Real-life experience of patients with sarcomatoid renal cell carcinoma: a multicenter retrospective study

Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant

Does progesterone therapy increase nuchal translucency in women with threatened miscarriage?

Objectives: The effect of exogenous progesterone on fetal nuchal translucency (NT) has been proposed recently. In this study, we aimed to compare the thickness of NT of patients receiving and not receiving progesterone for threatened miscarriage. Material and methods: This study was designed as a retrospective comparative study. Ninety five women treated with progesterone constituted the study group whereas 97 women who were not treated with progesterone constituted the control group. An ultrasonographic examination was performed on all of the women to measure NT. All patients were treated with oral micronized progesterone in the study group. The main parameters recorded for each woman were; age, body mass index (BMI), obstetrical characteristics, and gestational age at first examination, treatment duration of progesterone therapy, and results of combined and triple tests. Results: A total of 192 pregnant women with threatened miscarriage were included in this study. The mean NT thickness was statistically significantly higher in the study group (p < 0.001), and mean serum level of human chorionic gonadotropin (hCG) was also higher in this group (p < 0.05). There was no statistically significant difference between groups in terms of age, BMI, and gestational age at first examination. ROC curve analysis demonstrated that only increased NT (area under the curve: 0.634, p = 0.005, 95% CI: 0.541–0.727) was a discriminative factor for women receiving progesterone for threatened miscarriage. Also there was a positive correlation between NT and treatment duration (r = 0.269; p < 0.001). Conclusions: We think that oral progesterone therapy may increase NT depending on treatment duration without causing abnormal prenatal screening test results

Zooplankton of Çat Dam Lake (Malatya-Turkey) with a new record for Turkish rotifers Lecane intrasinuata (Olofsson, 1917)

There are many studies on the zooplankton of Turkish lakes, many of which are about seasonal fluctuations, distribution and hydrological changes. In recent years many scientists focused their attention on the zooplankton of Turkish inland waters (Dumont and De Ridder, 1987; Segers et al., 1992). The family Lecanidae consists of one genus, Lecane Nitzsch, 1827 with about 200 species. This genus is the most common rotifer species inhabiting in various aquatic environments (Segers 1994, 1995, 2008). They are from Monogonont rotifers and are diagnosed by the retractile head, the structure of the foot and toes and by the trophy in the female (Segers, 1995). Lecanids have got a loricate body and the body is compressed dorso-ventrally. The dorso ventral plates are connected by a flexible membrane. The feet have got two primitive segments of which only the posterior is movable. Toes varied remarkably within individuals of the same species (Arora, 1965). Their bodies resemble each other which cause difficulties in identifying species (Segers et al., 1992).

Factors impeding innovation. large and medium enterprises of Tomsk region in the period 2006-2016

The article analyzes the importance of factors impeding innovation of large and mediumsized enterprises of the Tomsk region from 2006 to 2016. The federal and regional statistical data are used for the analysis

COVID-19 infection, vaccine status, and avoidance behaviors in adults with attention deficit and hyperactivity disorder: A cross-sectional study

ObjectiveWe aim to examine infection risk and vaccine status of COVID-19 in attention deficit and hyperactivity disorder and evaluate the impact of demographic, clinical, and COVID-19-related factors on the infection status and behavioral avoidance of COVID-19. MethodsThis cross-sectional study assessed adults with attention deficit and hyperactivity disorder recruited from an outpatient psychiatry clinic. Patients and healthy controls completed a survey on sociodemographic data, COVID-19 infection status, and vaccine status. COVID-19 Disease Perception Scale, COVID-19 Avoidance Attitudes Scale, Attitudes toward COVID-19 Vaccine Scale, Adult Attention Deficit and Hyperactivity Disorder Self-report Screening Scale for DSM-5, Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale Symptoms Checklist, Patient Health Questionnaire-9, and State-Trait Anxiety Inventory were applied. ResultsNinety patients and 40 healthy controls participated. Patients did not differ from controls in COVID-19 infection and vaccine status, and behavioral avoidance of COVID-19. No demographic and clinical factor significantly affected the COVID-19 infection status. Patients scored higher than controls in the perception of COVID-19 as contagious (p = 0.038), cognitive avoidance of COVID-19 (p = 0.008), and positive attitudes toward the COVID-19 vaccine (p = 0.024). After adjustment of possible factors, a positive perception of the COVID-19 vaccine and a perception of COVID-19 as dangerous were the two factors significantly affecting behavioral avoidance of COVID-19 [R-2 = 0. 17, F(2) = 13.189, p < 0.0001]. ConclusionInfection and vaccine status of COVID-19 in patients did not significantly differ from controls. No demographic and clinical factor significantly affected the COVID-19 infection status. Approximately four-fifths of the patients were fully vaccinated as recommended by national and global health organizations. This has increased the knowledge base showing that the COVID-19 vaccine is acceptable and receiving the vaccine is endorsed by ADHD patients. Attention deficit and hyperactivity disorder itself may provoke no kind of mental disturbance in sense of perception of the danger of this disease. Our findings have increased the knowledge base showing that the COVID-19 vaccine is acceptable and the actual practice of receiving the vaccine is endorsed in this population. Our message for practice would be to take into account not only the core symptoms and the comorbidities of the disorder but also the perception of the disease while exploring its link with COVID-19

Preferential scattering by interfacial charged defects for enhanced thermoelectric performance in few-layered n-type Bi2Te3

Over the past two decades several nano-structuring methods have helped improve the figure of merit (ZT) in the state-of-the art bulk thermoelectric materials. While these methods could enhance the thermoelectric performance of p-type Bi2Te3, it was frustrating to researchers that they proved ineffective for n-type Bi2Te3 due to the inevitable deterioration of its thermoelectric properties in the basal plane. Here, we describe a novel chemical-exfoliation spark-plasma-sintering (CE-SPS) nano-structuring process, which transforms the microstructure of n-type Bi2Te3 in an extraordinary manner without compromising its basal plane properties. The CE-SPS processing leads to preferential scattering of electrons at charged grain boundaries, and thereby increases the electrical conductivity despite the presence of numerous grain boundaries, and mitigates the bipolar effect via band occupancy optimization leading to an upshift (by ~ 100 K) and stabilization of the ZT peak over a broad temperature range of ~ 150 K

CA-125/CEA ratio as a prognostic factor in type II endometrial cancer: a single institute experience

Objective: Type II (non-endometrioid) endometrial cancer is less common with an incidence of 10%-20%. It has an aggressive clinical course with heterogeneous clinic pathological features. The aim of this study is to evaluate prognostic factors and survival outcomes in type II endometrial cancer. Patients and Methods: Patients aged over 18 years with diagnosis of Stage IA-IVB type II endometrial cancer were included to the study. Between 2013 and 2019, a total of 76 patients were evaluated retrospectively. Results: Median overall survival (OS) was 25 months while median disease-free survival (DFS) was 22 months. Median DFS was 25 months (95% CI: 14.71-35.28) in patients with negative lymph nodes while it was 10 months (95% CI: 6.88-13.11) in patients with positive lymph nodes (p=0.017). Median OS was 28 months (95% CI: 23.05-32.95) in patients with a ratio of CA-125/CEA<25 while it was 16 months (95% CI: 5.19-26.80) in those with a ratio of CA-125/CEA≥25 (p=0.02). Patients with an Eastern Cooperative Oncology Group performance score (ECOG PS) <2 at the time of diagnosis had a significantly longer OS than ECOG PS≥2 [median 29 months (95% CI: 22.99-35.94) vs. 15 months (95% CI: 0.33-29.66); p=0.024]. In multivariate Cox regression analysis CA-125/CEA (HR:1.70, 95% CI: 1.01-2.83, p=0.042) was independent risk factor for OS. Conclusions: CA-125/CEA ratio may have prognostic significance in type 2 endometrial cancer, but it needs to be supported by randomized clinical trials

Malatya’da Sporun Yaygınlaştırılması Açısından Spor Tesislerinin Yeterlilik Düzeyinin İncelenmesi,

Sporu oluşturan bileşenlerden biri de spor tesisleridir. Topluma en iyi şekilde spor hizmeti verilmesinde spor tesislerinin niteliği önemli bir kriterdir. Sporun yaygınlaştırılmasında spor tesislerinin sayı ve çeşitliliğinin, toplumun spora ilişkin beklenti ve ihtiyaçlarının belli bir politika çerçevesinde ele alınması gerekmektedir. Bu araştırmanın amacı; Malatya’da sporun yayınlaştırılmasında spor tesislerinin yeterlilik düzeyi ve halkın spor eğiliminin incelenmesidir. Bu çalışmaya Malatya il merkezinde bulunan değişik meslek, yaş ve cinsiyet gruplarından oluşan toplam 2020 kişi gönüllü olarak katılmıştır. Çalışmaya katılan deneklere anket uygulanmıştır. Elde edilen verilerin değerlendirilmesinde frekans ve yüzde dağılımları hesaplanarak değişkenler arasında ilişki olup olmadığı Ki-Kare testi uygulanarak test edilmiştir. Araştırma sonucunda, Malatya’da yaşayan halkın çoğunluğunun spora ilgi duyduğu, ilgi duyulan spor branşları arasında futbolun ilk sırada yer aldığı, spor yapılmasına engel teşkil eden etmenlerin başında yeterli spor tesisinin olmamasının yer aldığı, kamu kurum ve kuruluşların yeterince spor tesislerine sahip olmadığı tespit edilmiştir. Ayrıca Malatya‘da kitle sporunun yaygınlaştırılması için spor tesislerinin ve spor kulüplerinin sayısının arttırılması gerektiği, halkın ilgisini çekecek spor organizasyonlarının düzenlenmesi ve mahallelerde semt sahalarının sayısının artırılmasının önemli olduğu sonucuna ulaşılmıştır

Vİews Of The Teachers And Administrators Of The High School Of Fine Arts And Sports On Diversity Management,

This study was conducted for the purpose of determining the views on management of diversity of the administrators and the teachers who work in Fine Arts and Sports High Schools. The sample group of the study consisted of 12 administrators and 70 teachers working in the fine Arts and Sports High Schools in province of Elazig, Usak, Trabzon, Corum and Eskisehir. In order to determine the views of the sample group, a scale developed by Balay and Saglam (2004) was used and the data obtained was analyzed in the SPSS package program. In this study it was determined that managers didn’t discriminate according to sexes, that there was a decrease in views of the managers and teachers that personal attitudes and behaviors and the administrative practices and principles were managed positively with their growing ages and that there was no difference in views of the study group regarding the diversity management in their schools according to their education status, vocational superiority, total service periods in management, service status and vocational field variants. In conclusion, it can be concluded that the differences between the administrators and the teachers in these educational institutions have a positive impact on the direction of improving the quality of education and that the employees’ beliefs, origins, cultural, etc. differences provide an advantage for these institutions and finally there were no discrimination in their administrative concepts