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Methodological Considerations in Blood Pressure Variability Assessment for Branch Atheromatous Disease
(WILEY, 2025) Aker, Mücahit; Kalçık, Macit; Bekar, Lütfü
Dear Editor, The recent multicenter study examining the relationship between systolic blood pressure variability (BPV) and 90-day functional outcomes in branch atheromatous disease (BAD) provides valuable data on a clinically challenging stroke subtype [1].
Comments on the relationship between microRNA-155-5p and postoperative inflammatory markers in children with acute suppurative appendicitis, and its role in predicting postoperative complications
(TURKISH J PEDIATRICS, 2025) Coşkun, Nurcan
Dear Editor, I read with interest the study by Dr. Duan et al.1 titled “The relationship between microRNA-155-5p and postoperative inflammatory markers in children with acute suppurative appendicitis and its role in predicting postoperative complications” published in The Turkish Journal of Pediatrics.
A scoping review of the health effects of fermented foods in specific human populations and their potential role in precision nutrition: current knowledge and gaps
(FRONTIERS MEDIA SA, 2025) Humblot, Christele; Alvanoudi, Panagiota; Alves, Emilia; Assuncao, Ricardo; Belovic, Miona; Bulmuş Tüccar, Tuğçe; Karagöz, Mustafa Fevzi
Background: Diets and specific foods have a significant impact on health, and individual responses to nutritional factors vary. This variability among humans can be considered a basis for developing personalized or precision nutrition. Fermented foods (FF) contain a wide range of macro- and micronutrients, bioactive compounds, and live or dead microorganisms. FF represent a diverse range of products and have garnered significant interest due to their potential health benefits. However, consistent evidence remains limited, possibly due to heterogeneity in individual responses. Objectives: The objective of this review is to assess and compile existing evidence on the variable responses of populations to FF and to determine whether FF could be integrated into a precision nutrition strategy. Design: Interventional and observational human studies were systematically collected. The publication identified the main factors likely to contribute to variable responses to FF across all health outcomes. The question was systematically addressed to assess the available evidence and identify knowledge gaps, guiding future research. A pragmatic approach was employed, following EFSA health claim guidelines, which require an assessment of food characteristics and mechanisms of action, as well as conducting a systematic search of human interventional studies. A similar approach was used to analyze data extracted from observational studies. The population included all humans (healthy and non-healthy, of all ages), encompassing both observational and interventional studies. The intervention consisted of the ingestion of any FF, while the control was defined as the absence or lower consumption of FF or consumption of a corresponding non-FF. Outcomes included all markers of the population's health status. Results: The main factors contributing to variable responses to FF across all health outcomes were related to initial phenotypic characteristics (biological sex, geographical origin, hormonal status, and age), baseline health status [metabolic syndrome [MetS], chronic metabolic pathologies, cancer, and psychological disorders], and genetic background. Additionally, since the gut microbiota is person-specific and influences metabolic responses, particular attention was paid to its functions and role in the variability of population responses to FF. Conclusion: Collectively, this review represents a first step toward evaluating the feasibility of using FF in tailored nutritional strategies. Systematic review registration: https://osf.io/69d3f/overview.
Long-Term Cardiac Outcomes Following Renal Denervation: A Need for Imaging-Based Evidence
(WILEY, 2025) Çelik, Muhammet Cihat; Çelik, Ömer Burak; Kalçık, Macit
Dear Editor, We read with interest the article by Sesa-Ashton et al., which examined electrocardiographic changes in left ventricular mass index (LVMI) and atrial fibrillation (AF) incidence over more than 8 years of follow-up after renal denervation (RDN) [1].
Real-world outcomes and prognostic factors in primary mediastinal B-cell lymphoma: a multicenter study of 157 patients
(SPRINGER, 2025) Küçükyurt, Selin; Koca, Oğuzhan; Demirsoy, Esra Terzi; Akın, Serkan; Doğan, Ali; Yıldız, Abdülkerim
Primary mediastinal B-cell lymphoma (PMBCL) is a rare and distinct subtype of non-Hodgkin lymphoma. No consensus exists on optimal frontline treatment, and the use of R-CHOP +/- radiotherapy (RT) and DA-EPOCH-R +/- RT remains common, yet comparative real-world data are limited. In our multicenter retrospective study, we analyzed PMBCL patients, stratified by the first-line therapy (R-CHOP-21 +/- RT or DA-EPOCH-R +/- RT). Primary outcomes were complete response (CR) rate, progression-free survival (PFS), and overall survival (OS), alongside assessment of treatment-related toxicities and prognostic factors for PFS and OS. We included 157 patients [R-CHOP +/- RT group (n = 80) and DA-EPOCH-R +/- RT group (n = 77)] with a median age of 31 years, of whom 68.2% were female. CR rates were similar for R-CHOP +/- RT (75%) and DA-EPOCH-R +/- RT (76.6%). RT use was higher in the R-CHOP group (41.2% vs. 19.5%, p = 0.002). DA-EPOCH-R had significantly higher toxicity (29.9% vs. 16.2%, p = 0.033). The median follow-up of the entire cohort was 29 months with 2-year PFS and OS rates of 73.9% and 83.6%, respectively. Also, PFS and OS did not differ between regimens. In patients achieving CR with R-CHOP, RT omission did not impact survival. Multivariate analysis identified older age, poor performance status, superior vena cava syndrome and splenic involvement as independent OS predictors, while pericardial effusion, splenic involvement and hemoglobin < 10.5 g/dL were linked to inferior PFS. R-CHOP-21 +/- RT and DA-EPOCH-R +/- RT provide comparable efficacy in PMBCL. Due to the higher toxicity of DA-EPOCH-R, for those achieving CR following R-CHOP, selective RT omission may be a reasonable alternative. Established and disease-specific prognostic factors should guide individualized treatment strategies.
Impact of the COVID-19 Pandemic on CLABSI Rates and Antibiotic Resistance: A Multicenter Study in Türkiye
(DOC DESIGN INFORMATICS CO LTD, 2025) Sargın Altınok, Elif; Keşke, Şiran; Batırel, Ayşe; Bilgin, Hüseyin; Akdoğan, Özlem
Objective: The COVID-19 pandemic significantly disrupted infection control practices in healthcare settings. Previous studies have reported increased rates of central line-associated bloodstream infections (CLABSI), particularly during the early stages and peak periods of the pandemic. This multicenter study aimed to evaluate the impact of the COVID-19 pandemic on CLABSI rates in T & uuml;rkiye over a four-year period from 2019 to 2022. Materials and Methods: We conducted a retrospective analysis of prospectively collected CLABSI data from hospitals across various regions of T & uuml;rkiye between 2019 and 2022. The study period was divided into three phases: pre-pandemic, early pandemic, and late pandemic. Demographic and clinical characteristics, mortality rates, and microbiological data were analyzed. Pathogen distribution and antibiotic resistance patterns were compared between the pre-pandemic and pandemic periods. Results: A total of 25 hospitals participated in the study. The CLABSI rates per 1000 catheter days were 4.26 in 2019, 4.13 in 2020, 3.68 in 2021, and 3.53 in 2022. Across all periods, 3238 pathogens were identified. Gram-negative bacteria predominated both before and during the pandemic, with Acinetobacter baumannii (18.6%) and Klebsiella pneumoniae (17.8%) being the most common. Notably, an increase in carbapenem and colistin resistance in K. pneumonia was observed during the pandemic compared to the pre-pandemic period. Conclusions: In T & uuml;rkiye, the predominant causative agents of CLABSI did not change during the pandemic, with Klebsiella spp. and A. baumannii being most frequently isolated. However, the rise in CLABSI-associated mortality during the pandemic highlights the broader impact of healthcare system disruptions.
Assisting the Diagnosis of Cirrhosis in Chronic Hepatitis C Patients Based on Machine Learning Algorithms: A Novel Non-Invasive Approach
(WILEY, 2025) Dirican, Emre; Bal, Tayibe; Önlen, Yusuf; Sarıgül, Figen; Baykam, Nurcan
Aim: This study aimed to determine the important features and cut-off values after demonstrating the detectability of cirrhosis using routine laboratory test results of chronic hepatitis C (CHC) patients in machine learning (ML) algorithms. Methods: This retrospective multicenter (37 referral centers) study included the data obtained from the Hepatitis C Turkey registry of 1164 patients with biopsy-proven CHC. Three different ML algorithms were used to classify the presence/absence of cirrhosis with the determined features. Results: The highest performance in the prediction of cirrhosis (Accuracy = 0.89, AUC = 0.87) was obtained from the Random Forest (RF) method. The five most important features that contributed to the classification were platelet, alpha lpha-feto protein (AFP), age, gamma-glutamyl transferase (GGT), and prothrombin time (PT). The cut-off values of these features were obtained as platelet < 182.000/mm3, AFP > 5.49 ng/mL, age > 52 years, GGT > 39.9 U/L, and PT > 12.35 s. Using cut-off values, the risk coefficients were AOR = 4.82 for platelet, AOR = 3.49 for AFP, AOR = 4.32 for age, AOR = 3.04 for GGT, and AOR = 2.20 for PT. Conclusion: These findings indicated that the RF-based ML algorithm could classify cirrhosis with high accuracy. Thus, crucial features and cut-off values for physicians in the detection of cirrhosis were determined. In addition, although AFP is not included in non-invasive indexes, it had a remarkable contribution in predicting cirrhosis. Trial Registration: Clinicaltrials.gov identifier: NCT03145844
Renal Function and Atrial Remodeling: Interpreting Voltage-Mapping Limitations
(WILEY, 2025) Aker, Mücahit; Kalçık, Macit; Bekar, Lütfü
To the Editor, We read with interest the recent article by Deng et al., hichexplored the association between renal function and left atriallow-voltage area (LVA) burden in patients with atrial fibrillation(Deng et al. 2025).
Critical Appraisal of Circadian Blood Pressure Patterns as Predictors of Mortality in the Intensive Care Setting
(WILEY, 2025) Kalçık, Macit; Bayam, Emrah
To the Editor, We have recently, with great interest, read the recent article byZhao et al., “Association of 24-h Blood Pressure Pattern withMortality in ICU Patients: A Retrospective Cohort Study” [1].
Integrating Sleep Disruption, Dietary Changes, and Therapy in Assessing the Effects of Ramadan Fasting on Blood Pressure
(WILEY, 2025) Yetim, Mücahit; Sarıhan, Abdullah; Kalçık, Macit
Is using inhaled corticosteroid effective against COVID-19 pneumonia severity and mortality?
(TURKISH ASSOC TUBERCULOSIS & THORAX, 2024) Kılıç, Hatice; Argüder, Emine; Civak, Musa; Demir, Emre
Introduction: It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia. Materials and Methods: The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed. Results: In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p< 0.05). Conclusion: In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.
The effect of aerobic and high-intensity interval training on plasma pentraxin 3 and lipid parameters in overweight and obese women
(PEERJ INC, 2024) Çiçek, Güner; Özcan, Oğuzhan; Akyol, Pelin; Işık, Özkan; Novak, Dario; Küçük, Hamza
Background. It is unclear whether different exercise programs lead to an increase in the concentration of plasma Pentraxin3 (PTX3), an anti-inflammatory protein. This study aimed to investigate the effects of aerobic exercise (AE) and high-intensity interval training (HIIT) on plasma PTX3 levels in overweight and obese women. Method. A total of 45 sedentary women aged between 32.26 ± 6.30 voluntarily participated in the study. The control group (CG, n = 15) was selected among normalweight women. Women in the group of participants who partook in exercise consisted of overweight and obese women according to a random method, including the AE group (n = 15) and the HIIT group (n = 15). The AE session conducted was 50 min in duration and consisted of warm-up exercises (5 min), and primary exercises (40 min, basic aerobic-step exercises). HIIT consists of warm-up exercises (5 min), primary exercises (work intervals: 6?10 × 1 min (80–90% HRmax), rest intervals: 1 min (walk, 50% HRmax), 21–29 min running. The exercises were applied for three sessions/week for 12 weeks. Fasting blood samples were taken from all participants before and after exercise and their body composition was measured. Results. As a result of two different 12-week exercises, serum PTX3 levels increased significantly by 47.53% in the AE group and 50.21% in the HIIT group (p < 0.01). It was determined that the mean PTX3 before and after exercise increased from 1.71 ± 0.43 to 2.47 ± 0.40 ng/dL and HIIT from 1.62 ± 0.39 to 2.31 ± 0.33 ng/dL. A significant decrease in body mass index (BMI) values were detected, approximately 5.81% in the AE group and 5.06% in the HIIT group (p < .01). A significant decrease was detected in glucose, insulin, HOMA-IR, LDL-C, and hsCRP whereas HDL-C and VO2max value increased significantly in both exercise groups (p < .05; p < .01). There were no significant differences in TG and TC levels between groups (p > .05). Also, no significant differences were found between the two types of exercises in terms of parameters. A significant negative correlation in the total sample was found between PTX3 with BMI, fat mass, LDL-C, and hsCRP.
Do We Know the Long-Term Effects of the Most PopularTraditional Swallow Maneuvers on the Submental Muscles?
(WILEY, 2024) Söyler, Ayşe Kübra; Kıylıoğlu, Nefati; Arslan, Selen Serel; Demir, Numan; Gök, Mustafa; Ertekin, Ersen; Düger, Tülin
Background: Various trainings focus on the submental muscles (SMs) for dysphagia rehabilitation because of their importancefor swallowing safety and efficiency. According to the current literature, swallow-specific tasks may be optimal exercises fordysphagia. The effortful swallow (ES) and the Masako maneuver (MM) are the most commonly used swallow-specific tasks inthe clinical settings for dysphagia for years, but long-term effects for these trainings is insufficient.Objectives: This study aims to investigate and compare the effects of ES and MM on SM activity, strength and thickness.Methods: Thirty-seven healthy adults were randomised to ES, MM and control groups, and ES and MM groups completed6 weeks of swallowing training. Participants in both training groups performed a total of 120 swallows in each session, whilecontrol group did not participate in any swallowing training. Surface electromyography was used to evaluate SM activity, digitaldynamometer for SM strength and ultrasonography for SM thickness.Results: Both trainings did not change SM activity (p > 0.05), but increased SM strength (p < 0.05). MM increased the thicknessof all SM (p < 0.05), and ES increased the thickness of mylohyoid (right, left) and digastric muscle (right) (p < 0.05), and therewas no change in all evaluation parameters in the control group (p > 0.05). Also, trainings were not superior to each other in anyparameter (p > 0.05).Conclusion: The results of this study provided new evidence to the literature to show that ES and MM trainings are effectivefor improving SM strength and thickness. Considering that SM is important in terms of swallowing safety and effectiveness, it isthought that both trainings may be promising by increasing the strength and mass of SM, especially in individuals with reducedSM strength and mass.
Health benefits and risks of fermented foods—the PIMENTO initiative
(FRONTIERS MEDIA SA, 2024) Todorovic, Smilja; Akpınar, Aslı; Assunção, Ricardo; Güzel, Mustafa
Worldwide, fermented foods (FF) are recognized as healthy and safe. Despite the rapid increase of research papers, there is a lack of systematic evaluation of the health benefits and risks of FF. The COST Action CA20128 "Promoting innovation of fermented foods" (PIMENTO) aims to provide a comprehensive assessment on the available evidence by compiling a set of 16 reviews. Seven reviews will cover clinical and biological endpoints associated with major health indicators across several organ systems, including the cardiovascular, gastrointestinal, neurological, immune, and skeletal systems. Nine reviews will address broader biological questions associated with FF including bioactive compounds and vitamin production, nutrient bioavailability and bioaccessibility, the role of FF in healthy diets and personalized nutrition, food safety, regulatory practices, and finally, the health properties of novel and ethnic FF. For each outcome assessed in the reviews, an innovative approach will be adopted based on EFSA's published guidance for health claim submissions. In particular, each review will be composed of three parts: (1) a systematic review of available human studies; (2) a non-systematic review of the mechanism of action related to the clinical endpoints measured by the human studies identified in part 1; and (3) a non-systematic review of the characterization of the FF investigated in the human studies identified in part 1. The evidence and research gaps derived from the reviews will be summarized and published in the form of a strategic road map that will pave the way for future research on FF.
Teachers' digital competences: a scale construction and validation study
(FRONTIERS MEDIA SA, 2024) Aydın, Mehmet Kemal; Yıldırım, Turgut; Kuş, Metin
Introduction: Improving teachers’ digital competences is sine qua non for eective teaching and learning in today’s digital society. However, there is a limited number of comprehensive and reliable scales to measure teachers’ digital competences. Regarding this, the present study aimed to develop and validate a comprehensive scale to assess teachers’ digital competences. Methods: Building on previous studies, a draft scale developed and piloted with a sample of teachers from all educational levels. The procedures of Exploratory Factor Analysis (EFA) were followed to refine the scale, resulting in a fivepoint Likert scale with 36 items loaded onto four factors. The final scale was called as Teachers’ Digital Competences Scale (TDC-S). Confirmatory factor analysis (CFA) was employed to validate the four-factor structure. Reliability analysis was performed using Cronbach’s alpha (?), McDonald’s omega (?), and Composite Reliability (CR), indicating high psychometric properties. Convergent and discriminant validity analyses were also performed to assess the validity of the latent structures in TDC-S. Results and discussion: The findings suggest that the TDC-S is a valid and reliable instrument for assessing teachers’ digital competences at all grade levels from primary to high schools. It can be used to inform teacher training and development programs, and to identify teacher candidates who need additional assistance regarding improving their digital competences
Heart Failure Awareness Survey in a Turkish Population: HFAS-TR
(KARE PUBL, 2024) Karabulut, Dilay; Günay, Şeyda; Sert Şekerci, Sena; Bekar, Lütfü
Objective: Heart failure is a leading cause of death and the most common diagnosis leading to hospitalization. Its awareness is lower than that of other cardiovascular diseases, both in the general population and among patients with heart failure (HF). This study aimed to establish the current level of knowledge about HF in patients with HF with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) in Türkiye. Methods: This questionnaire-based survey study is multicenter, conducted across 34 centers from December 2021 to July 2022. We performed a survey consisting of two sets of questions focusing on individual characteristics of the patients and HF-related knowledge. Results: The study included a total of 2,307 outpatient HF patients, comprising 70.5% males and 29.5% females with a mean age of 64.58 ± 13 (56-74) years and a mean body mass index value of 32.5 ± 10 kg/m2. HFrEF and HFmrEF were determined in 74.7% and 25.3% of patients, respectively. Thirty percent of the patients were unaware that they had HF. While 28.7% of the patients thought that they had sufficient information about HF, 71.3% believed they lacked adequate knowledge. In the study, 25.2% of the participants identified dyspnea, 22% identified tiredness, and 25.4% identified leg edema as the most common symptoms of HF. Only 27.4% of patients recognized all three typical symptoms of HF. Conclusion: We found that the study population’s knowledge about HF symptoms and the nature of the disease was poor. Educational and awareness activities are necessary to optimize outcomes and benefits.
Investigating AXIN1 gene polymorphisms in Turkish children with cryptorchidism: A pilot study
(ELSEVIER SCI LTD, 2024) Doğan, Gül; Yılmaz, Akın; İpek, Hülya; Metin, Mehmet; Peltek Kendirci, Havva Nur; Afşarlar, Çağatay Evrim
Introduction Cryptorchidism is one of the most common congenital anomalies in male children, occurring in 2e5% of full-term male infants. Both genetic and environmental factors are observed to play a role in its etiology. A study conducted in Japan identified the AXIN1 gene as being associated with cryptorchidism. Objective We aimed to conduct a pilot study on AXIN1 gene polymorphism in Turkish children with cryptorchidism, and whether AXIN1 gene polymorphism is a risk factor for cryptorchidism. Study design Between January 2023 and December 2023, we have planned a prospective controlled study including 84 boys operated for cryptorchidism as study group, and 96 boys operated for circumcision as control group. The remaining blood samples of preoperative laboratory tests in ethylenediamine tetraacetic acid (EDTA) tubes were kept at 20 Co freezer for genomic studies. Patient demographics, physical examination and operative findings were recorded, study patients were grouped according to testis localization. After collecting all samples, genomic DNA isolation procedure was done, and analysis of the 3 polymorphisms (rs12921862, rs1805105 and rs370681) of AXIN1 gene was performed using conventional Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) method. Genotype and allele frequencies of each group was analyzed and compared. Results The most common location of cryptorchid testis was proximal inguinal (53%), followed by distal inguinal (25.3%), bilateral (13.3%), and intra-abdominal (8.4%). Regarding the 3 polymorphisms of AXIN1 gene, there was no significant difference between study and control groups, in terms of genotype and allele frequencies (P > 0.05). Eight haplotype blocks were estimated for 3 polymorphisms of AXIN1. However, no significant difference was observed between study and control groups regarding haplotype distributions (P > 0.05). In addition, the comparison of the localization of testis with AXIN1 gene polymorphism did not show any significant difference among cryptorchid testis groups (P > 0.05). Discussion The AXIN1 gene is located on chromosome 16p and its polymorphisms have been associated with various diseases. In a Chinese study, the rs370681 polymorphism was found to be associated with cryptorchidism. However, our results showed no association between the AXIN1 gene haplotypes for the studied polymorphisms and cryptorchidism. Conclusion In this study we have investigated the AXIN1 gene polymorphism in Turkish children with cryptorchidism as a pilot study. Although we could not identify any difference as compared to control group, further research is necessary to uncover the underlying molecular mechanisms contributing to the development of cryptorchidism.
Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients
(MDPI, 2024) Turhan, Semin; Tutan, Duygu; Şahiner, Yeliz; Kısa, Alperen; Önen Özdemir, Sibel; Tutan, Mehmet Berksun; Kayır, Selçuk; Doğan, Güvenç
Abstract: Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ?RSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ? 72 (AUC 0.715) and ?RSBI ? ?3 (AUC 0.648). RSBI-2a ? 72 increased the likelihood of successful extubation by 10.8 times, while ?RSBI ? ?3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.
Data privacy-aware machine learning approach in pancreatic cancer diagnosis
(BMC, 2024) Akmeşe, Ömer Faruk
Problem Pancreatic ductal adenocarcinoma (PDAC) is considered a highly lethal cancer due to its advanced stage diagnosis. The fve-year survival rate after diagnosis is less than 10%. However, if diagnosed early, the fve-year survival rate can reach up to 70%. Early diagnosis of PDAC can aid treatment and improve survival rates by taking necessary precautions. The challenge is to develop a reliable, data privacy-aware machine learning approach that can accurately diagnose pancreatic cancer with biomarkers. Aim The study aims to diagnose a patient’s pancreatic cancer while ensuring the confdentiality of patient records. In addition, the study aims to guide researchers and clinicians in developing innovative methods for diagnosing pancreatic cancer. Methods Machine learning, a branch of artifcial intelligence, can identify patterns by analyzing large datasets. The study pre-processed a dataset containing urine biomarkers with operations such as flling in missing values, cleaning outliers, and feature selection. The data was encrypted using the Fernet encryption algorithm to ensure confdentiality. Ten separate machine learning models were applied to predict individuals with PDAC. Performance metrics such as F1 score, recall, precision, and accuracy were used in the modeling process. Results Among the 590 clinical records analyzed, 199 (33.7%) belonged to patients with pancreatic cancer, 208 (35.3%) to patients with non-cancerous pancreatic disorders (such as benign hepatobiliary disease), and 183 (31%) to healthy individuals. The LGBM algorithm showed the highest efciency by achieving an accuracy of 98.8%. The accuracy of the other algorithms ranged from 98 to 86%. In order to understand which features are more critical and which data the model is based on, the analysis found that the features “plasma_CA19_9”, REG1A, TFF1, and LYVE1 have high importance levels. The LIME analysis also analyzed which features of the model are important in the decision-making process. Conclusions This research outlines a data privacy-aware machine learning tool for predicting PDAC. The results show that a promising approach can be presented for clinical application. Future research should expand the dataset and focus on validation by applying it to various populations.
Service Quality and Related Factors in Primary Health Care Services: A Cross-Sectional Study
(MDPI, 2024) Değer, Mehmet Sait; Issever, Halim
Primary health care services aim to prevent diseases and improve health efficiently and effectively. This study measures perceived service quality in a primary healthcare organization and examines the effect of personality traits on service quality. The cross-sectional study population comprised individuals over the age of 18 who applied to the Bing & ouml;l Central Community Health Centre. A total of 460 participants were included in the study between November 2018 and March 2019. The participants completed a face-to-face questionnaire that included socio-demographic characteristics, the SERVQUAL Scale, and an abbreviated form of the revised Eysenck Personality Questionnaire. This study is based on doctoral research in public health. The study found median values for personality trait sub-dimensions as follows: neuroticism: 2, psychoticism: 2.65, extraversion: 4, and lying: 5. The SERVQUAL Score was -0.02. The study revealed that the quality of primary health care services did not meet the participants' expectations. The study findings also indicated that age, educational attainment, and extraverted and psychotic personality traits were significantly associated with the satisfaction of service quality expectations (p < 0.05). It is recommended to provide primary health care services in facilities with good physical characteristics, with sufficient and competent health personnel, and in a timely and accurate manner to improve service quality.

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