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With each passing day, maritime organisations are equipped with more technology, and these systems form a structure that creates international networks. Digitalisation will have implications and effects on value creation, business models, horizontal and vertical integration, services and work organisation. While digital technologies in the maritime sector reduce risks owing to transparency, adaptability, traceability, flexibility and scalability, can also give discernible improvements in terms of operational processes, cost reductions, etc.. In the developing maritime sector, there are a variety of digital technology-related challenges that remain to be overcome, but there is no structured overview of the main types of challenges/barriers encountered by specialists. In this study, we explore the challenges/barriers to digitalisation in the maritime sector and how these are perceived by employees in this sector. The aim of our research is to identify these challenges/barriers and understand the relationships between them. To categorise the challenges/barriers, the DEMATEL approach was used. As a result of the analysis, it is seen that the main hindrances to digitalisation in the maritime sector are the problems of complexity, integration and interoperability. In contrast, the difficulties of performance appraisal and scalability emerge as the least important issues affecting the implementation of digital technologies in this area. Our results indicate that economic problems exert a significant causal influence on the other challenges/barriers.

Background: The present study aimed to evaluate the safety and efficacy of transperitoneal laparoscopic adrenalectomy (LA) for large adrenal tumours by comparing the outcomes of tumours larger than 6 cm with those smaller than 6 cm and also to identify the risk factors associated with prolonged operative time in transperitoneal LA. Patients and Methods: One hundred and sixty-three patients underwent LA at our clinic from January 2014 to December 2020. Bilateral LA was performed in 20 of these 163 patients. A total of 143 patients were included in this study. Data were analysed retrospectively from the patients' medical records collected. Results: Large tumour (LT) group consists of 33 patients and the small tumour (ST) group consists of 110 patients. There was no statistically significant difference between the groups regarding conversion to open surgery and complications. A multiple regression analysis was conducted to identify the independent predictors of prolonged operation time. The tumour size ≥8 cm (odds ratio [OR], 19.132; 95% confidence interval [CI], 3.881–94.303; P < 0.001) and diagnosis of pheochromocytoma (OR, 2.762; 95% CI, (1.123–6.789, P = 0.026) were the significant predictors of prolonged operation time. Conclusion: Our study shows that LA can be considered the treatment of choice for small and large adrenal tumours. The tumour size ≥8 cm and diagnosis of pheochromocytoma are the independent risk factors for the prolonged operative time in transperitoneal LA.

Introduction: This study investigated the relationship between serum interleukin-20 (IL-20) levels and paclitaxel-associated neuropathy in patients with non-metastatic breast cancer. Paclitaxel-induced peripheral neuropathy (PIPN) is a significant side effect of paclitaxel chemotherapy, and the exact mechanism underlying PIPN is not fully understood. Methods: This prospective observational study was conducted with non-metastatic breast cancer patients between January 2022 and November 2022. Neuropathy symptoms were evaluated using the QLQ-CIPN20 questionnaire, and serum IL-20 levels were measured at three time points: before chemotherapy, on the 7th day after the first paclitaxel treatment, and after the last treatment. Univariate and multivariate logistic regression analyses were performed to identify factors predicting PIPN. Results: This study was completed with 59 female patients. During the study, 47 patients (79.6%) reported any degree of neuropathy, whereas 12 patients (20.4%) had no neuropathy. Univariate analysis to predict neuropathy measured on day 7 after first paclitaxel administration demonstrated that age, body mass index, 7th-day serum IL-20 level, and last cycle serum IL-20 level were predictive for PIPN. Conclusion: This study demonstrated the relationship between serum IL-20 levels and paclitaxel-related neuropathy in breast cancer patients. Further research targeting the function of IL-20 is needed to investigate potential strategies to prevent and treat PIPN.

Mezhep taassubunun yoğun olduğu Hicri V. Yüzyılda fukahânın birçok mezhebe mensup olduğu görülür. Beşinci yüzyılın sonu altıncı yüzyılın başlarında yaşayan Begavî’nin de yaşadığı çevre ve ilim tahsil ettiği hocalarının etkisiyle olmalı ki, amelen Şâfiî mezhebine mensup olduğu bilinmektedir. Ancak onun Şâfiî mezhebine mensup olması bu mezhebe taassupla bağlandığı anlamını gelmemelidir. Zira Begavî bir konuda kuvvetli olduğuna inandığı bir delil binaen hüküm verdiğinde mensubu bulunduğu mezhebin müftâbih görüşüne muhalif olsa dahi onu savunur. Bu da mensubu olduğu mezhebin dahi onu özgür ictihaddan alıkoymadığını, özgür içtihadın da onu mensup olduğu Şâfiî mezhebinden çıkarmadığını göstermektedir. Her dönemde fukahâ ve mezhepler arasında ihtilafın olduğu bilinmektedir. Şafiî mezhebi kaynakları incelendiğinde, özellikle furû fıkıhta ihtilafın erken dönemde Müzenî (v. 264) ile başlayıp İbn Süreyc (v. 306) ve İstahrî (v. 328) ile devam ettiği sonraki dönemlerde de ziyadesiyle varlığını sürdürdüğü malumdur. Begavî’nin de eserleri incelendiğinde onun da bu geleneği içerisinde yer aldığı görülür. Begavî tefsir, hadis, fıkıh ve kıraat gibi birçok farklı alanda eser telif etmiştir. Begavî’nin tefsir ve hadis alanlarındaki yetkinliği ve şöhreti günümüze kadar ulaşmıştır. Ancak fıkıh alanındaki yetkinliği için, özellikle akademik alanda, aynı şeyi söylemek zordur. Zira bu alandaki yetkinliğini ortaya koyacak kadar akademik çalışmanın yapılmadığını düşünüyoruz. Begavî, fıkıh alanında telif ettiği el-Fetâvâ, Fetâvâ-yı Begavî, el-Kifâye fi’l-furû, Şerhu’l-Muhtasar, Tâcu’l-arûs ve mezhebü’l-hemmî ve’l-bûs, Tercemetü’l-ahkâm fi’l-furû ve et-Tehzîb fî fıkhi İmami’ş-Şafiî eserleriyle mensup olduğu Şafiî mezhebinde söz sahibi olup kendisinden sonra mezhep fukahâsını ve literatürünü etkilemiştir. Begavî’nin fıkıh alanında telif ettiği eserleri arasında et-Tehzîb, genelde İslam hukuku için özelde ise Şafiî mezhebi için temel bir kaynak olarak kabul edilebilir. Çünkü Tehzîb, Şâfiî fukahânın itimat ve istifade edip çokça nakilde bulundukları bir kaynaktır. Begavî’nin Şafiî mezhebine mensubiyetinden dolayı fıkıh alanında telif ettiği eserlerindeki görüşleri, genelde bu mezhebin geliştirdiği doktrin çerçevesinde gelişmiştir. Bununla beraber Begavî, zaman zaman ileri sürdüğü görüşler ile İmam Şafiî’nin görüşlerine ve Şafiî mezhebindeki müftâbih görüşlere muhalefet ettiği olmuştur. Aynı zamanda Hanefi, Maliki ve Hanbeli mezheplerindeki müftâbih görüşlerin aksine görüşler de serdetmiştir. Begavî bu ihtilaflara konu olan görüşlerini bazen ayet ve hadisler ile bazen de kıyasla delillendirmektedir. Çalışmamızda Begavî’nin, dört sünni fıkhî mezhep olarak bilinen Hanefi, Maliki, Şafiî ve Hanbeli mezheplerine ibadet konularındaki ihtilaflarına delilleriyle birlikte yer verilmiştir. Araştırmamızda tespit edebildiğimiz kadarıyla Begavî, İbadetler konusunda, Abdest ve gusülde suyun kullanımında israfın hükmü, abdestte başın mesh edilmesinde vacip olan miktar, abdest alırken sargı (Atel, alçı vb.) üzerine mesh ederek namaz kılanın iyileştikten sonra namazlarını iade etmesinin gerekip gerekmediği ve imamlık yapmada kârî, fakih ve müttakînin önceliği gibi konularda dört mezhebin müftâbih görüşlerine ihtilaf etmiştir. Fukahâ, abdest ve gusülde suyun kullanımında israfın mekruh olduğunu ifade ederken Begavî, abdest ve gusülde suyun israf edilmesinin hükmünün haram olduğunu söyleyerek, fukahâya muhalefet etmiştir. Fukahâ, abdestte başın mesh edilmesinin en az miktarı konusunda farklı görüşler ileri sürerken Begavî, abdestte başın mesh edilmesinin miktarının nasiye kadar olmasının farz olduğunu söylemiştir. Yine fukahâ imamlık yapmada kârî, fakih ve müttakînin önceliği konusunda da farklı görüşlere kani olurken Begavî, bu konuda müttakîyi, kârî ve fakihe tercih ederek bu konu hakkındaki tercihini ortaya koymuştur. Abdest alınırken sargı üzerine mesh ederek namaz kılanın iyileştikten sonra namazlarını iade etmesinin gerekmediği kanaatinde olan cumhura karşı Begavî, Abdest alınırken sargı üzerine mesh ederek namaz kılanın iyileştikten sonra namazlarını iade etmesinin gerektiğini söyler ve bu gibi durumların insan hayatında nadir görünmesinden dolayı namazın iadesinin gerekliliğini beyan ederek görüşünü gerekçeleriyle beyan eder. Bu çalışmayı yapmaktaki amacımız hem Begavî’nin fıkıh alanındaki yetkinliğini hem de gerektiğinde onda mevcut olan özgür ictihad kabiliyetinin varlığını ve bunun sonucunda ortaya koyduğu görüş ve tercihlerini tespit ederek ilim dünyasına arz etmektir.

Background : Atherosclerosis is a disease that cholesterol plaque builds up inside arteries. The process of atherosclerosis starts when certain substances such as cholesterol, fats, and cellular waste products accumulate in the walls of arteries, and the immune system responds to these substances, triggering inflammation. Over time, this inflammation can cause the plaque to grow and harden, narrowing the artery and reducing blood flow. Carotid artery disease (CAD) is a conclusion of plaques in carotid artery. CAD can increase the risk of stroke, a potentially life-threatening condition that occurs when blood flow to the brain is interrupted. Objectives: The objectives of this study were to detect the association between carotid artery stenosis and inflammatory markers. Methods: This study was designed prospectively and included 109 and 100 patients having mild carotid stenosis and severe carotid stenosis, respectively. Further, 101 patients were included in the control group. The carotid ultrasonography was evaluated in all patients. After classifying the plaques into(severe stenosis) categories, they were also grouped into echogenicity plaques, namely, echolucent (soft) and echogenic (hard) plaques. Results: The uric acid (UA) values of the mild and severe stenosis groups were higher than that of the control group (P

Aim:Complementary therapies are being increasingly preferred in patients receiving anticancer therapy to strengthen the effect of chemotherapy and control cancer-related symptoms. In this study, we investigated the prevalence of complementary therapy (CT), the factors associated with its use, physician-patient information sharing about CT use, and the effect of CT on the survival and treatment process in lung cancer patients receiving chemotherapy.Methods:This study was designed as a cross-sectional study including patients who underwent chemotherapy for lung cancer between November 2020 and March 2022 in the department of medical oncology at Tekirdag Namik Kemal University. A structured questionnaire with twenty questions was used. Fluor-18-fluorodeoxyglucose positron emission tomography/CT, and brain magnetic resonance imaging were used to stage the patients. The stages were grouped as early (stages 1B-3A) and advanced (stages 3B-4A).Results:A total of 242 patients included in the study. One hundred and forty-seven (60.7%) patients reported using at least one type of CT since the first diagnosis. “Families/relatives” (n=128; 63.7%) and “other patients” (n=67; 33.3%) were the primary sources from which patients obtained CT information. The most widely used CT methods were recorded as phytotherapy (79.6%) and apitherapy (59.2%). 125 (85%) of the patients said that they used CT to support their existing anticancer treatments. Of the patients using CT, 94 (63.9%) stated that they did not disclose their use of CT to their physicians. The majority of patients stated that their physicians did not inquire about using CT. In the cox regression analysis performed to determine survival benefit, no survival benefit from the use of CT was determined (hazard ratio=0.86, p=0.495). In the subgroup analysis, the use of CT was associated with survival in early-stage patients, but no survival relationship was found in advanced-stage patients (log-rank p=0.027 and p=0.842, respectively).Conclusion:The use of CT in conjunction with medical treatment is common among patients with lung cancer. The influence of the oncologist in guiding the use of CT in cancer patients is weak. Additionally, the use of CT does not provide benefits in terms of survival.

Introduction: Trastuzumab emtansine (T-DM1) is one of the effective treatment options in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients. In this study, we aimed to find the effect of T-DM1 on survival, its tolerability and prognostic factors of T-DM1 treatment. Material and methods: The study was designed as a single-center, retrospective study that included patients treated in the oncology department of a university hospital in Turkey. HER2-positive patients with metastatic breast cancer who had a progression response to trastuzumab and taxane treatment and received T-DM1 treatment for at least 2 months between 2016-2022 were included in the study. Adverse events were defined according to the Common Terminology Criteria for Adverse Events v5.0 (CTCAE). Kaplan-Meier methodology and Cox proportional hazard modelling were used for survival analyses. Results: The median progression-free survival (mPFS) for T-DM1 was 10.4 months and the median overall survival (mOS) was 22 months. In the created univariate cox regression model, liver metastasis, ECOG performance status, and pre-treatment serum CA 15-3 were found to be factors associated with PFS. Liver metastasis (HR=2.54, p=0.019), ECOG performance status (HR=4.66, p=0.002), and serum CA 15-3 (HR= 2.55, p=0.041) maintained their statistical significance for PFS in the established multivariate analysis. In the regression analysis for OS, only ECOG performance status (HR= 2.61, p=0.023) was found to be prognostic. While toxicity occurred in 46 (82.1%) of the patients, grade 3-4 toxicity developed in 10 (17.9%) patients. The most common side effects were anemia, thrombocytopenia, fatigue and nausea. Conclusions: T-DM1 is a safe and tolerable agent that prolongs survival. Liver metastasis, ECOG performance status, and pre-treatment serum CA 15-3 levels are independent prognostic factors for patients using T-DM1.

Objective:We aimed to investigate the factors affecting the complete response (CR) rate and the effect of treatment response on survival in patients with extensive stage-small cell lung cancer (ES-SCLC) who received a combination of cisplatin and etoposide as first-line therapy.Method:This retrospective analysis included 140 ES-SCLC patients, who were followed in an oncology clinic. Patients were divided into two groups as CR and non-CR according to radiological evaluation after first line chemotherapy. Clinical and demographic characteristics and pre-treatment hemogram parameters were obtained from electronic medical record system.Results:While CR was seen in 34 (24.3%) of all patients after the first line chemotherapy, 106 (75.7%) patients were in the non-CR group. On univariate analysis, predictors for CR to treatment were the absence of brain metastasis, receiving 6 chemotherapy cycles and good performance status (p

In this study, we obtain asymptotic expansions for eigenvalues and eigenfunctions of the one–dimensional Sturm–Liouville equation with one classical Dirichlet type boundary condition and two-point nonlocal boundary condition. We analyze the characteristic equation of the boundary value problem for eigenvalues and derive asymptotic expansions of arbitrary order. We apply the obtained results to the problem with two-point nonlocal boundary condition.

Aim:In this study, we investigated the effect of pandemic on the diagnosis-treatment process in breast cancer patients receiving neoadjuvant chemotherapy.Materials and Methods:The clinicopathological characteristics of the total patients who received neoadjuvant chemotherapy for one year during the Coronavirus disease-2019 (COVID-19) pandemic period and one year before the pandemic were compared. A total of 92 patients were analyzed retrospectively.Results:The clinicopathological features in the pandemic and prepandemic periods were found to be similar. While the number of patients was 26 (28.3%) during the pandemic period, it was 66 (71.7%) in the prepandemic period. Pathology reporting time, chemotherapy administration time, preoperative preparation time and overall time from diagnosis to treatment were similar (p=0.305, p=0.171, p=0.104, p=0.061, respectively). Magnetic resonance reporting time was shorter during the pandemic period (p=0.005).Conclusion:The diagnosis and treatment times of breast cancer in patients receiving neoadjuvant chemotherapy in the pandemic period are similar to those in the pre-pandemic period. Nevertheless, decision should be made on a patient-specific basis considering COVID-19 infection risk.

As one of the most widely used tests, the erythrocyte sedimentation rate (ESR) is a measurement of sedimentation reaction in blood samples. Although the recommended method for ESR measurement is the Westergren method, this method has some disadvantages in comparison with automated ESR systems. In this cross-sectional study, we aimed to compare Vision C with the Westergren method.

Background: Cupping therapy (CT) is an ancient medical treatment since antiquity and is used for the treatment of such various disease states as contagious diseases, chronic or acute inflammatory disease, and autoimmune disorders. Ventricular repolarization is represented by QT and corrected-QT (QTc) intervals from surface electrocardiography. Objectives: As novel repolarization parameters, Tpeak-toTend (Tp-Te) interval, and Tp-Te/QT and Tp-Te/QTc ratios are suggested to correlate better with ventricular arrhythmia risk in various clinical conditions than sole QT and QTc intervals. In this study, we aimed to determine whether these parameters changed significantly after CT in healthy individuals. Methods: One hundred and twenty participants (57 women and 63 men; mean age: 49.0 ± 13.0 years) participated in this study. ECGs strips were recorded 1 hour before and 1 hour after CT from each participant, and relevant ECG parameters were compared. Results: Tp-Te interval [69.51 ± 11.54 msec vs 63.15 ± 10.89 msec, p = 0.001], Tp-Te/QT ratio [0.191 ± 0.030 vs 0.174 ± 0.031, p = 0.002] and Tp-Te/QTc ratio [0.175 ± 0.030 vs 0.159 ± 0.026, p = 0.001] were found to be significantly decreased 1 hour after the procedure compared with the pre-procedure values. However, no statistically significant change was observed in mean heart rate, QT and QTc intervals, QT/QRS and cQT/QRS, and frontal QRS/T angle after the procedure compared with the same parameters before the procedure (p > 0.05). Conclusions: In accordance with the results of our study, it is plausible to conclude that CT may exert cardioprotective effect. However, larger scale prospective studies are needed to support our findings.