Sağlık Araştırma ve Uygulama Merkezi Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11499/46036
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Article Enhancing Hospital Drug and Medical Supply Request Processes through a Clinically Prioritized and Demand-Variability–Aware Adaptive Decision Support Framework(Elsevier Ireland Ltd, 2026-07) İşli, Devrim; Aydın, LemanBackground: Rule-based replenishment thresholds in hospital information systems (HIS) are feasible and auditable but may respond slowly to demand variability and clinical criticality. Objective: To evaluate a decision-support framework that preserves a three-level request structure (minimum/critical/maximum) while adapting thresholds using short-horizon demand forecasts and uncertainty, stratified by VEN clinical priority (Vital-Essential-Non-essential), and to benchmark its forecasting component against a na & iuml;ve rolling 180-day mean predictor (mu 180). Methods: A retrospective unit-item-day panel was constructed from routine hospital records and classified by VEN. XGBoost forecasted 14- and 30-day cumulative demand; uncertainty was modeled using a rolling 30-day consumption standard deviation scaled by VEN-specific coefficients. Adaptive targets were mapped to existing HIS request levels and backtested against the baseline rule (7 & times;/15 & times;/30 & times; the rolling 180-day mean daily consumption) on a 30-day ML-available panel (35,801 unit-item-day records; 1269 series; 2025-09-30-2026-01-22). Forecast accuracy was compared with mu 180 using RMSE and WAPE, supported by calibration and Diebold-Mariano testing. Policies were evaluated using paired Wilcoxon tests and lead-time sensitivity analyses. Results: The proposed policy reduced stock-out days (54 to 10; -81.5%), days below critical (11,612 to 6396; -44.9%), ordering days (1936 to 550; -71.6%), and ordered quantity (853,119 to 579,795; p < 0.001). Stock-outs were eliminated for Vital items. XGBoost reduced WAPE by 62%-71% versus mu 180 across horizons, with absolute-error superiority confirmed by Diebold-Mariano testing. Inventory exposure increased (366,406 to 802,049), indicating a measurable safety-inventory trade-off. Conclusions: VEN-prioritized, forecast- and volatility-aware threshold adaptation improved service continuity and ordering efficiency within an auditable HIS workflow while quantifying trade-offs under alternative lead-time assumptions.Article Citation - WoS: 1Citation - Scopus: 1Functional capacity, physical activity, and arterial stiffness in patients with systemic sclerosis(Springer London Ltd, 2024-04-04) Tanriverdi, Aylin; Ozcan Kahraman, Buse; Sezgin, Nazenin Hande; Erez, Yesim; Acar, Serap; Birlik, Ahmet Merih; Ozpelit, EbruObjectives Systemic sclerosis (SSc) is a complex immune-mediated connective tissue disease, involving skin manifestations, vascular features, and organ-based complications that may affect functional capacity and physical activity. Functional capacity and physical activity are associated with arterial stiffness; however, this relationship has not been evaluated in patients with SSc. Therefore, the objective of this study was to investigate the association of functional capacity and physical activity with arterial stiffness in patients with SSc. Methods Sixty-five patients with SSc were enrolled in this cross-sectional study. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Functional capacity and physical activity were assessed with a six-min walk test (6MWT) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. Results All participants were women, and the mean age was 54.91 +/- 11.18 years. 6MWT distance and IPAQ-SF were inversely associated with cf-PWV in crude analysis (p < 0.05). The relationship between 6MWT distance and cf-PWV was maintained in the fully adjusted model (beta = - 0.007, 95% CI, - 0.013 to 0.000). Similarly, the association between IPAQ-SF and cf-PWV remained significant in the fully adjusted model (beta = - 0.001, 95% CI, - 0.002 to - 0.001). Conclusion The present study indicates that functional capacity and self-reported physical activity are independently associated with arterial stiffness in patients with SSc. Exercise interventions targeted to increase functional capacity and physical activity may help to regulate arterial stiffness in patients with SSc.Article Citation - WoS: 23Citation - Scopus: 25Exosome inhibition improves response to first-line therapy in small cell lung cancer(Wiley, 2024-02) Irep, Nesrin; Inci, Kubilay; Tokgun, Pervin Elvan; Tokgun, OnurExosomes are recognized as important mediators of cell-to-cell communication, facilitating carcinogenesis. Although there have been significant advancements in exosome research in recent decades, no drugs that target the inhibition of sEV secretion have been approved for human use. For this study, we employed GW4869 and Nexinhib20 as inhibitors of exosome synthesis and trafficking combined. First, we found that Nexinhib20 and GW4869 effectively inhibited RAB27A and neutral sphingomyelinase 2 (nSMase2) nsMase2. Interestingly, the inhibition of nsMase2 and RAB27A decreased expression of CD9, CD63 and Tsg101, both at RNA and protein levels. We used a combination treatment strategy of cisplatin/etoposide plus GW4869 or Nexinhib20 on small cell lung cancer (SCLC) cell lines. The combination treatment of GW4869 or Nexinhib20 effectively enhanced the inhibitory effects of first-line chemotherapy on the SCLC cells. Furthermore, we demonstrated that reducing exosome release through GW4869 and Nexinhib20 treatment effectively reduced cellular proliferation and significantly induced apoptosis in SCLC cells. Also, we showed that combining exosome inhibition with chemotherapy has a significant synergistic effect on cellular proliferation. We also found increased p53 and p21 expressions with western blot and significantly changing Bax, BCL2, caspase-3 and caspase-9 expressions. Inhibiting the exosome pathway offers opportunities for developing novel, effective treatment strategies for SCLC.Article Citation - WoS: 1Citation - Scopus: 1Comparison of three different methods in [Ga-68]Ga-PSMA11 radiolabeling(Wiley, 2022-07-31) Yuksel, Dogangun; Ugur, AyseIn this study, quality control parameters such as radiochemical yield, radiochemical purity, and in vitro stability of gallium (Ga-68)-prostate-specific membrane antigen-11 ([Ga-68]Ga-PSMA11) radiopharmaceutical obtained in a research laboratory with three different synthesis algorithms were evaluated and compared. Gallium (Ga-68) chloride precursor to be used in labeling in all three methods was obtained by using ITG brand Ge-68/Ga-68 generator. The first method for the [Ga-68]Ga-PSMA11 radiopharmaceutical was performed with the automated synthesis module, which is widely used in clinical practice. Its radiochemical yield, quality assurance, and stability met expectations. Radiolabeling success, suitability of quality control parameters, and in vitro stability of [Ga-68]Ga-PSMA11 radiopharmaceutical performed with ANMI kit were examined. The final product showed success in Ga-68-complexation kinetics. All quality control criteria performed met the expectation for clinical applications. Direct cold labeling of PSMA11 ligand with sodium bicarbonate buffer was examined. Results were similar to the ANMI kit. Considering that all three methods are successful in radiochemical labeling, labeling with NaHCO3 buffer shows the labeling preference when we choose the cheap, practical, and easy labeling option.