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Turkey's Eastern Mediterranean policy in the context of Turkish-Greek relations
No full text20.12.2025 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.Bu çalışmanın konusunu "Türk-Yunan İlişkileri Bağlamında Türkiye'nin Doğu Akdeniz Politikası" oluşturmaktadır. Doğu Akdeniz ve Ortadoğu bölgesi tarih boyunca imparatorlukların kontrol etmek istediği ve devletlerin mücadele ettiği çok önemli bir coğrafya olmuştur. Osmanlı İmparatorluğu sadece bu bölgeleri değil, aynı zamanda Balkanları ve Kuzey Afrika kıyılarını da kontrolü altına almıştır. 1571 yılında fethedilen Kıbrıs Adası, Doğu Akdeniz'de ileri bir jandarma karakolu ve batmayan bir uçak gemisi gibidir. Fransız İhtilali'nin etkisiyle 19. yüzyıl başlarında Osmanlı coğrafyasında yayılan ulusçu isyanlar baş göstermiş, yaşanan savaşlar sonucunda yeni devletler ortaya çıkmıştır. 1830 yılında Osmanlı'dan bağımsızlığını kazanan Yunanistan, kuruluşundan itibaren doğal yayılma alanı olan Türk coğrafyası üzerinde topraklarını tam altı defa genişletmiştir. Çalışmanın amacı, Türk-Yunan ilişkilerini ve Türkiye'nin Doğu Akdeniz politikasını incelemek, analiz etmek ve geleceğe ilişkin projeksiyon tutmaktır. İstiklâl Savaşı sonrasında Lozan Barış Andlaşması'nın imzalanmasıyla Türk-Yunan dengesi sağlanmış, ancak sonraki yıllarda Ege Denizi, Kıbrıs ve Doğu Akdeniz konularında iki ülke arasında uyuşmazlıklar ortaya çıkmıştır. Doğu Akdeniz'de 2000'li yılların başlarında hidrokarbon kaynaklarının keşfiyle bölge ülkeleri arasında deniz yetki alanlarının paylaşımı konusu gündeme gelmiş, Güney Kıbrıs Rum Yönetimi bazı bölge ülkeleriyle deniz yetki alanları sınırlandırması andlaşmaları yapmış, Türk kıta sahanlığı üzerinde çakışan deniz sahaları nedeniyle Kıbrıs uyuşmazlığı denize yayılmıştır. Bahse konu uyuşmazlık Türkiye-Güney Kıbrıs Rum Yönetimi, Kuzey Kıbrıs Türk Cumhuriyeti-Güney Kıbrıs Rum Yönetimi ve Türkiye-Yunanistan arasında üçlü bir uyuşmazlığa dönüşmüştür. Çalışmanın teorik ve hukuksal çerçevesi deniz hukuku üzerinden yapılandırılmış, Türk-Yunan ilişkileri 1923'ten 2024'e dek incelenmiştir. Bölge ülkeleri arasında deniz yetki alanlarının sınırlandırılması ile ortaya çıkan enerji kaynaklı kriz sadece Türkiye-Yunanistan arasında yaşanan bir kriz olarak kalmamış, bölgesel ve küresel aktörlerin de devreye girmesiyle uluslararası bir boyut kazanmıştır. Çalışma bu nedenle önemlidir ve güncelliğini korumaktadır.The subject of this study is "Turkey's Easter
Upadacitinib as a Rescue Therapy in Patients with Steroid- and Infliximab-Refractory Acute Severe Ulcerative Colitis: Real-Life Multicentre Results
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Comparison of PSI, CURB-65 and I-ROAD Scoring Systems ın Patients with Community-Acquired Pneumonia
No full textBackgroundIn patients with community-acquired pneumonia (CAP), scoring systems are important for determining disease severity and selecting the appropriate unit and antibiotics for treatment. The aim of this study was to determine the 30- and 90-day mortality rates, identify influencing factors, and compare the effectiveness of the PSI, CURB-65, and I-ROAD systems in predicting mortality among patients hospitalized for CAP. MethodsWe prospectively included adult patients with CAP requiring hospitalization at Hospital between January 2019 and January 2020. Patients were categorized based on the CURB-65, PSI, and I-ROAD systems, and their treatment success as well as 30- and 90-day survival rates were evaluated. ResultsThe study comprised 60 patients with CAP, of whom 40 were male (66.7%). When assessing factors influencing 30-day mortality, the impact of immunosuppression (p:0.004), presence of malignancy (p: 0.003), Apache II score (p:0.014), and steroid use (p:0.004) was found to be significant. Both PSI and CURB-65 had a impact on 30-day mortality (p = 0.005, p = 0.007). Although there was an observed difference in mortality between the I-ROAD groups, its effect on mortality was not statistically significant (p = 0.093). Analyzing 90-day mortality revealed that the PSI and CURB-65 classifications significantly affected mortality (p < 0.001; p = 0.037). Despite a mortality difference among the mild, moderate, and severe I-ROAD groups, the difference was not statistically significant (p = 0.256). ConclusionsBoth PSI and CURB-65 were significant predictors for both 30-day and 90-day mortality, with PSI exhibiting the highest specificity. I-ROAD did not show statistical significance, although a notable difference was found between the groups.Scientific and Technological Research Council of Turkiye (TUBITAK)Open access funding provided by the Scientific and Technological Research Council of Turkiye (TUBITAK). The authors received no financial support for the research, authorship, and/or publication of this article
A Turkish Patient with Spastic Paraplegia Type 4 with a De Novo Missense Mutation in the SPAST Gene
No full textSpastic paraplegia type 4 is a common type of autosomal-dominant pure hereditary spastic paraplegia that is brought on by variations in the SPAST gene. In this investigation, the SPAST genotype and clinical phenotype of a Turkish SPG4 patient were analyzed in an effort to provide additional genetic evidence for the pathophysiology of HSP. The clinical data of the proband and his family members were collected. After complete genomic DNA was isolated from peripheral blood, whole-exome sequencing technology was used to identify genes and analyze the pathogenicity of variants. Variants suspected of being pathogenic were found. Within this family, Sanger sequencing was used for verification. The sequencing of SPAST revealed a de novo missense c.1496G > A (p.Arg499His) and missense MEFV c.2177T>C (p.Val726Ala) variants. The parents and paternal relatives did not have the SPAST mutation. De novo variants of the c.1496G > A mutation in SPAST can arise at notably high frequencies. We discussed the case of a Turkish patient and examined the clinical characteristics of patients with the p.Arg499His variation in SPAST that have been documented in the literature. There is growing evidence that the p.Arg499His missense mutation in SPAST may be linked to early-onset HSP. The majority of pathogenic mutations were found in the protein's AAA domain, according to analysis of SPAST sequences; this may be closely related to the pathophysiology of SPG4. The results of this investigation may broaden the range of therapeutic applications for the p.Arg499His mutation in SPAST and offer a chance to investigate the genotype-phenotype relationship of SPG4 in more detail
THE PREVALENCE, DETERMINANTS, AND SOME BEHAVIORAL OUTCOMES OF PEER BULLYING: A CROSS-SECTIONAL STUDY IN TURKISH EARLY ADOLESCENCE
No full textTürkiye ranks high on the global scale of violence. The purpose of this study is to assess the prevalence, determinants, and behavioral consequences of peer bullying, a form of violence in early adolescence, in Türkiye. This study collected data from 868 individuals aged 11-14 from six schools representing different socioeconomic regions, selected through multistage stratified cluster sampling. The prevalence of bullying, victimization, and bully-victim status was measured using the Peer Bullying Scale – Self-Report Form (PBS-SRF). Their impact on various social behaviors, including participation in sports, cultural, and scientific activities, was also assessed. The prevalence rates were 15.8% for bullying, 15.3% for victimization, and 10.3% for bully-victims. Being a bully was significantly more common among males (OR;95%CI;p:2.04;1.02-4.10;0.04). The frequency of bullying was higher in private schools compared to public schools (OR;95%CI;p:2.70;1.15-6.35;0.020). Determinants for bully-victims included recent engagement in bullying (OR;95%CI;p:2.47;1.10-5.51;0.02), and belonging to an extended family (OR;95%CI;p:3.67;1.02-13.85;0.040). Key predictors of victimization included having a mother with a low education level (OR;95%CI;p:2.50;1.01-6.14;0.046). Bully-victims had significantly higher risks of experiencing behavirioal problems in sports participation (OR;95%CI;p:2.61;1.49-4.59;0.001), cultural (OR;95%CI;p:1.80;1.06-3.06;0.029), and engagement in scientific activities (OR;95%CI;p:1.90;1.10-3.28;0.022). These findings underscore the importance of targeted, community-based interventions focused on bullying prevention, particularly among the bully-victim group
The impact of smoking on nivolumab outcomes in renal cell carcinoma: real-world data from the Turkish Oncology Group Kidney Cancer Consortium
No full textBackground: The study aims to evaluate the effect of smoking status on treatment results in patients with metastatic renal cell carcinoma (RCC) treated with nivolumab in the second and following lines of therapy. Materials and Methods: The Turkish Oncology Group Kidney Cancer Consortium (TKCC) database was used to extract retrospective data from patients with metastatic RCC treated with nivolumab in the second line and beyond. Patients were evaluated according to their smoking status. Results: A total of 247 patients were evaluated. The majority of the current smokers were male (93.8%, P = .002). Nivolumab is mainly used in the second-line therapy (84.2%). Median time to treatment failure (TTF) and median overall survival were shorter in patients with currently smoking (10.81 vs. 4.11 months, P < .001 and 32.33 vs. 16.76 months, P < .049, respectively). Multivariate analysis showed that current smoking status was an independent adverse factor on median TTF (HR 2.06 95% confidence interval (CI) = 1.20-3.54, P = .009) and median OS (, HR 2.06, 95% CI = 1.25-3.38, P = .004) in metastatic RCC patients treated with nivolumab in the second line and beyond. Conclusions: Current smoking status is an independent adverse prognostic factor for both TTF and OS in patients with metastatic RCC treated with nivolumab in the second line and beyond
Lactate to albumin ratio as a determinant of intensive care unit admission and mortality in hospitalized patients with community-acquired pneumonia
No full textObjective Previous studies have shown that the lactate/albumin ratio (LAR) can be a prognostic biomarker in intensive care unit (ICU) patients. However, the usefulness of LAR in predicting mortality and guiding intensive care unit admission in hospitalized patients due to community-acquired pneumonia (CAP) remains unclear. This study aims to evaluate the predictive value of the LAR compared to Pneumonia Severity Index (PSI), Confusion, urea, respiratory rate, blood pressure, 65 years or older (CURB-65), and quick-Sequential Organ Failure Assessment (q-SOFA) scores in determining the need for ICU admission and mortality among hospitalized patients with CAP. Methods Adult patients diagnosed and hospitalized with community-acquired pneumonia between July 2021 and July 2023 were included. Patients' demographics, comorbidities, disease severity scores, laboratory findings at the admission and outcomes were recorded. Patients were grouped and compared according to admission place (ward or ICU). Results PSI, CURB-65, q-SOFA scores, and LAR were higher in ICU patients than in those admitted to the ward. Regarding the ICU admission, the AUC values for PSI, CURB-65, q-SOFA and LAR were 0.794 (95% CI: 0.737-0.843) (p < 0.001), 0.825 (95% CI: 0.771-0.870) (p < 0.001), 0.755 (0.690-0.813) (p < 0.001), and 0.749 (95% CI: 0.689-0.802) (p < 0.001), respectively. Regarding the mortality, the AUC values for PSI, CURB-65, q-SOFA, and LAR were 0.722 (95% CI: 0.661-0.778) (p < 0.001), 0.743 (95% CI: 0.683-0.797) (p < 0.001), 0.645 (0.575-0.711) (p: 0.02), 0.761 (95% CI: 0.702-0.814) (p < 0.001), respectively. There wasn't any difference detected in pairwise comparisons of ROC curves. Conclusion In this study, LAR was found to be a good predictor of ICU admissions and mortality in hospitalized patients with CAP and was non-inferior to PSI, CURB-65, or q-SOFA scores
Examining the earthquake-related experiences of people who experienced the earthquake in Turkey
No full textBackground: In the earthquake of magnitude 7.7 and 7.6 in Turkey on February 6, 2023, many buildings collapsed and many people suffered emotional and spiritual damage. It is important to understand the situations experienced by people who experienced the earthquake and to plan strategies according to these views in the future.Objectives: The aim of the study is to examine the preparations of people living in Hatay province before the earthquake, their experiences during the earthquake and their experiences after the earthquake in a qualitative design. Twenty-eight individuals (14 women and 14 men) between the ages of 18 and 65 years, who experienced the earthquake in Hatay, Turkey, participated in the study.Result: Participants were asked nine questions about before, during and after the earthquake using a semi-structured interview method. It was found that 32.1% of the participants made any preparations before the earthquake, all of them experienced the feeling of fear the most, 82.1% of them used prayer behavior instead of protective strategies during the earthquake, all of them were affected psychologically, socially, and economically, and 35.7% were physically affected.Conclusion: As a result of the analysis of participant opinions, it was seen that pre-earthquake preparation processes were insufficient, behaviors during the earthquake were not protective, and individuals and their environment were negatively affected after the earthquake
A novel concept for optimal operation of multi-swap stations serving electric metrobuses
No full textDue to the carbon emissions produced by the conventional transportation sector's use of fossil fuels, transportation vehicles are considered one of the leading contributors to global climate change. Additionally, in metropolises like Istanbul/T & uuml;rkiye, traffic congestion is one of the most significant issues. Taking these factors into account, there is a need to promote the use of public transportation vehicles and electrification of the system. This study focuses on the optimal energy management of multi-swap stations (MSSs) with photovoltaic (PV) systems serving an electric metrobus (EM) line. The presented framework is modeled using a mixed-integer linear programming (MILP) approach. In this system, when the batteries of the EMs on the route are running low, they can come to the stations where the swap operation can be performed, allowing them to exchange their batteries within the passenger boarding and disembarking times. Besides, the power transferring between batteries at swap stations is considered, which helps ensure flexible operation. The PV systems can be utilized for battery charging, and surplus energy can be sold to the power grid. Various test studies are conducted using data from the Istanbul Z34 metrobus route in this research. According to the results obtained from the study, the proposed structure demonstrates the effective operation of swap stations serving EMs. Doubling the PV capacity increased the profit to 6103 Turkish Liras (TL). In October, the highest energy selling revenue of 4791 TL was recorded due to elevated electricity prices. Inter-battery power transfer provided cost savings, with up to 50 TL saved in January, while prioritizing PV energy sales to the grid further reduced operating expenses.The 100th Year TUBITAK Science Encouragement AwardThe work of Ozan Erdinc was supported by 100th Year TUBITAK Science Encouragement Award
Niraparib-Associated Pulmonary Embolism in a Patient with BRCA Mutant Ovarian Cancer
No full textABS TRACTAmong the histological subtypes of ovarian cancer, high-grade serous ovarian carcinoma is the type most commonly associated with breast cancer 1/2 (BRCA1/2) mutations. The combination regimen of platinum and taxane is the first-line treatment for adva nced ovarian cancer. Maintenance therapy with poli-ADP riboz polimeraz inhibitors (PARPi), with or without bevacizumab, is recommended for patients with BRCA1/2-wt/homologous recombination deficiency-positive or BRCA1/2 mutations tumors who achieve a complete or partial responseto first- line platinum-paclitaxel chemotherapy following the completion of chemotherapy. The most common side effects associated with th e use of PARPi are hematologic toxicities. In our case, we aim to present a rare case of pulmonary thromboembolism associated with appro ximately 23 months of niraparib use. Pulmonary thromboembolism should be considered in patients with respiratory symptoms when prescribing PARPi