Recep Tayyip Erdoğan Üniversitesi Kurumsal Akademik Arşivi
DSpace@RTEÜ, Recep Tayyip Erdoğan Üniversitesi tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve yayınların etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Effect of hypertension on long-term adverse clinical outcomes and liver fibrosis progression in MASLD
(Elsevier, 2025) Zhou, Xiao-Dong; Lian, Li-You; Chen, Qin-Fen; Kim, Seung Up; Cheuk-Fung Yip, Terry; Yılmaz, Yusuf; Tacke, Frank
Background & Aims Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension with the risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD. Methods Three multicenter large cohorts were analyzed: the UK Biobank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression. Adverse clinical outcomes were defined as all-cause mortality, cardiovascular events, and/or liver-related events. Liver stiffness progression was defined as an increase in liver stiffness measurement from <10 kPa to ≥10 kPa or an increase of ≥20% for baseline liver stiffness measurement ≥10 kPa. Liver fibrosis progression was defined as a 1-stage fibrosis stage increase. Cox regression and Kaplan-Meier analyses were used to evaluate the impact of baseline hypertension on outcomes. Results A total of 107,316 adults from the UKBB cohort, 8,169 from the VCTE-Prognosis cohort, and 1,670 from the Paired Liver Biopsy cohort were included. The prevalence of hypertension was 37.1%, 33.4%, and 48.9%, respectively. In the UKBB cohort, hypertension was associated with long-term adverse clinical outcomes (adjusted hazard ratio [HR] 1.30, 95% CI 1.26-1.33, p <0.001). In the VCTE-Prognosis cohort, hypertension was associated with a higher risk of liver stiffness progression (adjusted HR 1.57, 95% CI 1.30-1.90, p <0.001), while in the Paired Liver Biopsy cohort, hypertension was associated with a greater risk of histologic liver fibrosis progression (adjusted HR 1.41, 95% CI 1.12-1.78, p = 0.004). Subgroup and sensitivity analyses supported these findings. Conclusions Hypertension is a modifiable risk factor that increases the risk of adverse clinical outcomes and progression of liver stiffness and fibrosis in MASLD. Impact and implications This study provides robust evidence from three large multicenter cohorts demonstrating that hypertension is independently associated with increased risks of adverse clinical outcomes and liver fibrosis progression in individuals with MASLD. These findings reveal that hypertension, traditionally managed from a cardiovascular perspective, also plays a critical and underrecognized role in liver disease progression, making them highly relevant for hepatologists, cardiologists, and primary care providers. Incorporating non-invasive fibrosis assessments into routine care for patients with MASLD and hypertension may facilitate early risk stratification and support targeted interventions to reduce both hepatic and cardiovascular complications.
Identifying future risk factors of uncontrolled asthma control: the TAAR study perspective
(Taylor & Francis Group LLC Philadelphia, 2025) Bozkurt, Nurgül; Abadoğlu, Öznur; Onaran, Ayşe Bilge Öztürk; Gökmen, Derya; Buhari, Gözde Koycu; Karadoğan, Dilek; Dönmez, Halil; Celik, Gulfem Elif
Objective: Risk factors associated with asthma symptom control is crucial for disease management. This study aimed to determine the risk factors of patients with uncontrolled asthma and to examine the relationship with their geographical patterns. Methods: This cross-sectional study was conducted at 36 centers across Turkey. Future risk factors (FRFs) such as exposure to triggers/allergens and inadequate or poor inhalation technique, etc., were identified based on the Global Initiative for Asthma (GINA) guidelines. The associations between FRFs and demographic and clinical characteristics, geographical regions, and levels of asthma control were analyzed. Results: The study included 2,053 adult asthma patients. At least one FRF was identified in 1576(76.8%) patients. The most common FRFs were exposure to allergens/triggers (n: 664; 32.3%), impaired asthma symptom control (n: 540; 26.3%), and eosinophilia (n: 526; 25.6%). Regarding regional differences, the most prevalent FRFs in the Marmara region were exposure to allergens/triggers and frequent use of short-acting beta-2 agonists (>3 boxes/year). In contrast, eosinophilia was more common in the Southeastern region, while inadequate or poor inhalation technique, noncompliance with treatment, and psychosocial or socioeconomic problems were more frequently observed in the Eastern Anatolia region. Asthma control was achieved in 79.5% of patients without any FRFs; however, this rate decreased significantly to 25% among patients with more than four FRFs. Conclusions: This study demonstrates that FRFs in asthma vary according to demographic and disease characteristics, as well as geographical distribution. An increased number of FRFs was associated with asthma control. However, an individualized approach remains essential for achieving optimal asthma management.
Novel RORA variants reveal genotype–phenotype diversity and variable expressivity in neurodevelopmental disorders
(Wiley, 2025) Ünsel Bolat, Gül; Bolat, Hilmi; Çitli, Şenol; Özdemir, Özlem; Barış, İbrahim
The RAR-related orphan receptor alpha (RORA) gene encodes a nuclear receptor involved in transcriptional regulation, circadian rhythm, and neurodevelopment. Dominant RORA variants are associated with intellectual developmental disorder with or without epilepsy or cerebellar ataxia, yet the phenotypic spectrum remains poorly defined. We performed comprehensive genetic and clinical analyses in four individuals with RORA variants from three unrelated families, using whole exome sequencing and chromosomal microarray analysis. Identified variants were confirmed by Sanger sequencing. Genetic analyses revealed three distinct RORA variants: a 15q21.2–q22.2 deletion encompassing RORA, a de novo nonsense variant c.499C>T (p.Gln167*), and a novel heterozygous frameshift variant c.683_686del (p.Glu228Valfs*78) segregating within a family. Clinical findings ranged from severe neurodevelopmental delay and epilepsy to mild intellectual disability and behavioral abnormalities, demonstrating marked intrafamilial variability. Notably, the same frameshift variant presented with differing phenotypes in the family, indicating variable expressivity—the first such observation reported in RORA-related disorders. Our findings broaden the genotypic and phenotypic spectrum of RORA-related neurodevelopmental disorders. The observed intrafamilial variability highlights the complexity of RORA-associated pathogenesis and underscores the importance of considering variable expressivity in future genotype–phenotype studies.
Multi-criteria optimization of cross-laminated timber (CLT) wall systems for energy, carbon, and cost performance: a case study for Türkiye’s climate zones
(Taylor and Francis Ltd., 2025) Çavdar, Ayça Akkan; Lakot Alemdağ, Esra
Given the construction sector`s role in climate change, this study investigated the energy performance of cross-laminated timber (CLT) as a sustainable alternative to reinforced concrete in Turkish residential buildings. A mid-rise building, in Türkiye, was modeled using DesignBuilder software and redesigned with CLT structural components. Ten CLT wall assemblies were evaluated across five distinct climate zones (cold, hot-humid, hot-dry, temperate-humid, and temperate-dry) in terms of energy demand, embodied carbon emissions, and material cost. The results show that CLT walls can provide a 41% reduction in heating energy consumption and a 20% reduction in embodied carbon value compared to conventional systems in cold climate region of Türkiye. Across five climate zones, optimized CLT wall systems achieved heating energy savings between 30.0% (Diyarbakır) and 42.5% (Antalya), cooling load reductions of 5.3% (Erzurum) to 63.4% (Diyarbakır), and embodied carbon decreases up to 10.2% (Antalya). Material costs for the optimized scenarios were approximately 24%–29% lower than reinforced concrete alternatives. A multi-criteria optimization method was applied to identify the optimal wall design for each zone. This study presents one of the first comparative analyses of CLT walls across different climatic zones in Türkiye, providing practical insights into climate-responsive, region-specific, energy-efficient and low-carbon construction strategies.
