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 Medication Regimen Complexity and Patient-Reported Adherence: A Cross-Sectional Study in Internal Medicine Outpatients(Dove Medical Press Ltd, 2026-02) Ertuna, Elif; Guray, Irem; Inci, Veli; Bucuk, Pinar Sirmatel; Gencer, Nagihan Sozen; Arun, Mehmet Zuhuri; Kilavuz, Asli; Sirmatel Bucuk, Pinar; Sozen Gencer, NagihanPurpose: Medication non-adherence and regimen complexity are significant barriers to achieving therapeutic goals. This study aimed to determine the impact of medication regimen complexity, and clinical characteristics of patients on medication adherence in internal medicine outpatients. Patients and Methods: This prospective cross-sectional study was conducted in the internal medicine and geriatric outpatient clinics of a tertiary university hospital. Adherence was assessed with Medication Adherence Report Scale (MARS-5), and regimen complexity was quantified using the Medication Regimen Complexity Index (MRCI) in 150 patients. Results: The mean age of the participants was 57.53 +/- 1.26 years. Only 44% of the participants demonstrated perfect adherence to therapy. The MRCI scores of geriatric patients (median: 11 (3-44) vs 19 (5-65)) and those hospitalized within the last six months (median: 12.75 (3-47) vs 20 (6-65.5)) were significantly higher. Complexity scores related to dosing schedule and instructions for use were especially higher in patients with hypertension or diabetes. No statistically significant correlation was found between the total MRCI score and patient-reported adherence scores (P=0.32). However, geriatric patients and recently hospitalized patients were less likely to fully adhere to therapy (chi 2 (1, N=150) = 4.71, P=0.030 and 4.23, P=0.040, respectively). Conclusion: Although a direct correlation between total regimen complexity and self-reported adherence was not observed, complexity poses a significant challenge for specific high-risk groups, including geriatric patients and those with recent hospitalizations. These findings may suggest that providing targeted medication counseling and medication regimen review, particularly in the early post-discharge period, might be crucial for optimizing adherence and clinical outcomes.Article Citation - WoS: 1Citation - Scopus: 2Trends and Methods in Intensive Care Unit (ICU) Research Using Machine Learning: Latent Dirichlet Allocation (lDA)-Based Thematic Literature Review(BMC, 2025-07-29) Topaloglu, Duygu; Polat, OlcayIntroductionThe use of machine learning (ML) in intensive care units (ICUs) has led to a large yet fragmented body of literature. It is imperative to conduct a systematic analysis and synthesis of this research to identify methodological trends, clinical applications, and knowledge deficits.MethodsA systematic literature review was conducted in accordance with the PRISMA guidelines, encompassing 2,507 ICU-focused ML publications from 2019 to 2024. Latent Dirichlet Allocation (LDA), an unsupervised topic modeling approach, was used with n-gram and no-n-gram tokenization strategies. Bayesian optimization approaches were used to increase model coherence and diversity.ResultsThe analysis demonstrated a substantial degree of methodological variability, emphasizing the predominance of studies on infection surveillance and complication prediction. N-gram tokenization efficiently identified clinically specific topics, but no-n-gram techniques produced larger interpretative groups. Underexplored fields include emerging research areas like drug response prediction, pediatric-specific modeling, and surgical risk classification.ConclusionIn conclusion, the study highlights the significance of methodological transparency and tokenization strategies while offering a thorough topic overview and identifying methodological trends in the literature on ICU - ML. Future research should prioritize neglected areas such as pediatric care modeling and therapy response, utilizing advanced ML techniques and multimodal data integration to enhance the outcomes of ICU patients.Article Pressure Injuries Related to the Positioning of Surgical Patients in the Operating Room and Identification of Associated Risk Factors: A Cross-Sectional Study(Wiley, 2025-06-26) Usul, Osman; Dizer, BernaSurgery represents a significant risk factor for the development of pressure injuries. However, risk factors related to positioning-induced pressure-injuries in surgical operating rooms have not been adequately investigated. Therefore, this study aimed to determine the presence of pressure injuries and associated risk factors related to patient positioning in the operating room. This prospective, descriptive, and cross-sectional study was conducted between November 2023 and July 2024 in operating rooms of a university hospital, including surgeries from various surgical departments, with a cohort of 140 patients determined using a G*Power analysis. Data collection tools included the 'Individual Characteristics Form', 'Risk Assessment Scale for Pressure Injuries Related to Surgical Positioning' and 'Postoperative Patient Evaluation Form', with data collected pre, intra and postoperatively. We found that 25.7% of patients developed Stage I pressure injuries post-surgery, with the supine position being the most prevalent risk factor (p = 0.023). Patients with diabetes, higher body mass index, advanced age, longer surgeries and certain anaesthesia types had significantly increased risks (p < 0.05). Furthermore, 17.9% of patients were classified as high-risk. These findings underscore the need for nurses to monitor high-risk patients closely, adjust positioning as needed and develop tailored care plans to mitigate risk.Article Citation - Scopus: 1Social media use in dermatology in Turkey: Challenges and tips for patient health(JMIR Publications Inc., 2024-03-28) A.S., Karadag; B., Kandi; B., Sanlı; H., Ulusal; H., Basusta; S., Sener; S., CalıkaSocial media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on “How social media works” at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists’ experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered. © 2024 JMIR Publications Inc.. All rights reserved.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.Article Identification of the sociodemographic and clinical characteristics of the patients who have undergone transcranial magnetic stimulation in a psychiatry clinic: A retrospective descriptive design(Wiley, 2021-05-05) Tasdemir Yigitoglu, Gulay; Cunkus, Nesrin; Ozgun Ozturk, Fatma; Saricay, KiymetPurpose The aim of this study, which is the first in this field in Turkey, is to determine the sociodemographic and clinical characteristics of patients who have undergone transcranial magnetic stimulation (TMS) in a psychiatry clinic. Design and Methods This study has a retrospective descriptive design. Data of 513 psychiatric patients who have undergone TMS between 2015 and 2018 in a university hospital were reviewed. Findings Significant differences were found between psychiatric diagnoses of the patients, based on their sex, marital status, and the number of courses of treatment with TMS (p < 0.05). Practical Implications It was suggested that nurses who would practice this procedure were required to be educated for TMS and nursing care to provide well and effective care.Article Citation - WoS: 9Citation - Scopus: 9Prenatal breastfeeding self efficacy scale: validity and reliability study(AVES, 2019-02-21) Hazar, Hale Uyar; Akca, Esin UzarAim: To determine the validity and the reliability of the Prenatal Breastfeeding Self-Efficacy Scale. Material and Methods: This was a methodologic study. The sample of the research comprised 200 pregnant women who presented to the outpatient clinic of Gynecology between April and June 2015. An introductory information form and the Prenatal Breast Self-Efficacy Scale were used to collect the data. In the analysis of the data, descriptive statistics, content validity index for coverage validity, exploratory factor analysis, and confirmatory factor analysis for construct validity, and Cronbach-alfa? for reliability were used. Results: In the explanatory factor analysis of the scale, the Kaiser-Meyer- Olkin floor number was 0.84 and the Barlett’s sphericity test results were ?2=1812.608; df=171; p<0.001. The contribution of the factors to total variance was 59.06%. According to confirmatory factor analysis of the scale, the Chi-square test result was as follows: ?2=254.23 (p<0.001, SD=146). The model fit indices were as follows: ?2/SD=1.74, Root Mean Square Error of Approximation=0.06, Comparative Fit Index=0.96, Normed Fit Index=0.92, Non-Normed Fit Index=0.96, Goodness of Fit Index=0.88 and Adjusted Goodness of Fit Index=0.85. The internal consistency reliability coefficient of Prenatal Breastfeeding Self-Efficacy Scale was 0.86. Conclusion: The Prental Breastfeeding Self-Efficacy Scale is a valid and reliable scale which is applicable to Turkish culture and an appropriate tool which can be used by all healthcare workers who wish to design and evaluate interventions to support breastfeeding in the prenatal period. © 2018 by Turkish Pediatric Association.