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Evaluation of treatment outcomes and tolerability in older patients with rectal cancer treated with radiotherapy accompanied by the G-8 geriatric score: TROD13-003 multicenter study
No full textIntroduction: The choice of treatment for rectal cancer often differs in older and younger patients, with the rate of radiotherapy use lower among older adults. In our daily practice, when evaluating a frail older patient with rectal cancer, we usually choose to give less treatment. This may be due to concern that the patient will not be able to tolerate radiotherapy. The Geriatric 8 score (G8GS) is a guide to evaluating treatment tolerability as it relates to frailty in older adults with cancer. The aim of this study was to evaluate treatment outcomes and tolerability in older patients with rectal cancer treated with radiotherapy (RT) accompanied by G8GS. Materials and Methods: Patients aged 65 and older with stage I-III rectal adenocarcinoma who were treated with RT and had a G8 evaluation were included in this multicenter retrospective study. Prognostic factors related to G8GS were calculated using Chi-square and logistic regression tests and survival rates were calculated by the Kaplan -Meier test using the SPSS v24.0 software. All p -values <= 0.05 were considered statistically significant. Results: A total of 699 patients from 16 national institutions were evaluated. The median age was 72 years (range 65 -96), and the median follow-up was 43 (range 1190) months. Four hundred and fifty patients (64%) were categorized as frail with G8GS <= 14 points. Frail patients had higher ages ( p = 0.001) and more comorbidities (p = 0.001). Ability to receive concomitant and/or adjuvant chemotherapy rates were significantly higher in fit patients ( p = 0.002 and p = 0.001, respectively). No significant difference was observed in terms of grade 3-4 early and late toxicity for both groups. Cancer-related death was higher ( p = 0.003), and 5and 8-year survival rates were significantly lower (p = 0.001), in the frail group. Age and being frail were significantly associated with survival. Discussion: Radiotherapy is a tolerable and effective treatment option for older adults with rectal cancer even with low G8GS. Being in the frail group according to G8GS and having multiple comorbidities was negatively associated with survival. Addressing the medical needs of frail patients through a comprehensive geriatric assessment prior to radiotherapy may improve G8GS, allowing for standard treatment and increased survival rates
Nurses' Attitudes Toward Brain Drain and the Associated Factors
No full textBackground:Brain drain refers to the emigration of scientists and other educated professionals from a low- or middle-income country to a high-income country for work. In recent years, this trend has increased, particularly in the health care arena. Prior studies among nurses and nursing students indicate that migration mainly occurs from low- and lower middle-income countries to high-income countries. This study aimed to explore the attitudes of Turkish nurses, nurse academics, and nursing students toward brain drain and the factors associated with these attitudes.Methods:The study used a mixed-methods research design. The quantitative part of the study was conducted with 1,018 participants. The qualitative part was conducted with 26 participants from the larger sample who volunteered for focus group interviews. Data were collected from June through August 2022 using an online survey, the Attitude Scale for Brain Drain, and a semistructured interview guide.Results:Of all participants, 84.3% indicated that they wanted to work and live abroad. Nearly 95% stated that there was a risk of brain drain in the nursing profession, with economic factors given as the most significant reason. As age and years of professional experience increased, brain drain tendency decreased. Nurses and nursing students had higher brain drain tendencies than nurse academics. In focus group interviews, participants reported concern that the brain drain might lead to losses in the qualified nursing workforce and increase the workload for the remaining nurses in the migrant-sending country, while cultural adaptation issues can be difficult for nurses in the migrant-receiving country.Conclusions:Brain drain in the nursing profession continues to be a current, crucial problem. This study showed that among Turkish nurses, nursing students, and nurse academics, the desire to work abroad was quite high, and all three groups had high brain drain tendency scores. Brain drain has serious consequences for both migrant-receiving and migrant-sending countries. These findings can help inform the development of initiatives aimed at preventing or mitigating nursing brain drain.
This study explored the attitudes of Turkish nurses, nurse academics, and nursing students toward the problem of brain drain in the nursing profession and the factors associated with these attitudes
Subcortical Volume Changes in Schizophrenia and Bipolar Disorder: A Quantitative MRI Study
No full textVolume abnormalities in subcortical structures, including the hippocampus, amygdala, thalamus, caudate, putamen, and globus pallidus have been observed in schizophrenia (SZ) and bipolar disorder (BD), not all individuals with these disorders exhibit such changes. In addition, the specific patterns and severity of volume changes may vary between individuals and at different stages of the disease. The study aims to compare the volumes of these subcortical structures between healthy subjects and individuals diagnosed with SZ or BD. Volumetric measurements of lateral ventricle, globus palllidus, caudate, putamen, hippocampus, and amygdale were made by MRI in 52 healthy subjects (HS), 33 patients with SZ, and 46 patients with BD. Automatic segmentation methods were used to analyze the MR images with VolBrain and MRICloud. Hippocampus, amygdala and lateral ventricle increased in schizophrenia and bipolar disorder patients in comparison with control subjects using MRIcloud. Globus pallidus and caudate volume increased in patients with schizophrenia and bipolar disorder compared control subjects using Volbrain. We suggested that our results will contribute in schizophrenia and bipolar disorder patients that assessment of the sub-cortical progression, pathology, and anomalies of subcortical brain compositions. In patients with psychiatric disorders, VolBrain and MRICloud can detect subtle structural differences in the brain
Practical equations for constitutive model of design-oriented FRP-confined concrete rectangular members
No full textThe strengthening with Fiber Reinforced Polymer (FRP) offers one of effective solution to increase strength, axial load and deformation capacity of reinforced concrete (RC) members. However, the use of FRP-confined models can diverge in reflecting FRP confinement behavior, and they require significant computational effort and time. Moreover, the use of these models and their impact on member responses is not studied. To address this, several design-oriented FRP-confined concrete models were utilized and compared by using axial load-moment interaction diagrams and the moment-curvature relationship. Comparisons revealed that compressive strength of FRP-confined members could increase to 2.5 times while axial strain capacity could increase 4.0 times compared to unconfined ones depending on FRP-confined model. Based on the statistical analysis of numerous analytical sections covering broad-range properties of FRP material, practical equations were developed for predicting compressive strength and strain at ultimate for the design and analysis of FRP-confined RC sections. The proposed equations were then subjected to a comparison with analytical and various experimental studies, and their impact on the moment-curvature responses was investigated. Results indicated that proposed equations were in a good agreement with analytical models by the correlation coefficient higher than 0.97. The mean residuals between proposed equations and experimental results were also found around the 10 %, showed that proposed model could capture the stress-strain behavior of FRP-confined concrete. Moment-curvature response produced by proposed model and existing FRP-confined models were also found comparable with experimental results. © 2024 Elsevier Lt
PCLDMA and p-PLA Integration
No full textIn bone tissue engineering, scaffold attributes such as pore dimensions and mechanical strength are crucial. This study synthesized polycaprolactone dimethacrylate (PCLDMA) from polycaprolactone (PCL), incorporating epichlorohydrin (Epi-PCL) and methacryloyl chloride (Meth-Cl). PCLDMA was blended with polylactic acid (p-PLA) to 3D-print bone scaffolds using stereolithography (SLA). Analytical techniques included nuclear magnetic resonance (NMR), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and compression testing. Degradation kinetics and cell viability were investigated using human osteoblast (HOB) cells. Findings revealed PCLDMA/p-PLA composite scaffold superiority over the original polymers. Notably, PCLDMA-60 (60% PCLDMA, 40% p-PLA) displayed optimal properties. Compressive strength varied from 0.019 to 16.185 MPa, porosity from 2% to 50%, and degradation rates from 0% to 0.4% over three days. Cell viability assays affirmed biocompatibility across various PCLDMA ratios. In conclusion, PCLDMA/p-PLA composite scaffolds, particularly PCLDMA-60, show great potential in bone tissue engineering. © 2024 by the authors
A Prospective, Multicenter Study
No full textObjectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 +/- 3.41 before administering Rhinapi; after administration, the average score was 6.23 +/- 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 +/- 1.55 to a mean of 7.31 +/- 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments
Integrating chemical analysis with in vitro, in silico, and network pharmacology to discover potential functional compounds from Marrubium astracanicum subsp. macrodon
No full textThe members of the genus Marrubium are of great interest because they contain biologically active compounds. With in this mind, we aimed to examine the chemical profiles and biological activities (antioxidant, enzyme inhibition and antimicrobial effects) of different extracts of Marrubium astracanicum subsp. macrodon. Extractions of the plants were carried out with the solvent n-hexane, acetone, acetone/water (70 %), and water. The antioxidant activity of these extracts was evaluated through six different assays, namely 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), cupric reducing antioxidant capacity (CUPRAC), ferric reducing antioxidant power (FRAP), metal chelating ability (MCA), and phosphomolybdenum (PBD). Additionally, the inhibitory effects of these solvents on five enzymes acetylcholinesterase (AChE), butyrylcholinesterase (BChE), tyrosinase, amylase, and glucosidase were investigated. The study detected 38 compounds in a plant, with the highest content in acetone and acetone/water extracts. The acetone/water extract demonstrated the highest antioxidant activity aligning with its superior total phenolic (51.9 mg gallic acid equivalent (GAE)/g) and flavonoid (31.0 mg rutin equivalent (RE)/g) content, highlighting a direct correlation between bioactive compound concentration and antioxidant potential across various assays. Regarding the enzyme inhibition activity, the acetone/water extract of this plant exhibited significant AChE inhibition measuring 2.5 mg galantamine equivalent (GALAE)/g and anti-glucosidase activity measuring 1.2 mmol acarbose equivalent (ACAE)/g. In antimicrobial evaluation, the acetone extract exhibited good antimicrobial activity against B. cereus at 0.2 mg/ml dose. In molecular docking analysis, delphinidin 3,5 diglucoside showed a good interaction with the active site of AChE active. Through the application of network pharmacology, an in-depth exploration was conducted to unravel the potential of compounds from M. astracanicum against Alzheimer's disease. The study specifically focused on identifying key targets within the Alzheimer's disease pathway, pinpointing crucial proteins such as Glycogen synthase kinase-3 (GSK3), Prostaglandin-endoperoxide synthase 2 (PTGS2), and Alzheimer's-associated amyloid precursor protein (APP). In summary, the plant can serve as a valuable ingredient in the production of functional products within the pharmaceutical, nutraceutical, and cosmeceutical applications. © 2024 Elsevier B.V
To internalize or not? Addressing key differences between Turkish migrant and native workers in construction employment
No full textPurposeMigration is on the rise due to globalization and human mobility. This has led to increased impacts that have affected many industries, including the construction industry. A large number of migrants are employed in the construction sector, and employers are challenged to make sure all employees are properly integrated to meet the demands needed for construction projects. This article addresses key differences between migrant and native workers to help hiring departments in the construction industry analyse workers' attitudes based on cultural and motivational factors to have the workforce they need to succeed.Design/methodology/approachThe research used both quantitative and qualitative surveys. A two-part questionnaire, designed through a comprehensive literature review, was carried out to identify key differences between native and migrant workers. The data were obtained and then analysed using different statistical approaches, including factor analysis protocol, factor structure model, reliability analysis, relative importance index and nonparametric test analysis. A semi-structured interview was then conducted to discuss all the findings.FindingsThe study indicated that migrant workers, compared to natives, tend to give more importance to their working environment, particularly accommodation, work safety and relations with teammates. Also, migrants typically take a socialistic approach instead of an individual approach while at work and reveal an extensive range of behaviours based on a sense of belonging. It might be more important for migrants to have a place in society, to have a settled life and to be integrated into an established order than to improve their rights and benefits. On the other hand, the study argued that native workers tend to prioritize their benefits at work, such as regular payments for overtime and insurance premiums. Their behaviours might carry a more neutral and individual attitude as well as specific cultural traces.Research limitations/implicationsThe study is limited to a sample of participants in the Turkish construction sector. Further research based on more cultural models and motivational factors with a larger group of respondents from different countries could offer better results. The results of the study might not apply to a broad context due to many other factors that affect worker behaviours, such as geography, cultural structures and working conditions. Despite these drawbacks, the present paper may help employers and other stakeholders understand the best way to incorporate migrants into the construction industry.Originality/valueThis research is very important for the construction industry in various countries that are currently employing thousands of migrants. Being able to address the key differences between migrants and native workers based on cultural and motivational factors might help with engagement and create a level of harmony in the field for greater productivity
An Exploratory Study on the London Smart City Strategy
No full textSmart city strategies have been developed in several cities worldwide to improve the well-being of residents, social life and economic welfare through digital transformation and technology-based interventions. The need for cities to supply assistive services and inclusive strategies for all people has also increased with the increasing urban population and smart city applications. Although technology offers several benefits for more inclusive and liveable environments, there are also drawbacks due to difficulties in adapting to digitalization and due to limited accessibility. The present study aims to explore smart city strategies from an inclusiveness perspective by analysing the London smart city strategy as a case study using a qualitative research methodology. Qualitative data analysis was conducted based on secondary data from London smart city strategy documents and semi-structured interviews with domain experts. Although inclusiveness is embedded in the London smart city strategy, there is still room for improvement. The results of this study indicate that spatial inclusion is the major focus of the London smart city policy where inclusive housing, transport and health management systems are promoted with a variety of assistive technologies with some scope on social and economic inclusion. This study proposed ways of boosting inclusiveness by improving citizen engagement through collaborations, increased transparency, and measures for preventing data misuse and misinterpretation. Using London as a case study, potential barriers in implementing inclusive strategies for smart cities in practice are highlighted, which may provide valuable learned lessons for other cities. © 2024 by the authors
Unveiling the potential antibacterial mechanism of Melaleuca cajuputi leaf extract by cell morphology studies and molecular docking analysis
No full textThe antimicrobial properties of the Melaleuca cajuputi plant have been documented. However, the underlying antimicrobial mechanisms remain relatively unexplored. Thus, this study aimed to investigate the antibacterial effects of M. cajuputi leaf extract against selected bacterial strains and unveil the potential antibacterial mechanisms of the most potent sub-fraction through time-kill assay, cell morphology studies, and molecular docking analysis. The fractions and sub-fractions were obtained from the methanolic extract of M. cajuputi leaf by bioassay-guided fractionation. The antibacterial activity was tested against Staphylococcus aureus, Streptococcus agalactiae, Klebsiella pneumoniae, and Escherichia coli using broth microdilution assay. The most potent sub-fraction, Melaleuca fraction 2d (MF2d), demonstrated remarkable antibacterial activity with MIC values ranging from 0.063 to 0.25 mg/mL and induced significant cellular damage against the tested bacteria. The chemical characterization of the most potent sub-fraction (MF2d) from methanolic extract of M. cajuputi leaf identified five (5) compounds with 2-isopropyl-10-methyl phenanthrene (83.09%) as the major component. In-silico molecular docking analysis revealed that all the docked ligands showed strong binding propensity towards target bacterial proteins, including DNA gyrase (PDB ID: 1ZI0), dihydropteroate synthase (PDB ID: 1AD1), and D-alanyl transferase (PDB ID: 6O93) with the binding energy ranging from - 6.0 to - 8.4 kcal/mol. The overall findings demonstrated the potential of the M. cajuputi plant as a valuable source of novel antibacterial agents