Istanbul Medeniyet University

This comprehensive review reevaluates psychopathology within the framework of Life History Theory, which examines how organisms allocate their limited time and energy between somatic effort (growth and survival) and reproductive effort (mating and parenting). The article first discusses how environmental harshness and unpredictability during early childhood shape individual life history strategies through developmental plasticity and differential susceptibility mechanisms. In this context, psychopathologies are examined along two main axes: the fast life spectrum, characterized by immediate gratification and risk-taking (externalizing problems, antisocial behaviors, borderline personality disorder), and the slow life spectrum, characterized by extreme caution, rule-bound behavior, and long-term investment (obsessive-compulsive traits and autistic traits). The question of why every strategy does not invariably turn into pathology is explained through expectation-environment mismatch and the general psychopathology factor (p-factor). Furthermore, as an alternative to toxic stress models, the hidden talents hypothesis is detailed, arguing that individuals growing up in stressful environments do not merely suffer cognitive impairment; rather, they can develop context-specific skills such as threat detection and mental set shifting. Consequently, the potential of the evolutionary perspective is emphasized in interpreting the function of symptoms in clinical practice, reducing patient stigmatization, and redefining the goal of therapy as improving the individual's perception of environmental safety rather than merely suppressing symptoms.

This study aims to develop a valid and reliable instrument to measure the overexcitabilities of gifted individuals. Participants comprised 584 gifted students from Science and Art Centers across Turkey during the 2023-2024 academic year. Data were gathered using the draft Overexcitability Areas Identification Scale (33 items) and a Personal Information Form. Validity was assessed through face, content, and construct validity, while reliability was determined using Cronbach’s alpha and item discrimination indices. Exploratory and Confirmatory Factor Analyses (EFA and CFA) were performed on separate samples (300 for EFA, 284 for CFA). Following EFA, nine items were removed. The CFA results demonstrated good fit: χ²/df = 1.856, RMSEA = 0.055, NFI = 0.85, IFI = 0.92, CFI = 0.92, TLI = 0.91. The final 21-item, five-factor scale demonstrated strong reliability (Cronbach’s α = 0.83; McDonald’s Omega ω = 0.80) and validity for assessing the overexcitabilities of gifted middle school students. The results demonstrate that the instrument can serve as a reliable screening and support planning tool within SACs to identify overexcitability profiles of gifted students.

The purpose of this study is to investigate the relationship between hand grip strength (HGS) and erectile dysfunction (ED) in men over 40 years old. The study aims to determine if HGS can serve as an indicator of ED severity and associated health conditions. In this study, 301 male participants were assessed for ED and HGS using standardised protocols. Participants completed questionnaires assessing ED severity, comorbidities and depression, while HGS was measured using a dynamometer and the relationship of the data obtained was evaluated. Participants with erectile dysfunction ED had higher rates of alcohol and cigarette consumption, comorbidities, and depression, along with lower hand grip strength HGS compared to those without ED. Additionally, lower HGS was associated with more severe ED and a higher prevalence of comorbid conditions such as hypertension, diabetes, and coronary artery disease. Our study underscores the potential of hand grip strength HGS as an indicator of ED severity, especially in patients with multiple comorbidities. While causality cannot be established due to the cross-sectional design, the findings support the integration of HGS measurements into clinical practice to enhance ED management and highlight the role of physical fitness in sexual health.

Post-truth çağında dezenformasyon, yalnızca yanlış veya yanıltıcı bilgilerin dolaşımıyla sınırlı kalmayan; toplumsal güvenin aşınması, kamusal aklın zayıflaması ve kurumların meşruiyetinin sorgulanması gibi çok boyutlu sonuçlar doğuran yapısal bir olguya dönüşmüştür. Sosyal medya platformları, hız, erişilebilirlik, düşük maliyet ve algoritmik görünürlük aracılığıyla doğru bilginin etkisini zayıflatmakta ve bireylerin bilgi edinme pratiklerini nesnel olgular yerine siyasal, ideolojik ve duygusal yönelimler lehine dönüştürmektedir. Bu bağlamda çalışma, Türkiye’de 2022 yılında Cumhurbaşkanlığı İletişim Başkanlığı’na bağlı olarak kurulan Dezenformasyonla Mücadele Merkezi’nin sosyal medya paylaşımlarına verilen kullanıcı yorumlarını inceleyerek, dezenformasyon karşıtı kurumsal iletişimin toplumsal güven üzerindeki yansımalarını analiz etmektedir. Kullanıcı yorumları valence, stance ve incivility kriterleri doğrultusunda sınıflandırılmış; elde edilen bulgular, kurumun güvenilirliğinin düşük algılandığını, eleştirilerin çoğunlukla tarafsızlık ve şeffaflık ekseninde yoğunlaştığını ve özellikle kriz dönemlerinde güvensizliğin derinleştiğini ortaya koymuştur. Çalışmanın sonuçları, dezenformasyonun yalnızca bilgi doğrulama pratikleriyle sınırlandırılamayacağını; aynı zamanda demokratik istikrarı, toplumsal güvenin yeniden inşasını ve kurumsal meşruiyetin sürdürülebilirliğini tehdit eden kritik bir meydan okuma olarak değerlendirilmesi gerektiğini göstermektedir.

Background/Objectives: Research on the association between change from baseline in patient-reported outcomes (PROs) and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC) exists. This study evaluated the association between post-baseline PROs and OS in patients with advanced NSCLC who received first-line cemiplimab-based therapy. Methods: We evaluated PRO data from two phase III studies (EMPOWER-Lung 1 [NCT03088540] and EMPOWER-Lung 3 [NCT03409614]) using a Cox proportional hazards model. Twelve pre-specified PRO scales from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Lung Cancer 13 module were evaluated. Landmark analyses were conducted at 3, 6, 9, and 12 months. Time-dependent analyses using change from baseline PROs as a time-dependent covariate were conducted to evaluate the association of post-baseline PRO improvement with OS. Results: At the 3-month landmark, we observed a 56% reduction in the risk of death (HR = 0.44; 95% CI: 0.32-0.62; nominal p < 0.0001) among stable/improved vs. worsened/unobserved PROs for global health status (GHS)/quality of life (QoL). Results at the 6-, 9-, and 12-month landmarks of GHS/QoL were consistent with those at the 3-month landmark. Time-dependent analyses showed that every 10-point improvement in GHS/QoL was associated with a 31% reduction in the risk of death (HR = 0.69; 95% CI: 0.64-0.75; nominal p < 0.0001). Conclusions: In patients with advanced NSCLC who received first-line cemiplimab-based therapy, improvements in post-baseline PROs are associated with improved OS. These results may inform endpoint selection and interpretation of future clinical trials.

Objective: In recent years, targeted therapies and immune checkpoint inhibitors have provided significant gains in survival and quality of life compared to conventional chemotherapies. However, due to biomarker-based selectivity, high cost, and reimbursement restrictions, the concepts of “necessity” and “indication appropriateness” have become controversial from a medicolegal perspective. This study aimed to evaluate the clinical and forensic aspects of innovative cancer drug use by reviewing court case files.Methods: A total of 455 case files submitted between January 1, 2022 and May 31, 2025, were retrospectively analyzed. Demographic data, cancer type and stage, histological subtype, performance status, previous treatments, innovative drug active agents, licensing and indication status, therapeutic intent, and council and board decisions were recorded. Data were evaluated using descriptive statistics.Results: Of the cases, 53.6% were female and 46.4% male; the most common age group was ≥65 years. The most frequent malignancies were lung (35.2%) and breast (20.0%) cancers, and 69.5% of the patients were in stage IV disease. The most frequently used drugs were pembrolizumab (29.7%), nivolumab (16.0%), and atezolizumab (12.5%). Of all uses, 99.1% were licensed and 85.1% were indication-appropriate. Treatment intent was adjuvant in 48.6%, neoadjuvant in 10.1%, and post-progression in 41.1% of the cases. Multidisciplinary council decisions were documented in 47.3% of files, and the Forensic Board concluded that treatment use was “appropriate” in 97.6% of cases.Conclusion: The findings indicate that innovative cancer drugs in Türkiye are mostly used within licensed and guideline-concordant indications. However, the lack of biomarker data and multidisciplinary council documentation constitutes an important limitation in medicolegal evaluations. Addressing these deficiencies would make therapeutic decisions more defensible both clinically and legally.

Ankylosing spondylitis (AS) is a prevalent autoimmune disorder that primarily affects the spinal joints, leading to chronic pain. Defining immune cell programs that contribute to AS is essential for the discovery of translational targets. Because immune function depends on metabolic state, we analyzed single-cell RNA sequencing data from peripheral blood mononuclear cells (PBMCs) of patients with AS and healthy controls (HCs), and constructed genome-scale metabolic models for each immune cell type to quantify differences in pathway activity and reaction fluxes between diseased and healthy conditions. Across datasets, AS showed consistent metabolic reprogramming, with increased flux through purine metabolism, fatty acid degradation, and glycolysis in CD14 monocytes and T cell subsets, including CD4 memory, CD4 naive, and CD8 T cells, indicating coordinated shifts in energy production and biosynthetic demand. To extend these findings, we constructed cell-type-specific protein-protein interaction networks and evaluated differential connectivity. We identified 63 rewired protein hubs across nine immune cell types. RPS11 emerged as a central hub linked to translation and prior evidence of AS pathogenesis. This integrative systems biology approach connects cell-type-specific metabolic alterations with rewired interaction hubs in an accessible clinical compartment, suggesting that PBMC-based multiomics signatures may support future biomarker development and therapeutic prioritization in autoimmune diseases.

Din, eğitim ve aile, insanla birlikte yaşayan olgulardır. Günümüzde toplumsal yapının temeli olan aile kurumu, düşünce ve sosyo ekonomik hayat pratiklerindeki değişime bağlı olarak hızla dönüşmektedir. Modern dönemde yaşanan aile sorunlarının neler olduğu ve İslam’ın aile yapısına dair sunduğu ilkesel ve değer temelli yaklaşımlarla, söz konusu krizlerin çözümünde nasıl bir alternatif oluşturabildiği, çalışmanın temel problemini oluşturmaktadır. Bu çalışma, modern dönemin aileye yüklediği sorun alanlarını tespit ederek, İslam’ın aileyi yeniden inşa etmeye yönelik sunduğu ilkeler çerçevesinde alternatif bir bakış açısı geliştirmeyi amaçlamaktadır. Araştırma, İslami perspektifin aile krizlerine çözüm üretme potansiyelini ortaya koyarken, aynı zamanda modern dünyada maneviyat eksenli bir aile vizyonu inşa etmenin imkanlarını da tartışmaya açmaktadır. Nitel araştırma yöntemlerinden doküman analizinin kullanıldığı çalışmanın bulguları, İslam’ın aile kurumuna yönelik sunduğu değer temelli çözüm önerilerinin, modern dünyada aile bağlarını güçlendirmek için önemli bir rehber olabileceğini göstermektedir. Bu bağlamda çalışma, aile politikalarına yönelik dinî ve kültürel perspektifleri dikkate alan yeni yaklaşımlar geliştirilmesine katkı sağlayacaktır.