Assessment of the Psychometric Properties of the Online Education Student Satisfaction Scale: A Methodological Study.

Background and Purpose: Assessing student satisfaction is essential in evaluating the quality of education. The number of valid and reliable tools that measure students' satisfaction with online education is limited. This methodological study aimed to assess the psychometric properties of the online education student satisfaction scale. Methods: Eleven academicians from the nursing field provided expert opinions on content validity. Separate 25 students evaluated the language clarity of the draft scale. The study sample included 525 third- and fourth-year nursing students. Finally, a group of 30 nursing students different from the sample participated in the test-retest. The study created an item pool based on the recent literature. The researchers calculated the items' content validity rates and the scale's content validity index by taking the experts' opinions. In addition, item-total score correlation analysis, exploratory factor analysis, discrimination analysis, stability test, and internal consistency analysis were performed. Results: An item with a low-correlation value was excluded from the scale. The correlation coefficients of the remained items were between .536 and .811. In the second round of exploratory factor analysis, a five-factor structure emerged that explained 72.1% of the total variance. In addition, item discrimination, stability, and internal consistency test results ensured that the scale was valid and reliable. Conclusions: The online education student satisfaction scale with five subdimensions containing 28 items is a valid and reliable tool. Researchers, educators, and managers may use it to evaluate students' satisfaction with online education.

An Evaluation of a Web-Based Crisis Management Training Program for Nurse Managers: The Case of the COVID-19 Crisis.

OBJECTIVE: The effective management of nursing services, the main power in patients' care and treatment in the front line of the fight against the COVID-19 pandemic, and nurse managers' effective leadership behaviors in the fight against the pandemic have been important key factors. It is thus critical to support nurse managers, strengthen them through training, and increase their competency so that they can successfully manage crises, disasters, or pandemics. This study aims to assess the effect of a web-based training program on the knowledge levels of nurse managers who worked during the COVID-19 pandemic. METHODS: This is a randomized controlled experimental study. The study population consisted of the members of the Nurse Managers Association. The intervention group had 30 participants, and the control group had 31 participants in the final. RESULTS: There was no statistically significant difference between the intervention and control groups' mean number of correct pre-test responses (P = 0.843). However, the intervention group's mean number of correct post-test responses was statistically significantly higher than the control group's after the web-based training program (P < 0.001). CONCLUSIONS: Web-based training programs can effectively increase nurse managers' knowledge levels. Therefore, web-based training programs should be developed in ordinary times for the management of crisis situations.

Total Lesion Glycolysis Obtained by FDG PET/CT in Diagnosing Solitary Pulmonary Nodules.

OBJECTIVE: To evaluate the diagnostic performance of total lesion glycolysis (TLG) obtained by 18F-FDG PET/ CT to differentiate malignant solitary pulmonary nodules (SPNs) from benign ones. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Nuclear Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey, from January 2018 to April 2022. METHODOLOGY: Eighty patients, who were found to have SPNs and underwent PET/CT imaging, were enrolled in this retrospective study. Parameters of PET-CT such as metabolic, volumetric, and metabolovolumetric were assessed concerning diagnostic value. Moreover, maximum standard uptake value (SUVmax) and TLG were combined and compared to improve diagnostic accuracy. RESULTS: The number of the detected benign and malignant SPNs was 38 and 42, respectively. Compared to the benign lesions, the malignant nodules presented significantly higher values in terms of SUVmax, TLG, and the volumes of metabolic tumour (MTV) and CT. Considering all parameters, the highest area under the curve (AUC) was occupied by TLG and SUVmax. The values for the sensitivity, specificity, and accuracy of SUVmax, TLG, and SUVmax combined with TLG were as follows respectively: 97.6%, 63.2%, and 81.2%; 85.7%, 92.1%, and 88.7%; and 85.7%, 94.7%, and 90%. CONCLUSION: The conventional value of SUVmax does not yield satisfactory results in order to separate the malignant nodules from the benign ones. The SUVmax value could be more valuable if it is used with TLG measurement in diagnosing SPNs. KEY WORDS: 18F-FDG PET/CT, SUVmax, TLG, Pulmonary nodule.

Decent work in nursing: Relationship between nursing work environment, job satisfaction, and physical and mental health.

AIM: To examine the relationship between nursing work environment, nurses' perception of decent work, job satisfaction, and physical and mental health. BACKGROUND: According to the psychology of working theory, work-related and overall well-being levels of employees with decent work increase as their basic needs are met. METHODS: This study was conducted as a cross-sectional, correlational study. The study sample consisted of 311 nurses working in two hospitals in a province of Turkey. The participants were selected using convenience sampling method. The model of the research was analyzed using structural equation modeling. This study was reported using the STROBE checklist for cross-sectional studies. RESULTS: The four dimensions of the nursing work environment were found to have a significant relationship with decent work. Decent work was found to have a direct relationship with physical and mental health. It had an indirect relationship between three subscales of work environment and physical and mental health, however, decent work had no significant relationship with job satisfaction. CONCLUSIONS: The findings of this study indicated the role of decent work environment and its relationship with nurses' physical and mental health. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers, policy makers, and decision-makers at all levels should improve nursing work environment and working conditions.

Comparison of Magnetic Resonance Imaging With Positron Emission Tomography/Computed Tomography in the Evaluation of Response to Neoadjuvant Therapy of Breast Cancer.

INTRODUCTION: The present study aims to determine the diagnostic accuracy of magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in predicting a pathological response of molecular subtypes of breast cancer to neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: We retrospectively analyzed patients with breast cancer who were operated after NAC between January 2018 and May 2020. Radiological responses were evaluated as per the Response Evaluation Criteria in Solid Tumors (RECIST) and changes in contrast enhancement patterns on MRI and the classification of PET Response Criteria in Solid Tumors (PERCIST) on PET-CT. The presence of a pathological response was evaluated based on the Sataloff classification. The agreement between the radiological response determined through imaging modalities before and after the NAC and the postoperative pathological complete response (pCR) was evaluated and compared statistically. Among the patients diagnosed with breast cancer between the ages of 18 and 80 y, those with N (+) at the time of diagnosis, those with T2 and advanced tumors, and those who were planned for breast conserving surgery were included in our study. Male patients, patients with distant metastases at the time of diagnosis, and patients with other system malignancies were excluded. RESULTS: The study included 88 patients who had undergone surgery for breast cancer after NAC between January 2018 and May 2020. The study was conducted retrospectively in a single center. The tumor diameters and standard uptake values significantly decreased after NAC (P < 0.001). Estrogen receptor (ER) and progesterone receptor (PR) positivity were negatively associated with pCR (P = 0.03 and P = 0.03, respectively), whereas there was a significant positive association between HER-2 positivity and pCR (P = 0.004). There was a moderate agreement between the RECIST criteria used with MRI and pCR (k: 0.46). Moreover, a good agreement between PET-CT-PERCIST and pCR was detected (k: 0.61). In predicting pCR after NAC, MRI showed a selectivity of 80.7%, a sensitivity of 65.2%, a positive predictive value (PPV) of 75%, and a negative predictive value (NPV) of 72.4%. The corresponding rates for PET-CT were 75.7%, 100%, 57.9%, and 100%. CONCLUSIONS: When evaluating pCR after NAC, MRI was found to be more sensitive in patients with ER-positive cancer cell nuclei with weak to medium staining intensity and a loss of E-cadherin expression, whereas PET-CT was found to be more sensitive in patients with HER-2 overexpression, Luminal B, or Ki-67 proliferation >14% (P = 0.01).

The value of parathyroid scintigraphy on lesion detection in patients with normocalcemic primary hyperparathyroidism.

OBJECTIVE: Primary hyperparathyroidism (PHPT) is one of the most frequent endocrine diseases. Most of the patients with PHPT are asymptomatic, and only 20% of them become symptomatic with increasing levels of calcium. It has been reported that normocalcemic primary hyperparathyroidism (NPHPT) may be the incipient period of PHPT where calcium (Ca) levels are in normal range, and it may advance to overt PHPT. Early diagnosis of PHPT is important in order to prevent its complications. In this retrospective study, we aimed to evaluate the role of 99mTc-MIBI parathyroid scintigraphy on lesion detection in patients with NPHPT. MATERIAL AND METHODS: The parathyroid scintigraphy database was reviewed retrospectively in patients with PHPT. 117 patients who underwent 99mTc-MIBI scintigraphy were recruited to the study. Serum calcium level above 10.5mg/dl was considered as hypercalcemia. RESULTS: A total of 117 patients (female/male:98/19) mean serum PTH levels (mean±SD) were 149±97pg/ml in normocalcemic group (Ca:9.6±0.6mg/dl, n:38) and 189±135pg/ml in hypercalcemic group (Ca:11.4±0.6mg/dl, n:79) (p:0.072). The sex and ages were not different between the scintigraphy positive and negative groups, but the lesion detection rates with parathyroid scintigraphy were 42% in normocalcemic group and 81% in hypercalcemic group (p<0.0001). CONCLUSIONS: Several factors including serum Ca, the imaging protocol, existence of multiglandular disease, the size and MIBI biokinetics of the adenoma may influence lesion detectability in parathyroid scintigraphy. Although high serum Ca level is an important parameter in predicting its success, parathyroid scintigraphy remains a valuable diagnostic method even in patients with NPHPT.

The Effect of FDG-PET/CT on Clinical Prognostic Staging of Breast Cancer Patients being Planned Neoadjuvant Treatment.

OBJECTIVE: To evaluate the effect of FDG-PET/CT in the radiological imaging of breast cancer (BC) patients planned for neoadjuvant treatment (NAT), on the clinical prognostic stage (CPS). STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey, between June 2014 and September 2020. METHODOLOGY: Consecutive patients with stage I-III breast cancer (BC) who were planned for neoadjuvant treatment (NAT). The distribution of CPS detected by both conventional radiological methods (c-CPS) and FDG-PET/CT (PET-CPS) were compared. RESULTS: Significant upstaging on CPS was detected with the addition of FDG-PET/CT to conventional imaging methods in 25/121 (20.7%) patients (p <0.001). In the c-CPS stage, IB, IIA, IIB, IIIA, IIIB patients, the stage change rate was 22.7%, 28.6%, 37.5%, 50%, and 9.1%, respectively. There was no change in patients with c-CPS stage IA and IIIC. There was a significant change in the cN stages (p <0.001), while no significant change was detected in the cT stages of the patients (p = 0.180). Upstaging was detected in 5/16 (6.3%, p=0.034), 14/71 (19.7%, p <0.01), 15 / 30 (50%, p <0.01) of initially cN 0, 1, 2 patients, respectively (p<0.001). CONCLUSION: The change in CPS was due to nodal upstaging. The effectiveness of including FDG-PET/CT in the initial radiological imaging in patients planned for NAT should be evaluated with prospective studies evaluating treatment choices to be used in NAT. Key Words: PET scan, Breast cancer, Positron emission tomography, Neoadjuvant treatment, Cancer staging, Staging system, TNM.

Diagnostic Value of Axillary Ultrasound, MRI, and 18F-FDG-PET/ CT in Determining Axillary Lymph Node Status in Breast Cancer Patients.

OBJECTIVE: Knowing axillary lymph node (ALN) status before surgery affects decisions about treatment modalities. Therefore, reliable, noninvasive diagnostic methods are important for determining ALN metastases. We aimed to accurately evaluate the patient's ALN status with noninvasive imaging modalities while making treatment decisions. MATERIALS AND METHODS: Patients who received the axillary ultrasound (AUS), magnetic resonance imaging (MRI), or 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) imaging modalities and whose ALNs were confirmed histopathologically by fine needle aspiration cytology (FNAC), sentinel lymph node biopsy (SLNB), or ALN dissection (ALND) were included in the study. RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of AUS for the detection of ALN metastases were 83%, 62%, 59.2%, 54.8%, and 79.1%, respectively. For MRI they were 86.1%, 75%, 68.5%, 51.6%, and 85.3%, respectively, and for 18F-FDG-PET/CT they were 78%, 53%, 56.2%, 51.4%, and 72.5%, respectively. ALNs were found to be metastatic in all patients who were reported positive in all three imaging modalities. ALN metastases were detected in 19 of 132 patients (false negativity, 14.3%) in whom AUS, MRI, and 18F-FDG-PET/ CT images were all reported as negative. CONCLUSION: In our study, we found that the diagnostic performance of MRI was slightly better than AUS and 18F-FDG-PET/CT. When we used imaging modalities together, our accuracy rate was better than when we used them alone. For accurate evaluation of axillary lymph nodes, imaging modalities should be complementary rather than competitive.

Benign Bone Cyst Mimicking Bone Metastasis Demonstrated on 68Ga-FAPI.

ABSTRACT: A 59-year-old woman with lobular breast cancer was referred to nuclear medicine department for a 68Ga-FAPI PET/CT study after completion of treatment to rule out the possibility of metastatic disease. It revealed a lytic lesion showing increased FAPI accumulation in the right acetabulum, highly suspicious for bone metastasis. In comparison to an initial 18F-FDG PET/CT study done 2 years before, the lytic lesion showing no FDG uptake in the right acetabulum remained unchanged, and the findings were consistent with bone cyst. This case highlighted that benign bone cyst may demonstrate increased 68Ga-FAPI uptake mimicking bone metastasis on 68Ga-FAPI PET/CT.

An investigation of the relationship between smartphone addiction and job performance of healthcare employees.

PURPOSE: To determine the smartphone addiction and employee performance levels of healthcare personnel working in a university hospital and to investigate their relationship. DESIGN AND METHOD: This study is descriptive and correlational design. The data collection tool consisted of the Descriptive Information Form, Smartphone Addiction Scale, and Employee Performance Scale. FINDINGS: The majority of participants were female, aged 30 and younger, working night shifts, and physicians. The majority of those who run out of monthly data bundles said they purchase once-off bundles. There was a negative statistically significant relationship between smartphone addiction and employee performance. PRACTICE IMPLICATIONS: Healthcare employees' level of smartphone addiction adversely affects employee performance and it is recommended for the managers of the institution to develop internal strategies to prevent those effects.

The Role of FDG PET/CT to Evaluation of Axillary Lymph Nodes after Neoadjuvant Chemotherapy in Breast Cancer.

OBJECTIVE: To determine the diagnostic value of breast and axillary maximum standard uptake (SUVmax) values for predicting ypT0 and ypN0 separately. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital, between May 2017 and September 2020.  Methodology: Consecutive patients with operated breast cancer (BC) after neoadjuvant chemotherapy (NAC) were evaluated. SUVmax on FDG-PET/CT after NAC at both primary tumour (postSUVmax-T) and axillary lymph nodes (postSUVmax-N) were assessed to predict the ypT0 and the ypN0, respectively.  Results: Clinically meaningful correlation was detected between postSUVmax-N with ypN0 in patients with human epidermal receptor-positive (Her2+) and triple-negative (TN) BC (in Her2+ BC: r=0.596, p <0.001, in TN BC: r=0.782, p = 0.001). The postSUVmax-N predicted ypN0 with 90.5% positive predictive value (PPV) and 85.7% negative predictive value (NPV) in patients with Her2+ and TN BC. The postSUVmax-T predicted ypT0 with 87.5% PPV and 100% NPV in patients with TN BC (AUC: 0.938, P <0.01) Conclusion: According to this study's findings, the FDG-PET/CT may be an alternative to sentinel lymph node biopsy (SNB) to protect patients from axillary lymph node dissection when the expected FNR of the SNB is high in patients with Her+ and TN BC. Key Words: Breast cancer, FDG PET/CT, Neoadjuvant therapy.

Usefulness of dynamic fluorodeoxyglucose positron emission tomography/computed tomography in diagnosing pulmonary arteriovenous malformation mimicking a lung tumour.

A 61-year-old male patient with known kidney dysfunction who underwent a non-contrast thorax CT and was then referred to our department for metabolic assessment of solitary pulmonary nodule (SPN). The patient underwent dynamic FDG PET/CT to differentiate benign from malignant SPN. This case illustrates the usefulness of dynamic FDG PET/CT imaging when assessing SPN especially in patients with suspicion for pulmonary arterio-venous malformation accompanying renal failure or contrast allergy.

Breast Metastasis of Primary Peritoneal Carcinoma Demonstrated on FDG PET/CT.

ABSTRACT: Primary serous peritoneal carcinomas (PSPCs) are rare, and dissemination other than intraperitoneal implantation is even rarer. Breast is an extremely unusual location of metastasis for PSPC. The distinction of breast metastasis of PSPC from primary breast cancer is crucial because the treatment and the prognosis are entirely different. Here we present a case of breast and axillary lymph node metastases from PSPC that were identified on staging FGD PET/CT.

F-18 Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography Findings of Isolated Gastric Tuberculosis mimicking Gastric Cancer and Lymphoma.

INTRODUCTION: Tuberculosis (TB) infection is still a challenging health issue, especially in developing countries. Diagnosing extrapulmonary infections, especially isolated organ involvement, is difficult in most cases even with the radiological, endoscopic, and histopathological examinations done for accurate diagnosis. Here we describe a case of isolated gastric TB with specific F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings mimicking gastric cancer/ lymphoma. CASE REPORT: A 20-year-old male patient was admitted to our hospital with abdominal pain in the epigastric region, weight loss, and fever especially at nights for 2 months. Physical examination was normal. Hemoglobin was 9.6 gm/dL; the patient had iron deficiency anemia. Upper gastrointestinal (GI) endoscopy was suggestive of gastric ulcer mimicking malignancy. F-18 FDG PET/CT revealed multiple hypermetabolic malignant lymphadenopathies in the abdomen and diffuse gastric wall thickening as linitis plastica and multiple hypermetabolic peritoneal implants in the omentum. Exploratory laparotomy was done for tissue diagnosis and exploration of the peritoneum for TB infection, lymphoma, and Crohn's disease to make differential diagnosis. Histopathology revealed granulomatous lymphadenitis with granulomas including giant cells, suspecting TB. Patient was put on antituberculosis treatment (ATT). After treatment, the complaints resolved, and he gained weight. Fusion PET/CT exhibited a complete response to ATT with no residual disease. CONCLUSION: According to our knowledge, this is the first report about F-18 FDG PET/CT findings in the diagnosis of isolated gastric TB. F-18 FDG PET/CT may provide help in the diagnosis and follow-up of isolated gastric TB in challenging cases.How to cite this article: Akdogan RA, Rakici H, Güngör S, Bedir R, Akdogan E. F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings of Isolated Gastric Tuberculosis mimicking Gastric Cancer and Lymphoma. Euroasian J Hepato-Gastroenterol 2018;8(1):93-96.

FDG PET/CT in Peritoneal Metastasis From Prostate Cancer.

Prostate cancer is one of the leading causes of cancer death in men. The prognosis in prostate cancer is greatly worsened by the presence of metastases, which are most commonly found in bone, lung, liver, and brain. The peritoneum is an extremely uncommon metastatic site for prostate cancer, even in autopsy series. We present a case of FDG PET/CT demonstration of peritoneal metastasis from prostate cancer.

Comparison of WHO, RECIST 1.1, EORTC, and PERCIST criteria in the evaluation of treatment response in malignant solid tumors.

AIM: To compare response assessment according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria in patients diagnosed with malignant solid tumors and who had received cytotoxic chemotherapy to establish the strength of agreement between each criterion. MATERIALS AND METHODS: Sixty patients with malignant solid tumors were included in this retrospective study. The baseline and the sequential follow-up fluorine-18-fluorodeoxyglucose PET/computed tomography (CT) of each patient were evaluated according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria. PET/CT images were used for both metabolic and anatomic evaluation. The concurrent diagnostic CT and MRI images (performed within 1 week of PET/CT) were also utilized when needed. The results were compared using the κ-statistics. RESULTS: The response and progression rates according to the WHO criteria were 37 and 38%, respectively. The same ratios were also found for RECIST 1.1 (κ=1). The response and progression rates according to the EORTC criteria were 47 and 40%, respectively. When PERCIST criteria were used, one patient with progressive disease was upgraded to stable disease (κ=0.976). As we found the same results with WHO and RECIST 1.1 criteria, we used WHO criteria to compare the anatomic and metabolic criteria. When we compared the WHO and EORTC criteria, there was an agreement in 80% of the patients (κ=0.711). With WHO and PERCIST criteria, there was an agreement in 81.6% of the patients (κ=0.736). CONCLUSION: Significant agreement was detected when the WHO, RECIST 1.1, EORTC, and PERCIST criteria were compared both within as well as between each other.

Clinical Impact of Preoperative Sentinel Lymph Node Imaging With SPECT/CT in the Management of Interscapular Malignant Melanoma.

A 31-year-old male patient with a biopsy-proven cutaneous malignant melanoma located in the interscapular area was referred to lymphoscintigraphy for preoperative sentinel lymph node mapping. Anterior and posterior planar images showed 3 hot spots suggesting left axillary sentinel nodes. Herein, we reported the contribution of preoperative SPECT/CT-guided sentinel lymph node excision on accurate staging, management, prognostic evaluation, and determination of the proper surgical positioning preoperatively.