This study aimed to assess sociodemographic characteristics, health-seeking behaviors, and breast cancer screening beliefs among women aged 18-69 years attending Family Health Centers (FHCs) in Ankara, Türkiye, and to determine predictors of participation in mammography screening. It is design as a descriptive, cross-sectional study. Between April 2024 and January 2025, data were collected from 718 women using a sociodemographic questionnaire and the Turkish-adapted Breast Cancer Screening Beliefs Scale (originally developed by Kwok et al., validated by Türkoğlu et al.). Descriptive analyses, Chi-square tests, and binary logistic regression were performed with IBM SPSS 25.0. Variables with p < 0.20 in univariate analyses were entered into multivariate modeling, and statistical significance was defined as p < 0.05. Statistically significant differences were found between age groups in terms of marital status, education level, housing situation, presence of chronic disease, general health perception, and history of non-breast cancer screening (p < 0.001). According to the logistic regression analysis, women who are aware of screening programs are 8.50 times more likely to have a mammogram, those who have undergone non-breast cancer screening are 5.52 times more likely, those with chronic diseases are 1.98 times more likely, and those who describe their health perception as "good/very good" are 1.90 times more likely. (Nagelkerke R² = 0.465). Mammography participation is influenced by both structural and personal determinants. Enhancing awareness, strengthening primary-care education, and addressing financial barriers could substantially improve screening uptake and facilitate earlier breast cancer diagnosis among Turkish women.
This study aims to examine the relationship between microplastic pollution awareness and environmental literacy levels among undergraduate nursing students. The study was conducted using a cross-sectional design. This study included 356 undergraduate nursing students selected from each academic year using proportional stratified sampling. Data were collected between March and June 2023 using a demographic form, the Microplastic Pollution Awareness Scale, and the Environmental Literacy Scale. Data analysis was performed using SPSS 23.0, with descriptive statistics, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation analyses. The mean microplastic pollution awareness score and environmental literacy score were 22.98 ± 4.85 and 85.21 ± 10.35, respectively. Participants who expressed willingness to receive environmental education and those who had previously heard of microplastics demonstrated higher mean scores for both microplastic pollution awareness and environmental literacy. A considerable proportion of participants reported not having previously heard of microplastics. Despite this, most nursing students (94.4%) exhibited high levels of environmental literacy. A positive correlation was found between microplastic pollution awareness and environmental literacy. This study highlights the potential importance of environmental literacy in raising nursing students' awareness of microplastic pollution. The current curriculum has limited content on environmental health, and it is mostly covered in a short section of the public health nursing course. These findings suggest that integrating content on environmental literacy and microplastic pollution across all stages of the nursing curriculum, as well as in in-service training, may be beneficial. Strengthening environmental literacy in nursing education may improve awareness of microplastic pollution and support nurses in promoting environmentally responsible behaviours and environmental health in clinical and community settings. This study addresses the limited evidence on microplastic pollution awareness among nursing students. The findings highlight the importance of environmental literacy in shaping awareness and can inform curriculum development and educational strategies targeting future nurses. This study was reported in accordance with the STROBE guidelines. No patient or public involvement.
Persistent inflammation, polymicrobial biofilm colonization, and impaired re-epithelialization characterize the chronic and treatment-resistant nature of diabetic wounds. Conventional treatment strategies often fail to adequately address the multifactorial pathophysiological mechanisms underlying these lesions. This review examines the biological functions, key components, and design principles of multifunctional hydrogel nanobiocomposites for diabetic wound healing. These hybrid systems combine natural biopolymers with functional nanoparticles specifically engineered for diabetic wound management. Such nanobiocomposite hydrogels provide an integrated platform capable of simultaneously controlling infection, modulating inflammation, and promoting tissue regeneration. Furthermore, the incorporation of bioactive agents, such as peptides and polyphenols, together with metallic nanoparticles, plays a critical role in enhancing therapeutic efficacy. Finally, this review discusses the major challenges associated with the clinical translation of these systems, including regulatory considerations, standardization, and large-scale manufacturing requirements, while delineating an actionable roadmap for their clinical integration.
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Composite grafting is a commonly used treatment option for Allen Zone II fingertip amputations; however, reported survival rates vary considerably across studies. Although several clinical and injury-related factors have been suggested to influence graft survival, independent predictors of failure and clinically meaningful ischemia duration thresholds remain insufficiently defined. This study aimed to identify independent clinical predictors of composite graft survival and to explore, secondarily, whether ischemia duration is associated with graft failure. Forty-two patients who underwent composite grafting due to Allen Zone II fingertip amputation between December 2021 and June 2023 were retrospectively evaluated. Baseline variables were collected from hospital records and surgical notes. Ischemia duration was calculated as the number of hours between the injury and the start of surgery. Diabetes mellitus (DM) and other comorbidities were verified using diagnostic codes and patient histories. The primary outcome measure was graft survival at 6 weeks postoperatively; necrosis affecting more than 25% of the graft surface area was defined as failure. Group comparisons, univariate and multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. Because of the limited number of outcome events and quasi-complete separation in the data, the multivariable model was additionally fitted using Firth's penalised likelihood method. Graft survival was achieved in 23 cases (54.8%), while 19 cases (45.2%) resulted in failure. Factors associated with graft failure included older age, longer ischemia duration, presence of DM, and crush/avulsion type injuries. In further analysis, DM and crush/avulsion injury mechanism emerged as the most important independent predictors of graft failure, whereas age and ischemia duration were less influential when considered alongside other variables. Penalised estimates were more conservative than unpenalised ones but preserved both associations (DM, OR 12.63; crush/avulsion mechanism, OR 12.29). In exploratory ROC analysis an ischemia duration threshold of 4.3 h was associated with failure, although ischemia duration was not an independent predictor. Overall, the combined evaluation of clinical variables demonstrated strong ability to distinguish between successful and unsuccessful graft outcomes. In cases of Allen Zone II fingertip amputations, the crush/avulsion mechanism and DM are the strongest independent predictors of composite graft failure. An ischemia duration exceeding 4.3 h was associated with failure in exploratory analysis but was not an independent predictor. Preoperative assessment of these parameters may inform patient selection, pending prospective validation.
In individuals with lower extremity amputation, a certain degree of gait asymmetry is biomechanically unavoidable and has been associated with reduced energy efficiency, secondary musculoskeletal complications, and diminished quality of life. The aim of this study was to investigate the effects of surface type, walking speed, and slope on gait symmetry in unilateral transtibial prosthesis users. : Ten male individuals with unilateral transtibial amputation (mean age 36.5 ± 10.3 years) who had been using prostheses for at least 1 year participated. Participants walked under 7 conditions varying in surface type, speed, and slope. Lower extremity spatiotemporal parameters and joint angular kinematics were recorded using an inertial motion analysis system. Symmetry indices were calculated for each parameter and analyzed. Knee frontal-plane range of motion (RoM) was more asymmetrical on uneven ground than on level ground (p=0.004). Step length was more asymmetrical during slow walking compared with fast walking (p=0.015). Swing phase duration (p=0.002) and ankle sagittal-plane RoM (p=0.002) were more asymmetrical during ramp ascent. Changes in walking surface, speed, or slope affect gait symmetry in unilateral transtibial prosthesis users, with effects varying by condition. The findings revealed that gait asymmetry in this population is not a fixed characteristic but a dynamic, condition-dependent response to the demands of the walking environment.
Managing chronic headache in older adults is complicated by multimorbidity and polypharmacy. This study evaluated 6-month clinical outcomes, tolerability, and response predictors following ultrasound-guided greater occipital nerve pulsed radiofrequency (GONPRF) in patients aged ≥65 years. This retrospective cohort study analyzed 152 patients undergoing ultrasound-guided GONPRF following a positive diagnostic block (≥50% relief). Pain intensity (numeric rating scale, NRS), headache frequency, attack duration (hours), and analgesic use (days/month) were assessed at baseline and 1, 3, and 6 months. The primary endpoint was therapeutic success, defined as a global perceived effect score ≥6 at 6 months. Predictors of response were analyzed via logistic regression. Adverse events were assessed through clinical records and patient interviews. Significant improvements occurred in NRS, headache frequency, attack duration, and analgesic use at all follow-up points ( P < 0.001). Therapeutic success was achieved by 56.6%, 52.6%, and 49.3% of patients at 1, 3, and 6 months, respectively. Outcomes were comparable between proximal and distal techniques. Higher baseline analgesic use was the sole independent predictor of a lower likelihood of treatment success ( P = 0.038, OR = 0.95). Adverse events (18.4%) were mild and resolved within 48 hours. Ultrasound-guided GONPRF was associated with significant improvements and was well-tolerated in this geriatric cohort. However, due to the retrospective design, lack of a control group, and potential selection bias, the findings should be interpreted cautiously.
Developmental trauma is a primary etiological factor in dissociative identity disorder (DID) and may lead to misdiagnosis due to symptom overlap with other psychiatric and neurological conditions. This case report describes an adolescent male with pronounced narcissistic vulnerability. The patient's background features an inconsistent parenting style-characterized by both overprotection and severe criticism-and significant paternal pressure to achieve academic success and embody an idealized, wise persona. Chronic exposure to these psychosocial stressors is hypothesized to have contributed to acute narcissistic rage, potentially associated with dissociative identity fragmentation. The initial clinical presentation involved functional neurological symptoms, which progressed to distinct identity states with amnesia. Treatment focused on supporting the patient's disrupted grandiose self-structure through an empathetic, mirroring psychotherapeutic approach. This intervention was associated with a marked reduction in dissociative symptoms. Further research is needed to clarify the complex role of narcissistic vulnerabilities in the development of dissociative identity presentations.
This cross-sectional study examined whether emotional eating, food craving acceptance, sex, and BMI predict eating disorder psychopathology in 531 Turkish university students (262 male, 269 female). Participants completed the Salzburg Emotional Eating Scale (SEES), Food Craving Acceptance and Action Questionnaire (FAAQ), and Eating Disorder Examination Questionnaire (EDE-Q). Males scored higher on emotional eating; females scored higher on food craving acceptance and EDE-Q. Several sex differences, including the EDE-Q global score, were not significant after Bonferroni correction or under the Turkish three-factor scoring. In a hierarchical regression, psychological variables added 10.7% of the variance beyond the 5.1% from sex and BMI (adjusted R2 = 0.148). Higher SEES (β = 0.227), higher FAAQ Acceptance (β = 0.256), and female sex (male = 1; β = -0.175) predicted higher EDE-Q; FAAQ Willingness and BMI did not. In an exploratory interaction, however, BMI predicted higher EDE-Q in males only. FAAQ findings warrant caution given moderate internal consistency.
Sarcopenia and coxarthrosis frequently coexist in older adults and may contribute to functional decline. Computed tomography (CT)-based muscle measurements are commonly used for the assessment of sarcopenia. To quantitatively evaluate the relationship between the presence and severity of coxarthrosis and sarcopenia using computed tomography (CT) and to investigate the usability of the upper thigh skeletal muscle as an alternative to the psoas muscle in the evaluation of sarcopenia in coxarthrosis. Patients who underwent a hip CT examination between June 2019 and May 2023 were evaluated retrospectively. Patients with coxarthrosis were included in the study. Coxarthrosis staging was performed according to the Tönnis classification. Muscle area and density values were measured at the L4 level for bilateral psoas muscles and skeletal muscle in the upper thigh level at the inferior tip of the ischial tuberosity. Increasing Tönnis grade remained independently associated with lower psoas and upper thigh muscle area and density (all Holm-adjusted P < 0.001). Muscle areas were lower in women than in men ( P = 0.001). There was no significant difference between the genders in terms of the psoas muscle density ( P > 0.05), while the upper thigh muscle density was significantly lower in women than in men ( P < 0.05). A positive correlation was detected between the areas and densities of the psoas and upper thigh muscles in every grade of coxarthrosis. The presence and severity of coxarthrosis are associated with the area and density of the psoas and upper thigh skeletal muscles. Upper thigh skeletal muscles may serve as an alternative muscle group for the imaging-based evaluation of sarcopenia.
Pharmaceutical supply chain disruptions from pandemics, natural disasters, and geopolitical conflicts increasingly threaten medications central to rehabilitation practice. Rehabilitation pharmacotherapy is especially exposed because many core agents have narrow therapeutic windows, require cold-chain logistics, lack ready substitutes, or carry life-threatening consequences when abruptly interrupted. This analysis examines vulnerabilities across three rehabilitation medication categories: spasticity-targeted therapies, pain and musculoskeletal therapeutics, and neurorehabilitation agents. We describe the clinical consequences of medication interruption across rehabilitation populations, then define and apply an expert-derived, literature-informed stockout risk matrix that classifies events along two dimensions. These dimensions comprise likelihood of stockout (manufacturer concentration, logistics chain integrity, lead time, and price volatility) and severity of clinical consequence (withdrawal-related morbidity, substitutability, and size of the affected patient population). The 2026 Strait of Hormuz crisis, during which Gulf Cooperation Council countries faced potential threats to the availability of medications across multiple logistics corridors, serves as a contemporary case illustration. A contingency framework that includes strategic reserves, protocol switching, telerehabilitation-based monitoring, and cross-border mutual aid is then outlined. Preparedness for pharmaceutical supply disruption appears to be an underdeveloped competency in Physical and Rehabilitation Medicine and merits attention in service delivery wherever import dependence or disruption risk applies.
This study aimed to evaluate dental students' perceptions and expectations regarding the potential benefits of a faculty undergoing an accreditation process, and to provide faculty-specific insights relevant to quality improvement processes. This cross-sectional descriptive study was conducted with 670 undergraduate students using a two-part questionnaire created in Google Forms to assess students' perceptions and expectations of accreditation. The first part assessed students' self-reported familiarity with accreditation, their self-reported familiarity with the accreditation status of their faculty and university, and the accrediting body responsible for overseeing accreditation processes, while the second explored their perceptions and expectations of the potential impact of accreditation on educational quality, clinical training, and professional outcomes. Students responded on a three-point scale ('Agree', 'Disagree', 'No opinion'). Responses were analysed collectively and by grade level. Additionally, two subgroups were defined as preclinical and clinical. Frequency and percentage were used to describe the variables. Pearson Chi-Squared and Fisher-Freeman-Halton Exact tests were used to compare group distributions, with a significance level of p < 0.05. In the first part of the questionnaire, 77% of students reported familiarity with the concept of accreditation, and 59.3% correctly identified that their faculty was not accredited. In the second part, students' perceptions regarding the impact of accreditation on the faculty and students exceeded the target rate of 70% for all items. The rate of 'No opinion' responses was significantly higher among first-year students compared to other grades (p < 0.05). Except for two items, the preclinical group showed significantly higher 'No opinion' rates than the clinical group (p < 0.05). Students demonstrated increasingly positive perceptions and expectations of accreditation with advancing clinical experience, and these perceptions were associated with more favourable evaluations of its potential impact on educational quality, career opportunities and social contribution.
This study aims to compare the diagnostic accuracy, appropriateness of treatment planning, and source citation performance of five large language models ChatGPT-4o (Free), ChatGPT-5.1 Plus, Microsoft Copilot, Google Gemini, and DeepSeek-R1 in root resorption scenarios. In December 2025, twelve clinical scenarios were created based on the classification of the European Society of Endodontology and each scenario was presented to all chatbots over four consecutive days. All responses were evaluated using a blinded assessment protocol and a binary scoring system. A total of 720 observations (12 cases × 4 repetitions × 3 criteria per model) were analyzed. The collected data were analyzed using chi-square, Fisher's exact, and Cochran Q tests. In terms of diagnostic accuracy, Microsoft Copilot (79.2%), ChatGPT-5.1 (77.1%), and ChatGPT-4o (Free) (75%) showed the highest performance. Google Gemini (68.8%) demonstrated a moderate level of accuracy, while DeepSeek (39.6%) showed markedly low performance. All models exhibited high accuracy in treatment plan recommendations, and no statistically significant differences were detected. Regarding citation accuracy, Copilot ranked first with 100% accuracy. Although large language models present potential as supportive decision-making tools in the evaluation of root resorption, diagnostic inconsistencies, limitations in source accuracy, and variability in responses restrict their independent use in clinical applications. Therefore, the outputs generated by these models should be interpreted cautiously within clinical decision-making processes.
Beta-lactamase production by Burkholderia cepacia complex (Bcc) leads to beta-lactam resistance and worsens patient prognosis. This study describes the activity of aztreonam, a monobactam, in combination with avibactam, a beta-lactamase inhibitor, against Bcc isolates. Broth microdilution and time-kill assays were conducted for planktonic cells. Additionally, broth microdilution was repeated using media supplemented with 5% and 10% bovine serum albumin to evaluate its impact on MICs. The effects of aztreonam/avibactam on biofilm formation and the metabolic activity of mature biofilms were determined in all biofilm-positive isolates. Additionally, the biofilm matrix of selected strains was analyzed in terms of viable bacterial count, total protein content, and extracellular DNA (eDNA) concentration, and the biofilm architecture was visualized using scanning electron microscopy (SEM). All the strains were determined to be resistant to aztreonam, and the MIC50 and MIC90 of aztreonam/avibactam were found to be 4/4 mg/L and 8/4 mg/L, respectively. Aztreonam/avibactam exhibited activity against planktonic form of Bcc, and decreased the aztreonam MIC values. Serum albumin activity was insignificant at low doses but affected the MIC more at high doses. Moderate to strong biofilm formation was observed in 25 of the 29 isolates, and aztreonam/avibactam showed strain- and concentration-dependent activity against Bcc biofilm formation and mature biofilms. The combination also reduced biofilm matrix components such as total protein and eDNA, and some strain-specific effects were observed at sub-inhibitory concentrations. These findings support the potential use of aztreonam/avibactam as a therapeutic option against Bcc infections by targeting both planktonic bacteria and key components of biofilm matrix.
Walking skills are negatively affected in people with Parkinson's disease (PwPD) when performing dual-tasks. However, the factors that contribute to this negative dual-task cost (DTC) remain unclear. This study was planned to investigate the factors associated with the DTC of walking in PwPD. Seventy-seven PwPD were included. Single task walking speed and dual-task walking speed were assessed with the 10-Meter Walking Test (10MWT). The following tests were used in the assessments: the Unified Parkinson's Disease Rating Scale (UPDRS) for clinical symptoms, the Single Leg Stance Test (SLST) for static balance, the Four-Square Step Test (FSST) for dynamic balance, the Trail Making Test (TMT) for attention, the Symbol Digit Modalities Test (SDMT) for processing speed, the Word List Generation Test (WLGT) for verbal fluency, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, the Falls Efficacy Scale-International (FES-I) for fear of falling, the Freezing of Gait Questionnaire (FOGQ) for freezing of gait, and the International Physical Activity Questionnaire (Short Form) (IPAQ-SF) for level of physical activity. Dual-task 10MWT scores of PwPD were significantly worse than single-task 10MWT scores (p < .001). Multiple linear regression analysis revealed that only SDMT (Β = -0.361, p < .001), dual-task 10MWT (Β = 0.294, p = .001), and TMT-B (Β = 0.338, p = .001) determined the DTC in PwPD. Dual-tasking has a negative impact on walking in PwPD and this DTC is associated with processing speed, dual-task walking speed and attention.
This study aims to investigate the association between tobacco use and central sensitization (CS), as measured by the Central Sensitization Inventory (CSI), and to identify demographic and clinical factors associated with CS. In this cross-sectional study, a total of 380 adults were included using a convenience sampling method between December 2024 and January 2025. Data collection was performed through an online survey platform to ensure accessibility and broad participation. The survey was distributed via digital platforms, social media networks, and email lists to reach a diverse adult population across Türkiye. Demographic characteristics, clinical variables, and tobacco product use status were recorded. Central sensitization was assessed using the CSI. Multiple linear and logistic regression analyses were performed to identify predictors of CSI scores. Of a total of 380 participants, 131 were male and 249 were female with a mean age of 41.21 ± 11.40 (range, 18 to 65) years. Tobacco users had significantly higher CSI total scores compared to non-users (p = 0.029). A higher proportion of individuals with a CSI score ≥ 40 was observed among tobacco users (p = 0.003). In the multiple linear regression model, age (β = -0.295), female sex (β = 6.255), chronic disease status (β = 4.524), chronic pain (β = 12.093), and tobacco use (β = 6.538) were independent predictors (p < 0.001). Logistic regression analysis indicated a significant association between tobacco use and the likelihood of having a CSI score ≥ 40 (odds ratio [OR] = 0.488, 95% confidence interval [CI]: 0.302-0.789). Tobacco use is positively associated with higher CS symptom severity. Given the cross-sectional design, these findings reflect a correlation rather than direct causality. Nevertheless, screening for smoking habits may provide valuable context during the clinical evaluation of chronic pain.
Adenovirus may cause life-threatening infections. While outcomes in immunocompromised patients are well documented, data on critically ill, immunocompetent adults remain limited. To describe the clinical characteristics and outcomes of adenovirus infection in adult intensive care unit (ICU) patients and to identify factors associated with 30-day mortality. This retrospective observational study included adult patients (≥ 16 years) admitted to ICUs between January 2020 and May 2025 with PCR-confirmed adenovirus infection and compatible clinical syndromes, with a primary focus on describing patient characteristics rather than analyzing virological features of the infection. Data were collected from 24 centers in 11 countries. Demographics, comorbidities, clinical characteristics, laboratory findings, treatments, and outcomes were recorded. The primary outcome was 30-day all-cause in-hospital mortality. Variables associated with mortality in univariate analyses were entered into a stepwise multivariable logistic regression model. A total of 126 patients were included; 40 (31.7%) died within 30 days of PCR positivity. The mean age of the entire cohort of patients was 44.9 ± 20.4 years (median 48; 16-95), and 38.9% were female. Pneumonia was the most common presentation (108/126, 85.7%), followed by upper respiratory tract infection (18.3%), gastroenteritis (6.3%), conjunctivitis (4.8%), meningoencephalitis (2.4%), and cystitis (1.6%). Significant immunosuppression was present in 29.4%. In multivariable analysis, independent predictors of 30-day mortality included mean arterial pressure ≤ 65 mmHg, SOFA score ≥ 5, increasing Charlson Comorbidity Index, central venous catheter placement, platelet count <50,000/µL (borderline significance), procalcitonin ≥ 0.1 ng/mL, and significant immunosuppression. The final model had 84.9% accuracy, 72.5% sensitivity, and 90.7% specificity. A high percentage of ICU patients with PCR-confirmed adenovirus infection died within 30 days. Hemodynamic instability, organ failure severity, comorbidity burden, inflammatory response, thrombocytopenia, and immunosuppression are key determinants of poor outcome.
The novel RANO risk score provides prognostic stratification for patients with IDH-wildtype glioblastoma(GBM) and includes age, Karnofsky Performance Scale(KPS), RANO resection class(RRC), and MGMT promoter methylation(MGMTm). However, MGMTm testing is unavailable in many countries. We aimed to explore the prognostic performance of a RANO-adapted clinical score excluding MGMTm. We applied the same scoring system established by original RANO score, excluding MGMTm. Three risk classes were defined as numerical scores derived through tertiles. The primary endpoint was overall survival(OS), and the secondary exploratory endpoint was progression-free survival(PFS). One-hundred twenty patients were included. Three risk classes were identified:low-risk(0-1 points,n:47, 39.2%), intermediate-risk(2-3 points,n:27, 22.5%), and high-risk(≥4 points,n:46, 38.3%). The median OS was 35.5 months(95% CI:21.1-49.9) for the low-risk group, 16 months(95% CI:9.9-22.1) for the intermediate-risk group, and 5 months(95% CI:3.6-6.3) for the high-risk group(p < 0.001). Similarly, the median PFS was 16.3 months(95% CI:12.3-20.3) for the low-risk group, 9.9 months(95% CI:7.2-12.6) for the intermediate-risk group, and 4.1 months(95% CI:3.5-4.7) for the high-risk group(p < 0.001). This simplified RANO-adapted score demonstrated promising prognostic stratification using basic clinical parameters. As a pragmatic adaptation study, external validation is required before clinical application, particularly in settings where MGMTm testing is unavailable. Glioblastoma is an aggressive type of brain cancer. Doctors often use simple scores to help estimate a patient’s outlook and to support discussions about care. One existing score, developed by the Response Assessment in Neuro-Oncology group, uses age, physical function, the amount of tumor removed during surgery, and a tumor test called MGMT promoter methylation. However, this tumor test is not available in many hospitals. In this study, we looked at whether a simpler version of this score could still give useful information when the MGMT test is not available. We reviewed the medical records of 120 patients with IDH-wildtype glioblastoma treated at one hospital. The simplified score used three pieces of information that are usually available in routine care: patient age, physical function after surgery, and how much of the tumor was removed. The simplified score separated patients into three groups with different survival outcomes. Patients in the lower-score group lived longer on average than patients in the higher-score group. This score should not be used to deny or limit treatment. It may help doctors explain expected outcomes and support communication with patients, especially where MGMT testing is not available. Because this was a small study from one hospital, more research in larger and more diverse patient groups is needed before this score can be widely used in clinical practice.
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