Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
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Uluslararası Borçlanma İlişkisi Bağlamında Osmanlı Devleti Mali Kurumlarının Dönüşümü
(Sosyal Bilimler Enstitüsü, 2025-08-13) Gümüş Ömeroğlu, Alev; Kamu Hukuku
The study examines the transformation of the Ottoman State's financial institutional structure in the context of the state's borrowing relationship with international markets in the middle of the century. Imperialism is considered in the thesis as an aspect that accelerated the uneven combined development
dynamics of capitalism throughout the 19th century and is examined as one of the main factors of the institutional transformation experienced by the Ottoman State throughout the 19th century. The creation
of the state's executive apparatus in the axis of the centralization, modernization and establishment of normative law of the state meant the creation of a resource that would standardize capitalist institutional
development and the organization of all kinds of economic, diplomatic and political relations to be established with the West according to Western norms. With international borrowing, the intervention of the European states in the state's financial institutions for the purpose of repaying debts and maintaining state indebtedness began. The dependent development of the Ottoman financial organization in the context of debt management was examined in the thesis with the establishment of the Düyun-u Umumiye İdaresi, an international financial control apparatus.
Toplumsal Düzenin İnşası ve Korunmasında Ceza Hukukunun Rolü
(Sosyal Bilimler Enstitüsü, 2025) Tuğlu Olpak, Ceren; Kamu Hukuku
Throughout the process of transition from the tribal rules produced by humans living in communities in primitive societies to the legal system of the modern state, various views have been developed regarding
the nature of law, primarily under the two headings of natural law and positive law. This thesis adopts approaches that neither base the source and content of law on transcendent elements nor evaluate it solely
according to normative validity criteria. In this study, law and legal norms are interpreted using a dialectical materialist and political economy methodology and are accepted as concepts that can be examined in light of given social and economic conditions. Law enacted by legitimate political authority is shaped in accordance with the demands and characteristics of the sovereign to whom it owes its validity. In this context, the study argues that a legal system that can be applied independently and impartially under equal conditions for everyone and that serves the interests of the entire society cannot exist in class societies, and that norms have a class character. Criminal law,
which is the area where this claim can be most clearly confirmed, therefore forms the focus of this thesis. The function of criminal law is often expressed in doctrine as the protection of social order. The “social
order” referred to here is the existing mode of production, production relations, and the social relations produced by this economic system. In this sense, the study first examines different modes of production,
the legal structures associated with these modes, and the relationship between law and political/economic structures. Subsequently, the role of criminal law as both an ideological and repressive apparatus is
examined, and from this, the class character of criminal norms is revealed. In the final section, contrary to the claims of bourgeois ideologists, it is argued that criminal norms do not have a class-neutral character
but are, on the contrary, one of the most effective tools of the ruling class. This conclusion is supported by various cases examined in light of the class instrumentalist perspective. The cases examined in the study,
involving organizations such as the TKP, DİSK, and TİP, show that these organizations' opportunities to engage in trade union activities and/or politics have been severely restricted by law. The fundamental approach revealed by the identification of the instrumentalization of the cases is that, like all legal norms, criminal norms also have a class character. However, the study also argues that in a classless society, it is possible to speak of a criminal law that is “in the interest of everyone.
Yabancı Dil Öğretiminde Pragmatik Yeterlik Kazanımı
(Türkiyat Araştırmaları Enstitüsü, 2026-07-23) Karagöz Selcan; Yabancı Dil Olarak Türkçe Öğretimi
This study aims to highlight the importance of pragmatic competence in foreign language teaching. Within this scope, near-synonymy, polysemy, homonymy, and metaphors were examined as instructional tools, and a theoretical framework was established regarding the pragmatic aspects of these linguistic phenomena. Based on this framework, it was emphasized that language learning requires not only the accurate use of language in terms of its structural and grammatical features but also its appropriate use according to context, culture, and communicative setting. Subsequently, drawing on the study of Glaser and Limberg (2020), the factors considered effective in the development of pragmatic competence were identified. These factors were classified under three themes: communicative skills, sociopragmatic skills, and interactional skills. Using a qualitative research method, the reading and listening texts, comprehension questions, and writing activities included in the Yeni İstanbul Turkish for Foreigners Coursebook (B1 Level) were analyzed in terms of pragmatic competence. The data obtained were evaluated within the framework of Canale and Swain’s (1983) model of communicative competence and Bachman’s (1990) model of language competence. According to the findings, the reading and listening texts in the coursebook generally contain pragmatic elements that support communicative, sociopragmatic, and interactional skills. However, it was found that the comprehension questions mainly focused on retrieving information directly from the texts, while questions designed to develop pragmatic competence were included only to a limited extent. Therefore, it is suggested that these questions be diversified in a way that encourages learners to interpret, express opinions, and use language appropriately according to context, thereby contributing to the development of pragmatic competence. The writing activities were found to be predominantly semi-controlled in nature and to gradually direct learners toward freer writing tasks in later units. These activities appeared to support the development of learners’ grammatical, discourse, sociolinguistic, and pragmatic competences. Furthermore, writing activities designed for different communicative purposes were found to contribute to learners’ ability to use language appropriately in context. Nevertheless, the largely semi-controlled nature of these activities may limit learners’ independent language production skills. Learners who become accustomed to writing through continuous guidance may experience difficulties when required to write without support, which may negatively affect their self-confidence and motivation. Therefore, it is recommended that writing activities in each unit gradually progress toward freer writing tasks. In conclusion, the coursebook examined was found to support the development of pragmatic competence to a certain extent. However, it is recommended that both the comprehension questions and writing activities be enriched with a greater number of tasks and questions specifically designed to foster pragmatic competence. Such improvements are expected to contribute more effectively to the development of learners’ pragmatic competence.
Kemik İliği Biyopsisi ile İlk Tanı Alan Solid Tümörlerde Klinik ve Laboratuvar Özellikler
(Tıp Fakültesi, 2026-06-05) Dilan Kayaalp; İç Hastalıkları
Kayaalp, D. Clinical and Laboratory Features of Solid Tumors Initially Diagnosed by
Bone Marrow Biopsy. Hacettepe University Faculty of Medicine, Department of Internal
Medicine, Thesis in Internal Medicine Specialty, Ankara, 2026.
Objective: Bone marrow metastasis is an uncommon but clinically significant manifestation
of advanced solid malignancies and is associated with poor prognosis. This study aimed to
evaluate the clinical, hematological, and biochemical characteristics of patients with solid
tumors initially diagnosed by bone marrow biopsy and to investigate their association with
overall survival.
Materials and Methods: A total of 30 patients with bone marrow metastasis from solid
tumors were retrospectively analyzed. Demographic data, primary tumor types, hematological
and biochemical findings, peripheral blood smear results, and survival data were recorded.
Overall survival was analyzed using the Kaplan–Meier method. Survival comparisons
between groups were performed using the log-rank test. Cox proportional hazards regression
analysis was conducted for selected variables.
Results: The median age at diagnosis was 57.5 years, and 73.3% of patients were male. The
most common primary tumors were lung (20%), breast (16.7%), gastric (13.3%), and prostate
cancer (13.3%); in 23.3% of patients, the primary tumor could not be identified. Anemia and
thrombocytopenia were each observed in 75% of patients, while bicytopenia was present in
60.7%. Among patients with available peripheral smear data, leukoerythroblastic changes
were observed in 50%, and features of microangiopathic hemolytic anemia in 25%.
Biochemical abnormalities were frequent, including elevated LDH (80.8%), ALP (85.7%),
CRP (72%), and ESR (65.4%), while hypoalbuminemia was detected in 28.6% of patients.
The median overall survival was 64 days (95% CI: 43.8–84.2 days). No statistically significant
association was found between hematological or biochemical parameters and overall survival.
Conclusion: Patients with bone marrow metastasis from solid tumors have a markedly poor
prognosis with a short median survival. Primary tumors are frequently unidentified, and
anemia and thrombocytopenia are the most common hematological abnormalities.
Leukoerythroblastosis may serve as an important peripheral blood finding suggestive of bone
marrow infiltration. However, conventional hematological and biochemical parameters alone
appear to have limited prognostic value in predicting survival.
Keywords: Bone marrow metastasis, solid tumors, myelophthisis, thrombocytopenia, anemia,
leukoerythroblastosis
GASTROENTEROLOJİ’YE ÖZGÜ YAPAY ZEKA DİL MODELİNİN KLİNİK PRATİKTE KULLANIMI
(Tıp Fakültesi, 2026-04-20) Ali Berkcan Bozdoğan; İç Hastalıkları
Bozdoğan Ali B.: Clinical Use of a Gastroenterology-Specific Artificial
Intelligence Language Model; Hacettepe University Adult Hospital Residency
Thesis, Department of Internal Medicine, Hacettepe University Faculty of
Medicine, Ankara, 2026.
Objective: This study aimed to evaluate the clinical decision support capacity of
GastroGPT, a retrieval-augmented generation (RAG)-based artificial intelligence
language model developed specifically for gastroenterology, and to perform a
comparative analysis with general-purpose large language models.
Materials and Methods: In this retrospective, multicenter comparative model
evaluation study, 200 standardized clinical cases selected from the archives of
Hacettepe University Faculty of Medicine, Department of Gastroenterology were
utilized. Cases were stratified to represent the following subspecialty areas: general
gastroenterology (50%), hepatology (26%), pancreatic diseases (9%), inflammatory
bowel diseases (6%), gastrointestinal oncology (5%), and endoscopy (4%). A total of
eight AI language models were evaluated, comprising four GastroGPT variants
(Deeplake, Faiss, Chroma, and 16K) and four general-purpose models (GPT-4,
Claude, Bard/Gemini, You.com). Model responses were scored by two independent
expert gastroenterologists in a blinded fashion using a 5-point Likert scale across five
criteria: diagnostic accuracy, appropriateness of recommended investigations,
guideline concordance of treatment recommendations, applicability of patient
management strategies, and overall performance. Additionally, hallucination rates,
source attribution quality, and response consistency were assessed.
Results: GastroGPT-Deeplake achieved the highest overall performance score
(53.8±5.9; maximum 60 points), significantly outperforming GPT-4 (50.1±6.8,
p=0.028) and Claude (49.3±7.2, p=0.012). GastroGPT variants demonstrated marked
superiority over general-purpose models in hallucination rates (4.2–6.8% vs. 8.3–
12.1%, p=0.018) and source attribution quality (62.8–78.3% vs. 23.5–34.7%). In the
vector database comparison, Deeplake significantly outperformed Faiss and Chroma
(p<0.001). GastroGPT's mean scores across the five evaluation criteria ranged from 4.00 to 4.21, with the highest performance observed in guideline concordance
(4.21±0.63). Case complexity had a significant effect on diagnostic accuracy
(F=7.361, p=0.0008); diagnostic accuracy scores in high-complexity cases
(3.81±0.83) were significantly lower compared to low-complexity cases (4.43±0.70;
Cohen's d=0.803). No significant performance differences were observed across
disease prevalence categories or subspecialty areas. Inter-rater reliability was excellent
(ICC>0.99, Pearson r=0.814, Cronbach's α=0.802). ROC analysis yielded an AUC of
0.908 for the overall performance criterion.
Conclusion: GastroGPT-Deeplake demonstrated superiority over general-purpose
large language models in both overall performance and safety parameters through
domain-specific RAG integration. The advantages of RAG technology in reducing
hallucination risk and ensuring source traceability are of critical importance for the
safety of medical AI applications. Our findings support the preferential use of domainspecific approaches over general-purpose models in developing AI-assisted clinical
decision support systems for gastroenterology practice.
Keywords: Artificial intelligence, large language model, gastroenterology,
GastroGPT, retrieval-augmented generation, clinical decision support
system, hallucination, vector database