Izmir Kâtip Çelebi University

About 80% of cases of breast cancer have expression of the estrogen receptor (ER). Estrogen is the primary cause of cancer cell growth in ER-positive malignancies. The ER enters the nucleus upon binding estrogen and binds to DNA to trigger the production of estrogen target genes, ultimately resulting in the advancement of the cell cycle. The gold standard for treating ER-positive breast cancer is estrogen deprivation, which involves using hormone therapy to stop the body from producing estrogen or from allowing estrogen to bind to the receptor. Although endocrine therapy (ET) has proven effective, low-grade side effects may reduce quality of life in the long term. In this section, we summarized hormonal treatment options, mechanisms of action, and side effects.

New research shows that adding immune checkpoint inhibitors (ICI) that target the PD-1/PD-L1 pathway to the standard neoadjuvant chemotherapy (NACT) for early-stage triple-negative breast cancer (TNBC) can increase the chances of a pathological complete response (pCR) and improve event-free survival (EFS), even if pCR is not achieved. It is obvious that additional therapies beyond chemotherapy are required in patients who do not acquire pCR. However, long-term immune-related toxicities are increased by adding ICI to the therapy regimen. No biomarker exists to predict which patients may benefit most from ICI. High-risk patients may benefit from ICI with NACT to improve pCR and cure rate. The four sequential steps that typically comprise immune-related adverse events (irAEs) are as follows: management includes the diagnosis and grading of irAEs, the elimination of differential diagnoses and pre-immunosuppression work-up, the selection of the best immunosuppression approach for grade 2 events, and the active evaluation at 72 h to modify treatment, respectively.

Background Overweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women. Methods In this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations. Results Of the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines. Conclusions Pre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed.

Purpose Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by recurrent episodes of fever and serositis, caused by mutations in the MEFV gene. Inflammatory pathways associated with FMF are linked to increased proinflammatory cytokines, which may be related to primary headaches, including migraine. The aim of this study was to evaluate the frequency of migraine and other primary headaches in FMF patients. Methods In this retrospective study, the medical records of FMF patients were analyzed. Demographic data, MEFV gene mutations, and headache histories were collected. The frequency of migraine was compared among patients with these mutations, and statistical analyses were conducted. Results The study included 148 FMF patients, comprising 56.1% females and 43.9% males, with a mean age of 11.3 ± 3.7 years. A family history of FMF was reported in 77.7% of patients, and 35.8% had a family history of migraine. Headaches were reported in 52.7% of patients: 24.3% non-specific, 15.5% tension-type, and 12.8% migraine. Of those with migraine, 8.1% had migraine with aura, and 4.7% without aura. Headaches were more frequently frontal in patients under 12 years of age and temporal in those aged ≥12 years (p = 0.011). The most common genetic mutations were M694V heterozygous and homozygous, with M694V and E148Q mutations linked to more frequent migraines, although not statistically significant. Conclusion FMF patients should be screened for primary headaches, particularly migraine. The high frequency of migraine observed in this study suggests that clinicians should particularly consider migraine as a diagnosis in headache episodes experienced by FMF patients.

In the human body, bioelectric cues are crucial for tissue stimulation and regeneration. Electrical stimulation (ES) significantly enhances the regeneration of nerves, bones, cardiovascular tissues, and wounds. However, the use of conventional devices with stimulating metal electrodes is invasive and requires external batteries. Consequently, electrically active materials with excellent biocompatibility have attracted attention for their applications in stimulation and regeneration in tissue engineering. To fully exploit the potential of these materials, biocompatibility, operating mechanisms, electrical properties, and even biodegradability should be carefully considered. In this review, we categorize various electrically active biomaterials based on their mechanisms for generating electrical cues, such as piezoelectric effect, triboelectric effect, and others. We also summarize the key material properties, including electrical characteristics and biodegradability, and describe their applications in tissue stimulation and regeneration for nerves, musculoskeletal tissues, and cardiovascular tissues. The electrically active biomaterials hold great potential for advancing the field of tissue engineering and their demonstrated success underscores the importance of continued research in this field.

This study investigates the impact of the uncanny valley (UV) phenomenon, originally introduced by Masahiro Mori in 1970, on reading comprehension among Turkish secondary school students using interactive e-books. The UV concept describes the discomfort people experience when encountering entities that appear almost human but have unnatural features. A total of 86 students, aged 10–15, participated in this quantitative research, where they engaged with characters exhibiting varying degrees of human likeness in English-voiced short stories. A Reading Comprehension Test (RCT) assesses reading comprehension of English as a Foreign Language (EFL). The RCT included 15 stories sourced from K5 Learning. This educational platform provides resources to enhance reading comprehension for kindergarten to grade 5 students, focusing on skills like identifying context clues, understanding cause and effect, and determining main ideas. The Attitude Toward Robots and Robot-Related Experiences Scale was also used to measure students’ attitudes toward computer-generated morphs. At the same time, the uncanny valley Scale assessed participants’ reactions to five computer-generated models to determine the presence of the UV effect. The study’s descriptive and inferential statistical analysis revealed that hyper-realistic characters elicited stronger feelings of eeriness, reducing engagement and negatively impacting comprehension. Heat maps further identified the eyes and lips as key areas triggering the UV effect, underscoring the importance of careful character design in educational tools. The study found that the UV effect significantly influenced participants’ EFL reading comprehension scores, particularly when characters were designed to evoke it. Characters in the ‘uncanny’ range were found to diminish engagement and comprehension, suggesting that a balance between realism and stylization in avatars is crucial for enhancing engagement and minimizing negative emotional responses. These results implicate the importance of visually balanced designs in educational technology to improve student engagement and learning outcomes.

Objective The aim of the present research was to assess and compare the piriform aperture dimensions of subjects with a unilateral cleft lip and palate (UCLP) and those of a control group using cone-beam computed tomography (CBCT). Design CBCT data of 40 subjects with a complete UCLP (28 males and 12 females, with a mean age of 17.21 ± 5.75 years) and 40 CBCT images of age- and sex-matched subjects with no cleft, serving as the control group (28 males, 12 females; mean age, 17.25 ± 5.74 years) were included in the study. The maximal height and width of the piriform aperture as well as nasal bone height were measured and statistically compared between the groups. Results There were no significant differences in the age and sex distributions between the groups. The mean piriform aperture height was significantly lower in the UCLP group than in the control group, while the mean piriform aperture width was significantly higher in the UCLP group compared to the control group ( P < .01). Furthermore, the mean bony nasal height was found to be significantly lower in the UCLP group than in the control group ( P < .01). Conclusions According to the present findings, UCLP is associated with changes in the piriform aperture dimensions due to lower height and higher width values. These structural alterations may contribute to the functional and aesthetic nasal challenges in patients with UCLP.

Turkey has experienced one of the largest rises in house prices in the world, particularly after the COVID-19. Given the entangled relationship between house prices, macroeconomics, and financial markets, it is crucial to understand the causes of house price hikes from both academic and policy perspectives. This study aims to identify the determinants of house prices in Turkey. The analysis employs a Bayesian sign- and zero-restricted Structural Vector Autoregression (SVAR) model, utilizing monthly data spanning the period from January 2011 to December 2023. The model incorporates six shocks considered to affect house prices: housing supply, housing demand, credit conditions, mortgage rates, exchange rates, and market sentiment. The findings reveal that housing supply, mortgage rates and credit conditions are the primary drivers of house prices in Turkey. Prior to 2018, housing supply shocks accounted for nearly half of the observed increase in house prices. However, in the post-2018 period, mortgage rates and credit conditions emerged as the predominant drivers of house price dynamics. Moreover, consumer sentiment and exchange rate fluctuations also significantly contribute to house price variations. These findings offer valuable policy insights for mitigating the risk of housing market booms.

Objective The limited predictive effect of genotype on familial Mediterranean fever (FMF) phenotype suggests that epigenetic factors and alternative mechanisms that may cause IL-1β release could contribute to phenotypic heterogeneity. The objective of this study was to examine the role of IL-1β levels and miR-21-5p, cathepsin B and pyrin levels, which were identified as potential factors causing IL-1β release through the use of bioinformatics tools, in the pathogenesis of FMF and their relationship with disease severity. Materials and methods 50 paediatric patients with FMF and 40 healthy children were enrolled in this study. Patients were divided into subgroups according to Pras disease severity score. Serum miR-21-5p expression levels were assessed by qRT-PCR, while serum pyrin, IL-1β and cathepsin B levels were determined by ELISA. Results Serum miR-21-5p was significantly downregulated in FMF patients compared with the control group (p<0.001), while serum pyrin, IL-1β and cathepsin B levels were markedly elevated (p<0.001 for each). Only miR-21-5p was negatively correlated with IL-1β (r=−0.855; p<0.001). In moderately severe FMF patients, miR-21-5p exhibited a statistically significant downregulation (p<0.001), whereas IL-1β and cathepsin B showed a statistically significant increase (p<0.001 and p<0.05, respectively). Furthermore, the Pras score showed a strong negative correlation (r=−0.738; p<0.001) with miR-21-5p levels. Multivariate logistic regression showed that in FMF, a one-unit decrease in miR-21 increased disease severity risk 6.76-fold, while a one-unit increase in cathepsin B raised it 1.71-fold. Conclusion This might be considered one of the mechanisms for subclinical inflammation in paediatric FMF patients through increased activation of cytokines via the downregulation of miR-21-5p. Our findings suggest that miR-21-5p and IL-1β play key roles in subclinical inflammation, and these molecules might be a potential therapeutic target.

Objective Juvenile SLE (jSLE) is an autoimmune disease characterised by the presence of high levels of autoantibodies, predominantly targeting nuclear antigens, resulting in a breakdown of self-tolerance. However, its pathogenesis is multifactorial and poorly understood. The aim of this study was to evaluate the potential of nuclear factor-kappa B (NF-κB) and peroxisome proliferator-activated receptor-gamma (PPAR-γ) as biomarkers for jSLE. Methods In this study, serum NF-κB and PPAR-γ levels were determined by immunoassay in 42 patients with jSLE. In addition, 19 juvenile systemic sclerosis (jSSc) and 25 age-matched healthy children were selected as patient control and healthy control, respectively. Results Serum NF-κB levels in patients with jSLE demonstrated a positive trend towards elevation compared with the controls with no significant difference (p=0.030). In addition, serum NF-κB levels in patients with jSSc were significantly higher than that of the healthy controls (p=0.005). Serum PPAR-γ levels were tend to be lower in both patients with jSLE and jSSc compared with the controls, with no significant difference. Specifically, NF-κB levels were significantly higher in patients with jSLE with cumulative damage (PedSDI≥1) compared with those without, at p=0.044. Logistic regression showed that PPAR-γ levels lower than 2.42 ng/mL were associated with the development of jSLE (OR 7.59) and lower than 2.16 ng/mL for jSSc (OR 10.90). The combined high levels of NF-κB with low PPAR-γ increased the risk of developing jSSc by 21.33-fold. Conclusions The observed trend of elevated NF-κB levels and decreased PPAR-γ levels in our study suggests their potential as biomarkers associated with increased proinflammatory signalling in jSLE and jSSc. However, our findings must be regarded as hypothesis-generating and confirmed in larger datasets. Moreover, their roles in monitoring the course of a disease and guiding therapeutic strategies in juvenile systemic autoimmune diseases need to be clearly investigated. Further extension of these findings may lead to better management and improvement in the outcomes of such patients.

Aim Posterior tibial nerve stimulation (PTNS) might stimulate the sacral nerves and lead to work pelvic floor muscles. We evaluated to effects of PTNS on continence results after extraperitoneal laparoscopic radical prostatectomy (eLRP) with three trocars during early post operative period. Methods Prospectively recorded data of eLRP with three trocars was retrospectively reviewed for continence results between January 2017 and April 2024. Demographic, clinical, and follow‐up data including age, prostate‐specific antigen, prostate volume, nerve sparing surgery, and Gleason score were considered for match‐paired analysis criteria. Patients were divided into two groups according to whether received PTNS therapy after surgery or not. Group 1 consisted of patients without PTNS ( n = 66), and Group 2 consisted of patients who were applied PTNS ( n = 66) after eLRP. Continence status, urine loss ratio (ULR), ICIQ‐SF, and SF‐12 Quality of Life Scale were recorded during outpatient control after 2nd, 3rd, 6th and 12th months of surgery. Statistically significant p was p ≤ 0.05. Results Mean follow‐up was 25 ± 8.7 months. There were 66 patients in each group and match‐paired analyses were performed. Group 2 had significant lower incontinence rate and ICIQ‐SF score at second and third months follow‐up ( p = 0.026 and p = 0.045; p = 0.044 and p = 0.031 respectively). Group 2 had significantly higher Physical Component Summary (PCS) and Mental Component Summary (MCS) ( p = 0.005 and p = 0.011 for PCS; p = 0.008 and p = 0.025 for MCS, respectively) at second and third months follow‐up. Additionally, ULR was significant better in Group 2 at second and third month of surgery ( p = 0.042, p = 0.037, respectively). All these parameters were comparable between groups after sixth and 12th months. Conclusions PTNS can be safely applied to provide early continence in patients underwent eLRP. Due to improved functional outcomes, higher quality of life might be gained in early follow‐up period.

This study assessed the time evolution of the bed morphology of six experiments performed by Bombar and Cardoso (Geomorphology 367:107329, 2020. https://doi.org/10.1016/j.geomorph.2020.107329) on mobile-bed confluences. These experiments were characterized by a unique junction angle, a fixed plan layout of the converging channels, constant water discharges and water discharge ratio, and six combinations of the converging sediment transport rates. The end aspect ratio of both channels was sufficiently large to avoid strong wall effects, and the flow was always subcritical and rough turbulent. The bed sediment was a uniform non-ripple forming sand. Detail analysis of the time evolution of the bed morphology showed that balanced fluxes of sediments through the boundaries of the system were a sufficient condition of equilibrium within the range of variables covered by the study. The most important morphological features of the confluence were discussed for several time instants, including those referring to the equilibrium phase. The equilibrium features essentially complied with the morpho-dynamic models reported in the literature for mobile-bed confluences, meaning that the time evolution and the end (equilibrium) values of the bed morphologies reported in this paper can be used to validate CFD models thought of as predictive tools of confluence morpho-dynamics. Two experiments are, indeed, ideal for this purpose since they converged to static equilibria, and wrong predictions cannot be attributed to oscillations of the bed, whereas those models may only be able to predict the average, equilibrium values of the bed features of experiments run with sediment supply into the main channel and characterized by the movement of bed forms.

The present study was designed to test the hypothesis that interpersonal emotion regulation leads to increased difficulties in intrapersonal emotion regulation, which in turn, leads to general psychological distress utilizing a three‐wave cross‐lagged panel design. Undergraduate students rated self‐report measurements of interpersonal emotion regulation, difficulties in intrapersonal emotion regulation, and psychological distress at baseline (T1, N = 369) and two follow‐up waves (T2 and T3), each separated by 3 months. The results indicated that although some lagged correlations between interpersonal emotion regulation strategies and difficulties in intrapersonal emotion regulation were significant, interpersonal emotion regulation strategies did not prospectively predict difficulties in intrapersonal emotion regulation. Notably, difficulties in intrapersonal emotion regulation significantly predicted psychological distress in subsequent waves. Additionally, psychological distress at T1 predicted distress at T3 through difficulties in intrapersonal emotion regulation at T2. This study is significant as it is the first to test the interpersonal emotion regulation model in a longitudinal design. However, the hypothesized pathway where interpersonal emotion regulation contributes to psychological distress through difficulties in intrapersonal emotion regulation, was not supported.

Earthquakes can often cause significant damage to buildings. After an earthquake, experts/managers need to make quick and accurate damage assessments. Traditionally, manual analysis processes have been widely used in damage assessment studies. The fact that these methods are time-consuming and based on human observation leads to certain limitations in damage assessment studies. In recent years, artificial intelligence techniques such as deep learning and machine learning have frequently been preferred in damage detection studies, and significant success has been achieved. This study aimed to automatically detect cracks/damages in the buildings in Diyarbakir city after the February 6, 2023 Kahramanmaras, Turkey earthquake. Our experimental dataset was collected by the researchers and named Kahramanmaras-Diyarbakir Earthquake Building Crack Dataset (KDBECD-2023). The data set consists of four categories in terms of damage level: undamaged, slightly damaged, moderately damaged, and heavily damaged buildings. DenseNet201 deep learning architecture and popular machine learning algorithms, Support Vector Machine, Random Forest, Decision Tree, and K-Nearest Neighbors (KNN) were used to classify cracks at different damage levels. In the experimental phase, feature extraction was performed with the DenseNet201 architecture. In addition, dimensional reduction was applied with the Principal Component Analysis method to reduce the computational complexity of the proposed hybrid study. According to the experimental results, the DenseNet201-KNN hybrid model gave the most successful result with an accuracy value of 94.62%. The results of this study can make important contributions to decision makers and experts in detecting cracks and damages in buildings after an earthquake.

This study aims to enhance the self‐cleaning properties of clay roof tiles by incorporating red mud as an industrial waste. This approach contributes to a sustainable environment by upcycling waste and developing an improved building material. Various analyses were conducted to compare the physical, structural, morphological, elemental, and optical properties of clay tiles with varying amounts of red mud. The characterization results indicated that the addition of red mud to clay roof tiles resulted in homogeneous and uniform tiles with enhanced physical properties. The red mud‐mixed clay roof tiles exhibited photocatalytic activity for the oxidation of methylene blue dye. Notably, while adding more than 5% red mud improved the physical properties, the optimal photocatalytic activity was observed in clay roof tiles with a 5% red mud addition. This study underscores the dual benefits of this approach: improving the functional properties of clay roof tiles and promoting the valorization of industrial waste.

The purpose of this study was to look into morphometric changes and establish the reproductive cycle. Phorcus turbinatus morphometric correlations were established, and the reproductive period and body indices were ascertained by taking histological sections. The idea that the primary growth occurs in the gastropod’s shell due to shell thickness can be supported by the meat yield and condition index, which exhibit a negative relationship with weight increase. The average annual HBA is 15.27 ± 0.26 mm. The overall weight was 1.60 ± 0.07 g on average. The range of the gonad index was 1.23 to 2.81%. Throughout the winter, the condition index was low; in the spring and summer, it rose. The results showed that the condition index was 4.24 ± 0.95–23.77 ± 4.48%, and the meat yield was 17.34 ± 0.99–33.27 ± 1.29%. P. turbinatus gonad stages were identified histologically as early active, late active, ripe, spawning, and recovery. Development and maturation over the course of the year demonstrate that, with the exception of the winter, reproductive activity is not interrupted. The primary reproductive phase was found to be between November and June, with temperature and nutrition assumed to be the abiotic elements influencing this, according to an analysis of data collected throughout the year.

The influence of social media on the mental health of adolescents has been controversial and the findings in the literature are inconclusive. Although prior studies have identified several factors that may cause or trigger the proposed relationship, little is known about the culture-related factors as an underlying mechanism that could explain the complexity of this association. This study addressed this gap by examining the associations between the two domains of social media (i.e., time spent on weekdays and weekends) and two mental health outcomes (anxiety and depression) in adolescents via the moderating effect of horizontal-vertical individualism and collectivism. 299 secondary school students (Mage = 15.21 years; 61% girls) from Türkiye (N = 176), Ireland (N = 70), and England (N = 53) completed self-report surveys. Spending more than four hours on weekdays and weekends was positively associated with anxiety and depression whereas spending more than two hours on social media during weekends was positively associated with anxiety in the entire sample. Horizontal and vertical individualism moderated the association between time spent on social media and depression in the entire sample. The study’s strengths and limitations, along with the implications of the findings for future research, are thoroughly discussed.

Context Neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have recently emerged in assessing pheochromocytomas and paragangliomas (PPGLs). However, their combined use with PASS scale has not yet been explored. Objective Our goal was to investigate the prognostic values of NLR and PLR and incorporate the PASS score into our analysis. Methods Data from 74 histologically confirmed pheochromocytomas/paragangliomas across two centres were assessed. Poor prognosis was characterised by the presence of metastasis or disease‐specific mortality. Clinical characteristics such as age, gender, primary tumour size and location, and urinary metanephrine and normetanephrine levels, alongside NLR, PLR, and the PASS score as prognostic markers, were analysed. The prognostic value of the PASS score combined with NLR or PLR was evaluated using Receiver Operating Characteristic Curve (ROC), univariate, and multivariate regression analyses. Results Sixty‐four patients with better prognosis and 10 patients with poor prognosis were included in the analysis, with mean PASS scores of 4 and 9, respectively. Poor prognosis was significantly higher in patients with NLR Á 3.43 (Area Under Curve(AUC) = 0.761; 70% sensitivity, 82.8% specificity, 38.9% PPV and 94.7% NPV) and with PLR > 193.12 (AUC = 0.738; 70% sensitivity, 76.2% specificity, 30% PPV and 94% NPV). The PASS and preoperative NLR or PLR combination predicted poor prognosis significantly in the multivariate models (OR: 125; 95% CI: 6.25–∞; p = 0.001 for PASS ≥ 6 and NLR > 3.43 and OR: 28.57; 95% CI: 3–250; p = 0.003 for PASS ≥ 6 and PLR > 193.12). Conclusion As the roles of NLR and PLR in prediction of prognosis is gaining recognition, combining these with PASS score may improve preoperative stratification of prognosis and management of patients.