Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
- HÜAES, Hacettepe Üniversitesi bünyesinde üretilen kitap, makale, tez, bildiri, rapor gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.
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AKUT KORONER SENDROMLU HASTALARDA HASTANE İÇİ MORTALİTENİN MAKİNE ÖĞRENME YÖNTEMLERİ KULLANILARAK KESTİRİMİ
(Sağlık Bilimleri Enstitüsü, 2026) Aktürk Sevinç; Biyoistatistik
Akturk, S., Prediction of In-Hospital Mortality in Patients with Acute Coronary Syndrome Using Machine Learning Methods, Hacettepe University Graduate School of Health Sciences, Biostatistics Program, Master's Thesis, Ankara, 2026. This study aimed to compare the performance of different machine learning algorithms in predicting in-hospital mortality in patients with acute coronary syndrome. The retrospective study included 657 patients, and the dataset was stratified according to mortality status, dividing it into 80% training (n=525) and 20% test (n=132) sets. Decision tree, random forest, XGBoost, logistic regression, Naive Bayes, support vector machines, and artificial neural networks methods were used to predict in-hospital mortality. Five-fold cross-validation, hyperparameter and Youden index-based threshold optimization were applied in model development; class imbalance was addressed with SMOTE. Variable significance was evaluated using a model-independent permutation-based approach. The median age of the patients was 62 years (IQR: 53–71), 72.8% were male, and 41.4% had STEMI, with an in-hospital mortality rate of 5.6%. Model performance varied depending on the applied modeling approach. In the baseline evaluation, logistic regression; following hyperparameter and threshold optimization, random forest; among the baseline models with SMOTE, the decision tree; and in the final stage, in which SMOTE, hyperparameter optimization, and threshold optimization were applied together, XGBoost were the models that stood out.In variable significance analyses, acute heart failure, acute kidney injury, leukocytes, and glucose were prominent variables. In conclusion, no single model consistently superior across all performance measures was identified; model performance varied depending on the modeling approach and evaluation criteria. The findings highlight the importance of evaluating model performance in clinical data with class imbalances using different criteria together.
Ankara’daki Bir Üniversite İdari Personelinin Kanser Taramalarına Yönelik Bilgi ve Tutumlarının Değerlendirilmesi
(Tıp Fakültesi, 2026-08-25) Kaan Aksu
Aksu K., Evaluation of Knowledge and Attitudes of Administrative Staff at a University in Ankara Regarding Cancer Screenings, Hacettepe University Faculty of Medicine Department of Public Health, Public Health Specialty Thesis, Ankara, 2026. This research was conducted to determine the knowledge levels, attitudes, and the variables influencing these factors among administrative staff working at the Beytepe Campus of a state university in Ankara regarding breast, cervical, and colorectal cancer screenings within the scope of national cancer screening programs. Cancer is recognized as one of the most significant public health problems both globally and in Türkiye due to high mortality rates, disability, and treatment costs. The success of early diagnosis and organized screening programs (such as KETEM, Family Health Centers, etc.) depends on the adoption of these programs by the target population and a participation rate exceeding 70%. This descriptive epidemiological study was carried out on 398 volunteers accessible within the university administrative staff population. Data were collected using a comprehensive questionnaire including sociodemographic characteristics, history of chronic diseases (most commonly thyroid, diabetes, and hypertension), healthy lifestyle habits such as tobacco and alcohol use, as well as the validated and reliable "Attitude Scale Towards Cancer Screenings" (24 items, maximum 120 points) and "Knowledge Scale Towards Cancer Screenings" (25 items, maximum 25 points). According to the findings, 63.6% of the participants were female, the mean age was 45.5, and 82.7% of the staff had a university or postgraduate education level. While 53.8% of the participants stated they were informed about national cancer screening programs, family physicians (48.6%) and social media platforms (36.9%) emerged as the primary sources of information. Only 34.8% of the staff had undergone at least one cancer screening in their lifetime; among these, breast cancer (81.2%) and cervical cancer (66.9%) screenings were common, while colorectal cancer screening remained significantly behind targets at 18.7%. The fact that a vast majority (80.4%) of those who did not undergo screening cited "not having any complaints" reveals an insufficient awareness that screenings are intended for asymptomatic individuals. Statistical analyses showed that women's median scores for both attitude (104.0) and knowledge (18.0) were significantly higher than those of men (p < 0.05). According to the knowledge scale results, 44.4% of the participants had an adequate level of knowledge (17.5 points and above). Statistical analyses revealed a positive and low correlation between knowledge levels and attitude scores (r=0.380; p<0.001). According to multivariate regression results, having children under the age of 18 negatively affected attitudes, whereas having knowledge and experience had a positive impact. Meanwhile, female gender, 55–64 age group, physical activity, and KETEM awareness were identified as the strongest predictors of the knowledge score. In conclusion, screening participation is low even among a highly educated group of university staff; therefore, it is recommended to develop strategies to increase participation in colorectal screenings—especially among male staff—to promote screening behavior as a preventive routine rather than a symptom-oriented action, and to expand institutional awareness training.
ÜÇ BOYUTLU YAZICI ARACILIĞI İLE HAZIRLANAN MİR- 132 VE TRANSFORME EDİCİ BÜYÜME FAKTÖRÜ-ß3 YÜKLÜ LİPOZOM İÇEREN DUAL ETKİLİ KİTOSAN HİDROJEL İSKELELERİNİN TEDAVİ ETKİNLİĞİNİN YANIK YARASINDA DEĞERLENDİRİLMESİ
(Sağlık Bilimleri Enstitüsü, 2026-09-02) SEZER AYSİMA; Eczacılık Temel Bilimleri
Although mortality rates in burn injuries have decreased, hypertrophic scarring that develops after burns reduces the quality of life of individuals and adversely affects their social participation. In this thesis, the combined use of the anti-inflammatory and pro-angiogenic effects of the miR-132 mimic together with the antifibrotic effect of TGF-β3 was employed to reduce persistent inflammation and TGF-β1-associated scar formation, thereby aiming to accelerate burn wound healing and to promote scarless healing. For this purpose, TGF-β3 was encapsulated into DOTMA/DOPC/CHOL-based cationic liposomes, while the miR-132 mimic was electrostatically complexed with liposomes to prepare lipoplex formulations. To enhance transfection efficiency, the PEGylated formulations were optimized by targeting a particle size of 100–200 nm and a zeta potential equal to or greater than +40 mV. The antifibrotic efficacy of the formulations was evaluated in a fibrosis model induced with TGF-β1 in L929 cells at the gene and protein levels by RT-qPCR and ELISA, respectively. Combined treatment optimized the COL1/COL3 ratio and produced a balanced antifibrotic response in collagen, MMP13, MMP9, RASA1 and cytokine levels. TGF-β3-loaded liposomes and miR-132-loaded lipoplexes were incorporated into chitosan-based hydrogel scaffolds fabricated by 3D printing in order to provide local and controlled release. The optimized hydrogel formulation exhibited appropriate printability and rheological properties; dispersion of the liposomes/lipoplexes within the hydrogel altered the swelling, degradation and mechanical properties, and the structural properties were evaluated by SEM, DSC and FTIR analyses. In the release studies, TGF-β3 release continued over 312 h and reached 96.64%, whereas 9.84% release was obtained from the miR-132 lipoplexes over the same period, with burst release being limited. In a murine burn wound model, the hydrogel scaffold containing miR-132 and TGF-β3 together accelerated wound closure between days 7 and 15 and regulated the COL1/COL3 ratio. Preservation of α-SMA levels in the combination group indicated that myofibroblast activity and contractile capacity were maintained during extracellular matrix remodelling. In conclusion, co-delivery of miR-132 and TGF-β3 from 3D-printed chitosan hydrogel scaffolds via liposome/lipoplex systems was shown to be a promising dual-acting approach for regulating inflammatory and fibrotic processes in burn wounds and for supporting scarless wound healing.
Kolorektal Kansere Bağlı Kolostomisi Olan Bireylerde Travma Sonrası Büyüme: Tanımlayıcı Nitel Çalışma
(Sağlık Bilimleri Enstitüsü, 2026-08-20) Emir Erkazancı, Gizem; Psikiyatri Hemşireliği
This study aimed to explore the experiences of post-traumatic growth among individuals living with a colostomy associated with colorectal cancer. The study was conducted using a descriptive qualitative design. The study population consisted of individuals with a colostomy who visited three firms selling stoma and wound care products to purchase stoma supplies. Using criterion sampling, the sample comprised 20 participants who met the inclusion and exclusion criteria. Data were collected using a "Descriptive Information Form" and a "Semi-Structured Interview Form" developed by the researchers. Semi- structured interviews were conducted either face-to-face or online. Following completion of the interviews, the audio recordings were transcribed verbatim and analyzed using inductive content analysis, resulting in four themes and ten subthemes. The subthemes of ''Shattering Experiences'' were ''Loss'' and ''The Unknown''; the subthemes of ''Dynamics Facilitating Growth'' were ''Support Systems'', ''Adaptation Strategies'', and ''Inner Resources''; the subthemes of ''Growth Experiences'' were ''Reframing the Self'' and ''Reconstruction of Values''; and the subthemes of ''Recommendations Informed by Experience'' were ''Individual Oriented'', ''Social Environment-Oriented'', and ''Service- Oriented''. Participants experienced cancer and colostomy as shattering experiences; social support, coping strategies, and inner resources provided a foundation for growth, while post-traumatic growth was experienced through changes such as enhanced interpersonal relationships, a greater appreciation of life, and spiritual transformation. It is recommended that the elements identified by participants as reflecting their growth experiences be considered by consultation-liaison psychiatric nurses as components in the development of counseling and intervention programs aimed at supporting individuals with a colostomy due to colorectal cancer in achieving growth through this experience, and that the effectiveness of these interventions be tested in experimental studies.
Yedisu Bölgesi Kurganlarının Tarihi ve Kültürel Açıdan Değerlendirilmesi
(Sosyal Bilimler Enstitüsü, 2026) Gülşah Çoban Akkıyal; Tarih
Inner Asia has historically served as a dynamic crucible of intense political, cultural, and ethnic mobility, functioning as the primordial homeland for nomadic societies such as the Turks and Mongols. Characterized primarily by pastoralism and seasonal migrations between summer and winter pastures, these steppe communities utilized portable tents as their most practical adaptation to nomadic life. Concurrently, recent archaeological excavations demonstrate that urban traditions also emerged within this nomadic landscape, beginning as early as the Saka period. This regional dynamism and socio-economic prosperity were profoundly catalyzed by the Great Silk Road, which expanded trade volumes, diversified social capacities, and funded monumental architecture alongside the exceptionally rich funerary contexts discovered today.
Representing all these dense historical characteristics, the Yedisu (Semirechye) region, encompassing a vast territory in southeastern Kazakhstan, stands out as a critical transit zone and a cultural hub for travelers and merchants alike. Consequently, the area preserves an extraordinary abundance of archaeological, written, and architectural remains, including ancient cities, fortresses, graves, tombstones, rock paintings, balbals, and stone statues.
This thesis focuses specifically on the kurgans of the Yedisu region, which constitute the richest repository of archaeological data available for tracing the developmental trajectory of Turkic cultural history back to its earliest epochs. By analyzing distinct kurgan groups dating between the 8th century BC and the 3rd century AD, this study comprehensively examines the material culture and historical traces of early nomadic societies, focusing predominantly on the Saka and Wusun communities.