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Efficacy of Second-Line Treatments After Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma and Related Prognostic Factors: A Multicenter Study by the Turkish Oncology Group (TOG)
No full textBackground/Aims: The treatment of hepatocellular carcinoma (HCC), which accounts for 90% of all liver cancers, is highly varied. The use of second-line treatments following progression on first-line atezolizumab and bevacizumab (Atez/Bev) for advanced HCC remains controversial. The aim of this study was to analyze the real-world clinical results of second-line treatments in progression after Atez/Bev and to determine the factors affecting prognosis. Materials and Methods: Fifty-eight patients treated with second-line sorafenib, regorafenib, and cabozantinib for progression after first-line Atez/Bev for advanced/metastatic HCC from 20 centers in T & uuml;rkiye between October 2020 and June 2024 were retrospectively analyzed. Responses were evaluated by Response criteria, specifically Response Evaluation Criteria in Solid Tumors (RECIST v1.1) criteria. Median overall survival (OS) and progression-free survival (PFS) were computed with the Kaplan-Meier method. The Cox regression model was utilized to analyze multivariate analyses. Results: About 82.8% of the patients were male and the median age of the whole group was 62 (range, 18-78) years. All patients progressed after first-line Atez/Bev and were given second-line treatment. The most commonly used second-line treatment option was sorafenib (70.7%), followed by regorafenib (12.1%) and cabozantinib (10.3%). Both median PFS (4.1 months) and median OS (7.8 months) were longer in patients treated with sorafenib compared to other treatments. In univariate analyses, Child-Pugh score B, high alpha-fetoprotein (AFP) levels (>200 ng/mL), extrahepatic spread, and Prognostic Nutritional Index (PNI) < 47.6 substantially raised the risk of overall mortality. Multivariate analysis showed that extrahepatic spread (HR (Hazard ratio): 0.41, P = .012), PNI level (HR: 0.24, P = .005), and AFP level (HR:1.97, P = .049) were independent predictors of OS. Conclusion: Although second-line therapies after Atez/Bev show different degrees of efficacy, survival rates are consistent with the literature. Extrahepatic spread, AFP level, and PNI level are the main prognostic factors. In light of this information, personalized treatment strategies may improve outcomes for this challenging patient group
The effect of Tactical Game Model on Increasing Pre-service Physical Education Teachers’ Critical Thinking Dispositions and Skills
No full textAim: The aim of this study is to determine the effect of Tactical Game Model (TGM) on increasing critical thinking dispositions and skills. The general question of the research is to determine whether exposure to the tactical game model has an effect on physical education teacher candidates' critical thinking dispositions and skills. Method: In the research, pre-test, post-test control group and quasi-treatment embedded mixed design were used. Participants were comprised of fifty-four (25 female, 29 male) student teachers from a Physical Education Teacher Education (PETE) program at a public university in Türkiye. Prior to the study, ethical permission was attained from the Hacettepe University Institutional Review Board, Department Review Board (Num. 35853172-755.02.06). The intervention programme was implemented for 10 weeks/20 hours. Basketball lesson was taught with TGFU with the experimental group. All lessons were recorded with a camera. The descriptive analysis method was preferred for analyzing qualitative data. The California Insight Assessment made descriptive statistics of quantitative data. The t-test was used in the dependent groups to compare the pretest and posttest scores of Treatment and the control groups. ANCOVA was used to compare the posttest scores, and to compare the subdimensions. In the collection of qualitative data; Student reflective diaries were collected from the treatment group at the end of each lesson, and semi-structured individual interviews were conducted by the researcher at the end of 8 weeks.Results: In the ANCOVA results, significant differences were found in favor of critical thinking dispositions and critical thinking skills post-test total scores.17 critical thinking components were found under the main themes. İndividual interviews, evidence was obtained that pre-service PETs’ teaching with TGM contributes to critical thinking. Based on the evidence obtained for critical thinking and the changes observed, it can be said that 10-week / 20-hours lessons have shown successful results in developing the critical thinking dispositions and skills.Discussion/Conclusion: The results of this study revealed the function of the Tactical Game Model on critical thinking in terms of teacher training programs. When the post-test scores obtained from the CCTDI obtained from the study were compared, it was observed that there were significant differences between the groups in the sub-dimensions of inquisitiveness, analyticity and maturity.It was found that the scores of the candidates in the TGM group differed significantly from the scores of the candidates in the control group. In our study, it was revealed that critical thinking, which was tried to be handled as a whole in the context of cognitive skills and affective dispositions, could be developed as a result of teaching with TGM for 10 weeks. Evidence was presented in the context of critical thinking dispositions and critical thinking skills.</p
POS1482-HPR COMPARISON OF THE EFFECTIVENESS OF TELEREHABILITATION IN INDIVIDUALS WITH OSTEOARTHRITIS FOLLOWING TOTAL KNEE ARTHROPLASTY: RANDOMIZED CONTROLLED TRIAL
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Memantine loaded micro/nanoscale magnetic motors for the treatment of Alzheimer's Disease
No full textMicro/nanomotors (MNM) are self-propelled devices operating at the nano or microscale, offering significant potential for applications such as drug delivery, cell manipulation, bio-imaging, diagnostics, and environmental remediation. In this study, we report for the first time the development of novel, magnetically actuated MNMs loaded with Memantine (Mem) toward the treatment of Alzheimer's Disease (AD). AD, a neurodegenerative disease with no cure, presents a significant challenge due to its increasing prevalence. This research aimed to design a targeted drug delivery system using Mem, a common AD treatment, loaded onto magnetically maneuverable MNMs. The fabricated Mem-loaded MNMs were thoroughly characterized in terms of morphology, particle size, drug loading efficiency, magnetic actuation and in vitro drug release kinetics. The final formulation exhibited a drug loading efficiency of 14.06 ± 5.2 % and achieved 95 ± 2.4 % drug release within 72 h. The average velocity of the Mem loaded magnetically propelled MNMs was determined as 16.3 ± 2.3 μm/s. Cytotoxicity assessments in SH-SY5Y cells confirmed the non-toxicity of the MNM formulation (77.08 ± 2.5 % viability at 48 h), while efficacy studies demonstrated significant BACE1 inhibition and TrkB upregulation, with superior blood brain barrier (BBB) model suppression versus Mem solution, indicating potential for enhanced BBB drug delivery and therapeutic benefit. Metabolomic analysis corroborated these findings, showing alterations in glutathione, asparagine, phosphatidylcholine, and phosphatidylinositol levels, consistent with AD-related metabolic changes. In vivo biodistribution in Balb-C mice showed significant MNM brain accumulation within 30 min. Altogether, this study suggests that magnetically actuated, Mem-loaded MNMs represent a promising strategy for leveraging efforts in managing Alzheimer's Disease through enhanced, site-specific drug delivery approaches.</p
Penis Reconstruction With Latissimus Dorsi Flap and Challenges for Penis Prosthesis in Phalloplasty
No full textBackgroundSeveral methods of penile reconstruction have been described. Free flaps are considered the most functional and aesthetically appropriate treatment method. The main purpose of this reconstruction is to create the urinary tract and provide the most aesthetically similar structure to the biological penile tissue while also providing penile tissue of a size that will ensure adequate sexual intercourse.This method was investigated through a retrospective analysis of patients who underwent penile reconstruction with a latissimus dorsi free flap, which we believe provides all these features. Thirty patients who underwent surgery between 2020 and 2023 were included in the study group.BackgroundSeveral methods of penile reconstruction have been described. Free flaps are considered the most functional and aesthetically appropriate treatment method. The main purpose of this reconstruction is to create the urinary tract and provide the most aesthetically similar structure to the biological penile tissue while also providing penile tissue of a size that will ensure adequate sexual intercourse.This method was investigated through a retrospective analysis of patients who underwent penile reconstruction with a latissimus dorsi free flap, which we believe provides all these features. Thirty patients who underwent surgery between 2020 and 2023 were included in the study group.MethodologyLatissimus dorsi flap is an important option for patients who need penile reconstruction, including those who want the donor site morbidity to be in a hidden area and those who have concerns about penis size.ResultTissue of a size that provides sexual function and a structure in which a penile prosthesis can be easily inserted is obtained in patients who have undergone penile reconstruction with the latissimus dorsi. In addition, there was no problem in creating a glans penis or corona using this method. Pendular urethral reconstruction was not performed in this case series.ConclusionsWe think that penile reconstruction with Latissimus dorsi, together with some of the modifications described, is one of the most functional and aesthetically appropriate methods
Unveiling the strain uniformity challenge: design and evaluation of a PDMS membrane for precise mechanobiology studies
No full textMechanotransduction and mechanosensing enable cells to respond to mechanical stimuli, essential in various physiological functions. Specialized cell stretching devices use stretchable, transparent, and biocompatible elastomeric membranes to study these responses. However, achieving strain uniformity is a key challenge, affecting data accuracy and reliability. This study designed a polydimethylsiloxane (PDMS) membrane with optimized uniformity for electromechanical cell stretching. Finite element analysis optimized membrane size and shape, achieving a 90% strain uniformity index-a 233% improvement over commercial membranes. By tailoring material properties like cross-linker ratio and curing time, membrane failure issues were resolved, enhancing applications in tissue engineering and mechanobiology research