yapılan değerlendirmede toplam puanda, yaşam memnuniyeti, sağlık sorumluluğu, stres yönetimi ve sosyal destek alt başlıklarında iki saatten az kullananların iki saatten fazla kullananlara göre daha fazla puan aldığı görülmektedir. Okul not ortalaması 85 puan altında olanlar 85 puan üstü olanlara göre ölçek toplam puanı, yaşam memnuniyeti ve sağlık sorumluluğu başlıklarında daha düşük puan elde etmiştir. Sağlık sorumluluğu, egzersiz ve stres yönetimi alanlarında anneleri sigara içmeyenlerin içenlere göre daha yüksek puan elde ettikleri görülmüştür. Ayrıca toplam puan, ve tüm alt gruplarında babaları sigara içmeyenler içenlere göre daha yüksek puan almıştır.Tartışma: Adolesan dönemde sağlığı geliştiren davranışların geliştirilmesi için cep telefonu ve bilgisayar/tablet kullanım süreleri azaltılmalı, kız öğrenciler için beslenme ve egzersiz konularında, erkek öğrenciler için ise yaşam memnuniyeti ve sağlık sorumluklarında destekleyici çalışmalar yapılmalıdır. Ayrıca sağlıklı yaşam davranışları geliştirilirse okul başarılarının da artabileceği göz önünde bulundurulmalıdır.

© 2021 Taylor & Francis Group, LLC.Purpose: This study evaluated the efficacy and safety of everolimus (EVE) plus exemestane (EXE) in hormone-receptor positive (HR+), human epidermal growth factor receptor-2-negative (HER2−) metastatic breast cancer (MBC) patients in real-life settings. Methods: Overall, 204 HR+, HER2− MBC patients treated with EVE + EXE after progressing following prior endocrine treatment were included. Overall survival (OS) and progression-free survival (PFS) and safety data were analyzed. Results: The objective response rate, median PFS, and median OS were 33.4%, 8.9 months, and 23.4 months, respectively. Multivariate analysis revealed that negative progesterone receptor status was a significant determinant of poor treatment response (p = 0.035) and PFS (p = 0.024). The presence of bone-only metastasis was associated with better treatment response (p = 0.002), PFS (p < 0.001), and OS (p = 0.001). Conclusion: We confirmed the favorable efficacy and safety profile of EVE + EXE for HR+, HER − MBC patients.

Eosinophilic granuloma (EG) is the unifocal osseous form of Langerhans cell histiocytosis (LCH), which usually affects the skull and long bones. Although it most commonly affects the pediatric age group, it can rarely be seen in adults. Skeletal involvement is common in adult patients, but isolated rib involvement is extremely rare. Differential diagnosis includes other osteolytic lesions such as Ewing’s sarcoma, tuberculosis, multiple myeloma, lymphoma, and primary bone malignancy. The diagnosis must be confirmed histopathologically. In addition to pathological Langerhans cells, inflammatory cells such as lymphocytes, eosinophils, and macrophages are observed in microscopy. Immunohistochemically, CD1a, S-100, and Langerin positivity are observed in biopsy and/or surgical excision material. Treatment options may vary depending on the localization and extent of the disease. In unifocal EG, close observation of the patient may be preferred, as well as surgical excision, radiotherapy, and intra-lesional steroid administration. The prognosis in patients with a single bone lesion is quite good compared to other groups. In this case report, we present a metachronous EG of rib developed in two different ribs by an interval of seven years, which were both surgically treated. In this mild variant of LCH, surgical resection with clean margins has a favorable outcome without the need for additional adjuvant therapy. Metachronous tumors may develop in isolated unifocal bone EGs, and long-term follow-up is mandatory.

Meta-analysis of single-case experimental designs may further knowledge about evidence-based practices for students needing remedial or special education. To contribute to evidence-based practice, a multivariate multilevel meta-analysis was used to synthesize the effectiveness of peer tutoring interventions on both academic and social-behavior outcomes. In total, 46 single-case studies met all inclusion criteria. Peer tutoring had a statistically significant effect on both academic and social-behavior outcomes, with a slightly larger effect on academic outcomes. Peer tutoring also had a significant effect on the trend in academic outcomes during the treatment phase (indicating that the intervention becomes more effective over time), but the effect on trends was slightly less than for social outcomes. Including moderators such as gender, age, disability type, and study quality reduced the amount of between-case and between-study heterogeneity. Limitations and implications of these findings are discussed.

Purpose We aimed to determine the COVID-19 infection rate and determine the factors that affect hospitalization and prognosis in patients receiving systemic chemotherapy (CT), immunotherapy (IT) and molecular-targeted therapies at our hospital within three months after the onset of COVID-19 pandemic. Materials and methods The patients who received systemic treatment at chemotherapy unit with diagnosis of cancer between 11 March 2020 and 11 June 2020 were included. The clinical and demographic characteristics of patients, the systemic treatments that they received (CT, IT, targeted therapies), and the stage of disease were determined. For the parameters that affect the hospitalization of COVID-19 infected patients were also determined. Results Among 1149 patients with cancer, 84 of them were infected with COVID-19, and the median age of infected patients was 61.0 (IQR: 21–84) and 60.7% of them were male. As a subtype of cancers lung cancer was more frequent in the patients who infected with COVID compared with non-infected ones and the difference was statistically significant when the underlying malignities were compared (32.1% vs 19.0%, p = 0.031). The hospitalization rate and receiving COVID-19 treatment were more frequent in metastatic patients who were receiving palliative therapy, and the difference was statistically significant ( p = 0.01, p = 0.03). In our study, infection rate was similar among patients treated with CT, IT and CT plus targeted therapy; however, fewer COVID-19 infections were seen at patients who received only targeted therapy. Conclusion COVID-19 infection is more frequent in cancer patients and tends to be more severe in metastatic cancer patients receiving anticancer treatment, and the continuation of palliative cancer treatments in these patients may cause increased cancer and infection-related morbidity and mortality.

Cinderella syndrome is a concept which is used to define woman who fear from being independent. Women with Cinderella syndrome are in the need of men’s refuge and protection. The syndrome is like a psychological dependence for women and in this dependence, situation being patient and moral is important for being rescued by a man as a reward. In the syndrome women expect a man to come and take control of their own lives so that they can live happily. The aim of the study developing a scale into Turkish culture to determine the level of Cinderella Syndrome in females. The Cinderella Syndrome Scale is a 5-point Likert Type scale which includes 25 items. Exploratory factor analysis (EFA) was conducted to define construct validity and three factors were determined, called “sexist attitude”, “escape from responsibility” and “quitting career”. According to EFA, three factors describe 54,69 % of the variance. Results of EFA were validated by confirmatory factor analysis (CFA). The Cronbach’s alpha was found as .94 for the total scale.

The purpose of the current study was to validate the Turkish version of the Subjective Underemployment Scales (SUS; Allan et al., 2017), a recently developed measure aimed at assessing the six components of underemployment: pay, status, field, hours, involuntary temporary work, and poverty wage employment. The proposed six-factor structure of the SUS was empirically supported among a diverse group of Turkish employees (211 female, 190 male with a mean age of 32.31; ranging from 20 to 63). Consistent with the original study, a six-factor correlational model produced better fit indices than single factor, higher order, and bifactor model. A series of multigroup confirmatory factor analyses provided evidence for configural, metric, and scalar invariance of the SUS, suggesting that the structure of the Turkish version of the scale was equivalent across gender, income, and social class groups. The results of the correlational analyses supported validity by significant positive correlations with measures of overqualification and withdrawal intentions and significant negative correlations with measures of job satisfaction, pay satisfaction, and meaningful work. The results of the study indicated the Turkish version of the SUS (T-SUS) provided a valid and reliable assessment of underemployment among Turkish employees. Also, findings of the present study help to gain an understanding of subjective underemployment experiences of Turkish employees and provide a framework for practitioners; employers, researchers, and policymakers to determine potential need for improvement through components of underemployment.

Background Ado-trastuzumab emtansine is an antibody-drug conjugate that combines the cytotoxic activity of emtansine with human epidermal growth factor receptor 2-targeted antitumor features of trastuzumab. Objective We conducted a study of metastatic breast cancer patients treated with trastuzumab emtansine. By evaluating progression-free survival, overall survival, and response rates, we aimed to find prognostic factors of trastuzumab emtansine treatment. Methods Our study is a single-center, retrospective, observational study. We have clinical data from 78 patients treated with trastuzumab emtansine for metastatic breast cancer, from May 2016 through May 2019, at Kartal Dr Lutfi Kirdar Education and Research Hospital, Medical Oncology Department. Our objective is to assess the survival and response rates in trastuzumab emtansine-treated individuals and the factors associated with survival. The factors we analyzed were cancer antigen 15-3 sensitivity, Eastern Cooperative Oncology Group-Performance Status, presence or absence of visceral metastases, presence or absence of cranial metastases, and treatment-associated thrombocytopenia. Results Among 78 patients, median progression-free survival was 7.8 months, and overall survival was 21.1 months. Twenty of the patients had an objective tumor response. The results showed that trastuzumab emtansine was tolerable with a manageable safety profile and consistent with the results of the previous literature. Mostly seen adverse events were anemia, thrombocytopenia, fatigue, and increased levels of alkaline phosphatase. Patients with Eastern Cooperative Oncology Group-Performance Status = 2 had worse progression-free survival and overall survival compared to ones with Eastern Cooperative Oncology Group-Performance Status Conclusions Trastuzumab emtansine prolongs progression-free survival and overall survival with a manageable safety profile. Thrombocytopenia, Eastern Cooperative Oncology Group-Performance Status, and cancer antigen 15-3 are correlated with progression-free survival and/or overall survival.

Bu araştırmanın amacı Türkiye’nin ulusal kanalı olan TRT Çocuk’ ta çocukların yaş düzeylerine göre, belirli kazanım ve temalar çerçevesinde hazırlanarak yayınlanan çizgi filmlerden biri olan ve araştırmaya katılan öğrenciler tarafından en çok sevilen “Rafadan Tayfa” adlı çizgi filmde yer alan değerlerin belirlenmesi amaçlanmıştır. Bu amaç doğrultusunda ilkokul birinci ve ikinci sınıf öğrencisi olan 282 öğrenciye (144 kız, 138 erkek) TRT Çocuk kanalında 6-8 yaş aralığı için hazırlanmış olan Türk yapımı çizgi filmlerin adları yazılı olarak verilmiş ve en çok sevdikleri çizgi filmi işaretlemeleri istenmiştir. Tercihleri doğrultusunda ilk sırada belirlenen “Rafadan Tayfa” adlı çizgi filmin ilk 40 bölümü nitel araştırma yöntemlerinden doküman analizi ile Hayat Bilgisi Programı’nda yer alan değerler doğrultusunda incelenmeye çalışılmıştır. Sonuç olarak incelenen bölümlerde en çok yer alan değerlerin sırasıyla “Yardımseverlik”, “Dayanışma” ve “Bilimsellik” olduğu, en az yer alan değerlerin ise “Dürüstlük”, “Misafirperverlik”, “Hoşgörü” “Estetik” ve “Vatanseverlik” olduğu belirlenmiştir.

WOS: 000488687200001 Peter Pan Syndrome is a concept that used to characterize the "never-growing" men who have reached an adult age, but cannot face their adult sensations and responsibilities. Individuals with Peter Pan Syndrome have difficulties in social and professional relationships because of their irresponsible behaviors and narcissistic properties. The purpose of this study is to develop a scale in order to measure the level of Peter Pen Syndrome in male individuals. In accordance with this purpose, the draft form was sent to experts to get their feedback, and some statements have been revised in accordance with the feedback. The Peter Pan Syndrome Scale is a twenty-two-item self-report measurement, and each item is evaluated on five-point Likert Type scale. Construct validity of the scale was determined by exploratory factor analysis (EFA) and a three-factor model was created, namely, "Escape from Responsibility", "Power Perception," and "Never Growing Child". EFA results shows that these three factors were describing 47.05% of the variance. Results of EFA were verified by confirmatory factor analysis (CFA). The internal consistency coefficient and the confidence coefficient of the split-half were used to determine the reliability of the scale. The Cronbach's alpha value was found to be 0.88 for the total scale.

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913–2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15–iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840–841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words “cancer” and “oncologist” meant for the students. The participant students were analyzed in two study groups; “group 1” (n = 1.255) were phases I and II students that had never attended an oncology lesson, and “group 2” (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of “death” (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students’ understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. © 2018, American Association for Cancer Education.

The cycle of duplication and division, known as the cell cycle, is the essential mechanism by which all living organisms reproduce. This activity allows students to develop an understanding of the main events that occur during the typical eukaryotic cell cycle mostly in the process of mitotic phase that divides the duplicated genetic material creating two genetically identical daughter cells.

e18552Background: To examine the rates of depression and anxiety among nurses working in oncology units and the situations in which these ratios may be related. Methods: A descriptive study. Nurses...

Noncooperative classification of the modulation type of communication signals finds application in both civilian and military contexts. Existing modulation classification methods for multiple-input multiple-output (MIMO) communication systems commonly require a priori information on the number of transmit antennas employed by the multiantenna transmitter, which, in most of the noncooperative scenarios involving modulation classification, is unknown and needs to be blindly extracted from the received signal. Since the problems of MIMO modulation classification and detection of the number of transmit antennas are highly coupled, we propose a decision theoretic approach for spatial multiplexing MIMO systems that considers these two tasks as a joint multiple hypothesis testing problem. The proposed method exhibits a high performance even in moderate to low SNR regimes while requiring no a priori knowledge of the channel state information and the noise variance. This work was supported by TUBITAK EEEAG under Grant 112E020. The associate editor coordinating the review of this paper and approving it for publication was P. A. Dmochowski Publisher's Version