Faculty of Health Sciences

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Health Risks Management Program in Schools: An Operational Study in Türkiye
(MDPI, 2023-02) Atak, Muhammed; Önal, Ayşe Emel; Şimşek, Zeynep; İşsever, Halim
This study was carried out to improve the quality of school health services with the operational epidemiology method. The study aimed to describe the current status of the School Health Protection and Improvement Program (SHPIP), the difficulties experienced during its implementation, to develop evidence-based solution methods, and to test the proposed solutions, in a district with a population of 400,513, 20.4% of which is of school age between the ages of 5–19. The “Health Risk Management Program at Schools”, which consists of the stages of putting the results into practice by sharing the results with the relevant parties, wasdeveloped. In this study, a cross-sectional research design was employed using questionnaire forms, while qualitative data were collected through the use of the phenomenological analysis method, specifically through the conduct of focus group interviews. SHPIP year-end evaluation forms of 191 schools were reviewed retrospectively, questionnaires were applied to 554 school staff and 146 family health center staff between 21 October 2019 and 21 November 2019 using the probabilistic sampling (simple random) method, and semi-structured focus group interviews were conducted with 10 school health study executives. The most common health risks in schools and the risks identified during the execution of school health services were identified. In order to eliminate the lack of in-service training, training modules for “School Health Management Teams” were developed and impact analyses were conducted. After the intervention, a significant difference was found in the compliance of schools with SHPIP, and the application of all components of the school health program increased from 10.0% to 65.6% (p < 0.05). The program has been integrated into the “School Health Protection and Improvement Program” (SHPIP) with the decisions of the District School Health Board and District Hygiene Council. © 2023 by the authors.
Observation of Same-Sign WW Production from Double Parton Scattering in Proton-Proton Collisions at ?s=13 TeV
(AMER PHYSICAL SOC, 2023-09-01) Çakır, Affan
The first observation of the production of (WW +/-)-W-+/- bosons from double parton scattering processes using same-sign electron-muon and dimuon events in proton-proton collisions is reported. The data sample corresponds to an integrated luminosity of 138 fb(-1) recorded at a center-of-mass energy of 13 TeV using the CMS detector at the CERN LHC. Multivariate discriminants are used to distinguish the signal process from the main backgrounds. A binned maximum likelihood fit is performed to extract the signal cross section. The measured cross section for production of same-sign W bosons decaying leptonically is 80.7 +/- 11.2(stat) (+9.5)(-8.6)(syst) +/- 12.1(model) fb, whereas the measured fiducial cross section is 6.28 +/- 0.81(stat) +/- 0.69(syst) +/- 0.37(model) fb. The observed significance of the signal is 6.2 standard deviations above the background-only hypothesis.
Azimuthal correlations in Z plus jets events in proton-proton collisions at ?s=13TeV
(EUROPEAN PHYSICAL JOURNAL C, 2023-11-01) Çakır, Affan
The production of Z bosons associated with jets is measured in pp collisions at v s = 13 TeV with data recorded with the CMS experiment at the LHC corresponding to an integrated luminosity of 36.3 fb(-1). The multiplicity of jets with transverse momentum pT > 30 GeV is measured for different regions of the Z boson's pT(Z), from lower than 10 GeV to higher than 100 GeV. The azimuthal correlation Delta phi between the Z boson and the leading jet, as well as the correlations between the two leading jets are measured in three regions of p(T)(Z). The measurements are compared with several predictions at leading and next-to-leading orders, interfaced with parton showers. Predictions based on transverse-momentum dependent parton distributions and corresponding parton showers give a good description of the measurement in the regions wheremultiple parton interactions and higher jet multiplicities are not important. The effects of multiple parton interactions are shown to be important to correctly describe the measured spectra in the low pT(Z) regions.
Search for single vector-like B quark production and decay via B ? bH(b(b)over-bar) in pp collisions at ?s=13 TeV with the ATLAS detector
(SPRINGER, 2023-11-23) Çakır, Affan
A search is presented for single production of a vector-like B quark decaying into a Standard Model b-quark and a Standard Model Higgs boson, which decays into a b (b) over bar pair. The search is carried out in 139 fb(-1) of root s = 13 TeV proton-proton collision data collected by the ATLAS detector at the LHC between 2015 and 2018. No significant deviation from the Standard Model background prediction is observed, and mass-dependent exclusion limits at the 95% confidence level are set on the resonance production cross-section in several theoretical scenarios determined by the couplings c(W), c(Z) and c(H) between the B quark and the Standard Model W, Z and Higgs bosons, respectively. For a vector-like B occurring as an isospin singlet, the search excludes values of c(W) greater than 0.45 for a B resonance mass (m(B)) between 1.0 and 1.2 TeV. For 1.2 TeV < m(B <) 2.0 TeV, c(W) values larger than 0.50-0.65 are excluded. If the B occurs as part of a (B, Y) doublet, the smallest excluded c(Z) coupling values range between 0.3 and 0.5 across the investigated resonance mass range 1.0 TeV < m(B) < 2.0 TeV.
Search for pair-production of vector-like quarks in pp collision events at ?s=13 TeV with at least one leptonically decaying Z boson and a third-generation quark with the ATLAS detector
(ELSEVIER, 2023-08-10) Çakır, Affan
A search for the pair-production of vector-like quarks optimized for decays into a Z boson and a third-generation Standard Model quark is presented, using the full Run 2 dataset corresponding to 139 fb-1 of pp collisions at & RADIC;s = 13 TeV, collected in 2015-2018 with the ATLAS detector at the Large Hadron Collider. The targeted final state is characterized by the presence of a Z boson with high transverse momentum, reconstructed from a pair of same-flavour leptons with opposite-sign charges, as well as by the presence of b-tagged jets and high-transverse-momentum large-radius jets reconstructed from calibrated smaller-radius jets. Events with exactly two or at least three leptons are used, which are further categorized by the presence of boosted W, Z, and Higgs bosons and top quarks. The categorization is performed using a neural-network-based boosted object tagger to enhance the sensitivity to signal relative to the background. No significant excess above the background expectation is observed and exclusion limits at 95% confidence level are set on the masses of the vector-like partners T and B of the top and bottom quarks, respectively. The limits depend on the branching ratio configurations and, in the case of 100% branching ratio for T-+ Zt and 100% branching ratio for B-+ Zb, this search sets the most stringent limits to date, allowing mT > 1.60 TeV and mB > 1.42 TeV, respectively. & COPY; 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons .org /licenses /by /4 .0/). Funded by SCOAP3.
Measurement of cross sections for production of a Z boson in association with a flavor-inclusive or doubly b-tagged large-radius jet in proton-proton collisions at p s=13 TeV with the ATLAS experiment
(AMER PHYSICAL SOC, 2023-11-02) Çakır, Affan
We present measurements of cross sections for production of a leptonically decaying Z boson in association with a large-radius jet in 13 TeV proton-proton collisions at the LHC, using 36 fb-1 of data from the ATLAS detector. Integrated and differential cross sections are measured at particle level in both a flavor inclusive and a doubly b-tagged fiducial phase space. The large-radius jet mass and transverse momentum, its kinematic relationship to the Z boson, and the angular separation of b-tagged small-radius track jets within the large-radius jet are measured. This measurement constitutes an important test of perturbative quantum chromodynamics in kinematic and flavor configurations relevant to several Higgs boson and beyond-Standard-Model physics analyses. The results highlight issues with modeling of additional hadronic activity in the flavor-inclusive selection, and a distinction between flavor-number schemes in the b-tagged phase space.
First measurement of the forward rapidity gap distribution in pPb collisions at ?sNN=8.16 TeV
(AMER PHYSICAL SOC, 2023-11-20) Çakır, Affan
For the first time at LHC energies, the forward rapidity gap spectra from proton-lead collisions for both proton and lead dissociation processes are presented. The analysis is performed over 10.4 units of pseudorapidity at a center-of-mass energy per nucleon pair of ffisffi than in previous measurements of diffractive production in proton-nucleus collisions. For lead dissociation processes, which correspond to the pomeron-lead event topology, the EPOS-LHC generator predictions are a factor of 2 below the data, but the model gives a reasonable description of the rapidity gap spectrum shape. For the pomeron-proton topology, the EPOS-LHC, QGSJET II, and HIJING predictions are all at least a factor of 5 lower than the data. The latter effect might be explained by a significant contribution of ultraperipheral photoproduction events mimicking the signature of diffractive processes. These data may be of significant help in understanding the high energy limit of quantum chromodynamics and for modeling cosmic ray air showers.
Measurements of Higgs boson production in the decay channel with a pair of ? leptons in proton-proton collisions at ?s=13 TeV
(SPRINGER, 2023-11-05) Çakır, Affan
Measurements of Higgs boson production, where the Higgs boson decays into a pair of tau leptons, are presented, using a sample of proton-proton collisions collected with the CMS experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 138 fb(-1). Three analyses are presented. Two are targeting Higgs boson production via gluon fusion and vector boson fusion: a neural network based analysis and an analysis based on an event categorization optimized on the ratio of signal over background events. These are complemented by an analysis targeting vector boson associated Higgs boson production. Results are presented in the form of signal strengths relative to the standard model predictions and products of cross sections and branching fraction to tau leptons, in up to 16 different kinematic regions. For the simultaneous measurements of the neural network based analysis and the analysis targeting vector boson associated Higgs boson production signal strengths are found to be 0.82 +/- 0.11 for inclusive Higgs boson production, 0.67 +/- 0.19 (0.81 +/- 0.17) for the production mainly via gluon fusion (vector boson fusion), and 1.79 +/- 0.45 for vector boson associated Higgs boson production.
Measurement of the mass dependence of the transverse momentum of lepton pairs in Drell-Yan production in proton-proton collisions at ?s=13TeV
(SPRINGER, 2023-07-17) Çakır, Affan
\The double differential cross sections of the Drell-Yan lepton pair (l(+)l(-), dielectron or dimuon) production are measured as functions of the invariant mass m(ll), transverse momentum p(T)(ll), and phi(eta)*. The phi(eta)* observable, derived from angular measurements of the leptons and highly correlated with p(T)(ll), is used to probe the low-p(T)(ll) region in a complementary way. Dilepton masses up to 1 TeV are investigated. Additionally, a measurement is performed requiring at least one jet in the final state. To benefit from partial cancellation of the systematic uncertainty, the ratios of the differential cross sections for various m(ll) ranges to those in the Zmass peak interval are presented. The collected data correspond to an integrated luminosity of 36.3 fb(-1) of proton-proton collisions recorded with the CMS detector at theLHCat a centre-of-mass energy of 13 TeV. Measurements are compared with predictions based on perturbative quantum chromodynamics, including soft-gluon resummation.
Measurement of differential cross sections for the production of a Z boson in association with jets in proton-proton collisions at ?s=13 TeV
(AMER PHYSICAL SOC, 2023-12-17) Çakır, Affan
A measurement is presented of the production of Z bosons that decay into two electrons or muons in association with jets, in proton-proton collisions at a center-of-mass energy of 13 TeV. The data were cross sections are measured as a function of the transverse momentum (pT) of the Z boson and the transverse momentum and rapidities of the five jets with largest pT. The jet multiplicity distribution is measured for up to eight jets. The hadronic activity in the events is estimated using the scalar sum of the pT of all the jets. All measurements are unfolded to the stable-particle level and compared with predictions from various Monte Carlo event generators, as well as with expectations at leading and next-to-leading orders in perturbative quantum chromodynamics.
Reconstruction of decays to merged photons using end-to-end deep learning with domain continuation in the CMS detector
(AMER PHYSICAL SOC, 2023-09-05) Çakır, Affan
A novel technique based on machine learning is introduced to reconstruct the decays of highly Lorentz boosted particles. Using an end-to-end deep learning strategy, the technique bypasses existing rule-based particle reconstruction methods typically used in high energy physics analyses. It uses minimally processed detector data as input and directly outputs particle properties of interest. The new technique is demonstrated for the reconstruction of the invariant mass of particles decaying in the CMS detector. The decay of a hypothetical scalar particle A into two photons, A gamma gamma, is chosen as a benchmark decay. Lorentz boosts gamma L 1/4 60-600 are considered, ranging from regimes where both photons are resolved to those where the photons are closely merged as one object. A training method using domain continuation is introduced, enabling the invariant mass reconstruction of unresolved photon pairs in a novel way. The new technique is validated using pi 0 gamma gamma decays in LHC collision data.
Two-particle azimuthal correlations in ?p interactions using pPb collisions at ?sNN=8.16 TeV
(ELSEVIER, 2023-11-05) Çakır, Affan
The first measurements of the Fourier coefficients (V-n Delta) of the azimuthal distributions of charged hadrons emitted from photon-proton (gamma p) interactions are presented. The data are extracted from 68.8nb(-1) of ultra-peripheral proton-lead (pPb) collisions at root s(NN)= 8.16 TeV using the CMS detector. The high energy lead ions produce a flux of photons that can interact with the oncoming proton. This gamma p system provides a set of unique initial conditions with multiplicity lower than in photon-lead collisions but comparable to recent electron-positron and electron-proton data. The V-n Delta coefficients are presented in ranges of event multiplicity and transverse momentum (p(T)) and are compared to corresponding hadronic minimum bias pPb results. For a given multiplicity range, the mean p(T) of charged particles is smaller in gamma p than in pPb collisions. For both the gamma p and pPb samples, V-1 Delta is negative, V-2 Delta is positive, and V-3 Delta consistent with 0. For each multiplicity and p(T) range, V-2 Delta is larger for gamma p events. The gamma p data are consistent with model predictions that have no collective effects. (c) 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP(3).
CMS PYTHIA 8 colour reconnection tunes based on underlying-event data
(SPRINGER, 2023-11-02) Çakır, Affan
New sets of parameter tunes for two of the colour reconnection models, quantum chromodynamics-inspired and gluon-move, implemented in the PYTHIA 8 event generator, are obtained based on the default CMS PYTHIA 8 underlying-event tune, CP5. Measurements sensitive to the underlying event performed by the CMS experiment at centre-of-mass energies root s = 7 and 13 TeV, and by the CDF experiment at 1.96 TeV are used to constrain the parameters of colour reconnection models and multiple-parton interactions simultaneously. The new colour reconnection tunes are compared with various measurements at 1.96, 7, 8, and 13 TeV including measurements of the underlying-event, strange-particle multiplicities, jet substructure observables, jet shapes, and colour flow in top quark pair (t (t) over bar) events. The new tunes are also used to estimate the uncertainty related to colour reconnection modelling in the top quark mass measurement using the decay products of t (t) over bar events in the semileptonic channel at 13 TeV.
Measurements of jet multiplicity and jet transverse momentum in multijet events in proton-proton collisions at ?s=13 TeV
(SPRINGER, 2023-11-02) Çakır, Affan
Multijet events at large transverse momentum (p(T)) are measured at root s = 13 TeV using data recorded with the CMS detector at the LHC, corresponding to an integrated luminosity of 36.3 fb(-1). The multiplicity of jets with p(T) > 50 GeV that are produced in association with a high-p(T) dijet system is measured in various ranges of the p(T) of the jet with the highest transverse momentum and as a function of the azimuthal angle difference Delta phi(1,2) between the two highest p(T) jets in the dijet system. The differential production cross sections are measured as a function of the transverse momenta of the four highest p(T) jets. The measurements are compared with leading and next-to-leading order matrix element calculations supplemented with simulations of parton shower, hadronization, and multiparton interactions. In addition, the measurements are compared with next-to-leading order matrix element calculations combined with transverse-momentum dependent parton densities and transverse-momentum dependent parton shower.
Search for CP violating top quark couplings in pp collisions at ?s=13 TeV
(SPRINGER, 2023-11-05) Çakır, Affan
Results are presented from a search for CP violation in top quark pair production, using proton-proton collisions at a center-of-mass energy of 13TeV. The data used for this analysis consist of final states with two charged leptons collected by the CMS experiment, and correspond to an integrated luminosity of 35.9 fb(-1). The search uses two observables, O-1 and O-3, which are Lorentz scalars. The observable O-1 is constructed from the four-momenta of the charged leptons and the reconstructed top quarks, while O-3 consists of the four-momenta of the charged leptons and the b quarks originating from the top quarks. Asymmetries in these observables are sensitive to CP violation, and their measurement is used to determine the chromoelectric dipole moment of the top quark. The results are consistent with the expectation from the standard model.
Search for light Higgs bosons from supersymmetric cascade decays in pp collisions at ?s=13TeV
(SPRINGER, 2023-11-02) tum, A.; Yetkin, Esra Akkuş
A search is reported for pairs of light Higgs bosons (H-1) produced in supersymmetric cascade decays in final states with small missing transverse momentum. A data set of LHC pp collisions collected with the CMS detector at root s = 13 TeV and corresponding to an integrated luminosity of 138 fb(-1) is used. The search targets events where both H-1 bosons decay into b (b) over bar pairs that are reconstructed as large-radius jets using substructure techniques. No evidence is found for an excess of events beyond the background expectations of the standard model (SM). Results from the search are interpreted in the next-to-minimal supersymmetric extension of the SM, where a "singlino" of small mass leads to squark and gluino cascade decays that can predominantly end in a highly Lorentz-boosted singlet-like H-1 and a singlino-like neutralino of small transversemomentum. Upper limits are set on the product of the squark or gluino pair production cross section and the square of the b (b) over bar branching fraction of the H1 in a benchmark model containing almost mass-degenerate gluinos and light-flavour squarks. Under the assumption of an SM-like H-1 -> b (b) over bar branching fraction, H-1 bosons with masses in the range 40-120 GeVarising from the decays of squarks or gluinos with a mass of 1200-2500 GeV are excluded at 95% confidence level.
Azimuthal Correlations within Exclusive Dijets with Large Momentum Transfer in Photon-Lead Collisions
(AMER PHYSICAL SOC, 2023-08) Tumasyan, A.; Çakır, Affan
The structure of nucleons is multidimensional and depends on the transverse momenta, spatial geometry, and polarization of the constituent partons. Such a structure can be studied using high-energy photons produced in ultraperipheral heavy-ion collisions. The first measurement of the azimuthal angular correlations of exclusively produced events with two jets in photon-lead interactions at large momentum transfer is presented, a process that is considered to be sensitive to the underlying nuclear gluon polarization. This study uses a data sample of ultraperipheral lead-lead collisions at ffiffiffiffiffiffiffi p = 5.02 TeV, corresponding to sNN an integrated luminosity of 0.38 nb-1, collected with the CMS experiment at the LHC. The measured second harmonic of the correlation between the sum and difference of the two jet transverse momentum vectors is found to be positive, and rising, as the dijet transverse momentum increases. A well-tuned model that has been successful at describing a wide range of proton scattering data from the HERA experiments fails to describe the observed correlations, suggesting the presence of gluon polarization effects.
Assessing the Clinical Impact of Lutetium-177 DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) on Metastatic Neuroendocrine Tumors: A Multicenter Real-World Data from Türkiye
(2023) Ünal, Çağlar; Seçuk, Nalan Alan; Duymaz, Tomris
Objectives: This study aimed to evaluate the clinical outcomes, including progression-free survival (PFS), overall sur-vival (OS), Objective Response Rate (ORR), and Disease Control Rate (DCR), in patients received Lutetium-177 (Lu-177) DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) for metastatic neuroendocrine tumors. This study further stratified outcomes based on tumor grade, Ki-67 status, primary tumor localization, number of treatment cycles, and associated adverse effects.Methods: We conducted a multicenter retrospective study analyzing the data of 73 patients with metastatic NETs across 17 different hospitals in various regions of Turkiye. A total of 73 metastatic NET patients underwent Lu-177 DOT-ATATE PRRT between December 2013 and March 2023. Results: Over a median follow-up of 52.7 months, patients showed a median PFS of 13.7 months and OS of 51.2 months. The ORR was 29.6%, and the DCR was 66.2%. Grade 1 and 2 tumor patients had superior outcomes (PFS: 16.9 months, OS: 55.5 months) compared to grade 3 tumor patients (PFS: 8.5 months, OS: 29.5 months). Based on their Ki-67 status, those <= 20% had prolonged PFS (16.9 months) and OS (55.5 months) than those between 21 and 55% (PFS: 5.9 months, OS: 41.3 months). Regarding primary tumor localization, the PFS values were 13.1, 15.3, 13.7, and 8.6 months for pancreatic, GIS, lung, and unknown origin tumors, respectively. The OS across tumor types fluctuated between 41.1 and 54.1 months. Patients who received more than four cycles demonstrated significantly improved median PFS (22.4 months) and OS (90.3 months) compared to those who received <= 4 cycles (median PFS: 9.3 months; median OS: 41.8 months). Grade 3-4 adverse effects were observed in 21.9% of patients.Conclusion: Our findings affirm that PRRT is a potent and well-tolerated treatment for metastatic NETs. Notably, pa-tients who received more than 4 cycles of PRRT experienced a markedly improved median PFS and OS compared to their counterparts who received <= 4 cycles.
MCM-2 Levels as a Potential Biomarker for Predicting High-Risk Breast Cancer Patients According to TAILORx Classification
(DOVE MEDICAL PRESS LTD, 2023-10-14) Ünal, Çağlar; Özmen, Tolga; Dıuymaz, Tomris
Background: The minichromosome maintenance protein-2 (MCM-2) is a more sensitive proliferation marker than Ki-67. This study aimed to evaluate the relationship between MCM-2 and Oncotype DX recurrence score (ODX-RS) and determine an MCM-2 cutoff value in high-risk patients according to TAILORx risk categorization. Methods: Hormone receptor (HR) positive HER-2 negative early-stage breast cancer patients (pT1-2, pN0-N1, M0) who had ODX-RS were included in the study. According to the TAILORx trial, patients were divided into two groups with high (ODX-RS >= 26) and low risk (ODX-RS <26) in terms of ODX-RS. Formalin-fixed-paraffin-embedded tissues of patients were re-evaluated, and 3 mu m sections were prepared for MCM-2 immuno-histochemical staining. The relationship between ODX-RS and the percentage of MCM-2 staining was evaluated in two groups. The ROC curve analysis was performed to determine the MCM-2 cut-off value for the TAILORx high-risk group (ODX-RS >= 26). Results: The mean MCM-2 value was significantly higher in the high-risk group [(60.2 +/- 11.2 vs 34.4 +/- 13.8, p < 0.001)]. In the multivariate analysis, MCM-2 (OR: 1.27, 95% CI: 1.08-1.49, p = 0.003) and progesterone receptor (PR) levels <= 10% (OR: 60.9, 95% CI: 4.1-89.7, p = 0.003) were found to be independent factors indicating a high-risk group. A one-unit increase in MCM-2 level increased the likelihood of being in the high-risk group by 1.27 times. In the ROC curve analysis, the optimal MCM-2 cut-off level was 50 (AUC: 0.921, sensitivity: 86.7%, specificity: 96.0%, p < 0.001). Conclusion: Our study is the first study in the literature to investigate the relationship between ODX-RS and MCM-2 levels in HR-positive HER-2 negative early breast-cancer patients. In this study, MCM-2 was an independent risk factor in identifying high-risk patients according to TAILORx risk classification. MCM 2 cut-off value (50) may help the decision on adjuvant chemotherapy in patients where the Oncotype DX test cannot be performed.
Evaluation of Anti-Mullerian Hormone Levels, Antral Follicle Counts, and Mean Ovarian Volumes in Chemotherapy-Induced Amenorrhea among Breast Cancer Patients: A Prospective Clinical Study
(MDPI, 2023-10) Ünal, Çağlar; Özmen, Tolga; Duymaz, Tomris
Estradiol (E2), a follicle-stimulating hormone (FSH), AMH, and inhibin B levels, along with AFC and MOV, are used to determine ovarian reserve in pre-menopausal women. Studies have shown that AMH levels are more sensitive than those of E2, FSH, and inhibin B and that AFC and MOV can be used to evaluate ovarian reserve. AMH, AFC, and MOV measurements were performed before and after adjuvant SC in 3-month periods for one year. Patients were classified as experiencing chemotherapy-induced amenorrhea (CIA) if they did not have menstrual cycles for a period of six months or longer following the conclusion of their chemotherapy treatment. We aimed to evaluate the factors affecting chemotherapy-induced amenorrhea in breast cancer patients treated with adjuvant chemotherapy and the performance of baseline measurements of AMH, AFC, and MOV to predict chemotherapy-induced amenorrhea. The effects of different chemotherapy regimens on the AMH level, AFC, and MOV in CIA patients were investigated. Seventy-one patients were eligible for this study, and the median age was 38 years (range: 23–45). The median follow-up was 37 months (range: 20–51), and CIA developed in 62% of the patients. The AMH level and AFC were significantly decreased one year after SC (p < 0.0001), whereas MOV was not (p = 0.507). AMH levels before chemotherapy (median: 1.520 vs. 0.755, p = 0.001) and at the end of the first year (median: 0.073 vs. 0.010, p = 0.030) and pre-treatment AFC (median: 12 vs. 4.50, p = 0.026) were lower in patients with CIA compared to those without CIA. The AMH levels before SC were the most valuable and earliest factor for predicting CIA development. In addition, there was no difference between the chemotherapy regimens (including or not including taxane) in terms of CIA development.

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