Perspective of turkish medicine students on cancer, cancer treatments, palliative care, and oncologists (ares study): A study of the palliative care working committee of the turkish oncology group (TOG)

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913–2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15–iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840–841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words “cancer” and “oncologist” meant for the students. The participant students were analyzed in two study groups; “group 1” (n = 1.255) were phases I and II students that had never attended an oncology lesson, and “group 2” (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of “death” (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students’ understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. © 2018, American Association for Cancer Education

Modeling, design, and synthesis of gram-scale monodispersed silver nanoparticles using microwave-assisted polyol process for metamaterial applications

High-yield monodispersed silver (Ag) nanospheres were modeled, designed, and synthesized by microwave-assisted (MW-assisted) polyol method from AgNO3, polyvinyl pyrrolidone (PVP), and ethylene glycol (EG), as precursors, at 145 °C within a short reaction time of 2 min, and the results were compared to those of conventional polyol method. Maintaining the PVP:AgNO3 molar ratio, the effect of increasing the amounts of AgNO3 and PVP at a constant amount of EG (40 mL) on the final product was evaluated. The synthesized nanoparticles (NPs) were characterized by SEM, UV–Vis spectroscopy, FTIR and DLS analysis. The results showed that with increasing the amount of AgNO3 to 0.5 and 1 g, monodispersed Ag nanoparticles (Ag NPs) with particle sizes of 54 and 61 nm were formed, as per the plasmon absorption peaks at 436 and 442 nm, respectively. Moreover, using 40 mL of the EG solution, we could obtain a high yield of the NPs (~90%). The sub-gram yield was excellently high, offering great opportunities for commercializing the procedure. Also, the proposed study paves a new way for Ag NPs realization for different practical applications ranging from MW to optics

Seismic Response of Underground Lifeline Systems

This paper presents and discusses the recent developments related to seismic performance and assessment of buried pipelines. The experience from the performance of pipelines during last earthquakes provided invaluable information and lead to new developments in the analysis and technologies. Especially, the pipeline performance during Canterbury earthquake sequence in New Zealand is taken as a case study here. The data collected for the earthquake sequence are unprecedented in size and detail, involving ground motion recordings from scores of seismograph stations, high resolution light detection and ranging (LiDAR) measurements of vertical and lateral movements after each event, and detailed repair records for thousands of km of underground pipelines with coordinates for the location of each repair. One of the important learnings from the recent earthquakes is that some earthquake resistant design and technologies proved to be working. This provides a motivation to increase international exchange and cooperation on earthquake resistant technologies. Another observation is that preventive maintenance is important to reduce the pipeline damage risk from seismic and other hazards. To increase the applicability and sustainability, seismic improvements should be incorporated into the pipe replacement and asset management programs as part of the preventive maintenance concept. However, it is also important to put in the most proper pipeline from the start as replacing or retrofitting the pipelines later requires substantial investment. In this respect, seismic considerations should be taken into account properly in the design phase

Targeted dielectric coating of silver nanoparticles with silica to manipulate optical properties for metasurface applications

An epsilon-negative metamaterial (ENM) containing core@shell nanoparticles (NPs) was designed, where silver (Ag) NPs served as core and silica (SiO2) was used as spacer shell. AgNPs were synthesized in large scale, using microwave-assisted polyol method, in three average particle sizes, as 30, 54, and 61nm, with a narrow particle size distribution. Optical absorption of Ag NPs was investigated using UV–Vis spectroscopy. Their optical behavior was also theoretically predicted for different thicknesses of the SiO2 shell immersed in media of different refractive indices using the Clausius - Mossotti equation. Based on the results, optimal outputs were obtained with a SiO2 shell of 10nm in thickness encompassing 54nm Ag NPs based on the analytical model and numerical simulations here developed for core-shell structures. Then 10nm SiO2 shell was grown on 54nm Ag NPs by sol-gel synthesis. The NPs were then characterized by UV–Vis, TEM, SEM, EDX, DLS, and zeta potential analyses. The synthesized core-shell NPs can be used to establish epsilon-negative properties in polymer layers within visible range of wavelengths

SMEs' purchasing habits : A procurement maturity model for stakeholders

Although micro companies overpower the small and medium enterprise (SME) segment, generalizations are often with medium size companies, and therefore, there are many unknowns, especially when it comes to its buying behavior. Conformist studies and industry practices assume SMEs to be “normative” or “conservative” buyers; however, this hypothesis is untested. This article aims to scrutinize the reality, and proposes a unified model that rejects pre-containerization in buying behavior typologies, as well as selectiveness in terms of audience type, whether it is corporate, SME, or consumer. While replacing researchers’ perceptions with the audience’s, the model yields actual knowledge that can lead to audience’s beliefs in lieu of the opposite, which is used to mislead stakeholders. The study shows that SMEs also buy like individuals and spend in a similar way to consumers’, including not only “normative” and “conservative” but also “negligent” and “impulse” zones. From the research-implications perspective, future studies by behaviorists can explore why SMEs purchase in this way. Marketers may benefit from the finding that SMEs buy like individuals. In addition, SMEs may want to be conscious of their purchasing habits, and—utilizing the newly introduced “risk score” frontier—policymakers should assess the consequences of these habits at the macro level

Analytic philosophy for biomedical research: the imperative of applying yesterday's timeless messages to today's impasses

The mantra that "the best way to predict the future is to invent it" (attributed to the computer scientist Alan Kay) exemplifies some of the expectations from the technical and innovative sides of biomedical research at present. However, for technical advancements to make real impacts both on patient health and genuine scientific understanding, quite a number of lingering challenges facing the entire spectrum from protein biology all the way to randomized controlled trials should start to be overcome. The proposal in this chapter is that philosophy is essential in this process. By reviewing select examples from the history of science and philosophy, disciplines which were indistinguishable until the mid-nineteenth century, I argue that progress toward the many impasses in biomedicine can be achieved by emphasizing theoretical work (in the true sense of the word 'theory') as a vital foundation for experimental biology. Furthermore, a philosophical biology program that could provide a framework for theoretical investigations is outlined

Prevalence of obstructive sleep apnea after treatment for advanced T-stage head and neck cancer

Purpose: Treatment of head and neck cancer (HNC) may lead to obstructive sleep apnea (OSA), but conclusive results on the prevalence of OSA are lacking. The objective of this study is to investigate the prevalence of OSA in a cohort of patients treated for advanced T-stage HNC. Methods: A cross-sectional study was conducted in two tertiary cancer care centers including patients at least 1 year after treatment with curative intent with surgery and/or (chemo)radiotherapy ((C)RT) for advanced T-staged (T3-4) cancer of the oral cavity, oropharynx, hypopharynx, or larynx. A polysomnography (PSG) was performed in all participants. OSA was defined as an apnea–hypopnea index (AHI) of 15 events/h or higher or an AHI of 5 events/h and higher with OSA related symptoms, such as sleeping problems, daytime dysfunction and/or cardiac/metabolic comorbidities collected through file review and questionnaires. Results: Of the 67 participants, 48 (72%, 95% CI 59–82%) were diagnosed with OSA. Possible risk factors are male gender, higher BMI, greater neck circumference, more nicotine pack years, cardiometabolic comorbidities, use of medication with sleepiness as side effect, present tonsils, lower T-stage (T3 vs. T4 stage), higher AJCC stage and a HPV-negative tumor. Conclusion: In this population of advanced T-stage HNC patients, the prevalence of OSA was 72%, which is considerably higher than in the general population (2–50%). Given the high prevalence, screening of this entire subgroup for OSA may be indicated. Future studies to identify high risk factors and develop an OSA screening protocol are needed

Developmental variations in plasma leptin, leptin soluble receptor and their molar ratio in healthy infants

<p>Abstract</p> <p>Background</p> <p>Leptin and its soluble receptor (sOB-R) are important to regulation of body composition but there are no data on the developmental variations in these plasma variables and their relationship with body composition measurements,</p> <p>Methods</p> <p>Weight, length, and body composition (bone, fat and lean mass) by dual energy absorptiometry, and plasma variables were measured in healthy infants at 2, 4, 8 and 12 months.</p> <p>Results</p> <p>15 whites and 29 African Americans (21 males and 23 females) with mean birth weight 3357 +/- 45 (SEM) g and gestation of 39.3 +/- 0.17 weeks were studied. The overall Z score for weight, length and weight for length during the study were 0.00 +/- 0.15, -0.08 +/- 0.11 and 0.12 +/- 0.14 respectively. With increasing age, plasma leptin (1.0 to 18.2, median 5.5 ng/mL) and sOB-R:leptin molar ratio (10.1 to 247.4, median 59.9) were lowered (r = -0.47, p < 0.01; and r = -0.37, p < 0.05 respectively), best predicted by weight Z score and percentage of fat mass, and higher in African American and female. Presence of body composition measurements eliminated the race and gender effect on the plasma variables. Plasma sOB-R (49.5 to 173.9, median 81.3 ng/mL) did not change significantly with age and was correlated and predicted only by body composition measurements.</p> <p>Conclusion</p> <p>In healthy growing infants, plasma leptin but not sOB-R decreases with age. Gender, race and anthropometric measurements are additional physiological determinants predictive of plasma leptin and the receptor:ligand ratio. However, body composition is the only variable that can predict plasma leptin and its soluble receptor and the receptor: ligand ratio; and body composition measurements eliminated the race and gender effect on these plasma variables.</p