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
Impact of fatigue on patient-reported outcomes and work productivity in chronic hepatitis b and c: insights from a multinational registry study
(Wiley, 2026) Yılmaz, Yusuf; Yu, Ming-Lung; Alswat, Khalid; El-Kassas, Mohamed; Ferret, Maria Buti; Keklikkıran, Çağlayan; Younossi, Zobair M.
Fatigue in chronic viral hepatitis may be associated with decreased health-related quality of life and other patient-reported outcomes (PROs). We evaluated the relationship between fatigue and PROs in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Patients with CHB and CHC enrolled in the Global Liver Registry completed PRO instruments: FACIT-F, CLDQ (for CHB), CLDQ-HCV (for CHC), and WPAI:SHP. Fatigue was defined as FACIT-F Fatigue Scale (FS) score < 30 (scale range: 0–52). Among 2888 patients from 14 countries, 1561 had CHB (mean age 47 ± 13 years; 60% male; 13% advanced fibrosis; 13% depression; 17% fatigue) and 1327 had CHC (50 ± 13 years; 47% male; 21% advanced fibrosis; 18% depression; 28% fatigue). CHB-fatigue was associated with younger age, female, obesity, anxiety, depression (all p < 0.01) and worse PRO scores: CLDQ (scale 1–7): 4.1 ± 0.9 vs. 5.8 ± 0.9; FACIT score (range 0–108): 67.6 ± 14.5 vs. 87.7 ± 13.7; work productivity impairment (range 0–1): 0.33 ± 0.29 vs. 0.11 ± 0.22 (all p < 0.0001). Multivariable analysis confirmed the association of fatigue with lower PRO scores, impairment up to −23% (p < 0.01). CHC-fatigue was associated with female sex, obesity, type 2 diabetes, anxiety, depression (all p < 0.05) and worse PRO scores: CLDQ-HCV: 3.8 ± 1.0 vs. 5.5 ± 1.0; FACIT: 61.8 ± 14.1 vs. 85.6 ± 14.5; work productivity impairment: 0.49 ± 0.32 vs. 0.17 ± 0.25 (all p < 0.0001). In multivariable models, fatigue remained associated with reduced PRO scores, impairment up to −33% (p < 0.01). Almost one in five patients with chronic viral hepatitis report significant fatigue, which is associated with substantial PRO and work productivity impairment. Routine assessment for and management of fatigue in CHC or CHB care is essential.
Patient-reported outcomes in a pituitary tumor center of excellence (PTCOE)–aligned pituitary clinic compared with general endocrinology care
(Springer, 2026) Yağcı, Ali Nail; Pekmezci, Aslıhan; Uygur, Meliha Melin; Burhan, Sebnem; Celik, Melda; Aktas Yagci, Fatma; Hatipoglu, Esra
Purpose: Pituitary Tumor Centers of Excellence (PTCOE) were developed to standardize multidisciplinary care for pituitary disorders; however, their impact on patient-reported outcomes remains insufficiently characterized. This study aimed to compare health-related quality of life, illness perception, and outpatient satisfaction between patients followed in a PTCOE-aligned, though not formally accredited, specialized pituitary clinic and those managed in general endocrinology clinics, and to identify organizational factors associated with these outcomes. Methods: In this cross-sectional study, 175 adults with prolactinoma (n = 70), non-functioning pituitary adenoma (n = 54), acromegaly (n = 35) and Cushing’s disease (n = 16) were evaluated across two tertiary endocrinology centers. Patient-reported outcomes were assessed using validated Turkish versions of the SF-36, Illness Perception Scale, and Outpatient Satisfaction Scale. Results: Certain baseline clinical profiles differed significantly between the two groups, with patients in the specialized clinic exhibiting higher rates of pituitary surgery (63.9% vs. 32.1%, p = 0.001) and hypopituitarism (28.9% vs. 14.1%, p = 0.02). Patients in the specialized clinic showed significantly lower SF-36 Role Physical, Role Emotional, Social Functioning, and Bodily Pain scores (all p ≤ 0.03). Illness-perception patterns also diverged, with higher Timeline, Consequences, and Treatment Control scores in the specialized clinic. Outpatient satisfaction, however, was consistently higher across all subscales in the specialized clinic (all p ≤ 0.006). In multivariable analyses, clinic type, sex, hypopituitarism, surgical history, and follow-up duration independently contributed to variation in multiple patient-reported outcome domains. Conclusion: PTCOE-aligned specialized care was associated with more favorable illness representations and higher patient satisfaction, even among cases with greater disease burden. This underscores the need for integrating patient-reported outcomes into the evaluation and refinement of pituitary care models.
Nonlinear finite element model for the dynamic analysis of sandwich beams with a frequency-dependent viscoelastic core layer considering normal transverse stresses
(Elsevier, 2026) Youzera, Hadj; Meftah, Sid Ahmed; Tounsi, Abdelouahed; Bousahla, Abdelmoumen Anis; Balubaid, Mohammed; Aljedani, Jabr; Yaylacı, Murat
In this work the nonlinear forced vibration problem of sandwich beams is approached with the Finite element modelling method. In the analytical formulation, in addition to axial normal and shear stresses, the normal transverse stress was also considered. The refined higher-order zig-zag theory is employed in the kinematic model to assess the non-linear vibration of sandwich beams, whose core's elastic modulus and loss factor vary with frequency. Applying the Hamilton's principle has resulted in the governing equations of motion. The finite element method and the arc-length method are used to solve a system of nonlinear equations, resulting in the nonlinear frequency response. The results indicate that the sandwich structures exhibit different nonlinear hardening behavior by changing the viscoelastic layer's geometric and material characteristics. The impact of boundary conditions on the frequency-response curves and the contribution of transverse normal stress are considered in the parametric investigation.
Evaluation of imaging protocols for detecting tooth ankylosis using different CBCT devices: an in vitro study
(Oxford University Press, 2026) Özel, Şelale; Köse, Taha Emre; Şatır, Samed
Background: To compare the diagnostic accuracy of CBCT images acquired with different imaging protocols for detecting tooth ankylosis. Methods: Thirty extracted permanent teeth (20 single-rooted, 10 three-rooted) were prepared; ankylosis was simulated in 20 by selectively removing Teflon from roots previously coated to mimic the periodontal ligament. Samples were embedded in stone plaster and imaged using 4 protocols on 2 CBCT units. CBCT images were primarily evaluated by a blinded radiologist (present/absent). Micro-CT was performed on 20% of specimens to verify the model. Agreement and accuracy metrics (Fleiss/Cohen κ, sensitivity, specificity, PPV, NPV) were calculated. Results: Protocol 2 (0.25 mm voxel) showed the most favorable performance (κ = 0.113; sensitivity 71.4%; PPV 52.6%; NPV 60%). Protocol 3 (0.35 mm voxel) performed worst (κ = −0.104; sensitivity 53.8%; PPV 43.8%; NPV 45.5%). Except for Protocol 3, sensitivity was high (≥71.4%) while specificity remained low (35.7%–42.9%). Limitations: The study has its own limits. Different imaging protocols using in clinical practice to detect ankylosis can be investigated as well to provide different approaches assessing ankylosis. Conclusion: CBCT demonstrated high sensitivity but low specificity for ankylosis detection, indicating a propensity for false positives. Smaller voxel sizes (0.25–0.30 mm) improved detection, whereas 0.35 mm was least reliable.
An integrated approach to determine appropriate stormwater management strategies for urban areas with various land-uses: the case of Güneysu
(Wiley, 2026) Bekiryazıcı, Fatih; Köseoğlu, Ali; Bekiryazıcı, Zafer; Acar, Cengiz
This study focuses on a multi-criteria decision-making (MCDM) analysis backed by EPA's SWMM (storm water management model) to investigate stormwater management (SM) strategies for urban areas consisting of different land-use types. Güneysu city center (Rize, Türkiye) is used to exemplify areas consisting of impermeable surfaces, blocks of buildings, and green areas. The rising irregularity in expected rainfall coupled with unplanned urban development causes material damage and casualties worldwide. Extreme rainfalls and topographical factors worsen the scenario in regions with a high amount of precipitation. Güneysu city center consists of different land-use types located in a small region, and the reports from the Turkish Disaster and Emergency Management Presidency (AFAD) state 127 recent casualties from flood-related events in Rize. In this study, an MCDM approach is used to determine appropriate SM strategies for different land-use types in Güneysu. Additional SWMM simulations are carried out to compare total and mean surface runoff values to highlight the consistency of the findings. Results show that permeable pavements are the most suitable SM alternative for impermeable surfaces with a similarity (to ideal solution) coefficient (Formula presented.) in TOPSIS and a total surface runoff reduction rate of (Formula presented.) in SWMM. Similarly, rain gardens (TOPSIS: (Formula presented.), SWMM: (Formula presented.)) and green roofs (TOPSIS: (Formula presented.), SWMM: (Formula presented.)) are the most suitable alternatives for green areas and blocks of buildings, respectively. In contrast to literature, where SM planning studies mostly focus on a single type of land-use or single/combined SM approaches for specific regions, this study presents a tailored approach where suitable alternatives are assessed for each different type of land-use in a densely populated urban area. The most appropriate SM strategy is selected for each land-use type with an integrated approach that considers MCDM results with sensitivity analysis and SWMM simulations to achieve the best surface runoff reduction. This methodology provides a comprehensive approach for strategizing effective SM where combined SM alternatives are selected according to the specific characteristics of the land-use.
