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Background The aim of this study was to identify and evaluate the clinicopathologic factors and to elucidate the clinical importance of performance status on the outcome of patients with pancreatic cancer. Materials and method The data of 335 patients with histologically confirmed diagnosis of pancreatic cancer who were treated and followed up between 2000 and 2010 were recorded from medical charts. Results The median age of the patients was 59 years (range 25–88 years) and 226 (67.5 %) were male. The study group comprised localized disease (18 %), locally advanced disease (36 %) and metastatic disease (46 %). The median survival of all patients was 280 days and the 4-year survival rate was 5 %. Univariate analysis indicated that initial poor performance status of patients (PS 2–4) was significantly associated with shorter survival in localized ( p  = 0.015), locally advanced ( p  = 0.01), metastatic stage ( p  < 0.001) and in the whole group ( p  < 0.001). Multivariate analyses also showed the same findings except in local disease ( p  = 0.04 for locally advanced disease, p  = 0.002 for metastatic stage, and p  < 0.001 for all stages). In patients with poor performance status, severe weight loss (>10 %) ( p  = 0.007), large tumor diameter (>3 cm) ( p  = 0.046), and especially metastatic disease ( p  < 0.001) were associated with significantly shorter overall survival. Conclusions The performance status of a patient is the major prognostic factor predicting overall survival for all stages of pancreatic cancer. Severe weight loss, large tumor, and metastatic disease were found to be unfavorable prognostic factors in patients with poor performance status.

Non-small cell lung cancer (NSCLC) is characterized by a complex and heterogeneous molecular basis. Telomerase reverse transcriptase (TERT) gene promoter mutations have been implicated in various cancer types. We aimed to investigate the status of TERT promoter region mutations in NSCLCs and determine associations of clinicopathological connections, driver mutations, programmed death-ligand 1 (PD-L1) expression, and overall survival (OS) in the Turkish population. The study included 186 patients diagnosed with NSCLC at a tertiary care center pathology department between 2017 and 2022. TERT promoter mutations were present in 2.7% and associated with old age (p = 0.015). The levels of PD-L1 expression were higher in TERT mutants (p = 0.016). TERT mutants had shorter median OS than wild types (p = 0.006) and TERT mutation was an independent risk factor (p = 0.004). TERT and EGFR mutations may co-occur and be associated with shorter median OS in patients who continue to receive EGFR treatment (p < 0.001). TERT promoter mutations were associated with high PD-L1 expression and adverse prognosis in NSCLC. In addition, they may play a major role in patients' poor clinical outcomes during EGFR therapy. In conclusion, TERT may be a significant parameter for future follow-up and treatment selection of NSCLC.

Introduction Talazoparib is a strong PARP inhibitor with significant catalytic inhibition as well as the ability to cause PARP entrapment at DNA damage sites. It is one of the recommended treatments for individuals with BRCA-mutant advanced breast cancer, although research on its efficacy in advanced ovarian cancer is limited. The purpose of this study was to evaluate the efficacy of talazoparib in advanced breast and ovarian cancer patients with BRCA mutations. Materials and methods Patients with advanced breast (HR + or TNBC) and ovarian cancer who had germline BRCA mutations were included in this multicenter, retrospective study. There were no exclusion criteria regarding treatment-line, metastatic sites or performance status. All patients received talazoparib treatment via early-access programme. The primary endpoint was PFS. Secondary endpoints were OS and ORR. Results There were 47 and 42 patients in the breast cancer (BC) and ovarian cancer (OC) cohorts, respectively. In BC cohort, after median 13.6 months follow-up the median PFS was 6.5 months (5.0–8.1 months, 95% CI). In this heavily pretreated cohort, the ORR was 31.9% and the estimated 12-month OS rate was 73.6%. In OC cohort, the median follow up period was 13.7 months and the median PFS was 9.1 months (7.3–10.8 months, 95% CI). The ORR was 47.6% and the estimated 12-month OS rate was 75.9% in OC patients. Conclusion Talazoparib may be an effective therapy option for patients with advanced BRCA-mutant breast cancer. In the absence of prospective phase 2/3 data, the outcomes of OC cohort may also considerably contribute to the literature on BRCA-mutant ovarian cancer.

: We aimed to evaluate the real-world outcomes of first-line osimertinib in patients with advanced -mutant non-small cell lung cancer, together with the progression patterns, including the management and outcomes of oligoprogressive disease in the real-world setting. : Patients who received first-line osimertinib at 33 oncology centers across Türkiye were retrospectively analyzed. : The median (IQR) age of 143 patients was 59.4 (50.9-68.9), 62.9% were female, and 68.5% were non-smokers. The most frequently identified mutations were exon 19 deletion (64.3%) and exon 21 L858R (28.7%). The median progression-free survival (PFS) was 17.6 months (95% CI 14.6-20.6). Exon 19 deletion subgroup had significantly longer median PFS than exon 21 L858R subgroup (22.0 vs. 11.7 months; HR = 0.40 [95% CI 0.25-0.64]; < 0.001). Of the patients who experienced disease progression, 51.2% had oligoprogression. Among these, 81.8% received local ablative treatments (LATs) while continuing osimertinib. The median time to osimertinib discontinuation was significantly longer in patients treated with LATs than in those who continued osimertinib without LATs (8.5 vs. 3.0 months; = 0.001). In the overall cohort, 12- and 24-month overall survival (OS) rates were 93.0% and 82.5%, respectively. The median OS was significantly longer in patients with oligoprogression compared to those with systemic progressive disease (57.7 vs. 36.5 months; = 0.007). Any-grade and grade ≥ 3 osimertinib-related adverse events occurred in 55.2% and 6.3% of patients, respectively. : This study supports the real-world effectiveness and tolerability of first-line osimertinib. Oligoprogression was associated with longer OS compared with systemic progression, and the integration of LATs in carefully selected patients with oligoprogression may be associated with prolonged osimertinib treatment duration and favorable post-progression outcomes.

This study evaluated whether prophylactic treatment with a cefazolin could prevent infections in patients who had a surgically inserted totally implantable venous access device (TIVAD). We conducted a prospective, randomized, double-blind, placebo-controlled trial comparing wound infection rates in 404 patients (203 received prophylactic cefazolin, 201 received a placebo) undergoing TIVAD insertion. Infections were evaluated 3, 7, 14, and 30 days after discharge and outcomes were compared and analyzed. Groups were well matched for all preoperative variables studied, including comorbid conditions. Superficial surgical site infection developed in 5 patients (2.5%) from the antibiotic group and 6 (3%) from the placebo group ( P = .75). One from each group developed deep surgical site infection. Both patients were readmitted and underwent repeated debridement, which eventually resulted in port loss in 1 patient. We do not recommend the use of prophylactic antibiotics in TIVAD insertion because they will not decrease the already low rate of postoperative infectious complications. Registration number NCT00867295 ( http://www.clinicaltrials.gov).

In this research, the removal of boron and arsenic from geothermal water was examined by using novel N-methyl-d-glucamine functionalized gel-like resins (abbreviated as 1JW and 2JW) synthesized by the membrane emulsification method. The outcomes were compared with those of commercially available boron selective chelating ion exchange resin (Diaion CRB 05). According to the results obtained with the novel resins, it was possible to reduce both boron and arsenic concentrations in geothermal water by using these novel gel-like chelating resins below their permissible levels for agricultural irrigation (<1 mg B/L) and drinking water (<0.01 mg As/L) by using the batch method. The optimum resin concentration required for almost complete boron removal (more than 95%) with the two chelating resins was determined to be 2 g/L. The novel gel-like chelating resins 1JW and 2JW achieved 94% of arsenic removal by using the resin concentration of 8 g/L, while the required resin concentration was 32 g/L for 94% of arsenic removal using commercially available Diaion CRB05 resin. In addition, the column performance characteristics of the novel chelating resins for the separation of boron were studied, and the results were compared to those obtained with Diaion CRB05. According to the column data obtained, the total resin capacities of the Diaion CRB05, 1JW, and 2JW resins were calculated as 6.29, 5.08, and 4.64 mg B/mL-resin, respectively.

We aim to derive a fraud detection approach applicable to conditions where historical fraud data is absent, inadequate, or outdated for making predictions. To this end, we propose a new approach to fraud detection based on expert opinion, enabling tailored tools for various conditions of economic/institutional environments. For this, we determined the relative importance of common fraud indicators based on a widely used model in the literature. We then used this information to formulate a scoring alternative to conventional versions, which uses either the original coefficients or the coefficients obtained from training the model. Finally, these scoring alternatives were compared by their detection performances. The design of this research demanded a multifaceted dataset consisting of expert opinions, financial statement data of non-financial companies in the Istanbul Stock Exchange, and local regulatory authority’s notifications on fraudulent companies. The analysis of the detection performances indicates that the proposed alternative scoring method poses a feasible alternative with competitive performance and fewer data requirements. This research’s approach sidesteps the training data requirement and provides financial analysts, auditors, and regulatory bodies a versatile classifier for various use cases regarding financial data, such as detecting fraudulent financial activity, as demonstrated in this study.

In this study, the development and validation of a 35th percentile female multi-body head–neck model are presented to study whiplash-related disorders in rear-end impacts. The volunteer sled tests conducted by the Japan Automobile Research Institute (JARI) with an impact velocity of 7.9 km/h have been utilized for the validation process. The proposed method in the development of the female multi-body head-neck model is characterized by its simplicity, efficiency, and capability of the biofidelic responses. Compared to the volunteer response corridors, the model has maximum absolute errors of 3.67 mm and 2.45 deg in head translational and head angular displacements, respectively, in the most optimum solution. The outcomes demonstrate that this head-neck model for a 35th-percentile female can give a high level of accuracy in rear impact simulations.

Background Total-body positron emission tomography/computed tomography (PET/CT) scanners are characterized by higher signal collection efficiency and greater spatial resolution compared to conventional scanners, allowing for delayed imaging and improved image quality. These advantages may also lead to better detection of physiological processes that diagnostic imaging professionals should be aware of. The gallbladder (GB) is not usually visualized as an 18 F-2-fluorodeoxyglucose ( 18 F-FDG)-avid structure in routine clinical PET/CT studies; however, with the total-body PET/CT, we have been increasingly visualizing GB activity without it being involved in an inflammatory or neoplastic process. The aim of this study was to report visualization rates and characteristics of GB 18 F-FDG uptake observed in both healthy and oncological subjects scanned on a total-body PET/CT system. Materials and methods Scans from 73 participants (48 healthy and 25 with newly diagnosed lymphoma) who underwent 18 F-FDG total-body PET/CT were retrospectively reviewed. Subjects were scanned at multiple timepoints up to 3 h post-injection. Gallbladder 18 F-FDG activity was graded using liver uptake as a reference, and the pattern was qualified as present in the wall, lumen, or both. Participants’ characteristics, such as age, sex, body-mass index, blood glucose, and other clinical parameters, were collected to assess for any significant correlation with GB 18 F-FDG uptake. Results All 73 subjects showed GB uptake at one or more imaging timepoints. An increase in uptake intensity overtime was observed up until the 180-min scan, and the visualization rate of GB 18 F-FDG uptake was 100% in the 120- and 180-min post-injection scans. GB wall uptake was detected in a significant number of patients (44/73, 60%), especially at early timepoint scans, whereas luminal activity was detected in 71/73 (97%) subjects, especially at later timepoint scans. No significant correlation was found between GB uptake intensity/pattern and subjects’ characteristics. Conclusion The consistent observation of GB 18 F-FDG uptake recorded in this study in healthy participants and subjects with a new oncological diagnosis indicates that this is a normal physiologic finding rather than representing an exception.

Objective: To provide an overview of drug use in children in three European countries. Design: Retrospective cohort study, 2000-5. Setting: Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants: 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure: Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of \"recurrent/chronic\" use (three or more prescriptions a year) and \"non-recurrent\" or \"acute\" use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results: Three levels of drug use could be distinguished in the study population: high (>10/100 children per year, moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion: This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.