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Bu çalışmada işyerinde engellilere yönelik tutumlarla sosyal üstünlük yönelimi, sistemi meşrulaştırma, adil dünya inancı ve bazı bireysel-örgütsel değişkenlerle ilişkilerinin belirlenmesi hedeflenmiştir. Araştırma kamuya ait bir işyerinde, çalışmaya gönüllü olarak katılmayı kabul eden tüm personelle gerçekleştirilmiştir.Engellilere yönelik çalışmalar sosyal bilimler içerisinde görece yeni bir alandır. Engelli konusu ve engellilik hali öncelikle tıbbın ardından mimari, şehir planlamacılığı, endüstriyel tasarım gibi bilim dallarının kapsamına girmiş, engellilik hali düzeltilmesi gereken bir bozukluk olarak algılanmıştır. Sosyal model çerçevesinde engellilerin durumunun ele alınması yaklaşık olarak 1960'lı yılların sonrasına denk gelir. İkinci Dünya savaşı sonrasında gazilerin rehabilitasyonu ve azalan işgücüne engeli olan bireylerin katılmasına duyulan gereksinim de engellilik halinin kişisel değil toplumsal bir yaklaşım gerektirdiğini ortaya koymuştur (Bezmez vd., 2011: 17).Günümüzde İnsan Hakları Modeline uygun olarak, toplumsal destek sistemlerinin engeli olan bireylere fırsat eşitliği sağlaması beklenir; ancak olumsuz tutum ve önyargılar bunu zorlaştırır (Subaşıoğlu, 2008: 401). Üstelik engeli olan bireylere yönelik ayrımcılık diğer dezavantajlı gruplara (kadınlar, etnik-dini azınlıklar, LGBTİ+ bireyler) düşünüldüğünde daha görünmez biçimde gerçekleşir. Özellikle engeli olan bireylerin istihdamı tüm dünyada beklenen ve hedeflenen düzeyde gerçekleşmemekte; istihdam edilen engelliler de düşük vasıflı işlerde ve düşük ücretle çalışmaktadırlar (Yıldırım vd., 2011: 48-51).

Background/Objectives: Signaling imbalances involving epidermal growth factor receptor (EGFR) and aldose reductase (ALR2) are frequently associated with the biology of several solid tumors, including non-small-cell lung cancer (NSCLC) and breast cancer. This work sought to prepare and investigate a small set of hydrazonylthiazole derivatives as potential modulators of both targets with relevance to cancer therapy. Methods: Thirteen compounds (1–13) were synthesized and examined for their effects on A549 (NSCLC), MCF-7 (breast cancer), and Jurkat leukemia cells, together with peripheral blood mononuclear cells (PBMCs) to determine selectivity. The most active molecules were further analyzed through apoptosis studies, EGFR and ALR2 inhibition assays, docking calculations, and 200 ns molecular dynamics (MD) simulations. SwissADME was used to estimate pharmacokinetic and drug-likeness features. Results: Among all derivatives, compound 13, prepared here for the first time, showed the strongest activity on A549 and MCF-7 cells (IC50: 1.33 ± 0.41 µM; 1.74 ± 0.38 µM) and displayed a very high selectivity index (SI = 138.9). It also triggered apoptosis in A549 cells and reduced EGFR activity by 74% at 10 µM. In contrast, compound 5 acted as the most efficient ALR2 blocker (KI = 0.08 ± 0.01 µM). MD simulations showed that both compounds maintained stable contact patterns with essential residues in the EGFR and ALR2 binding pockets. SwissADME analysis suggested suitable oral absorption and drug-likeness for both molecules. Conclusions: Compound 13 behaves as a selective EGFR-directed agent capable of inducing apoptotic cell death in NSCLC, while compound 5 shows strong affinity toward ALR2. These outcomes indicate that both structures may serve as useful starting points for further development of small molecules acting on EGFR- and ALR2-related pathways.

Gastric cancer remains one of the most common malignancies and a leading cause of cancer-related mortality worldwide. Human epidermal growth factor receptor 2 (HER2) status is a key biomarker influencing both prognosis and treatment selection. While HER2-positive patients benefit from trastuzumab, outcomes for HER2-low and HER2-zero groups remain less clearly defined. In this retrospective cohort study, we reviewed 507 patients diagnosed with metastatic gastric adenocarcinoma between 2015 and 2023. Patients were classified as HER2-zero (n = 134), HER2-low (n = 303), or HER2-positive (n = 70) based on immunohistochemistry and in situ hybridization results. Clinicopathologic features, treatment strategies, and survival outcomes were analyzed. Kaplan-Meier methods estimated progression-free survival (PFS) and overall survival (OS), whereas Cox regression identified independent prognostic factors. The HER2-positive group achieved a median PFS of 9.0 months and OS of 20.0 months, superior to HER2-zero patients (PFS: 6.1; OS: 14.5;  < .001). HER2-low patients demonstrated intermediate outcomes (PFS: 6.7; OS: 16.6 months). Group distribution was HER2-zero 26.4%, HER2-low 59.8%, and HER2-positive 13.8%. All HER2-positive patients received trastuzumab-based therapy. Multivariate analysis confirmed HER2-positive status as an independent predictive factor for both progression (hazard ratio [HR] = 0.65) and mortality (HR = 0.62). HER2 status is a strong predictive determinant in metastatic gastric cancer. Trastuzumab provided significant real-world benefit for HER2-positive patients, validating the impact of targeted therapy. Notably, HER2-low patients had better outcomes than HER2-zero, supporting the recognition of HER2-low as a distinct subgroup with potential eligibility for future HER2-directed treatments.

Objectives:This study aimed to examine the distribution and variations in vaginal pathogens throughout different trimesters of pregnancy, utilizing both vaginal culture and polymerase chain reaction (PCR) techniques, in order to ascertain the presence and prevalence of microorganisms across the various stages of pregnancy.Materials and Methods:A total of forty-six healthy pregnant women with no reported discharge complaints were recruited for this study. They were monitored at 6-13 weeks, 20-26 weeks, and 32-38 weeks of gestation until delivery. Vaginal swab samples were collected and subjected to multiplex PCR, microscopic examination, aerobic culture media, and gram staining.Results:Candida species (spp.) emerged as the most frequently isolated microorganisms in vaginal swab samples from each trimester, followed by Escherichia coli and Ureaplasma urealyticum. The prevalence of Candida spp. increased proportionally with advancing trimesters. Notably, the pregnancies of these women showed no complications such as premature labor or premature membrane rupture. Gardnerella vaginalis was the predominant microorganism isolated in the first trimester, succeeded by Atopobium vaginae, Bacteroides fragilis, Mobiluncus curtisii, and Mobiluncus mulieris in decreasing order. However, the quantity of Gardnerella vaginalis did not exhibit a significant increase in the second and third trimesters.Conclusion:This study suggests Gardnerella vaginalis as the most commonly isolated vaginal microorganism during the first trimester, alongside other bacterial species associated with bacterial vaginosis. Importantly, the quantities of these bacteria remained relatively stable in the second and third trimesters. These findings suggest a dynamic shift in vaginal microbiota during pregnancy, including an escalation in Candida spp. as pregnancy progresses. Further research is warranted to comprehend the implications of these changes and their potential ramifications for vaginal and feto-maternal health.

Background: Metastatic gastric cancer (GC) and gastroesophageal junction (GEJ) cancer are associated with a poor prognosis. Recent advancements in treatment have incorporated trastuzumab, anti-PD-1 agents, and anti-claudin therapies alongside chemotherapy (ChT), significantly improving outcomes. Contemporary studies predominantly employ doublet ChT as the backbone for these regimens, although historically triplet ChT regimens have been favored, particularly in younger patients requiring rapid tumor shrinkage. Objective: The aim of this study was to compare the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of advanced GC and GEJ adenocarcinoma. Design: This was a retrospective multicenter study. Methods: Patient data were obtained from the databases of 25 hospitals across Turkey. Demographic and clinicopathological characteristics were documented. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan–Meier method, and group discrepancies were assessed with log-rank test. Results: A total of 493 patients were included in the analysis, with similar baseline characteristics between the two groups. The objective response rate was 36.3% in the mDCF group and 38% in the mFOLFOX-6 group (p = 0.7). The median PFS was 6 months for mDCF and 7 months for mFOLFOX-6 (p = 0.2), while the median OS was 12 months for mDCF and 11 months for mFOLFOX-6 (p = 0.4). Grade 3–4 neutropenia occurred in 27.6% of patients treated with mDCF versus 17.8% with mFOLFOX-6 (p = 0.01). Likewise, grade 3–4 anemia was more frequent in the mDCF group (9.5%) compared to the mFOLFOX-6 group (4.8%; p = 0.04). Conclusion: Modified FOLFOX-6 demonstrated comparable efficacy to mDCF in the treatment of advanced GC and GEJ adenocarcinoma. Moreover, mFOLFOX-6 was associated with a lower incidence of hematological adverse effects.

Abstract Introduction This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs). Methods We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey. Results The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second- and ≥third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment. Conclusions and Relevance The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET. This article reports on the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors.

Background: Ampullary adenocarcinoma is a rare cancer for which there are no standard adjuvant treatment recommendations due to the lack of randomized clinical trials. The primary aim of this analysis is to investigate the efficacy of adjuvant FOLFIRINOX treatment in patients with resected ampullary adenocarcinoma. Materials and Methods: This multicenter retrospective cohort study was conducted at 15 institutions in Turkey between August 2007 and January 2024, involving 211 patients with resected, non-metastatic ampullary adenocarcinoma receiving adjuvant chemotherapy with various chemotherapy regimens with or without chemoradiation. Clinicopathological and treatment-related parameters were recorded. Disease-free survival (DFS) and overall survival (OS) were analyzed by using Kaplan–Meier estimates. Cox proportional hazards regression was used to identify covariates associated with OS. Results: The median follow-up time was 52 months, and 116 patients (55.2%) were alive at the time of the analysis. The median age was 61 years (32–82). mFOLFIRINOX was administered to 16.6% of the patients (n = 35). The 3-year DFS rate was 79.41% in the FOLFIRINOX-treated arm and 53.9% in the other treatment arm (p = 0.034 for mDFS). The median OS was non-reached in patients receiving mFOLFIRINOX treatment, while it was 51 months in patients receiving other treatments (p = 0.071). While no statistically significant results were reached, a trend toward statistically significant survival times was observed in the FOLFIRINOX arm. After adjustment for other prognostic parameters, mFOLFIRINOX remained an independent statistically significant parameter for better OS (HR; 95% CI: 3.24; 1.02–10.9; p = 0.046). Conclusions: FOLFIRINOX treatment has shown efficacy in the adjuvant treatment of ampullary cancer, independent of histological subtype. The findings should be validated in large prospective trials.

Background: Adenocarcinoma arising from the ampulla of Vater is an extremely rare neoplasm, and there are limited data regarding frontline therapy for metastatic disease. We investigated the outcomes of first-line treatment with FOLFIRINOX by comparing it with other treatments in patients with advanced ampullary adenocarcinoma. Methods: We included 123 patients with advanced ampullary adenocarcinoma who were treated with frontline FOLFIRINOX (n = 32), fluorouracil (FU)-based chemotherapy (n = 20), and gemcitabine-based chemotherapy (n = 65) between August 2007 and January 2024 in this retrospective study. The median progression-free survival (mPFS) and overall survival (mOS) according to treatment and clinicopathological features were calculated using the Kaplan–Meier method. Results: The median age of the patients was 62 years (range, 36–78), and 75,6% of the patients had an ECOG performance status of 0–1. The mOS were 13 months (95% CI, 10.6–14.4), 11 months (95% CI, 10.6–14.4), and 12 months (95% CI, 10.6–14.4), respectively [p = 0.865]. There were no significant differences in OS among the chemotherapeutic agents according to histological subtypes. However, FOLFIRINOX and FU-based treatments appeared more effective in the intestinal subtype, while gemcitabine-based therapies were less effective. In the pancreaticobiliary subtype, FU-based therapies yielded a shorter outcome compared to FOLFIRINOX and gemcitabine-based therapies. Grade 3 or 4 hematologic toxicities were higher in patients treated with FOLFIRINOX. Conclusions: In advanced ampullary adenocarcinoma, despite higher toxicity, frontline FOLFIRINOX showed a trend toward an OS benefit in the intestinal subtype while providing a similar outcome in the pancreaticobiliary subtype.