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Ovarian cancer is the most mortal gynecological malignancy among women worldwide. The appropriate treatment protocol is cytoreductive surgery and the main aim is to remove all primary carcinoma focus and all metastatic lesions. A 37 years old woman (gravida 5, para 3) presented with complaints of abdominal distension. During the gynecological examination, bilateral adnexal masses in the solid structure were observed. Staging surgery was performed and 8 cycles of adjuvant chemotherapy regimen were given. A pathological axillary lymph node was detected in the positron emission tomography-computed tomography (PET/CT) imaging at the follow-up 6 months after the end of the chemotherapy regimen. The biopsy result from the axillary lymph node was reported as serous carcinoma metastasis. Metastasis of ovarian carcinoma to the axillary lymph node is uncommon and has a poor prognosis. High-grade ovarian serous carcinoma with axillary lymph node metastasis was presented in this case report.

Objective: Randomized placebo controlled trials (RCT) are very important for testing efficacy and safety of a medical treatment. There is no too much RCT`s in childhood bipolar disorder manic episode. In these trials, high placebo response poses a problem for the definition of real drug responses in practice. Therefore, analysis of predictors of drug and placebo response are important for conducting more reliable RCT`s in the future. Method: Comprehensive search conducted in PubMed, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and some other electronic databases. Studies including participants with Bipolar Disorder manic episode and associated symptoms (e.g ADHD, irritability) included. There was no restriction in terms of sex, ethnicity or initial severity. Participants over age 18 were excluded. Random effect size model was used for calculate effect sizes for placebo and drugs. Results: A total of 1974 participants and 11 studies were included in the meta-analysis. Risperidone was highest effect size among drug arms. Number of the sites and number of the participants were associated with higher placebo response in meta-regression. We did not find any variable had an impact on drug response. There was no any publication bias in this meta-analysis. Conclusion: We found similar results as adult studies. Modifying number of the sites or ramdomized sample size may limit placebo response and could improve the efficacy of RCT`s and enhance drug-placebo contrasts.

Üretim atıksuyu petrol ve doğalgaz üretimi sırasında oluşarak petrol ve doğalgazın yeraltından pompalanması ile birlikte yüzeye çıkmaktadır. Üretim atıksuyu, içerisinde birçok organik ve inorganik bileşik içeren ve bu nedenle deşarjı öncesinde uygun şekilde arıtılması gereken bir atıksu türüdür. Üretim atıksularının arıtılmasında fiziksel, kimyasal ve/veya biyolojik yöntemler kullanılmaktadır. Bu çalışmada, petrol ve doğalgaz üretim atıksularının biyolojik olarak arıtılabilirliğinin ortaya konması amaçlanmıştır. Bu kapsamda; petrol ve doğalgaz üretimi ve sadece doğalgaz üretimi yapan sahalardan elde edilen üretim atıksuyu ardışık kesikli reaktör (AKR) sisteminde arıtılmıştır. Doğalgaz üretim sahasından alınan atıksuyun yüksek tuzluluk içeriğinden dolayı, biyolojik arıtılabilirliğinin düşük seviyede olduğu görülmüştür. Petrol ve doğalgaz üretim sahasından alınan üretim atıksuyunda ise ortalama KOİ giderim verimi %68 seviyesine ulaşmıştır. Petrol ve doğalgaz üretim atıksuyunun biyolojik olarak arıtılamayacak (inert) fraksiyonları da çalışma kapsamında belirlenmiştir. Üretim atıksuyunda %86 oranında biyolojik olarak giderilebilen KOİ içeriği olduğu saptanmış ve geri kalan kısmın inert partiküler ve inert çözünmüş KOİ olduğu tespit edilmiştir. Üretim atıksuyunda inert karakterizayonun ve biyolojik arıtılabilirliğinin belirlenmesi, en uygun arıtma prosesi seçiminde yol gösterici olması bakımından oldukça önemlidir.

The paper is based upon the research that explored the formation of hybrid cultural identities of five first-generation Turkish immigrants to the United States working in the high-technology sector. Postcolonial theoretical perspective was used to conceptualize the formation of hybrid cultural identities in the globalized world, and Interpretive Phenomenological Analysis was employed to analyze in depth the lived experiences of the participants. The research findings indicated four broad common experiences narrated in the interviews: Shifting Identities, Identities in Comparison, Identities against Power, and Transforming Self. These findings concurred with the postcolonial assumptions that challenged the generalizations of cultural identity in clinical psychology theory and research.

Diğer bütün kurumlar gibi, futbol takımları da hedef kitleleri ve taraftarlarıyla etkileşim içerisine girmek için pazarlama amaçlı halkla ilişkilerden yararlanmaktadır. Yeni pazarlama yaklaşımında etkileşim, bağlantı kurma ve işbirliğinin önemli olması nedeniyle futbol takımlarının taraftarları ve diğer hedef kitleleriyle iletişimlerinde sosyal medya büyük bir öneme sahiptir .Bu yaklaşımla,çalışmada, Türk futbol liginde bugüne kadar şampiyon olan beş takımın sosyal medya kullanımları, pazarlama halkla ilişkilerinin uygulama alanları açısından incelenmektedir. Söz konusu futbol takımlarının sosyal medya uygulamalarından ürün tanıtımı, satış desteği, pazarlama desteği ve reklam desteği gibi amaçlarla pazarlama halkla ilişkilerinden yararlandıkları ve sosyal medya uygulamalarını Facebook ve Twitter hesapları aracılığıyla gerçekleştirdiklerigörülmektedir.

Background: Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools., Aims: To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics., Method: Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts., Results: Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = -0.34 years, s.e. = 0.08), major depression (β = -0.34 years, s.e. = 0.08), schizophrenia (β = -0.39 years, s.e. = 0.08), and educational attainment (β = -0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO., Conclusions: AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.

Psychiatric disorders show heterogeneous symptoms and trajectories, with current nosology not accurately reflecting their molecular etiology and the variability and symptomatic overlap within and between diagnostic classes. This heterogeneity impedes timely and targeted treatment. Our study aimed to identify psychiatric patient clusters that share clinical and genetic features and may profit from similar therapies. We used high-dimensional data clustering on deep clinical data to identify transdiagnostic groups in a discovery sample (N = 1250) of healthy controls and patients diagnosed with depression, bipolar disorder, schizophrenia, schizoaffective disorder, and other psychiatric disorders. We observed five diagnostically mixed clusters and ordered them based on severity. The least impaired cluster 0, containing most healthy controls, showed general well-being. Clusters 1-3 differed predominantly regarding levels of maltreatment, depression, daily functioning, and parental bonding. Cluster 4 contained most patients diagnosed with psychotic disorders and exhibited the highest severity in many dimensions, including medication load. Depressed patients were present in all clusters, indicating that we captured different disease stages or subtypes. We replicated all but the smallest cluster 1 in an independent sample (N = 622). Next, we analyzed genetic differences between clusters using polygenic scores (PGS) and the psychiatric family history. These genetic variables differed mainly between clusters 0 and 4 (prediction area under the receiver operating characteristic curve (AUC) = 81%; significant PGS: cross-disorder psychiatric risk, schizophrenia, and educational attainment). Our results confirm that psychiatric disorders consist of heterogeneous subtypes sharing molecular factors and symptoms. The identification of transdiagnostic clusters advances our understanding of the heterogeneity of psychiatric disorders and may support the development of personalized treatments., (© 2021. The Author(s).)