Search results for: Ahmet Kaplan
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 183

Search results for: Ahmet Kaplan

93 Place of Radiotherapy in the Treatment of Intracranial Meningiomas: Experience of the Cancer Center Emir Abdelkader of Oran Algeria

Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

Abstract:

Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

Procedia PDF Downloads 101
92 An Examination of Teachers’ Interactive Whiteboards Use within the Scope of Technological, Pedagogical, and Content Knowledge (TPACK)

Authors: Ismail Celik, Pavlo Antonenko, Seyit Ahmet Kiray, Ismail Sahin

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The aim of the present study was to thoroughly investigate the teachers’ interactive whiteboards (IWBs) use within the scope of the technological pedagogical and content knowledge (TPACK) framework based on the school practice observations of in-service teachers collected by pre-service teachers. In this study, teachers’ use of IWBs in their classes was investigated by using phenomenography, which is a qualitative research method design. The participants of this study consisted of teachers working in a province of Turkey. Within the scope of the study, 337 teachers from 61 different schools were observed by preservice teachers during School Experience classes. The teachers use the IWBs to review the points not understood by the students, to share knowledge, to enhance motivation, to maintain student participation/practice and for in-process, formative assessment. The problems teachers face while using the IWBs can be IWB-based (touchscreen problems/frozen image/lack of software), administration-based, student-based and teacher-based (lack of knowledge of use, need for technical support). It is considered that technological knowledge (TK) is important in solving the problems experienced with IWBs, and technological pedagogy knowledge (TPK) and technological content knowledge (TCK) are important in using the IWBs in an interactive and pedagogically meaningful way that uses IWBs affordances and is relevant to the instructional objectives.

Keywords: TPACK, technology integration, interactive whiteboard, technology in education

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91 Systematic Review and Meta-Analysis of Mid-Term Survival, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair

Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

Procedia PDF Downloads 82
90 The Innovative Leadership in Air Forces

Authors: Ahmet Emre Yonder

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The concept of present time is inevitably and rapidly changing. That provokes unbalanced, uncertain and elusive platform in the world order. Keeping up with this fluctuation requires a willingness to step beyond the comfort zones and to take a step through unknown. That is the perspectives of organizations in which the shareholders persistently create and then they share their creation. Moreover they are adapted to the unpredictable shifts and they establish vision. These are the meaning of innovation which is a process that converts new ideas to invaluable outcomes and that process can be ensured via innovative leaders. Leaders’ creativity is needed when challenging against countless complicated and unsteady situations in the battlefield. However, little attention has been paid to the importance of being innovative leader apart from innovating new technologies so far. Additionally, in most situation militarist organizations are hesitant to welcome different attitudes and that may discourage new ideas. Furthermore military leaders may complain about the lack of sources in today's world where the sources are very rare. In that point military leaders should change the strategies they apply from conventional views to the innovation of different point of views. But the constant occupation in Air Forces can be counted as a huge obstacle for innovative thinking. An organizational structure is needed to be developed for solutions of the problems which the creative leaders will encounter.This article focuses on how to raise innovative military leaders with innovative thinking skills and the need for a change from conventional to the innovative leadership in Air Forces. It also gives important suggestions to encourage raising innovative military leaders.

Keywords: air force, creativity, leadership, military, innovation

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89 Prognostic Impact of Pre-transplant Ferritinemia: A Survival Analysis Among Allograft Patients

Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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88 Development of Automated Quality Management System for the Management of Heat Networks

Authors: Nigina Toktasynova, Sholpan Sagyndykova, Zhanat Kenzhebayeva, Maksat Kalimoldayev, Mariya Ishimova, Irbulat Utepbergenov

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Any business needs a stable operation and continuous improvement, therefore it is necessary to constantly interact with the environment, to analyze the work of the enterprise in terms of employees, executives and consumers, as well as to correct any inconsistencies of certain types of processes and their aggregate. In the case of heat supply organizations, in addition to suppliers, local legislation must be considered which often is the main regulator of pricing of services. In this case, the process approach used to build a functional organizational structure in these types of businesses in Kazakhstan is a challenge not only in the implementation, but also in ways of analyzing the employee's salary. To solve these problems, we investigated the management system of heating enterprise, including strategic planning based on the balanced scorecard (BSC), quality management in accordance with the standards of the Quality Management System (QMS) ISO 9001 and analysis of the system based on expert judgment using fuzzy inference. To carry out our work we used the theory of fuzzy sets, the QMS in accordance with ISO 9001, BSC according to the method of Kaplan and Norton, method of construction of business processes according to the notation IDEF0, theory of modeling using Matlab software simulation tools and graphical programming LabVIEW. The results of the work are as follows: We determined possibilities of improving the management of heat-supply plant-based on QMS; after the justification and adaptation of software tool it has been used to automate a series of functions for the management and reduction of resources and for the maintenance of the system up to date; an application for the analysis of the QMS based on fuzzy inference has been created with novel organization of communication software with the application enabling the analysis of relevant data of enterprise management system.

Keywords: balanced scorecard, heat supply, quality management system, the theory of fuzzy sets

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87 Identifying of Hybrid Lines for Lpx-B1 Gene in Durum Wheat

Authors: Özlem Ateş Sönmezoğlu, Begüm Terzi, Ahmet Yıldırım, Ramazan Özbey

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The basic criteria which determine durum wheat quality is its suitability for pasta processing that is pasta making quality. Bright yellow color is a desired property in pasta products. Durum wheat pasta making quality is affected by grain pigment content and oxidative enzymes which affect adversely bright yellow color. Of the oxidative enzymes, lipoxygenase LOX is the most effective one on oxidative bleaching of yellow pigments in durum wheat products. Thus, wheat cultivars that are high in yellow pigments but low in LOX enzyme activity should be preferred for the production of pasta with high color quality. The aim of this study was to reduce lipoxygenase activities of the backcross durum wheat lines that were previously improved for their protein quality. For this purpose, two advanced lines with different parents (TMB2 and TMB3) were used recurrent parents. Also, Gediz-75 wheat with low LOX enzyme activity was used as the gene source. In all of the generations, backcrossed plants carrying the targeted gene region (Lpx-B1.1) were selected using SSR markers by marker assisted selection method. As a result, the study will be completed in three years instead of six years required in a classical backcross breeding study, leading to the development of high-quality candidate varieties. This research has been financially supported by TÜBİTAK (Project No: 112T910).

Keywords: durum wheat, lipoxygenase, LOX, Lpx-B1.1, MAS, Triticum durum

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86 VHL, PBRM1, and SETD2 Genes in Kidney Cancer: A Molecular Investigation

Authors: Rozhgar A. Khailany, Mehri Igci, Emine Bayraktar, Sakip Erturhan, Metin Karakok, Ahmet Arslan

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Kidney cancer is the most lethal urological cancer accounting for 3% of adult malignancies. VHL, a tumor-suppressor gene, is best known to be associated with renal cell carcinoma (RCC). The VHL functions as negative regulator of hypoxia inducible factors. Recent sequencing efforts have identified several novel frequent mutations of histone modifying and chromatin remodeling genes in ccRCC (clear cell RCC) including PBRM1 and SETD2. The PBRM1 gene encodes the BAF180 protein, which involved in transcriptional activation and repression of selected genes. SETD2 encodes a histone methyltransferase, which may play a role in suppressing tumor development. In this study, RNAs of 30 paired tumor and normal samples that were grouped according to the types of kidney cancer and clinical characteristics of patients, including gender and average age were examined by RT-PCR, SSCP and sequencing techniques. VHL, PBRM1 and SETD2 expressions were relatively down-regulated. However, statistically no significance was found (Wilcoxon signed rank test, p > 0.05). Interestingly, no mutation was observed on the contrary of previous studies. Understanding the molecular mechanisms involved in the pathogenesis of RCC has aided the development of molecular-targeted drugs for kidney cancer. Further analysis is required to identify the responsible genes rather than VHL, PBRM1 and SETD2 in kidney cancer.

Keywords: kidney cancer, molecular biomarker, expression analysis, mutation screening

Procedia PDF Downloads 461
85 Human Behaviour During an Earthquake: Descriptive Analysis on Indoor Video Recordings

Authors: Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan

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The earthquake research literature generally examines emotional, cognitive, and behavioral responses after an earthquake. Studies concerning the behavioral responses to earthquakes reveal that after the earthquake, people either flee in a panic or do not act according to the stereotype that they act irrationally and anti-socially and sometimes give rational and adaptive reactions. However, the rareness of research dealing with human behavior experiencing the earthquake moment makes it necessary to pay particular attention to these behavior patterns. In this direction, this study aims to examine human behavior indoors in case of rising earthquake intensity. In Turkey, located on geography in the earthquake zone, devastating earthquakes took place, such as in "Istanbul" with a magnitude of 7.4 in 1999 and in "Elazığ" with a magnitude of 6.8 in 2020. Occurred recently, the "Kahramanmaraş" earthquake affected 11 provinces, with a magnitude of 7.7 and 7.6 in 2023. In addition, there is expected to be a devastating earthquake in Istanbul, experts warn. For this reason, it is essential to understand human behavior for disaster risk. Management and pre-disaster preparedness to be effective and efficient and to take realistic measures to protect human life. Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan. In this study, which is currently part of a project supported by The Scientific and Technological Council of Turkey (TUBITAK), the indoor recordings during the earthquakes in Elazig on January 24, 2020, and in İzmir on October 30, 2020, are examined, and the people's behavior during the earthquake is analyzed. In this direction, video recordings taken from the YouTube archives of İzmir and Elazığ Disaster and Emergency Management Presidency (AFAD) Directorates and metropolitan municipalities are examined. The researchers have created an observation form in line with the information in the relevant literature to classify people's behavior during an earthquake. It is intended to determine the behavioral patterns by classifying according to the form and video analysis of the people heading toward the door, remaining stable, taking protective measures, turning to people, and engaging in "other" behaviors outside of these behaviors during the earthquake. A total of 60 video analyzes are carried out from Elazığ and İzmir. The descriptive statistic has been used with the SPSS 23.0 package program in the data analysis. It is found that in the event of an increase in the severity of the earthquake, unlike Elazığ, in İzmir, protective action is preferred to the act of remaining stable. In addition, it is observed that with the increase in the earthquake's intensity, women attempt to take more protective action while men head toward the door. In contrast, a rise is observed in the behavior of young people heading toward the door and taking protective actions, while there is a decrease in their behavior directing to people. These findings, unlike the literature, reveal that human behavior during earthquakes cannot be reduced to a single behavior pattern, such as drop-cover-hold-on. The results show that it is necessary to understand the behaviors of individuals during the earthquake and to develop practical policy proposals for combating earthquakes by considering sociocultural, geographical, and demographic variables.

Keywords: descriptive analysis, earthquake, human behaviour, disaster policy.

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84 Time to Cure from Obstetric Fistula and Its Associated Factors among Women Admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa Ethiopia: A Survival Analysis

Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

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Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

Procedia PDF Downloads 90
83 Exclusive Breastfeeding Abandonment among Adolescent Mothers: A Cohort Study

Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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82 The Views of Teachers, Students and Parents on the FATIH Project

Authors: Şemsettin Şahin, Ahmet Oğuz Aktürk, İsmail Çelik

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This study investigated the views of teachers, students and students' parents on the FATIH (Movement of Enhancing Opportunities and Improving Technology) Project, which was put into service by the Ministry of National Education in cooperation with the Ministry of Transportation in Turkey in November 2010 for the purpose of increasing students' success and planned to be completed within 5 years. The study group consisted of teachers employed in a pilot school in the province of Karaman in central Turkey included within the scope of the FATIH Project, students attending this school and parents whose children are students in that school. The research data were collected through forms developed by the researchers to determine the views of teachers, students and students' parents on the FATIH Project. The descriptive analysis method, one of the qualitative research methods, was used in the study. An analysis of the data revealed that a large majority of the teachers and the students believed that if computers were used to serve their set purpose, then they could make considerable contributions to education. A large majority of the students' parents, on the other hand, regard the use of computers in education as a great opportunity for the students. The views of the teachers, students and students' parents on the FATIH Project usually overlap. Most of the participants in the study pointed out that the FATIH Project was intended to use technology effectively in education. Moreover, each individual participant described their role in the FATIH Project in accordance with their relative position and stated that they could perform whatever was expected of them for the effective and efficient use and progress of the project. The views of the participants regarding the FATİH Project vary according to the kind of the participants.

Keywords: education, FATIH project, technology, students

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81 The Qualification and Quality of Space Sciences and Space Engineering Education in Turkey

Authors: Hatice Canan Gungor, Ahmet Akdemir

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The fields of engineering and technological sciences are increasing in quality and quantity day by day all over the world. Countries have to follow, implement and adapt these developments in order to economical empowerments. In our era, it's possible to follow the rapidly developing technology and to produce new technologies by inquisitive, curious, numerical thinking individuals who can show several approaches to problem solving. In this case, countries should develop te result oriented and need-focused curriculums in university education. As in the whole world, there are more space studies in our country as well. Universities should undertake the task of supply the need for staff of this technological race. In this context, questions about the purpose, content and learning outcomes of the space sciences and space engineering departments in our country will be researched answers to reveal the characteristic of this section. In this study, it was determined in which universities the space engineering and the departments of basic sciences educate with formal education and the contents of this education, and the universities were compared with each other as of 2017. In our country three universities provide Aeronautical and Aerospace Engineering, two universities provide Space Sciences and Technologies, two universities provide Aerospace Engineering, two universities provide Aeronautics and Astronautics Engineering education. In all universities, specialized courses are taught after basic engineering education. But the question that needs to be answered is, do the lessons benefit in practice? The answer of this question will reveal the quality of the education. This paper suggests that surveys be conducted to search for the answer to this question. It's thought to be the base for the next works.

Keywords: education, space engineering, space science, quality of systems

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80 The Importance of a Coating and Architecture of the Surface Metal on the Survival of Uncemented Total Knee Arthroplasty

Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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79 Combinational Therapeutic Targeting of BRD4 and CDK7 Synergistically Induces Anticancer Effects in Hepatocellular Carcinoma

Authors: Xinxiu Li, Chuqian Zheng, Yanyan Qian, Hong Fan

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Objectives: In hepatocellular carcinoma (HCC), oncogenes are continuously and robustly transcribed due to aberrant expression of essential components of the trans-acting super-enhancers (SE) complex. Preclinical and clinical trials are now being conducted on small-molecule inhibitors that target core-transcriptional components, including as transcriptional bromodomain protein 4 (BRD4) and cyclin-dependent kinase 7 (CDK7), in a number of malignant tumors. This study aims to explore whether co-overexpression of BRD4 and CDK7 is a potential marker of worse prognosis and a combined therapeutic target in HCC. Methods: The expression pattern of BRD4 and CDK7 and their correlation with prognosis in HCC were analyzed by RNA sequencing data and survival data of HCC patients from TCGA and GEO datasets. The protein levels of BRD4 and CDK7 were determined by immunohistochemistry (IHC), and survival data of patients were analyzed using the Kaplan-Meier method. The mRNA expression levels of genes in HCC cell lines were evaluated by quantitative PCR (q-PCR). CCK-8 and colony formation assays were conducted to assess cell proliferation of HCC upon treatment with BRD4 inhibitor JQ1 or/and CDK7 inhibitor THZ1. Results: It was shown that BRD4 and CDK7 were often overexpressed in HCCs and were associated with poor prognosis of HCC by analyzing the TCGA and GEO datasets. BRD4 or CDK7 overexpression was related to a lower survival rate. It's interesting to note that co-overexpression of CDK7 and BRD4 was a worse prognostic factor in HCC. Treatment with JQ1 or THZ1 alone had an inhibitory effect on cell proliferation; however, when JQ1 and THZ1 were combined, there was a more notable suppression of cell growth. At the same time, the combined use of JQ1 and THZ1 synergistically suppresses the expression of HCC driver genes. Conclusion: Our research revealed that BRD4 and CDK7 coupled can be a useful biomarker in HCC prognosis and the combination of JQ1 and THZ1 can be a promising therapeutic therapy against HCC.

Keywords: BRD4, CDK7, cell proliferation, combined inhibition

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78 Role of P53, KI67 and Cyclin a Immunohistochemical Assay in Predicting Wilms’ Tumor Mortality

Authors: Ahmed Atwa, Ashraf Hafez, Mohamed Abdelhameed, Adel Nabeeh, Mohamed Dawaba, Tamer Helmy

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Introduction and Objective: Tumour staging and grading do not usually reflect the future behavior of Wilms' tumor (WT) regarding mortality. Therefore, in this study, P53, Ki67 and cyclin A immunohistochemistry were used in a trial to predict WT cancer-specific survival (CSS). Methods: In this nonconcurrent cohort study, patients' archived data, including age at presentation, gender, history, clinical examination and radiological investigations, were retrieved then the patients were reviewed at the outpatient clinic of a tertiary care center by history-taking, clinical examination and radiological investigations to detect the oncological outcome. Cases that received preoperative chemotherapy or died due to causes other than WT were excluded. Formalin-fixed, paraffin-embedded specimens obtained from the previously preserved blocks at the pathology laboratory were taken on positively charged slides for IHC with p53, Ki67 and cyclin A. All specimens were examined by an experienced histopathologist devoted to the urological practice and blinded to the patient's clinical findings. P53 and cyclin A staining were scored as 0 (no nuclear staining),1 (<10% nuclear staining), 2 (10-50% nuclear staining) and 3 (>50% nuclear staining). Ki67 proliferation index (PI) was graded as low, borderline and high. Results: Of the 75 cases, 40 (53.3%) were males and 35 (46.7%) were females, and the median age was 36 months (2-216). With a mean follow-up of 78.6±31 months, cancer-specific mortality (CSM) occurred in 15 (20%) and 11 (14.7%) patients, respectively. Kaplan-Meier curve was used for survival analysis, and groups were compared using the Log-rank test. Multivariate logistic regression and Cox regression were not used because only one variable (cyclin A) had shown statistical significance (P=.02), whereas the other significant factor (residual tumor) had few cases. Conclusions: Cyclin A IHC should be considered as a marker for the prediction of WT CSS. Prospective studies with a larger sample size are needed.

Keywords: wilms’ tumour, nephroblastoma, urology, survival

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77 The Detection of Implanted Radioactive Seeds on Ultrasound Images Using Convolution Neural Networks

Authors: Edward Holupka, John Rossman, Tye Morancy, Joseph Aronovitz, Irving Kaplan

Abstract:

A common modality for the treatment of early stage prostate cancer is the implantation of radioactive seeds directly into the prostate. The radioactive seeds are positioned inside the prostate to achieve optimal radiation dose coverage to the prostate. These radioactive seeds are positioned inside the prostate using Transrectal ultrasound imaging. Once all of the planned seeds have been implanted, two dimensional transaxial transrectal ultrasound images separated by 2 mm are obtained through out the prostate, beginning at the base of the prostate up to and including the apex. A common deep neural network, called DetectNet was trained to automatically determine the position of the implanted radioactive seeds within the prostate under ultrasound imaging. The results of the training using 950 training ultrasound images and 90 validation ultrasound images. The commonly used metrics for successful training were used to evaluate the efficacy and accuracy of the trained deep neural network and resulted in an loss_bbox (train) = 0.00, loss_coverage (train) = 1.89e-8, loss_bbox (validation) = 11.84, loss_coverage (validation) = 9.70, mAP (validation) = 66.87%, precision (validation) = 81.07%, and a recall (validation) = 82.29%, where train and validation refers to the training image set and validation refers to the validation training set. On the hardware platform used, the training expended 12.8 seconds per epoch. The network was trained for over 10,000 epochs. In addition, the seed locations as determined by the Deep Neural Network were compared to the seed locations as determined by a commercial software based on a one to three months after implant CT. The Deep Learning approach was within \strikeout off\uuline off\uwave off2.29\uuline default\uwave default mm of the seed locations determined by the commercial software. The Deep Learning approach to the determination of radioactive seed locations is robust, accurate, and fast and well within spatial agreement with the gold standard of CT determined seed coordinates.

Keywords: prostate, deep neural network, seed implant, ultrasound

Procedia PDF Downloads 200
76 Cup-Cage Construct for Treatment of Severe Acetabular Bone Loss in Revision Total Hip Arthroplasty: Midterm Clinical and Radiographic Outcomes

Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

Procedia PDF Downloads 68
75 Analytical Study: An M-Learning App Reflecting the Factors Affecting Student’s Adoption of M-Learning

Authors: Ahmad Khachan, Ahmet Ozmen

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This study aims to introduce a mobile bite-sized learning concept, a mobile application with social networks motivation factors that will encourage students to practice critical thinking, improve analytical skills and learn knowledge sharing. We do not aim to propose another e-learning or distance learning based tool like Moodle and Edmodo; instead, we introduce a mobile learning tool called Interactive M-learning Application. The tool reconstructs and strengthens the bonds between educators and learners and provides a foundation for integrating mobile devices in education. The application allows learners to stay connected all the time, share ideas, ask questions and learn from each other. It is built on Android since the Android has the largest platform share in the world and is dominating the market with 74.45% share in 2018. We have chosen Google-Firebase server for hosting because of flexibility, ease of hosting and real time update capabilities. The proposed m-learning tool was offered to four groups of university students in different majors. An improvement in the relation between the students, the teachers and the academic institution was obvious. Student’s performance got much better added to better analytical and critical skills advancement and moreover a willingness to adopt mobile learning in class. We have also compared our app with another tool in the same class for clarity and reliability of the results. The student’s mobile devices were used in this experimental study for diversity of devices and platform versions.

Keywords: education, engineering, interactive software, undergraduate education

Procedia PDF Downloads 156
74 Pyrolysis of the Reed (Phragmites australis) and Evaluation of Pyrolysis Products

Authors: Ahmet Helvaci, Selcuk Dogan

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Reed in especially almost all the lakes in Western Anatolia grows naturally. Due to the abundance of reed, pyrolysis of reed is very economical and practical application. In this study, it is aimed to determine the optimum conditions for the pyrolysis of the reed which is a cheap and abundant raw material and to evaluate pyrolysis products. For this purpose, reed was used obtained from Eber Lake located in the borders of Bolvadin county of Afyonkarahisar. Optimum pyrolysis conditions have been determined by examining the effects of changes in pyrolysis temperature and pyrolysis time. The evaluation of the obtained liquid and solid pyrolysis products has been investigated. Especially evaluability of solid carbon black production of tires has been investigated. Tire samples were prepared with carbon black samples obtained as a result of the pyrolysis process at different temperatures. Then, performance tests were made and compared with reference carbon blacks, used in the market and standards. At the same time, surface area measurement analysis of carbon black samples was made and compared again with reference carbon blacks. In addition, the fuel values of liquid products were also determined by calorimeter. It has been determined that the best surface area (about 370 m²/g) for carbon black samples, for tire production is 40 minutes at 500ᵒC. It was also found that the best result for evaluation studies in tire production was carbon black samples obtained at 450ᵒC pyrolysis temperature. In addition, it was seen that the calorimetry results of the liquid product obtained during 60 minutes of pyrolysis were quite good (around 5500 kcal/kg).

Keywords: evaluation of products, optimization, pyrolysis, reed

Procedia PDF Downloads 193
73 Feasibility Study of Friction Stir Welding Application for Kevlar Material

Authors: Ahmet Taşan, Süha Tirkeş, Yavuz Öztürk, Zafer Bingül

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Friction stir welding (FSW) is a joining process in the solid state, which eliminates problems associated with the material melting and solidification, such as cracks, residual stresses and distortions generated during conventional welding. Among the most important advantages of FSW are; easy automation, less distortion, lower residual stress and good mechanical properties in the joining region. FSW is a recent approach to metal joining and although originally intended for aluminum alloys, it is investigated in a variety of metallic materials. The basic concept of FSW is a rotating tool, made of non-consumable material, specially designed with a geometry consisting of a pin and a recess (shoulder). This tool is inserted as spinning on its axis at the adjoining edges of two sheets or plates to be joined and then it travels along the joining path line. The tool rotation axis defines an angle of inclination with which the components to be welded. This angle is used for receiving the material to be processed at the tool base and to promote the gradual forge effect imposed by the shoulder during the passage of the tool. This prevents the material plastic flow at the tool lateral, ensuring weld closure on the back of the pin. In this study, two 4 mm Kevlar® plates which were produced with the Kevlar® fabrics, are analyzed with COMSOL Multiphysics in order to investigate the weldability via FSW. Thereafter, some experimental investigation is done with an appropriate workbench in order to compare them with the analysis results.

Keywords: analytical modeling, composite materials welding, friction stir welding, heat generation

Procedia PDF Downloads 159
72 Characterization of Some Bread Wheat Genotypes for Drought Tolerance Using Molecular Markers

Authors: Begüm Terzi, Özlem Ateş Sönmezoğlu, Ahmet Yildirim

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Drought is the most important factor that limiting the production and productivity of wheat in the world. The yield of wheat, which is one of the most important crop in the world, reduced depend on drought. Researches to minimize effects of drought are one of the most important about breeding of drought resistant varieties. In recent years, benefiting from the drought resistance wild species and rapid advances in molecular biology studies, researches about drought have been accelerated and number of studies were made on molecular plant breeding which included the molecular mechanisms related to drought resistance. The aim of the present study was characterization of some bread wheat lines for drought tolerance which commonly cultivated in different location of Turkey. In this study, registered 9 bread wheat varieties which on the physiological tests about drought tolerance and 10 bread wheat line has been developed by Transitional Zone Agricultural Research Institute were used. SSR, STS, RAPD and SNP markers that associated with drought tolerance were used. The polymorphisms of the markers were determined by screening of two control varieties. For these purpose 40 molecular markers were used and 12 markers of them were polymorphic among the drought tolerance and the drought sensitive varieties. Control varieties were screened using polymorphic markers. All the DNAs on the genotypes will be searched for the presence of QTLs mapped to different chromosomes. Result of the research, the studied genotypes will be grouped according to drought tolerance and will be detected drought tolerance varieties by molecular markers. In addition, the results will be compared also with physiological tests. The drought tolerant wheat genotypes may be used in breeding studies related to drought stress.

Keywords: bread wheat, drought, molecular marker, Triticum aestivum

Procedia PDF Downloads 386
71 A Research on the Benefits of Drone Usage in Industry by Determining Companies Using Drone in the World

Authors: Ahmet Akdemir, Güzide Karakuş, Leyla Polat

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Aviation that has been arisen in accordance with flying request that is existing inside of people, has not only made life easier by making a great contribution to humanity; it has also accelerated globalization by reducing distances between countries. It is seen that the growth rate of aviation industry has reached the undreamed level when it is looked back on. Today, the last point in aviation is unmanned aerial vehicles that are self-ventilating and move in desired coordinates without any onboard pilot. For those vehicles, there are two different control systems are developed. In the first type of control, an unmanned aerial vehicle (UAV) moves according to instructions of a remote control. UAV that moves with a remote control is named as drone; it can be used personally. In the second one, there is a flight plan that is programmed and placed inside of UAV before flight. Recently, drones have started to be used in unimagined areas and utilize specific, important benefits for any industry. Within this framework, this study answers the question that is drone usage would be beneficial for businesses or not. To answer this question, applied basic methodologies are determining businesses using drone in the world, their purposes to use drone, and then, comparing their economy as before drone and after drone. In the end of this study, it is seen that many companies in different business areas use drone in logistics support, and it makes their work easier than before. This paper has contributed to academic literature about this subject, and it has introduced the benefits of drone usage for businesses. In addition, it has encouraged businesses that they keep pace with this technological age by following the developments about drones.

Keywords: aviation, drone, drone in business, unmanned aerial vehicle

Procedia PDF Downloads 257
70 The Effects of High-frequency rTMS Targeting the Mirror Neurons on Improving Social Awareness in ASD, the Preliminary Analysis of a Pilot Study

Authors: Mitra Assadi, Md. Faan

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Background: Autism Spectrum Disorder (ASD) in a common neurodevelopmental disorder with limited pharmacological interventions. Transcranial Magnetic Stimulation (rTMS) has produced promising results in ASD, although there is no consensus regarding optimal targets or stimulation paradigms. A prevailing theory in ASD attributes the core deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus (IFG). Methods: Thus far, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.36 years have completed the study by receiving 10 session of high frequency rTMS to the IPL. The subjects were randomized to receive stimulation on the left or right IPL and sham stimulation to the opposite side. The outcome measures included the Social Responsiveness Scale – Second Edition (SRS-2) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency task. Results: None of the 11 subjects experienced any adverse effects. The rTMS did not produce any improvement in verbal fluency, nor there was any statistically significant difference between the right versus left sided stimulation. Analysis of social awareness on SRS-2 (SRS-AWR) indicated a close to significant effect of the treatment with a small to medium effect size. After removing a single subject with Level 3 ASD, we demonstrated a close to significant improvement on SRS-AWR with a large effect size. The analysis of the data 3-month post TMS demonstrated return of the SRS-AWR values to baseline. Conclusion: This preliminary analysis of the 11 subjects who have completed our study thus far shows a favorable response to high frequency rTMS stimulation of the mirror neurons/IPL on social awareness. While the decay of the response noted during the 3-month follow-up may be considered a limitation of rTMS, the presence of the improvement, especially the effect size despite the small sample size, is indicative of the efficacy of this technique.

Keywords: rTMS, autism, scoial cognition, mirror neurons

Procedia PDF Downloads 70
69 Effect of Architecture and Operating Conditions of Vehicle on Bulb Lifetime in Automotive

Authors: Hatice Özbek, Caner Çil, Ahmet Rodoplu

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Automotive lighting is the leading function in the configuration of vehicle architecture. Especially headlights and taillights from external lighting functions are among the structures that determine the stylistic character of the vehicle. At the same time, the fact that lighting functions are related to many other functions brings along difficulties in design. Customers expect maximum quality from the vehicle. In these circumstances, it is necessary to make designs that aim to keep the performance of bulbs with limited working lives at the highest level. With this study, the factors that influence the working lives of filament lamps were examined and bulb explosions that can occur sooner than anticipated in the future were prevented while the vehicle was still in the design phase by determining the relations with electrical, dynamical and static variables. Especially the filaments of the bulbs used in the front lighting of the vehicle are deformed in a shorter time due to the high voltage requirement. In addition to this, rear lighting lamps vibrate as a result of the tailgate opening and closing and cause the filaments to be exposed to high stress. With this study, the findings that cause bulb explosions were evaluated. Among the most important findings: 1. The structure of the cables to the lighting functions of the vehicle and the effect of the voltage values are drawn; 2. The effect of the vibration to bulb throughout the life of the vehicle; 3 The effect of the loads carried to bulb while the vehicle doors are opened and closed. At the end of the study, the maximum performance was established in the bulb lifetimes with the optimum changes made in the vehicle architecture based on the findings obtained.

Keywords: vehicle architecture, automotive lighting functions, filament lamps, bulb lifetime

Procedia PDF Downloads 154
68 Real-World Comparison of Adherence to and Persistence with Dulaglutide and Liraglutide in UAE e-Claims Database

Authors: Ibrahim Turfanda, Soniya Rai, Karan Vadher

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Objectives— The study aims to compare real-world adherence to and persistence with dulaglutide and liraglutide in patients with type 2 diabetes (T2D) initiating treatment in UAE. Methods— This was a retrospective, non-interventional study (observation period: 01 March 2017–31 August 2019) using the UAE Dubai e-Claims database. Included: adult patients initiating dulaglutide/liraglutide 01 September 2017–31 August 2018 (index period) with: ≥1 claim for T2D in the 6 months before index date (ID); ≥1 claim for dulaglutide/liraglutide during index period; and continuous medical enrolment for ≥6 months before and ≥12 months after ID. Key endpoints, assessed 3/6/12 months after ID: adherence to treatment (proportion of days covered [PDC; PDC ≥80% considered ‘adherent’], per-group mean±standard deviation [SD] PDC); and persistence (number of continuous therapy days from ID until discontinuation [i.e., >45 days gap] or end of observation period). Patients initiating dulaglutide/liraglutide were propensity score matched (1:1) based on baseline characteristics. Between-group comparison of adherence was analysed using the McNemar test (α=0.025). Persistence was analysed using Kaplan–Meier estimates with log-rank tests (α=0.025) for between-group comparisons. This study presents 12-month outcomes. Results— Following propensity score matching, 263 patients were included in each group. Mean±SD PDC for all patients at 12 months was significantly higher in the dulaglutide versus the liraglutide group (dulaglutide=0.48±0.30, liraglutide=0.39±0.28, p=0.0002). The proportion of adherent patients favored dulaglutide (dulaglutide=20.2%, liraglutide=12.9%, p=0.0302), as did the probability of being adherent to treatment (odds ratio [97.5% CI]: 1.70 [0.99, 2.91]; p=0.03). Proportion of persistent patients also favoured dulaglutide (dulaglutide=15.2%, liraglutide=9.1%, p=0.0528), as did the probability of discontinuing treatment 12 months after ID (p=0.027). Conclusions— Based on the UAE Dubai e-Claims database data, dulaglutide initiators exhibited significantly greater adherence in terms of mean PDC versus liraglutide initiators. The proportion of adherent patients and the probability of being adherent favored the dulaglutide group, as did treatment persistence.

Keywords: adherence, dulaglutide, effectiveness, liraglutide, persistence

Procedia PDF Downloads 126
67 The Effect of Primary Treatment on Histopathological Patterns and Choice of Neck Dissection in Regional Failure of Nasopharyngeal Carcinoma Patients

Authors: Ralene Sim, Stefan Mueller, N. Gopalakrishna Iyer, Ngian Chye Tan, Khee Chee Soo, R. Shetty Mahalakshmi, Hiang Khoon Tan

Abstract:

Background: Regional failure in nasopharyngeal carcinoma (NPC) is managed by salvage treatment in the form of neck dissection. Radical neck dissection (RND) is preferred over modified radical neck dissection (MRND) since it is traditionally believed to offer better long-term disease control. However, with the advent of more advanced imaging modalities like high-resolution Magnetic Resonance Imaging, Computed Tomography, and Positron Emission Tomography-CT scans, earlier detection is achieved. Additionally, concurrent chemotherapy also contributes to reduced tumour burden. Hence, there may be a lesser need for an RND and a greater role for MRND. With this retrospective study, the primary aim is to ascertain whether MRND, as opposed to RND, has similar outcomes and hence, whether there would be more grounds to offer a less aggressive procedure to achieve lower patient morbidity. Methods: This is a retrospective study of 66 NPC patients treated at Singapore General Hospital between 1994 to 2016 for histologically proven regional recurrence, of which 41 patients underwent RND and 25 who underwent MRND, based on surgeon preference. The type of ND performed, primary treatment mode, adjuvant treatment, and pattern of recurrence were reviewed. Overall survival (OS) was calculated using Kaplan-Meier estimate and compared. Results: Overall, the disease parameters such as nodal involvement and extranodal extension were comparable between the two groups. Comparing MRND and RND, the median (IQR) OS is 1.76 (0.58 to 3.49) and 2.41 (0.78 to 4.11) respectively. However, the p-value found is 0.5301 and hence not statistically significant. Conclusion: RND is more aggressive and has been associated with greater morbidity. Hence, with similar outcomes, MRND could be an alternative salvage procedure for regional failure in selected NPC patients, allowing similar salvage rates with lesser mortality and morbidity.

Keywords: nasopharyngeal carcinoma, neck dissection, modified neck dissection, radical neck dissection

Procedia PDF Downloads 171
66 Down-Regulated Gene Expression of GKN1 and GKN2 as Diagnostic Markers for Gastric Cancer

Authors: Amer A. Hasan, Mehri Igci, Ersin Borazan, Rozhgar A. Khailany, Emine Bayraktar, Ahmet Arslan

Abstract:

Gastric cancer (GC) has high morbidity and fatality rate in various countries and is still one of the most frequent and deadly diseases. Novel mitogenic and motogenic Gastrokine1 (GKN1) and Gastrokine 2 (GKN2) genes that are highly expressed in the normal stomach epithelium and plays an important role in maintaining the integrity and homeostasis of stomach mucosal epithelial cells. Significant loss of copy number and mRNA transcript of GKN1 and GKN2 gene expression were frequently observed in all types of gastric cancer. In this study, 47 paired samples that were grouped according to the types of gastric cancer and the clinical characteristics of the patients, including gender and average of age were investigated with gene expression analysis and mutation screening by monetering RT-PCR, SSCP and nucleotide sequencing techniques. Both GKN1 and GKN2 genes were observed significantly reduced found by (Wilcoxon signed rank test; p<0.05). As a result of gene screening, no mutation (no different genotype) was detected. It is considered that gene mutations are not the cause of inactivation of gastrokines. In conclusion, the mRNA expression level of GKN1 and GKN2 genes statistically was decreased regardless the gender, age or cancer type of patients. Reduced of gastrokine genes seems to occur at the initial steps of cancer development. In order to understand the investigation between gastric cancer and diagnostic biomarker; further analysis is necessary.

Keywords: gastric cancer, diagnostic biomarker, nucleotide sequencing, semi-quantitative RT-PCR

Procedia PDF Downloads 472
65 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs

Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

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Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

Procedia PDF Downloads 73
64 Evaluation of Complications Observed in Porcelain Fused to Metal Crowns Placed at a Teaching Institution

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

Procedia PDF Downloads 209