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Real-world outcomes of adjuvant paclitaxel and trastuzumab therapy in lymph node-negative, HER2-positive early-stage breast cancer: A multicenter retrospective data analysis
No full textBackground: Approximately 15-20% of early-stage breast cancers overexpress HER2, which is associated with an increased risk of recurrence. Although adjuvant anti-HER2 therapies have significantly improved patient outcomes, the optimal treatment strategy remains uncertain, particularly for patients with small, lymph node-negative tumors, where concerns about potential overtreatment and toxicity persist. The objective of this study was to evaluate overall survival (OS), recurrence-free survival (RFS), and treatment-related neuropathy in patients with early-stage HER2-positive breast cancer treated with adjuvant trastuzumab and paclitaxel. Methods: A total of 129 patients, aged 18 to 75 years, diagnosed with early-stage HER2-positive breast cancer, were retrospectively analyzed in this multicenter study. All patients had received adjuvant treatment with trastuzumab and paclitaxel (TH regimen) between November 2016 and July 2023. The study involved the collection of demographic information, pathological features, and treatment-related details. Overall survival (OS) was defined as the primary study endpoint, while recurrence-free survival (RFS), disease control rate (DCR), and treatment-related neuropathy were evaluated as secondary outcomes. Results: The median follow-up time was 70.9 months. The 2-year and 5-year OS rates were 95.3%, and the 5-year RFS rate was 96.8%. No statistically significant differences in OS or RFS were observed in relation to tumor size (T1 vs. T2), hormone receptor status, Ki-67 index, tumor grade, or the use of adjuvant endocrine or radiotherapy (all p > 0.05). Neuropathy developed in 53.5% of patients, mostly grade 1. Conclusions: Adjuvant TH therapy shows favorable long-term outcomes in early-stage HER2-positive breast cancer
A study on contemporary Iraqi Turkmen short stories
No full textBu çalışma, Irak Türkmen edebiyatının önemli bir türü olan hikâyeciliği sosyo-kültürel boyutlarıyla ele almaktadır. Irak Türkmen hikâyecileri yalnızca edebî üretim yapmakla kalmayıp, aynı zamanda kimlik, kültür ve dil mücadelesinin de sözcüsü olmuşlardır. Özellikle 20. yüzyılın ikinci yarısından itibaren yoğunlaşan kimlik baskısı, göç ve asimilasyon gibi sorunların Türkmen hikâyelerine nasıl yansıdığı incelenmiş; hikâyelerin kültürel direnişin bir aracı olarak nasıl işlev gördüğü değerlendirilmiştir. Bu bağlamda, Mehmet Ömer Kazancı tarafından hazırlanan Günümüz Irak Türkmen Öyküsü adlı antoloji merkez alınarak çağdaş Irak Türkmen hikâyeciliği kapsamlı bir şekilde analiz edilmiştir. Antolojide yer alan 32 yazarın biyografik bilgileri ve edebî kimliklerine dair bilgiler sunulmuş; seçilen örnek hikâyeler üzerinden yapı, tema ve izlek analizleri yapılarak kültür ve değer unsurları belirlenmiştir. Ayrıca, hikâyelerde yer alan sosyal eleştiri temaları ve dil-anlatım özellikleri de değerlendirme kapsamına alınmıştır. Çalışma; giriş, üç ana bölüm ve sonuç ile kaynakça kısımlarından oluşmaktadır. Birinci bölümde Irak Türkmenlerinin tarihçesi, coğrafi yerleşimleri, demografik yapısı, dil özellikleri ve edebî gelenekleri ele alınmıştır. İkinci bölümde hikâyelerin yapısal özellikleri; olay ve durum hikâyesi ayrımı, olay örgüsü, kişi, zaman, mekân, dil ve anlatım yönünden incelenmiştir. Üçüncü bölümde ise tema ve izlekler mercek altına alınmış; bu incelemeye zemin hazırlamak amacıyla yazarların eğitim ve meslek bilgilerini içeren bir tablo ile hikâyelerin tema sıklıklarını gösteren istatistiksel bir tabloya yer verilmiştir. Sonuç olarak, bu çalışma çağdaş Irak Türkmen hikâyesinin birikim ve gelişim çizgisini ortaya koymayı ve bu edebî mirasın korunmasının önemine dikkat çekmeyi amaçlamaktadır.This study explores short story writing, a prominent genre in Iraqi Turkmen literature, from a socio-cultural perspective. Iraqi Turkmen short story writers have not only produced literary works but also served as spokespersons in the struggle for identity, culture, and language. The research focuses on how issues such as identity pressure, migration, and assimilation—particularly intensified since the second half of the 20th century—are reflected in Turkmen short stories, and how these stories function as instruments of cultural resistance. Within this context, a comprehensive analysis is conducted based on the anthology Contemporary Iraqi Turkmen Short Stories compiled by Mehmet Ömer Kazancı. The biographical and literary profiles of the 32 authors featured in the anthology are presented. Selected stories are analyzed in terms of structure, theme, and motifs, through which elements of culture and values are identified. Additionally, themes of social criticism, along with linguistic and narrative features, are examined. The study consists of an introduction, three main chapters, a conclusion, and a bibliography. The first chapter provides a historical overview of the Iraqi Turkmen, including their geographical distribution, demographic structure, language characteristics, and literary heritage. The second chapter analyzes the structural components of the stories—such as the distinction between plot-driven and situational narratives, as well as plot, characters, setting, time, language, and style. The third chapter focuses on themes and motifs. To support this thematic analysis, two tables are included: one detailing the authors' educational and professional backgrounds, and another presenting a statistical overview of thematic distribution across the stories. Ultimately, the study aims to highlight the development and richness of contemporary Iraqi Turkmen short story writing and to emphasize the importance of preserving this literary tradition
Transcranial microsurgery as a salvage strategy in giant pituitary adenomas: A single-center experience and long-term follow-up results
No full textIntroduction Endoscopic transsphenoidal surgery (ETSS) is the preferred approach for most pituitary adenomas. However, transcranial microsurgery remains relevant for giant adenomas with complex features. This study presents long-term outcomes and complications in a single-surgeon series of patients with giant pituitary adenomas who underwent transcranial resection. Material and methods This retrospective study analyzed 29 patients with giant pituitary adenomas (≥ 4 cm) who underwent transcranial surgery between 2009 and 2018 at Bursa Uludağ University Faculty of Medicine. Inclusion criteria were: a minimum tumor diameter of 4 cm, histologically confirmed pituitary adenoma, tumor resection via a transcranial approach, regular postoperative follow-up, and a minimum follow-up of 60 months. Data collected included patient demographics, clinical presentation, tumor characteristics, surgical details, extent of resection, and long-term outcomes (minimum 60 months follow-up). Results The mean patient age was 48.17 ± 12.92 years. Vision loss was the most common presenting symptom (n = 20). Gross total resection (GTR) was achieved in 51.7% (n = 15) and subtotal resection (STR) in 48.3% (n = 14). Postoperative improvement in visual function was observed in 48.3% (n = 14), while 20.7% (n = 6) experienced deterioration. Endocrinological remission occurred in 20.7% (n = 6). Complications included diabetes insipidus (24.13%, n = 7), cerebrovascular events (10.34%, n = 3), and mortality (17.24%, n = 5). Conclusions Transcranial surgery for giant pituitary adenomas can achieve favorable outcomes in terms of tumor control and visual function improvement. However, it is associated with a risk of complications, including endocrinological and cerebrovascular events. Careful patient selection, meticulous surgical technique, and close postoperative monitoring are essential for optimizing outcomes. Transcranial microsurgery remains an important tool in the armamentarium of neurosurgeons managing complex giant pituitary adenomas
Role of the probiotic supplementation on intestinal inflammation and structural integrity in Wistar rats subjected to a cafeteria diet during development
No full textProbiotics have gained significant interest in medical and veterinary sciences due to their potential to improve gastrointestinal health. This study investigates the protective role of probiotics on intestinal health in male Wistar rats exposed to a cafeteria diet during development. The experimental groups were divided into four: control, probiotics, cafeteria diet, and cafeteria diet with probiotics. Probiotics groups were administered daily at 1 x 108 CFU throughout the experiment. Ileum and colon tissues were analyzed via Fourier-transform infrared spectroscopy, histopathological analysis, and immunohistochemical staining. The cafeteria diet group showed altered lipid profiles, increased protein carbonylation (a marker of oxidative stress), and increased mast cell density, indicating increased intestinal inflammation. Probiotic supplementation significantly reduced inflammation by reducing TNF-alpha (P <= 0.0001) and IL-1(3 (P <= 0.0001). These results suggest that probiotic supplementation during an unhealthy diet can mitigate adverse effects by reducing oxidative stress and inflammation. Thus, probiotics could offer therapeutic potential in mitigating cafeteria diet-induced intestinal changes, serving as a promising dietary intervention during development to manage metabolic disorders in both humans and animals
Evaluation of the effect and side effect of tyrosine kinase inhibitors on the treatment of metastatic renal cell carcinomas
No full textBu çalışma, metastatik renal hücreli karsinom (mRHK) tedavisinde tirozin kinaz inhibitörlerinin (TKİ) etkinlik ve yan etkilerini retrospektif olarak değerlendirmeyi amaçlamaktadır. mRHK, ileri evrede tanı konulan ve yaşam süresi beklentilerini sınırlayan bir kanser türüdür. Türkiye'de interferon alfa tedavisi geleneksel olarak birinci basamak tedavi olarak uygulanmasına rağmen, progresyon gösteren hastalarda TKİ'ler gibi hedefe yönelik tedaviler öncelikli hale gelmiştir. Çalışmada, 2010-2018 yılları arasında mRHK tanısı almış ve TKİ tedavisi görmüş 65 hasta incelenmiştir. Bu retrospektif analizde, hastaların demografik ve klinik verileri ile tedaviye verilen yanıtlar değerlendirilmiştir. Ana bulgular arasında sunitinib ve pazopanib tedavilerinin sağkalım sonuçlarının literatürle uyumlu olduğu ve yan etkiler arasında halsizlik, hipertansiyon, dermatit gibi etkilerin öne çıktığı belirlenmiştir. Ortalama sağkalım süresi 26 ay olarak hesaplanmıştır. Çalışmanın sonuçları, TKİ’lerin mRHK tedavisindeki etkisini destekler nitelikte olup, gelecekte yapılacak daha geniş hasta gruplarını içeren prospektif çalışmalarla bu etkinliğin daha iyi anlaşılabileceği öne sürülmüştür.This study aims to retrospectively evaluate the efficacy and side effects of tyrosine kinase inhibitors (TKIs) in the treatment of metastatic renal cell carcinoma (mRCC). mRCC is a type of cancer diagnosed at advanced stages and significantly limits life expectancy. In Turkey, interferon-alpha has traditionally been used as a first-line treatment; however, targeted therapies such as TKIs have become a priority for patients showing progression. In the study, 65 patients who were diagnosed with mRCC and treated with TKI between 2010 and 2018 were examined. This retrospective analysis evaluated the demographic and clinical data of patients and their response to treatment. Key findings indicated that the survival outcomes of sunitinib and pazopanib treatments were consistent with the literature, with fatigue, hypertension, and dermatitis being prominent side effects. The average survival duration was calculated as 26 months. The results of the study support the effectiveness of TKIs in the treatment of mRCC and suggest that their impact could be better understood through prospective studies involving larger patient cohorts in the future
The application of scCO2 medium in cellulosic fibers: A sustainable approach in textile production
No full textThis review explores to treat cellulosic fibers in the supercritical carbondioxide (scCO(2)) medium. Substituting traditional chemical processes with supercritical solvents can markedly reduce water consumption and chemical waste in textile manufacturing. This approach not only enhances process efficiency but also preserves the chemical and physical properties of cellulose, thereby minimizing environmental impact. The study advocates for adopting supercritical processes as a novel method for sustainable textile production. It underscores the significant role these processes can play in enhancing sustainability and efficiency within the textile industry
Analysis of temperature distribution in convection ovens using radial and tangential fans with different heat sources and air curtain designs
No full textThe performance of convectional food ovens is critical not only for optimizing the cooking process through rapid and efficient heat transfer but also for ensuring homogeneous temperature distribution both between and within trays. In this study, the effect of radial-type fans used in ovens on the temperature distribution across trays was analyzed using both experimental and numerical methods. It was determined that radial fans in conventional designs increase temperature differences between trays, negatively impacting heat transfer uniformity. To address this issue, an innovative airflow system incorporating a tangential fan (cross-flow fan) was designed. The developed system was subjected to CFD analyses under different fan speeds and heater power settings using the FloEFD software. The most suitable design was determined, and a prototype was subsequently produced. Experimental measurements on the prototype were compared with CFD analysis results, and validation was achieved. The findings indicate that the design utilizing a tangential fan reduced the temperature difference from 35 degrees C to 16 degrees C and provided more efficient heat transfer, achieving 11,4% energy savings within 1 hour. This study comprehensively highlights the impact of fan type, air curtain design, and heating element selection on oven performance, offering an innovative solution to enhance energy efficiency and improve cooking uniformit
Relationship of intensive care unit nurses' attitudes towards futile treatment with compassion fatigue and turnover intention
No full textBackground: Intensive care units (ICUs) are high-stress environments where nurses frequently encounter futile treatments. These experiences can lead to compassion fatigue (CF) and increase turnover intention (TI) among ICU nurses. Aim: To examine the levels of attitudes towards futile treatment (ATFT), CF and TI among ICU nurses, to explore their relationship and identify the factors influencing ATFT. Study Design: This cross-sectional study involved 440 ICU nurses who were members of the Turkish Society of Critical Care Nurses. Data were collected via an online survey using the Attitudes Towards Futile Treatment Scale (ATFTS), Compassion Fatigue-Short Scale (CFS) and Turnover Intention Scale (TIS). Descriptive statistics, correlation analyses and hierarchical regression analyses were conducted to analyse the data. Results: The findings of the study indicated that ICU nurses' ATFTS, CFS and TIS scores were 43.18 ± 6.44, 74.25 ± 23.33 and 8.39 ± 3.03, respectively. There was a significant negative correlation between ATFTS and CFS (r = −0.428, p =.001) as well as TIS (r = −0.204, p =.029). In the final hierarchical regression model, the significant predictors of ATFTS included participation in patient-related decisions (β = −0.148, p =.001), performing futile treatment practices (β = 0.342, p =.001), work burnout (β = −0.165, p =.015), secondary trauma (β = −0.130, p =.011) and TI (β = −0.170, p =.039). Conclusion: This study found that ICU nurses' ATFTs are negatively correlated with compassion fatigue and turnover intention. Enhancing ICU nurses' involvement in decision-making and providing psychological and emotional support to manage compassion fatigue and turnover intention may help improve their attitudes towards futile treatment. Relevance to Clinical Practice: The study highlights the critical need to address compassion fatigue and turnover intention among intensive care unit (ICU) nurses to mitigate their negative attitudes towards futile treatments. By improving emotional resilience and involving nurses more actively in ethical decision-making processes, health care institutions can enhance the quality of care provided in ICUs, reduce turnover rates and ultimately support the well-being of the nursing staff
Lightweight design of lattice-embedded brake pedals using artificial intelligence -based optimization
No full textThe application of lattice structures has become increasingly important in designing complex components due to additive manufacturing (AM) advancements. Various types and design parameters of lattice structures allow weight reduction while maintaining the required strength and improving mechanical properties, with the strength varying based on these parameters. One common approach to calculating this strength is by using software solvers like SimSolid, which employs the meshless analysis solution (MAS). Considering the variety of parameters, the complexity of lattice structures, and the computational difficulties in analysis methods, identifying the optimal lattice structure for a design is highly challenging. To overcome this challenge, artificial neural networks (ANNs) are integrated into the optimization algorithm used in this study. The training data for the ANN are obtained from the analysis results of the designs generated using the design parameters selected by the Latin hypercube sampling (LHS) method. The ANNs integrated non-dominated sorting genetic algorithm II (NSGA-II) optimization algorithm is used to minimize the mass while ensuring the strength of the material by keeping the maximum stress within the permissible limits. The method is applied to the weight reduction of the brake pedal, approximately 26.96 % is achieved while maintaining the required strength under existing conditions
Effect of shear rate and duration change on the rheological properties of cementitious systems having different C 3 A content
No full textTime dependent rheological behavior of cementitious systems significantly affects pumpability, degree of compressibility and hydrostatic pressure. Rheological parameters are affected by cement type, amount and fineness, additive type and dosage, ambient conditions, measurement device, method and process. It was reported that the C3A content is important parameters affecting the rheological behavior of the cementitious systems. However, since the number of studies examining the effect of C3A and measurement methods on thixotropic behavior is limited. In this study, the effects of maximum shear rate, duration and shear rate increase ratio variation on thixotropy of cementitious systems having different C3A content (2.13 %, 3.60 %, 6.82 % and 9.05 %) were investigated. Rheological behavior of mixtures at beginning and 20th-minute was examined by using loop test. As a result of increase in C3A content and decrease in shear rate, the dynamic yield stress, apparent viscosity, structural build-up area and structure formation ratio values increased