The linguistic validation of the gut feelings questionnaire in Turkish.

BACKGROUND: 'Gut feelings' are frequently used by general practitioners in the clinical decision-making process, especially in situations of uncertainty. The Gut Feelings Questionnaire (GFQ) has been developed in the Netherlands and is now available in English, French, German, Polish, Spanish, and Catalan, enabling cross-border studies on the subject. However, a Turkish version of the GFQ is lacking. OBJECTIVES: A Turkish version of the GFQ. METHODS: A linguistic validation procedure was conducted, which took place in six phases: forward translation (step 1), backward translation (step 2), first consensus (step 3), cultural validation (step 4), second consensus (step 5), and final version (step 6). RESULTS: The absence of literal equivalent of the term 'gut feelings' in Turkish was determined. The word 'intuition' was chosen as the Turkish literal equivalent of 'gut feelings'. There were also some challenges in finding the exact meanings of words and expressions in Turkish literature. However, we succeeded in finding adequate and responsible solutions. A Turkish version of the GFQ is available now. CONCLUSION: With these validated GFQs, Turkish GPs can facilitate studies of the role of 'gut feelings' in clinical reasoning.

Oxygen transmission rates of skin substitutes and graft survival.

AIM: Oxygen is required for cell migration into the scaffold and for the survival of the overlying graft in the use of a single-layer scaffold. In the absence of diffusion from the avascular wound base, such as in areas above the bone/tendon, oxygen delivery from the lateral edges of the scaffold is important. This study compared the oxygen permeability of skin scaffolds, currently commercially available in Turkey (Nevelia®, MatriDerm®, and Pelnac®), in the lateral plane. MATERIALS AND METHODS: To measure oxygen permeability, an interconnected closed system was created. Oxygen permeability was evaluated based on the color change that occurred as a result of the reaction of iron with oxygen. After the dermal matrices placed in the closed system were exposed to oxygen, the color change on the surface of the dermal matrices was measured, and electron microscopic images were recorded to compare deformation before and after the procedure. RESULTS: Two scaffolds did not show deformation after the procedure while Pelnac® had minimal deformation. The oxygen rates on the nitrogen side of the test apparatus were found to be 29%, 34%, and 27% for Nevelia®, MatriDerm®, and Pelnac®, respectively; and the oxygen transmission lengths (length of color change) of these scaffolds in the lateral plane were 1, 2, and 0.5 cm, respectively. CONCLUSION: Although none of the scaffolds showed significant deformation, and all continued to exhibit their scaffold properties after the procedure, MatriDerm® was determined to be the most suitable scaffold for use in avascular areas, with a 2-cm oxygen transmission length in terms of lateral oxygenation.

Outcomes of Sterotactic Body Radiotherapy (SBRT) for pelvic lymph node recurrences after adjuvant or primary radiotherapy for prostate cancer.

BACKGROUND: There is a paucity of data on the management of recurrent lymph nodes after primary or adjuvant radiotherapy (RT) for prostate cancer (PCa). In this study, we report our tertiary cancer center experience with stereotactic body radiotherapy (SBRT) for the management of pelvic lymph node recurrences after adjuvant or primary RT for PCa. MATERIALS AND METHODS: Patients who underwent SBRT for pelvic lymph node metastases from PCa between 2013 and 2019 were retrospectively assessed for local control (LC), androgen deprivation treatment-free survival (ADT-FS), and toxicity outcomes. The primary endpoint was LC and ADT-FS. The secondary endpoint was late treatment toxicity. RESULTS: Twenty-two lesions of 18 patients receiving SBRT for pelvic lymph node recurrences for PCa between February 2013 and March 2019 were evaluated. At a median follow-up duration of 29.5 months (range: 9-54 months), LC was 95.5% vs. 90.2% at 1 and 2 years, respectively. Ten patients received palliative ADT following SBRT after a median period of 14.5 months (range: 6-31 months). ADT-FS was 72.2% and 54.3% at 1 and 2 years, respectively. Comparative analysis of biologically effective dose (BED) values revealed that higher BED10 values were associated with higher ADT-FS (P = 0.008). ADT-FS was 55.6% and 88.9% for BED10 <50 Gy and for BED10 >50 Gy, respectively (P = 0.008). Assessment of late toxicity outcomes revealed that the most common toxicity was urinary toxicity and fatigue; however, no patient had ≥ grade 3 toxicity. CONCLUSION: Our tertiary cancer center experience confirms the safety and efficacy of SBRT for the management of pelvic lymph node recurrences from PCa.

Comparative outcomes of short-term and long-term fractionation with temozolomide in older glioblastoma patients: Single-center experience.

Background: The main goal of our study is to comparatively evaluate outcomes of hypofractionation and long-term fractionation with temozolomide (TMZ) in glioblastoma patients older than 65 years. Methods: Eighty patients with glioblastoma meeting the eligibility criteria of >65 years of age, the Karnofsky performance score (KPS) >60, no previous radiotherapy (RT) to the brain referred to our department between October 2009 and October 2016 for adjuvant chemoradiotherapy after surgery were studied. The first group of patients received a dose of 6000 cGy in 30 fractions and the second group was delivered 4000 cGy in 15 fractions All patients used TMZ concomitantly with RT. We used the paired t-test and the Wilcoxon signed-rank test with Statistical Package for the Social Sciences, version 15.0 (SPSS, Inc., Chicago, IL, USA) software for statistical analysis. Results: Forty-six patients were men (57.5%), and 34 patients (42.5%) were woman. Median age was 68 years (range 66-87). Median KPS was 75 (range 60-100). Median follow-up time was 12 months (range 6-30). Median overall survival was 15.2 months and 14.3 months for patients with hypofractionation and conventional fractionation, respectively, with no statistical significance (P = 0.13). Conclusion: Hypofractionation should be recommended to the elderly glioblastoma patients older than 65 years because of the short treatment time, reduced acute adverse effects of both TMZ and RT compared to long-term fractionation.

Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults.

Pilocytic astrocytoma (PA) may be seen in both adults and children as a distinct histologic and biologic subset of low-grade glioma. Surgery is the principal treatment for the management of PAs; however, selected patients may benefit from irradiation particularly in the setting of inoperability, incomplete resection, or recurrent disease. While conventionally fractionated radiation therapy has been traditionally utilized for radiotherapeutic management, stereotactic irradiation strategies have been introduced more recently to improve the toxicity profile of radiation delivery without compromising tumor control. PAs may be suitable for radiosurgical management due to their typical appearance as well circumscribed lesions. Focused and precise targeting of these well-defined lesions under stereotactic immobilization and image guidance may offer great potential for achieving an improved therapeutic ratio by virtue of radiosurgical techniques. Given the high conformality along with steep dose gradients around the target volume allowing for reduced normal tissue exposure, radiosurgery may be considered a viable modality of radiotherapeutic management. Another advantage of radiosurgery may be the completion of therapy in a usually shorter overall treatment time, which may be particularly well suited for children with requirement of anesthesia during irradiation. Several studies have addressed the utility of radiosurgery particularly as an adjuvant or salvage treatment modality for PA. Nevertheless, despite the growing body of evidence supporting the use of radiosurgery, there is need for a high level of evidence to dictate treatment decisions and establish its optimal role in the management of PA. Herein, we provide a concise review of radiosurgery for PA in light of the literature.

Optimal timing of thoracic irradiation for limited stage small cell lung cancer: Current evidence and future prospects.

Lung cancer is a global health concern as the leading cause of cancer related mortality worldwide. Small cell lung cancer (SCLC) poses a formidable challenge to the treating physicians with the worst prognosis among all lung cancers. However, limited stage SCLC (LS-SCLC) has a relatively better outcome with multimodality management. Efforts have been focused on optimal integration of treatment modalities to achieve an improved therapeutic ratio for patients with LS-SCLC. While chemotherapy and thoracic radiation therapy (TRT) are primary components of initial management for LS-SCLC, there is no consensus on optimal timing of TRT. Within this context, we herein provide a concise overview of current evidence and future prospects regarding the optimal timing of thoracic irradiation for LS-SCLC in light of the literature.

Adaptive radiation therapy (art) for patients with limited-stage small cell lung cancer (LS-SCLC): A dosimetric evaluation.

Background: Adaptive radiation therapy (ART) refers to redesigning of radiation therapy (RT) treatment plans with respect to dynamic changes in tumor size and location throughout the treatment course. In this study, we performed a comparative volumetric and dosimetric analysis to investigate the impact of ART for patients with limited-stage small cell lung cancer (LS-SCLC). Methods: Twenty-four patients with LS-SCLC receiving ART and concomitant chemotherapy were included in the study. ART was performed by replanning of patients based on a mid-treatment computed tomography (CT)-simulation which was routinely scheduled for all patients 20-25 days after the initial CT-simulation. While the first 15 RT fractions were planned using the initial CT-simulation images, the latter 15 RT fractions were planned using the mid-treatment CT-simulation images acquired 20-25 days after the initial CT-simulation. In order to document the impact of ART, target and critical organ dose-volume parameters acquired from this adaptive radiation treatment planning (RTP) were compared with the RTP based solely on the initial CT-simulation to deliver the whole RT dose of 60 Gy. Results: Statistically significant reduction was detected in gross tumor volume (GTV) and planning target volume (PTV) during the conventionally fractionated RT course along with statistically significant reduction in critical organ doses with incorporation of ART. Conclusion: One-third of the patients in our study who were otherwise ineligible for curative intent RT due to violation of critical organ dose constraints could be treated with full dose irradiation by use of ART. Our results suggest significant benefit of ART for patients with LS-SCLC.

Concise review of stereotactic irradiation for pediatric glial neoplasms: Current concepts and future directions.

Brain tumors, which are among the most common solid tumors in childhood, remain a leading cause of cancer-related mortality in pediatric population. Gliomas, which may be broadly categorized as low grade glioma and high grade glioma, account for the majority of brain tumors in children. Expectant management, surgery, radiation therapy (RT), chemotherapy, targeted therapy or combinations of these modalities may be used for management of pediatric gliomas. Several patient, tumor and treatment-related characteristics including age, lesion size, grade, location, phenotypic and genotypic features, symptomatology, predicted outcomes and toxicity profile of available therapeutic options should be considered in decision making for optimal treatment. Management of pediatric gliomas poses a formidable challenge to the physicians due to concerns about treatment induced toxicity. Adverse effects of therapy may include neurological deficits, hemiparesis, dysphagia, ataxia, spasticity, endocrine sequelae, neurocognitive and communication impairment, deterioration in quality of life, adverse socioeconomic consequences, and secondary cancers. Nevertheless, improved understanding of molecular pathology and technological advancements may pave the way for progress in management of pediatric glial neoplasms. Multidisciplinary management with close collaboration of disciplines including pediatric oncology, surgery, and radiation oncology is warranted to achieve optimal therapeutic outcomes. In the context of RT, stereotactic irradiation is a viable treatment modality for several central nervous system disorders and brain tumors. Considering the importance of minimizing adverse effects of irradiation, radiosurgery has attracted great attention for clinical applications in both adults and children. Radiosurgical applications offer great potential for improving the toxicity profile of radiation delivery by focused and precise targeting of well-defined tumors under stereotactic immobilization and image guidance. Herein, we provide a concise review of stereotactic irradiation for pediatric glial neoplasms in light of the literature.

Adaptive radiation therapy of breast cancer by repeated imaging during irradiation.

Breast cancer is the most frequent cancer among females and also a leading cause of cancer related mortality worldwide. A multimodality treatment approach may be utilized for optimal management of patients with combinations of surgery, radiation therapy (RT) and systemic treatment. RT composes an integral part of breast conserving treatment, and is typically used after breast conserving surgery to improve local control. Recent years have witnessed significant improvements in the discipline of radiation oncology which allow for more focused and precise treatment delivery. Adaptive radiation therapy (ART) is among the most important RT techniques which may be utilized for redesigning of treatment plans to account for dynamic changes in tumor size and anatomy during the course of irradiation. In the context of breast cancer, ART may serve as an excellent tool for patients receiving breast irradiation followed by a sequential boost to the tumor bed. Primary benefits of ART include more precise boost localization and potential for improved normal tissue sparing with adapted boost target volumes particularly in the setting of seroma reduction during the course of irradiation. Herein, we provide a concise review of ART for breast cancer in light of the literature.

Breathing adapted radiation therapy for leukemia relapse in the breast: A case report.

BACKGROUND: Infiltration of the breast by leukemic cells is uncommon but may manifest as an oncological emergency requiring prompt management. Extramedullary relapse of T-cell acute lymphoblastic leukemia (T-ALL) within the breast is exceedingly rare and there is paucity of data in the literature regarding this entity. No consensus exists on management of isolated extramedullary breast relapses of T-ALL. Herein, we report a case of isolated extramedullary breast relapse of T-ALL treated with breathing adapted radiation therapy (BART) using the active breathing control (ABC) system. CASE SUMMARY: The patient was a 33-year-old female with diagnosis of T-ALL. She received intensive systemic chemotherapy that resulted in complete remission of her disease, and then underwent allogeneic hematopoietic stem cell transplantation. After a 15 mo period without symptoms and signs of progression, the patient presented with palpable masses in both breasts. She complained from severe pain and swelling of the breasts. Imaging workup showed bilateral breast lesions, and diagnosis of breast infiltration by leukemic cells was confirmed after immunohistopathological evaluation. The patient suffering from severe pain, discomfort, and swelling of both breasts due to leukemic infiltration was referred to the Radiation Oncology Department for symptomatic palliation. Whole breast irradiation was delivered to both breasts of the patient with BART using the ABC system. The patient had complete resolution of her symptoms after treatment with BART. CONCLUSION: BART with the ABC system resulted in complete resolution of the patient's symptoms due to leukemic infiltration of both breasts with T-ALL. This contemporary treatment technique should be preferred for radiotherapeutic management of patients with leukemic infiltration of the breasts to achieve effective symptomatic palliation.

Production of a new platform based calixarene nanofiber for controlled release of the drugs.

The aim of this study is to develop an electrospun calixarene nanofiber based calixarene for controlled release of hydrophobic drugs. To accomplish this, we have synthesized 5,17-bis-[Methyl-N-Methyltranylate]-25,26,27,28-tetrahydroxycalix[4]arene (Compound 3) of which nanofiber (F-14) was produced by electrospinning. The fabricated multilayered electrospun nanofiber was first characterized in terms of morphology and then drug loading and release kinetics were studied in different physiological pH. For this purpose, we have selected two fluorescent drugs which are thiabendazole (Tbz) and donepezil (Dnp) as model drugs to show the usage of the synthesized nanofiber in drug delivery system. Drug loading and release kinetics were monitored by using fluorescence spectroscopy. According to the results, maximum amount of loaded Dnp onto nanofiber was found to be as 30.529 µg in 20 mM Tris buffer, pH 7.4 end of 120 min. Data showed that loading amount of Tbz onto the nanofiber was measured to be as 1.688 µg to the 2.25 cm2 of surface in 20 mM of Tris buffer, pH 7.4 at the end of 120 min. While max release of Dnp from nanofiber was also 9.720 µg at pH 2.2, that of Tbz from nanofiber was 0.243 µg at pH 7.4 at the end of 90 min. Drug loading to nanofibers was clarified by SEM, TEM, EDX and FT-IR analysis.

Fabrication of Calixarene Based Protein Scaffold by Electrospin Coating for Tissue Engineering.

In this study, calixarene was synthesized by using different functional groups as p-tert-butyl-Calix[4]arene ester and amides. Calixarene nanofibers were produced by electrospin coating. Protein immobilization onto the calixarene nanofibers was carried out with human serum albumin (HSA). The maximum amount of binding on produced three different calixarene nanofibers (DE, 2-AMP and 3-AMP) was compared by using a fluorescence technique for protein analysis. Result showed that maximum binding amount was found to be as 177.85 mg cm-2 for 3-AMP surface. The protein binding was also characterized by using SEM, TEM, AFM and FT-IR. From obtained results, calixarene-albumin nanofiber was also fabricated by spin coating using 3-AMP which has ability max binding of protein.

Electrospun Nanofibrous Polyacrylonitrile/calixarene Mats: an Excellent Adsorbent for the Removal of Chromate Ions from Aqueous Solutions.

Herein, calixarene molecules containing piperidine units at lower rim or upper rim of calix skeleton was turned into a water resistant composite nanofiber adsorbent using polyacrylonitrile (PAN) polymeric support via electrospinning process. The PAN based calixarene nanofibrous adsorbents showed an excellent adsorption capacity toward the toxic chromate anions in aqueous solution. Furthermore, this new nanofiber mats would be promising filter materials for drinking water purification.

Topotactic Synthesis of Porous Cobalt Ferrite Platelets from a Layered Double Hydroxide Precursor and Their Application in Oxidation Catalysis.

Monocrystalline, yet porous mosaic platelets of cobalt ferrite, CoFe2 O4 , can be synthesized from a layered double hydroxide (LDH) precursor by thermal decomposition. Using an equimolar mixture of Fe2+ , Co2+ , and Fe3+ during co-precipitation, a mixture of LDH, (FeII CoII )2/3 FeIII1/3 (OH)2 (CO3 )1/6 ⋅m H2 O, and the target spinel CoFe2 O4 can be obtained in the precursor. During calcination, the remaining FeII fraction of the LDH is oxidized to FeIII leading to an overall Co2+ :Fe3+ ratio of 1:2 as required for spinel crystallization. This pre-adjustment of the spinel composition in the LDH precursor suggests a topotactic crystallization of cobalt ferrite and yields phase pure spinel in unusual anisotropic platelet morphology. The preferred topotactic relationship in most particles is [111]Spinel ∥[001]LDH . Due to the anion decomposition, holes are formed throughout the quasi monocrystalline platelets. This synthesis approach can be used for different ferrites and the unique microstructure leads to unusual chemical properties as shown by the application of the ex-LDH cobalt ferrite as catalyst in the selective oxidation of 2-propanol. Compared to commercial cobalt ferrite, which mainly catalyzes the oxidative dehydrogenation to acetone, the main reaction over the novel ex-LDH cobalt is dehydration to propene. Moreover, the oxygen evolution reaction (OER) activity of the ex-LDH catalyst was markedly higher compared to the commercial material.

Two novel calixarene functionalized iron oxide magnetite nanoparticles as a platform for magnetic separation in the liquid-liquid/solid-liquid extraction of oxyanions.

This article focuses on the syntheses of 25,27-bis[3-(N-ethylsulfonic acid)aminopropxy]-26,28-dihydroxy-5,11,17,23-tetra-tert-butyl-calix[4]arene (3) and 25,27-bis[3-(N-ethyl-dihydrogen phosphate)aminopropxy]-26,28-dihydroxy-5,11,17,23-tetra-tert-butyl-calix[4]arene (4) as well as their immobilization onto [3-(2,3-epoxypropoxy)-propyl]-trimethoxysilane-modified Fe3O4 magnetite nanoparticles, and the extraction abilities of four new extractants which were characterized by a combination of FTIR, (1)H NMR, elemental analyses, transmission electron microscopy (TEM) and thermogravimetric analyses (TGA) involving electrostatic and hydrogen bonding interactions between the calixarene and oxide anions such as arsenate and dichromate anions. The extraction results indicate that these new calixarene derivatives having high extraction capabilities would be used as effective extractants for the removal of the dichromate/arsenate ions from water.

Synthesis and evaluation of chromate and arsenate anions extraction ability of a N-methylglucamine derivative of calix[4]arene immobilized onto magnetic nanoparticles.

In this study, 5,17-bis-[(N-methylglucamine)methyl]-25,26,27,28-tetrahydroxy-calix[4]arene (3) was synthesized by the treatment of calix[4]arene with a secondary amine N-methylglucamine and formaldehyde. The calixarene derivative (3) was characterized by a combination of FTIR, (1)H NMR and elemental analyses. Followingly, using the macrocyclic building block, the compound 3 was immobilized by [3-(2,3-epoxypropoxy)propyl]trimethoxysilane-modified Fe(3)O(4) magnetite nanoparticles (EPPTMS-MN). The prepared calix[4]arene immobilized material was characterized by a combination of Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and thermogravimetric analyses (TGA). Moreover, the studies regarding the removal of arsenate and dichromate ions from the aqueous solutions were also carried out by using the compound in solid-liquid extraction experiments. It was found that the calix[4]arene-based magnetic material has high extraction ability towards dichromate and arsenate anions in 66% (at pH 1.5) and in 86% (at pH 3.5), respectively.