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This study was conducted in order to reveal the level of instructional leadership behavior scores of school administrators working in public secondary schools according to the opinions of teachers and to examine them in terms of various variables. The working group of this research, which was designed in the converging parallel pattern of the mixed method, was formed through easily accessible sampling. 383 teachers in the central districts of Mersin province formed the quantitative data study group and 5 teachers formed the qualitative data study group. The semistructured interview form prepared by the researcher and the "Instructional Leadership Scale" developed by Alig-Meilcarek (2003) and adapted to Turkish by Sahin (2011) were used as data collection tools. Kolmogorov Smirnov test was applied for normality test. Kolmogorov Smirnov value is <0.05. Skewness value is between -+ 3 values and the kurtosis value is between +-10 values. Kline (2011) mentioned that normality tests can be performed if the normal distribution has a skewness value of ± 3 and a kurtosis value of ± 10. Since the quantitative data showed a normal distribution, they were analyzed by independent T-test analysis, while the qualitative data were analyzed with the help of content analysis. When the research findings were evaluated, it was found that there was no significant difference between the school administrators' instructional leadership scores according to the gender of the participants.

Objective: Acute electrical stimulation of the common peroneal nerve (cPNS) has been shown to cause an immediate reduction in systolic blood pressure (SBP) in spontaneous hypertense rats (SHR), but the effect of this treatment in sub-chronic ambulatory SBP is unknown. Here we developed an implantable wireless WNClip neural stimulator to test the efficacy of 5-week cPNS as a treatment for hypertension. Results: Daily cPNS 2 Hz monophasic stimulation at threshold for 8 minutes every day for five weeks, reduced SBP in WKY animals by −4 mm Hg, and in SHR animals by −21 mmHg in week 5 (p < 0.01). Ambulatory SBP measured daily recorded approximately twenty-four hours after the cPNS treatment, showed a significant reduction from the first (176.6 ± 24.1 mm Hg; n = 5) to the last week of treatment (165.7± 42.7 mm Hg; n = 4), a −9 mm Hg reduction (p < 0.01). Evaluation of heart rate during the treatment showed no significant difference caused by the daily 8-minute cPNS. Conclusions: Electrical stimulation of the common peroneal nerve induced a reduction in SBP that is comparable to that reportedly achieved pharmacologically by ACE inhibitor Ramipril, or by renal denervation procedures. These results support the notion that neuromodulation of the common peroneal nerve can serve as an alternative treatment for drug resistant hypertension.

Objective: Stress urinary incontinence (SUI) affects a third of the female population and is characterized by involuntary urine leakage during abdominal efforts such as sneezing, laughing, or coughing. Acute neuromodulation of the bulbospongiosus nerve (BsN) was shown to increase bladder efficiency in aged and multiparous rabbits. This study investigates the efficacy of sub-chronic BsN neuromodulation in alleviating SUI-like deficits in mature multiparous rabbits, characterized by increased urine leakage and reduced leak point pressure. Results: Using the voiding spot assay, we observed a 40% reduction in urine leakage events after 30 days of BsN stimulation, which correlated with a 60% increase in daily micturition volume, a 10-fold increase in voided volume, and improvements in voiding efficiency and leak point pressure compared to negative control animals. Conclusion: In multiparous rabbits, BsN neuromodulation improves important SUI-like metrics including bladder capacity and urethral closure, supporting the use of this bioelectronic modality as treatment for SUI.

Based on emerging evidence on the role for specific single-nucleotide variants (SNVs) in EIF2AK3 encoding the integrated stress response kinase PERK, in neurodegeneration, we assessed the association of EIF2AK3 SNVs with neurocognitive performance in people with HIV (PWH) using a candidate gene approach. This retrospective study included the CHARTER cohort participants, excluding those with severe neuropsychiatric comorbidities. Genome-wide data previously obtained for 1047 participants and targeted sequencing of 992 participants with available genomic DNA were utilized to interrogate the association of three noncoding and three coding EIF2AK3 SNVs with the continuous global deficit score (GDS) and global neurocognitive impairment (NCI; GDS ≥ 0.5) using univariable and multivariable methods, with demographic, disease-associated, and treatment characteristics as covariates. The cohort characteristics were as follows: median age, 43.1 years; females, 22.8%; European ancestry, 41%; median CD4 + T cell counts, 175/µL (nadir) and 428/µL (current). At first assessment, 70.5% used ART and 68.3% of these had plasma HIV RNA levels ≤ 200 copies/mL. All three noncoding EIF2AK3 SNVs were associated with GDS and NCI (all p  13 were independently associated with GDS and NCI (p

Introduction: Laparoscopic appendectomy (LA) has become one of the most frequently performed abdominal surgeries worldwide, surpassing the traditional open technique. Over time, the increasing experience of surgeons in minimally invasive surgery and, notably because patients’ aesthetic and cosmetological concerns have allowed surgeons to modify these techniques. In our study, we aimed to introduce the invisible scar laparoscopic appendectomy (ISLA) modified technique and present early postoperative outcomes. Methods: Our study included 66 patients who underwent LA between August 2022 and April 2024. Half of these patients were in the ISLA group, and the other half were in the control group. The sequence of priority for matching the prognostic variables was age, sex, laparoscopic appendicitis grade, and body mass index. We retrospectively examined and compared the demographic data, discharge times, 30-day postoperative readmission rates, and operative data of these patients between the groups. Results: There was no significant difference in postoperative 30-day complications, length of hospital stays, and drain usage between the two groups (p=0.708, p=0.841, and p=0.708, respectively). The duration of the operation was slightly longer in the ISLA group (p=0.006). Conclusion: ISLA can be performed safely by experienced surgeons with appropriate case selection.

AIM: To examine the subclinical alterations in the retina and choroid between patients with 2019 coronavirus disease (COVID-19)-related lung involvement and the healthy control group. METHODS: In this prospective case-control study, 85 cases with lung involvement due to COVID-19 and 50 healthy cases were included. Best-corrected visual acuity, intraocular pressure measurement, and anterior and posterior segment examination were performed on both eyes for each individual. Choroidal and retinal changes were examined and recorded by optical coherence tomography angiography. RESULTS: All choroidal thickness measurements of the COVID-19 group showed no statistically significant difference when compared to healthy individuals. When vascular density and perfusion density values were compared, there was a decrease in the average of these values in the COVID-19 group, although it was not statistically significant (P=0.088, P=0.065 respectively). When the fovea avascular zone (FAZ) area values were compared, the average was 0.57±0.38 in the COVID-19 group, while it was 0.54±0.24 in the control group. CONCLUSION: Although our data are not statistically significant, the decrease in vascularity and perfusion and the accompanying FAZ expansion are detected in the acute period (1st month). These changes may anatomically alter the retina in the long term and affect functional vision. Future ischemia-related alterations in the retina caused by a prior COVID-19 infection may arise in situations without comorbidities and may require concern in the patient's systemic assessment.

Bu çalışmanın amacı ilkokul 4. sınıf düzeyinde gerçekleştirilen matematiksel modelleme etkinliklerinin öğrencilerin matematiğe yönelik kaygıları ile ölçme öğrenme alanındaki akademik başarı düzeylerine etkisini belirlemektir. Yarı deneysel desenlerden ön test-son test kontrol gruplu modele göre tasarlanan araştırmada çalışma grubu, bir devlet ilkokulunda öğrenim görmekte olan 72 dördüncü sınıf öğrencisinden oluşmaktadır. Veri toplama aracı olarak araştırmacılar tarafından oluşturulan “İlkokul 4. Sınıflara Yönelik Ölçme Öğrenme Alanı Başarı Testi” ile Mutlu ve Söylemez (2018) tarafından geliştirilen “İlkokul Öğrencileri İçin Matematik Kaygı Ölçeği” kullanılmıştır. Deney grubunda 10 hafta boyunca MEB kazanımlarına uygun olarak tasarlanan matematiksel modelleme etkinlikleri uygulanırken, kontrol grubu mevcut planlama dâhilinde matematik derslerine devam etmiştir. Ön test ve son test uygulamaları neticesinde elde edilen veriler üzerinde bağımsız gruplar t testi ve Mann-Whitney U testleri uygulanmıştır. Yapılan analizler neticesinde deney grubunda yer alan öğrencilerin ölçme öğrenme alanına yönelik başarı düzeylerinin istatistiksel olarak artış gösterdiği, aynı zamanda matematiğe yönelik kaygı düzeylerinde ise yine istatistiksel olarak azalma meydana geldiği tespit edilmiştir. Araştırmanın sonucunda matematiksel modelleme etkinliklerinin öğrencilerin ölçme öğrenme alanındaki akademik başarı düzeyleri ile matematik kaygı düzeyleri üzerinde anlamlı derecede olumlu etki meydana getirdiği sonucuna ulaşılmıştır.

Autoinflammatory bone diseases (AIBDs) constitute a recently identified subset of autoinflammatory diseases. These conditions are characterized by an exaggerated inflammatory response in the bones without any apparent etiology. Inflammatory bone lesions associated with AIBDs exhibit chronic inflammation, are typically culture-negative, and do not exhibit discernible microorganisms on histopathological examination. The most common and representative AIBD is chronic non-bacterial osteomyelitis (CNO), which is also known as chronic recurrent multifocal osteomyelitis. Another variant of CNO, which is typically observed in older teenagers or adults, is known as synovitis, acne, hyperostosis, pustulosis, osteitis syndrome. This condition is distinguished by its notable skin manifestations. Advancements in genetic research have led to the identification of three novel monogenic subtypes within the category of AIBDs. These include Majeed syndrome, pyogenic arthritis, pyoderma gangrenosum, and acne syndrome, and interleukin-1 receptor antagonist deficiency syndrome. Another monogenic AIBD, called cherubism, affects only the maxilla and mandible. Data on the diagnosis and treatment of these rare diseases are extremely limited. However, if not diagnosed and treated promptly, it can result in significant complications, including severe disability and mortality. Thus, it is imperative to maintain a high level of clinical awareness of these diseases. These rare diagnoses should be considered in patients with musculoskeletal complaints in whom no specific etiology can be identified or in patients with systemic manifestations such as cutaneous and gastrointestinal symptoms or fever. In such patients, the diagnostic process, which encompasses imaging and genetic studies, should be initiated promptly.

Abstract Background Machine learning (ML) is increasingly used to predict clinical deterioration in intensive care unit (ICU) patients through scoring systems. Although promising, such algorithms often overfit their training cohort and perform worse at new hospitals. Thus, external validation is a critical – but frequently overlooked – step to establish the reliability of predicted risk scores to translate them into clinical practice. We systematically reviewed how regularly external validation of ML-based risk scores is performed and how their performance changed in external data. Methods We searched MEDLINE, Web of Science, and arXiv for studies using ML to predict deterioration of ICU patients from routine data. We included primary research published in English before December 2023. We summarised how many studies were externally validated, assessing differences over time, by outcome, and by data source. For validated studies, we evaluated the change in area under the receiver operating characteristic (AUROC) attributable to external validation using linear mixed-effects models. Results We included 572 studies, of which 84 (14.7%) were externally validated, increasing to 23.9% by 2023. Validated studies made disproportionate use of open-source data, with two well-known US datasets (MIMIC and eICU) accounting for 83.3% of studies. On average, AUROC was reduced by -0.037 (95% CI -0.052 to -0.027) in external data, with more than 0.05 reduction in 49.5% of studies. Discussion External validation, although increasing, remains uncommon. Performance was generally lower in external data, questioning the reliability of some recently proposed ML-based scores. Interpretation of the results was challenged by an overreliance on the same few datasets, implicit differences in case mix, and exclusive use of AUROC.

In this study, it was aimed to examine the effects of using Web 2.0 tools in environmental education on the attitudes of preschool children towards the environment. The research used a combination of quantitative and qualitative data. Quantitative data were collected through the "Attitudes Toward the Environment Scale: Children's Attitudes Toward the Environment Scale-Preschool Version (CATESPV)", and the qualitative data were collected through the "Interview Form" created by the researcher. A total of 38 children, 18 of them in the experimental group and 20 of them in the control group, aged between 60-72 month old attending a public day care center, participated in the study group of the research. One of the parents (mother or father) of the experimental group, which is the group where qualitative data were collected, participated in the research with 18 participants. Attitude towards the environment constitute dependent variable in the research. Independent variable is environments with and without Web 2.0 tools are used. In this research, two-factor ANOVA analysis for repeated measurements used for independent samples of the quantitative data obtained, descriptive analysis was applied to qualitative data. As a result of the research, a significant difference was determined between the average scores of children's attitudes towards the environment after the experimental procedure in the environment where Web 2.0 tools were used in environmental education. It was determined that the changes in the mean scores of attitudes towards the environment of the two groups before the experimental procedure were significantly higher in favor of the group in the environment where Web 2.0 tools were used in environmental education. In this study, it was concluded that the environment in which Web 2.0 tools are used in environmental education is effective in developing children's attitudes towards the environment. According to the qualitative findings, the parents in the experimental group stated that these tools made learning interesting, memorable and facilitating, provided continuity and permanence in learning, and were effective in developing correct attitudes.

Over the past two decades Biomedical Engineering has emerged as a major discipline that bridges societal needs of human health care with the development of novel technologies. Every medical institution is now equipped at varying degrees of sophistication with the ability to monitor human health in both non-invasive and invasive modes. The multiple scales at which human physiology can be interrogated provide a profound perspective on health and disease. We are at the nexus of creating avatars (herein defined as an extension of digital twins) of human patho/physiology to serve as paradigms for interrogation and potential intervention. Motivated by the emergence of these new capabilities, the IEEE Engineering in Medicine and Biology Society, the Departments of Biomedical Engineering at Johns Hopkins University and Bioengineering at University of California at San Diego sponsored an interdisciplinary workshop to define the grand challenges that face biomedical engineering and the mechanisms to address these challenges. The Workshop identified five grand challenges with cross-cutting themes and provided a roadmap for new technologies, identified new training needs, and defined the types of interdisciplinary teams needed for addressing these challenges. The themes presented in this paper include: 1) accumedicine through creation of avatars of cells, tissues, organs and whole human; 2) development of smart and responsive devices for human function augmentation; 3) exocortical technologies to understand brain function and treat neuropathologies; 4) the development of approaches to harness the human immune system for health and wellness; and 5) new strategies to engineer genomes and cells.

Azerbaijan, a country with hydrocarbon resources, seeks to restructure its economy and energy system to become more resilient to climate change. The European Union's call for international climate action offers opportunities for a green energy transition in Azerbaijan. However, the economic, social, climatic, and environmental elements driving this transition are understudied. This article follows the example of the World Economic Forum’s System Value Analysis to study how complementary the impact of policies and solutions targeting sustainable development, the environment, climate action, and the green energy transition is in Azerbaijan. For this purpose, we analyze the energy market in Azerbaijan and the potential of renewable energy resources. The main aim is to reveal not only the economic advantages of the energy transition but also its political and strategic contribution to Azerbaijan. We argue that Azerbaijan's strategic engagement with the EU is crucial, as it serves as a means for Europe to bolster energy security and assist Azerbaijan in its political drive and strategy for transitioning to green energy. Additionally, it fulfills Azerbaijan's commitments to global climate initiatives.

Bu çalışma, moringa tohum çimlenmesi ve fidan gelişimi olmak üzere iki aşamadan oluşmaktadır. Öncelikle moringa tohumlarına kontrol dışında, dört farklı uygulama (a: 35°C’deki ılık suda 24 saat bekletme; b: 1000 ppm GA3 çözeltisinde 24 saat bekletme; c: -1MPa polietilen glikol (PEG) çözeltisinde 24 saat bekletme; d: 2500 ppm mikrobiyal gübre çözeltisinde 24 saat bekletme) yapılmıştır. Kontrollü koşullarda gerçekleştirilen çimlendirme denemelerinde sıcaklık, 25°C ve oransal nemi ise %80’in üzerinde olacak şekilde ayarlanmıştır. Tohum ekiminden sonra, çimlenme oranı, süresi ve çimlenme enerjisi her bir uygulama için belirlenmiştir. Çimlenmeden sonra fidanlar 1:1 oranında torf ve perlit içeren yetiştirme ortamına aktarılmıştır. Daha sonra fidanlara 15 gün ara ile altı defa NPK, NPK + 2500 ppm mikrobiyal gübre ve NPK + 5000 ppm mikrobiyal gübre uygulamaları yapılmıştır. Yetişen bitkilerde 90 gün sonra, bitki boyu, gövde çapı, klorofil miktarı, gövde, kök yaş ve kuru ağırlıkları belirlenmiştir. Araştırma bulguları, tohum çimlenme oranı, süresi ve enerjisi açısından en iyi sonucun, tohumların viyollere ekimden önce 35°C’deki ılık suda 24 saat bekletme uygulamasının verdiğini göstermiş ve bu uygulamayı 1000 ppm GA3 çözeltisinde 24 saat bekletme uygulaması izlemiştir. Fidan büyüme ve gelişmesi açısından incelenen parametreler göz önüne alındığında, standart NPK’nın mikrobiyal gübre ile birlikte kullanımı, standart NPK’ya göre daha iyi sonuç vermiştir. Araştırma sonucunda, tohum çimlenmesi açısından 35 oC’deki ılık suda 24 saat bekletme ve fidan gelişimi açısında ise standart NPK’nın mikrobiyal gübre ile birlikte kullanımı tavsiye edilmiştir.

Çeltik, dünya nüfusunun yarısından fazlası için temel gıda kaynağı olan en önemli tahıl ürünlerinden biridir. Artan dünya nüfusunu sürdürülebilir bir şekilde besleyebilmek adına, tarımsal sulama yöntemlerinin geliştirilmesi ve su kaynaklarının verimli kullanımı üzerine çalışmaların yoğunlaşması gerekliliği giderek artmaktadır. Çeltik bitkisinin sulanan tarım alanlarının %34-43'ünü kullandığı tahmin edilmektedir. Küresel ölçekte su kaynakları hızla azalmaktadır ve çeltik üretiminde ihtiyaç duyulan toplam sulama suyu miktarı; kullanılan çeltik çeşidi, toprağın özellikleri ve ekim yöntemleri gibi çeşitli faktörlere göre farklılık göstermektedir. Bu çalışma, Tesadüf Blokları deneme desenine göre düzenlenmiştir. Çalışmada 2 çeltik çeşidi, 2 farklı sulama yöntemi (Geleneksel ve Alternatif tava ıslatma kurutma) ve 3 farklı ekim yöntemi (Sulu, Kuruya ve Fideleme) seçilmiş ve araştırma üç tekrarlamalı olmak üzere 36 lizimetrede yürütülmüştür. Araştırmada çeltikle ilgili bitki boyu, ana sap kalınlığı, salkım uzunluğu, metrekaredeki bitki sayısı, tane verimi, bin tane ağırlığı, kırıklı randıman ve kırıksız randıman gibi özellikler incelenmiştir. İncelenen parametreler üzerine araştırma konularının istatistiksel olarak etkisi olduğu tespit edilmiştir. Tane verimi açısından su uygulamasında geleneksel sulama ile alternatif ıslatma kurutma sulama yöntemi arasında %25 oranında tane verimin azaldığı tespit edilmiştir. Ekim yöntemleri açısından ise, sulu ekim, kuru ekim ve fideleme yöntemleri birbirini takip etmiştir. Yapılan araştırma sonucunda en yüksek tane veriminin suya ekim yönteminde ve geleneksel sulama ile elde edildiği tespit edilmiştir.

Abstract Background A large proportion of individuals experience functional impairment in everyday life due to climate worry. However, the current understanding of this functional impairment is limited by the use of suboptimal measures. Furthermore, it is not known whether functional impairment due to climate worry affects pro-environmental behaviors (PEBs) or whether individuals who experience such impairment perceive a need for support. The aims of the current study were (1) to extend previous research using an established measure of functional impairment (the Work and Social Adjustment Scale, WSAS), (2) to explore the associations between climate worry, functional impairment, and PEBs, and (3) to describe the characteristics and the perceived need for support of individuals with functional impairment due to climate worry. Methods A cross-sectional survey targeting adult individuals who experience climate worry. Participants were recruited nationally in Sweden between September and October 2022. The survey included measures of climate worry severity, climate worry frequency, functional impairment, PEBs, depressive symptoms, sleep problems, and questions related to perceived need for support. Results A total of 1221 adults (75% women, mean age 46.3 years) were included in the analyses. Multivariate structural equation modeling revealed that climate worry severity and frequency were significantly associated with PEBs (β = 0.34 and β = 0.45, respectively). Climate worry frequency was associated with functional impairment (β = 0.41). Functional impairment was only marginally associated with PEBs (β = 0.05). Approximately 40% of the sample (n = 484) reported a high frequency and high severity of climate worry. Among these, one-third (n = 153) scored above the cutoff for significant impairment on the WSAS. Individuals in this group (high severity and frequency of climate worry as well as significant functional impairment) were more likely to experience depressed mood and sleep problems and were more interested in receiving support, specifically concerning strategies for worry management and sustainable behavior change. Conclusions Using an established measure of functional impairment, we found an association of climate worry with functional impairment and PEBs. Importantly, as there is a perceived need for support in individuals with impairment due to climate worry, interventions targeting this specific subgroup should be developed.

Abstract Objective In cone-beam computed tomography (CBCT), voxel resolution and size directly affect image quality. This study aimed to analyze the effect of voxel resolution on the linear and volumetric measurements of tooth and pulp in three-dimensional images obtained with different voxel sizes and to test the repeatability of these measurements. Materials and methods CBCT images of 30 extracted single-rooted permanent teeth were obtained using 3 different voxel sizes (0.1-, 0.2-, 0.4-mm). Two observers performed volumetric and linear measurements of pulp and teeth using semi-automatic segmentation. The data were analyzed using descriptive and nonparametric tests. For interobserver reliability, the Wilcoxon signed test and Kendall’s tau correlation coefficient were used. The intraobserver repeatability was analyzed using the intraclass correlation coefficient. The significance level was set at 0.05. Results Friedman test showed no significant difference (p > 0.05) in volumetric measurements between different voxels in one of the observers, but a significant difference was found in the pulp volume measurement in the other (p 0.05). The interclass reliability (Wilcoxon signed test and Kendall’s tau correlation coefficient) and intraobserver repeatability (intraclass correlation coefficient) decreased as the voxel size increased for linear and volumetric measurements of tooth and pulp (p > 0.05). While the values indicated “good” and “excellent” reliability for all parameters measured on the 0.1- and 0.2-mm voxels, a few “moderate” reliability values were found on the 0.4-mm voxel. Conclusion Voxel sizes of 0.1- and 0.2-mm did not significantly affect linear and volumetric tooth measurements. When the voxel size increased, the reliability and repeatability decreased. To increase measurement reliability, the voxel size should be as small as possible.

Objective: We investigated the occurrence and characteristics of secondary solid cancers (SSCs) in patients with Philadelphia chromosome-negative myeloproliferative neoplasms (Ph- MPNs) from Türkiye. We identified the potential risk factors for SSC development, including the impact of cytoreductive therapies, and we assessed the influence of SSC on patient survival. Materials and Methods: A total of 1013 Ph- MPN patients diagnosed between 1995 and 2022 were retrospectively analyzed. Data related to demographics, clinical and laboratory parameters, SSC development, cytoreductive therapy exposure, and survival outcomes were collected. Statistical analyses were performed using IBM SPSS Statistics 26.0. Results: Of the analyzed Ph- MPN patients, 6.6% developed SSC, with carcinoma being the most common type. Older age at the time of Ph- MPN diagnosis and male sex were associated with SSC occurrence. Ph- MPN patients diagnosed with SSC and patients with no diagnosis of SSC showed no significant difference in complete blood count results, spleen size, Ph- MPN diagnostic groups, or driver mutation frequencies. However, patients with SSC had a higher frequency of arterial thrombosis and a tendency towards an increased rate of total thrombosis (p=0.030 and p=0.069, respectively). In multivariate analysis, arterial thrombosis was the sole independent risk factor and interferon (IFN)-based therapy was the sole protective factor for SSC development. Median overall survival (OS) did not differ between patients with and without SSC except for polycythemia vera patients with SSC, who had shorter OS (175±15 versus 321±26 months, respectively; p=0.005). Conclusion: This study highlights the prevalence and characteristics of SSCs in Turkish patients diagnosed with Ph- MPNs. Arterial thrombosis was associated with increased SSC risk while IFN-based therapy offered potential protection from SSC. Screening for SSC in Ph- MPN patients with arterial thrombosis may be valuable. These findings emphasize the importance of malignancy screening in Ph- MPN patients, especially in high-risk subgroups, and call for further research to elucidate the underlying mechanisms and optimize treatment strategies.

In this article , the importance and development of international entrepreneurship were examined, investigating how global economic dynamics influence the role of entrepreneurship on national and international levels. The primary aim of the research is to offer a comprehensive approach to examining Turkey's international entrepreneurship ecosystem and evaluating the effectiveness of entrepreneurial centers. The study aims to analyze the criteria affecting the success of entrepreneurial centers and their role in the internationalization process. The first section of the thesis delves into the definition of entrepreneurship, its historical evolution, and contemporary theoretical approaches, detailing various types of entrepreneurship from social to e-entrepreneurship. The second section focuses on the intersections of international trade and entrepreneurship, emphasizing the concept of internationalization and the role of entrepreneurial centers both globally and in Turkey. The methodology of the study is built upon meetings with decision-making authorities and creating Analytic Hierarchy Process (AHP) matrices. These matrices were employed to determine the priorities of different criteria and alternatives. The role of entrepreneurial centers in the development of international entrepreneurship is analyzed using the AHP method. This analysis aims to reveal the impact of leading entrepreneurial centers in Turkey and globally on the internationalization process and its contributing factors.

Background/Objectives: Dose reductions in CDK4/6 inhibitors, such as ribociclib and palbociclib, are often necessary due to treatment-related toxicities in patients with advanced breast cancer. This study aims to evaluate the impact of the timing of dose reductions on progression-free survival (PFS) and overall survival (OS) in a real-world cohort. Methods: This single-center, retrospective study included patients treated with ribociclib or palbociclib between 2019 and 2023 at a cancer center in Turkey. Dose reductions due to drug-related toxicities were recorded, and survival outcomes were analyzed. Patients were categorized based on the timing of dose reductions: within the first 3 months (early) and after 3 months (late). Results: Among 392 patients (mean age 57.13 years), 16.8% had dose reductions within 3 months, 21.7% had late dose reductions, and 61.5% had no dose reductions. The mPFS was 14.26 months for early dose reductions, 33.12 months for late dose reductions, and 20.6 months for no dose reductions (p < 0.001). The mOS was 37.12 months for early dose reductions, not reached for late dose reductions, and 57.76 months for no dose reductions (p < 0.001). Hematological toxicity, primarily neutropenia, was the most common cause of dose reductions. The ECOG performance status, line of therapy, and CDK4/6 inhibitor type were also significant predictors of PFS and OS. Conclusions: Early dose reductions in CDK4/6 inhibitors negatively affect PFS and OS, highlighting the importance of maintaining treatment intensity in the first 3 months. However, late dose reductions do not negatively affect progression-free survival (PFS) or overall survival (OS), with late dose reductions associated with better outcomes. Prospective studies in larger patient populations will further clarify our knowledge on this subject.

Crossed modules are algebraic structures that generalize the concept of group extensions. They involve group-like objects (often groups or groupoids) with additional structure and mappings between them that satisfy certain properties. Generalized crossed modules further extend this concept to higher-dimensional settings or more general algebraic contexts. In this paper, we studied the fibration and co-fibration of generalized crossed modules.

Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disorder, characterized by recurrent fever and serositis. It primarily affects individuals of Mediterranean descent, including Arabs, Armenians, Turks, and Jews. The Mediterranean fever (MEFV) gene, responsible for FMF, was discovered in 1997. Biallelic pathogenic variants lead to excessive activation of the pyrin inflammasome, resulting in inflammation. Clinical manifestations include recurrent fever, abdominal pain, and joint involvement, with attacks typically lasting 12-72 hours. Diagnosis relies on clinical criteria and is supported by genetic testing. Colchicine is the primary treatment to reduce attack frequency and prevent the complications like renal amyloidosis. Despite advancements in understanding FMF, including its genetic basis and treatment options, challenges remain in distinguishing it from other autoinflammatory diseases. Co-existing conditions such as juvenile idiopathic arthritis and inflammatory bowel disease are common among FMF patients. Ongoing research should aim to clarify the development of the disease, enhance diagnostic accuracy, and address its clinical presentation and genetic variability, with a focus on identifying new genetic mutations and epigenetic factors that contribute to its pathogenesis.

(1) Background: Metastatic L-type sarcomas (liposarcoma and leiomyosarcoma) are rare and have a poor prognosis. Trabectedin is an effective agent that can be used after anthracyclines. This study was designed to evaluate the real-life effectiveness and safety of trabectedin. (2) Methods: A retrospective multicenter study was conducted on patients who were treated with trabectedin for metastatic L-type sarcomas at ten tertiary oncology centers between 2015 and 2023. The objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF), and overall survival (OS) were evaluated in the cohort. Cox regression analysis was used to determine prognostic factors for survival. (3) Results: A total of 98 patients (52% liposarcoma and 48% leiomyosarcoma) were included in the study. The median treatment line was three (range: 1 to 6). Thirteen patients (13.3%) underwent local treatment due to oligoprogression, and dose reduction was required in seventeen patients (17.3%) due to toxicity. The ORR and DCR were 16% and 42%, respectively. The median TTF was 3 months, and the median OS was 10 months. In univariate analysis, a significantly longer median TTF was observed in patients who underwent local treatment (p = 0.008), obtained objective responses (p < 0.001), and underwent dose reduction (p = 0.002). No statistical differences were observed according to the histologic subtype and metastatic site. In the multivariate analysis for OS, it was found that obtaining an objective response was a good prognostic factor (p = 0.003), while the presence of liver metastases was associated with a poor prognosis (p = 0.016). (4) Conclusion: Trabectedin is a suitable option for L-type sarcoma after doxorubicin-based treatments. Survival was not worse in patients who underwent dose reduction. The use of local therapies simultaneously with trabectedin can be effective.

Transition metal-doped diluted semiconductor materials have attracted significant interest in spintronic applications. In order to investigate the structural, optical, electrochemical, and magnetic properties of these diluted magnetic semiconductors, transition metal-doped ZnO thin films were successfully produced at room temperature using a low-cost sol-gel spin coating technique with the same molar ratios. XRD analyses revealed that all samples adopted the crystal structure of ZnO. Optical measurements indicated high transparency in the visible region for all samples, while electrical measurements confirmed that all samples were n-type semiconductors. Finally, magnetic measurements showed that pure ZnO and Al-doped ZnO exhibited diamagnetic behavior, while Ni and Co doped ZnO displayed magnetic behavior. These results show that Co and Ni-doped ZnO films can be used as diluted magnetic semiconductor materials in spintronic applications.