Digitális egyenlőtlenségek és digitális tőkemegoszlás Romániában

A tanulmány a digitális egyenlőtlenségek és a digitális tőkemegoszlás romániai helyzetét vizsgálja az európai és a romániai nyilvános statisztikai adatok másodelemzése alapján. Az elemzés két feltételezés megerősítését célozza: 1. a digitális technológia széles körű elterjedése ellenére a digitális egyenlőtlenségek nem egyenlítődnek ki; 2. a hagyományos és a digitális tőke megoszlása hasonló tendenciákat követ. A feltételezéseket a vizsgálat igazolta. Az elmúlt tíz évben Romániában az internethasználók aránya folyamatosan nőtt, azonban a másodlagos és harmadlagos digitális megosztottság tekintetében Románia és az európai országok között jelentős szakadék húzódik. Keywords: digitális egyenlőtlenségek, digitális tőke, digitális technológia diffúziója

A romániai fiatalok szemlélete az internet természetéről és hasznáról

Tanulmányunkban a romániai fiatalok szemléletét vizsgáltuk az internet természetéről és hasznáról. A tanulmány fő kérdése, hogy a romániai fiatalok hogyan viszonyulnak az internethez, ugyanis a pozitív hozzáállás kedvezően, a negatív hozzáállás kedvezőtlenül befolyásolja az internethasználatot. A tanulmány első felében az attitűdök sajátosságait és összetevőit mutattuk be, majd az internethasználat és az internettel kapcsolatos hozzáállás viszonyát tárgyaltuk. A tanulmány második felében az EU Kids Online III (2013) nemzetközi kutatás Romániára vonatkozó kvalitatív empirikus adatai alapján kerestük a választ a tanulmány fő kérdésére

Morphological and pathological response in primary systemic therapy of patients with breast cancer and the prediction of disease free survival

AIM: To identify breast cancer subtypes likely to respond to primary systemic therapy (PST or neoadjuvant therapy) and to assess the accuracy of physical examination (PE) and breast ultrasonography (US) in evaluating and predicting residual size of breast carcinoma following PST. METHODS: 116 patients who received at least two cycles of PST between 1998 and 2009 were selected from a prospectively collected clinical database. Radiological assessment was done by mammography and US. Prior to PST, tumors were subclassified according to core biopsy (NCB) and/or fine-needle aspiration-based immunohistochemical profiles of NCB. Pathological response rates were assessed following the surgeries by using Chevallier classification. Tumor measurements by PE and US were obtained before and after PST. Different clinical measurements were compared with histological findings. Disease-free survival (DFS) was assessed. RESULTS: Pathological complete remission (pCR=Chevallier I/II) was observed in 25 patients (21.5%), 44% of whom had triple negative histology, 28% Her2 positive and 76% had high-grade tumor. Of 116 patients, 24 received taxane-based PST, 48 combined taxane + anthracycline treatment, 8 trastuzumab combinations, 21 anthracycline-based treatments, and 15 other treatments. In the taxane treated group, the pCR rate was 30%, in the taxane + anthracycline group 25%, in the anthracycline group 9.5%, and in trastuzumab group 37.5%. After PST, PE and US were both significantly associated with pathology (P<0.001 and P=0.004, respectively). Concerning OS, significant difference was observed between the Chevallier III and IV group (P=0.031) in favor of Chevallier III group. In the pCR group, fewer events were observed during the follow-up period. CONCLUSIONS: Our results show that even limited, routinely used immunohistochemical profiling of tumors can predict the likelihood of pCR to PST: patients with triple negative and Her2-positive cancers are more likely to achieve pCR to PST. Also, PE is better correlated with pathological findings than US

Response evaluation after primary systemic therapy of Her2 positive breast cancer – an observational cross-sectional study

Aim To evaluate (I) trastuzumab-containing primary systemic therapy (PST) in human epidermal growth factor receptor 2 (Her2) overexpressing breast carcinomas.; (II) compare the pa - tients who achieved and those who did not achieve pathologi - cal complete remission (pCR), and (III) analyze the accuracy of different clinical-imaging modalities in tumor response moni - toring. Methods 188 patients who received PST between 2008 and 2014 were reviewed and 43 Her2 overexpressing breast can - cer patients (28 Luminal B/Her2-positive and 15 Her2-positive) were enrolled. 26 patients received mostly taxane-based PST without trastuzumab (Group 1) and 17 patients received tras - tuzumab-containing PST (Group 2). We compared the con - cordance between pCR and complete remission (CR) defined by breast-ultrasound, CR defined by standard 18F-fluoro-de - oxy-glucose positron emission tomography and computer - ized tomography (FDG-PET/CT) criteria (Method 1) and CR defined by a novel, breast cancer specific FDG-PET/CT criteria (Method 2). Sensitivity (sens), specificity (spec), and positive (PPV ) and negative predictive values (NPV ) were calculated. Results Ten patients (38.5%) in Group 1 and eight (47%) in Group 2 achieved pCR. pCR was significantly more frequent in Her2-positive than in Luminal B/Her2-positive tumors in both Group 1: ( P = 0.043) and Group 2: ( P = 0.029). PET/CT evaluated by the breast cancer specific criteria (Method 2) differentiated pCR from non-pCR more accurately in both groups (Group 1: sens = 77.8%, spec = 100%, PPV = 100%, NPV = 71.4%; Group 2: sens = 87.5%, spec = 62.5%, PPV = 70%, NPV = 83.3%) than standard PET/CT criteria (Method 1) (Group 1: sens = 22.2% spec = 100% PPV = 100% NPV = 41.7%; in Group 2: sens = 37.5%, spec = 87.5%, PPV = 75% NPV = 58.3%) or breast ultrasound (Group 1, sens = 83.3% spec = 25% PPV = 62.5% NPV = 50%; Group 2, sens = 100% spec = 12.5% PPV = 41.6% NPV = 100%). Conclusion The benefit of targeted treatment with trastu - zumab-containing PST in Her2 overexpressing breast cancer was defined in terms of pCR rate. Luminal B/Her2-positive subtype needs further subdivision to identify patients who would benefit from PST. Combined evaluation of tumor re - sponse by our novel, breast cancer specific FDG-PET/CT crite - ria accurately differentiated pCR from non-pCR patients

Ki-67 as a controversial predictive and prognostic marker in breast cancer patients treated with neoadjuvant chemotherapy

BACKGROUND: Studies have partly demonstrated the clinical validity of Ki-67 as a predictive marker in the neoadjuvant setting, but the question of the best cut-off points as well as the importance of this marker as a prognostic factor in partial responder/non-responder groups remains uncertain. METHODS: One hundred twenty patients diagnosed with invasive breast cancer and treated with neoadjuvant chemotherapy (NAC) between 2002 and 2013 were retrospectively recruited to this study. The optimal cut-off value for Ki-67 labeling index (LI) to discriminate response to treatment was assessed by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier curve estimation, log-rank test and cox regression analysis were carried out to reveal the association between Ki-67 categories and survival (DMFS = Distant metastases-free survival, OS = Overall survival). RESULTS: Twenty three out of 120 patients (19.2%) achieved pathologic complete remission (pCR), whereas partial remission (pPR) and no response (pNR) to neoadjuvant chemotherapy (NAC) was detected in 60.8% and 20.0%, respectively. The distribution of subtypes showed a significant difference in pathological response groups (p < 0.001). Most of the TNBC cases were represented in pCR group. The most relevant cut-off value for the Ki-67 distinguishing pCR from pNR cases was 20% (p = 0.002). No significant threshold for Ki-67 was found regarding DMFS (p = 0.208). Considering OS, the optimal cut-off point occurred at 15% Ki-67 (p = 0.006). The pPR group represented a significant Ki-67 threshold at 30% regarding OS (p = 0.001). Ki-67 and pPR subgroups were not significantly associated (p = 0.653). For prognosis prediction, Ki-67 at 30% cut-off value (p = 0.040) furthermore subtype (p = 0.037) as well as pathological response (p = 0.044) were suitable to separate patients into good and unfavorable prognosis cohorts regarding OS. However, in multivariate analyses, only Ki-67 at 30% threshold (p = 0.029), and subtype (p = 0.008) were independently linked to OS. CONCLUSIONS: NAC is more efficient in tumors with at least 20% Ki-67 LI. Both Ki-67 LI and subtype showed a significant association with pathological response. Ki-67 LI represented independent prognostic potential to OS in our neoadjuvant patient cohort, while pathological response did not. Additionally, our data also suggest that if a tumor is non-responder to NAC, increased Ki-67 is a poor prognostic marker

Az FDG-PET-CT szerepe az emlőrák primer szisztémás kezelése során: a metabolikus változások és a patológiai remisszió összefüggései = The Role of FDG-PET-CT in the Evaluation of Primary Systemic Therapy in Breast Cancer: Links Between Metabolic and Pathological Remission

Introduction: FDG-PET-CT is highly sensitive in detection of viable tumour tissue, giving an importance for that in oncological diagnostics. Aim: The authors analysed retrospectively the relationship between metabolic response and changes in Ki-67, a proliferation marker. Methods: Staging FDG-PET-CT scans (before and after therapy) SUVs (Standardized Uptake Value), and morphological changes in the primary tumour and axillary lymph node region were evaluated in 30 patients with breast cancer. Calculated ΔSUV were compared with Ki-67 proliferation marker (measured in biopsies and surgical specimens). Results: The decrease of SUV and size were significant in the primary tumour and the axillary lymph node region. Decrease of Ki-67 was significant. Significant correlation was found between Ki-67 and SUV before therapy, initial Ki-67 and ΔSUV, and ΔKi-67 and ΔSUV. Conclusions: The metabolic changes were more sensitive in the measurement of the therapeutic response than morphological remission, and they correlated well with the pathological response, in not standardized clinical conditions even. Orv. Hetil., 2012, 153, 1958–1964. </jats:p

ONLINE OPPORTUNITIES AND USER TYPES AMONG ROMANIAN YOUNG PEOPLE

The aim of the study is to analyze patterns of online usage of Romanian teenagers aged 9–16 years old, and to define the main online user types among them. We outlined user types taking into consideration differences of individual online media repertoires. The premise of the study is that Romanian young people are not omogeneus regarding their online media repertoires, but we can identify several user types among them. We looked for individual and social factors which influence patterns of online use of Romanian young people. We base our study on the analysis conducted on the empirical data of the EU Kids Online II (2010) project regarding Romanian yout

Digital practices in everyday lives of 4 to 6 years old Romanian children

The purpose of this study is to present some findings of a broader research called Digital literacy and multimodal practices of young children from Romania. The mentioned research was part of the EU COST Action IS1410 involving similar endeavours from over 30 countries (COST 2014; Bakó, 2016: p. 146). In our research we used several sources for data collection such as children and their parents, as well as kindergarten educators. We collected qualitative data using three methods: the visual method of drawing, semi-structured interviews and observation. In this study we present digital practices of 4 to 6 years old Romanian children based on interviews made with the children’s parents. We found similar results to other Romanian (Velicu, Mitarcă, 2016) and European (Chaudron, 2015) research such as: the access and use of digital technology is present but not dominant in the daily routines of Romanian young children; Romanian young children’s favourite digital devices are tablets and smartphones; Romanian young children’s familiar digital activities are watching YouTube videos, playing games, making or watching photos and videos about themselves and their families; Romanian young children learn the use of digital devices by observation and imitation, and through testing; the level of Romanian young children’s digital skills is basic; the digitally unexperienced Romanian parents are not supportive with children’s digital endeavours