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Applications of Catalan Neural Network (CaNN) model
No full textIn this paper, we construct Catalan neural network (CaNN) model and examine the nonlinear solvers of the ordinary nonlinear differential equation using the CaNN model with linear and nonlinear activation functions. Using a single-layer functional linking neural network (FLANN) architecture, we extend input models using the first five Catalan polynomials, update network parameters that we initially randomly select, and use error backpropagation algorithms. The CaNN trial solution for solving nonlinear differential equations is in excellent agreement with the analytical solution. Also, the validity of the CaNN method is investigated by treating second-order differential equations of Lane-Emden type as boundary and initial value problems
Cross-country Treatment Practices after pCR Following Neoadjuvant Trastuzumab (H) and Pertuzumab (P) in HER2+ Early Breast Cancer: Preliminary Results from the PEARL-HER2 Study
No full textBackground: Pts with HER2+ early BC who achieve pCR following neoadjuvant chemotherapy (NACT) with HP routinely continue dual anti-HER2 therapy, although the added benefit of continuing HP versus H alone in this setting remains uncertain, with added cost and toxicity. PEARL-HER2 aims to clarify this question by evaluating whether adjuvant HP provides additional clinical benefit compared to H alone. Here, we report a preliminary cross-country comparison of clinical practices. Method: PEARL-HER2 is an international, retrospective cohort study including pts with HER2+ early BC who achieved pCR (ypT0/isN0) after NACT and HP. Eligible pts started NACT between Jan-2014 and Dec-2023. This descriptive analysis, data cut-off of 20-Jun-2025, summarizes diagnostic, and treatment data stratified by country. Results: Of 1045 pts screened, 649 with pCR were eligible for this analysis. Country-level characteristics are shown in Table 1. Differences in baseline characteristics included a higher proportion of pre-/perimenopausal pts in Argentina (56%), higher ER positivity in Belgium (58%) and lower Ki-67 expression in Turkey (21%). Imaging practices also differed: breast MRI was routinely used in Spain, Portugal, and Belgium, but infrequent in Turkey (15%). Staging with FDG-PET was more commonly employed in Turkey (65%) and Belgium (44%), whereas CT and bone scan were predominant elsewhere. Anthracycline-free regimens were more frequent in Argentina (100%) and Belgium (34%), contrasting with near-universal anthracycline use in Portugal and Turkey. Adjuvant HP was continued in >90% of pts in Belgium vs. <9% in Iberian countries, highlighting disparities in access. Among ER+ patients, ET use was near-universal (97%), though OFS-based combinations were infrequent even in very young pts. With a median follow-up of 44 months (IQR 29-67), only 35 relapses (5.4%) were reported, 18 (51%) of which in the central nervous system (CNS).Conclusion: This preliminary analysis reveals marked international variability in post-pCR management of HER2+ early BC. These findings should be interpreted with consideration of the unequal distribution of patients across countries, with Portugal contributing over two-thirds of the cohort. Differences in imaging and tumor burden likely reflect national screening and staging practices, while variation in adjuvant P use likely reflects national funding policies, with routine access in Belgium but limited or no reimbursement in Iberian countries. Notably, over half of reported relapses occurred in the CNS. PEARL-HER2 continues to accrue and follow patients to clarify the role of adjuvant P in this setting.Table 1. Country-level characteristicsCharacteristicsTotal (n=649)Argentina (n=18)Belgium (n=86)Portugal (n=437)Spain (n=80)Turkey (n=28)p-valueAge at diagnosis in years, median (IQR)51.9 (44.4-62.0)52.9 (40.9-63.2)52.7 (43.9-64.2)52.1 (45.0-61.4)53.8 (42.5-62.1)48.6 (45.2-57.9)0.729Pre-/peri-menopausal status, n (%)303 (46.7)10 (55.6)36 (41.9)208 (47.7)35 (43.8)14 (50.0)0.039NST subtype, n (%)595 (91.8)15 (88.2)81 (94.2)396 (90.6)75 (93.8)28 (100.0)0.788Lobular subtype, n (%)18 (2.8)1 (5.9)4 (4.7)11 (2.5)2 (2.5)0 (0.0)–Grade 3, n (%)322 (49.7)8 (47.1)54 (62.8)216 (49.4)31 (38.8)13 (46.4)0.318ER-negative, n (%)314 (48.4)14 (77.8)36 (41.9)207 (47.4)39 (48.8)18 (64.3)<0.001Ki-67 <20%, n (%)58 (10.2)0 (0.0)7 (8.1)30 (8.3)15 (18.8)6 (21.4)<0.001DCIS present, n (%)191 (29.5)0 (0.0)32 (37.2)113 (25.9)39 (48.8)7 (25.0)<0.001Tumor size in mm, median (IQR)32.0 (23.0-50.0)52.0 (25.0-66.0)31.0 (22.0-47.0)32.0 (23.0-49.0)28.0 (21.0-52.5)30.0 (23.0-40.0)0.246Clinical N0, n (%)251 (38.8)2 (11.1)16 (18.6)185 (42.3)37 (46.3)11 (42.3)<0.001Genetic testing performed, n (%)185 (28.5)5 (27.8)27 (31.4)122 (27.9)26 (32.5)5 (18.5)0.667Breast MRI performed, n (%)552 (85.2)13 (72.2)80 (93.0)375 (85.8)80 (100.0)4 (14.8)<0.001FDG-PET used, n (%)144 (22.3)5 (27.8)38 (44.2)65 (14.9)19 (23.8)17 (65.4)<0.001Anthracycline-based NACT, n (%)536 (82.6)0 (0.0)56 (65.1)396 (90.6)57 (71.3)27 (96.4)<0.001Adjuvant pertuzumab, n (%)137 (21.1)14 (77.8)81 (94.2)37 (8.5)5 (6.3)0 (0.0)<0.001ET use among ER+, n (%)336 (96.8)5 (83.3)45 (91.8)231 (97.9)44 (100.0)11 (91.7)0.028OFS use among pre/peri, n (%)74 (22.0)0 (0.0)10 (22.3)46 (19.9)16 (36.4)2 (18.2)0.042</table
18F-FDG PET/BT görüntülemesinde kahverengi yağ dokusu gelişimini etkileyen hasta ve ortam kaynaklı parametrelerin değerlendirilmesi
No full textDetermining the Difficulties Faced by Syrian Students in a Primary School: A Qualitative Study
No full textArteria Facialis'in Topografik ve Morfometrik Özelliklerinin Kadavra Diseksiyonuve BT Anjiografi ile İncelenmesi
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Comprehensive analysis of FLT3-mutated patients with acute myeloid leukemia with updated 2022 European LeukemiaNet recommendations: insights from the Turkish AML registry project
No full textBackground: This study aimed to evaluate the prognostic significance and clinical impact of the revised 2022 European LeukemiaNet (ELN) classification for acute myeloid leukemia (AML), focusing particularly on patients harboring fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations. Methods: A retrospective, multicenter observational study was conducted by the Turkish Society of Hematology-Acute Leukemias Working Group, analyzing 312 adult patients newly diagnosed with AML from January 2012 to December 2022. Patients with acute promyelocytic leukemia were excluded. FLT3-ITD mutations were detected using polymerase chain reaction and, when available, next-generation sequencing. Patients were classified according to the 2017 ELN risk stratification, and FLT3-ITD-positive cases were reclassified based on the updated 2022 ELN criteria. Endpoints were complete remission (CR), disease-free survival (DFS), and overall survival (OS). Results: FLT3-ITD mutations were identified in 54 (17.3%) patients. According to the 2022 ELN classification, 29 patients previously categorized as the favorable (n = 6) or adverse-risk (n = 23) groups were reclassified into the intermediate-risk group, highlighting the substantial impact of removing the FLT3-ITD allelic ratio from risk stratification. With a median follow-up of 31.8 months, OS significantly differed among the 2017 ELN favorable-, intermediate-, and adverse-risk categories (not reached, 21.6 months, and 9.5 months, respectively, p < 0.001). FLT3-ITD-positive patients demonstrated significantly inferior DFS (p = 0.038) and OS (p = 0.009) compared to FLT3-ITD-negative patients. In patients achieving first CR, allogeneic hematopoietic stem cell transplantation (HSCT) improved OS in intermediate-risk (p = 0.003), showed a trend in adverse-risk (p = 0.098), and no benefit in favorable-risk (p = 0.351). Among reclassified FLT3-ITD-positive patients, survival outcomes aligned closely with the original intermediate-risk group defined by the 2017 ELN, supporting the rationale behind the ELN revision. Conclusions: Our findings validate the prognostic utility of the revised 2022 ELN guidelines, especially regarding FLT3-ITD-positive AML, emphasizing that the exclusion of the FLT3-ITD allelic ratio yields a more biologically consistent risk categorization. Furthermore, the data support tailored ELN-based risk stratification for older AML patients. Given the modest benefit of HSCT in adverse-risk patients, future refinements should further stratify this group to address their unmet therapeutic needs and enhance survival outcomes. Trial registration: The study was registered at ClinicalTrials.gov (NCT05979675)
POLİETİLEN/TERMOPLASTİK NİŞASTA VE POLİ (LAKTİK ASİT)/TERMOPLASTİK NİŞASTA BAZLI AKILLI GIDA AMBALAJLARI ÖZELLİKLERİ ÜZERİNE DOĞAL İNDİKATÖR OLAN KURKUMİNİN ETKİSİ
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