Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/7
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Article Comparative Evaluation of Vision Transformers and Convolutional Networks for Breast Ultrasound Image Classification(Open Exploration Publishing Inc, 2026) Naral S.; Cakmak Y.; Pacal I.; Pacal, Ishak; Cakmak, Yigitcan; Naral, SuleymanAim: Interobserver variability continues to limit the consistency of breast ultrasound interpretation. This study compares two Vision Transformer (ViT) models and two Convolutional Neural Network (CNN) models for automated three-class breast ultrasound classification, with a specific focus on the tradeoff between predictive performance and computational efficiency. Methods: Swin Transformer Base and DeiT Base were evaluated alongside InceptionV3 and MobileNetV3 Large using the public Breast Ultrasound Images (BUSI) dataset, which contains 780 images labeled as benign, malignant, and normal. A consistent on-the-fly augmentation pipeline was applied during training to promote robustness and reduce sensitivity to incidental image variations. Results: Swin Transformer Base achieved the highest test accuracy (0.9167) and F1 score (0.8981). MobileNetV3 Large reached an accuracy of 0.8583 with substantially lower computational demand. The efficiency contrast was pronounced, with Swin requiring 30.33 GFLOPs versus 0.43 GFLOPs for MobileNetV3 Large. Conclusions: On this benchmark, ViT models can yield higher classification performance, while lightweight CNNs offer a strong efficiency profile that may better match deployment-constrained settings. These results suggest that model selection should be guided by both predictive accuracy and operational feasibility within the target clinical workflow. © The Author(s) 2026.Article Comprehensive Proteomic and Metabolomic Analysis of Novel Substituted Fluoroquinolone Derivatives in Escherichia Coli Isolates(John Wiley and Sons Ltd, 2026) Nigiz Ş.; Kulabaş N.; Türe A.; Kablan S.; Koçak E.; Özkul C.; Küçükgüzel İ.; Koçak, Engin; Nigiz, Şeyma; Kablan, Sevilay Erdoğan; Özkul, Ceren; Kulabaş, Necla; Küçükgüzel, İlkay; Türe, AslıAntimicrobial resistance is one of the most important global problems, and new antibiotic requirements have been emerging as a key point in this issue. In the present work, we focused on the efficiency of two novel promising fluoroquinolone derivatives on resistant Escherichia coli isolates at the molecular level. Their mode of action and adaptation process were evaluated by using proteomics and metabolomics analysis. Proteomics analysis showed that two compounds have an effect mainly on the ribosomal process and energy metabolism. Moreover, we observed compounds that affect various important antimicrobial targets, such as ribosomal subunits, phosphotransacetylase, and chaperone proteins. In metabolomics analysis, we found that compounds altered bacterial metabolism directly. Pathway analysis showed that cofactor biosynthesis and energy metabolism were affected mainly by undertreated groups. Our experiments demonstrated that novel fluoroquinolone derivatives have promising results at the molecular level and results will contribute to further studies. © 2026 John Wiley & Sons Ltd.Article Fully Synthetic, Nature-Inspired Exosome-Mimetics for Melanoma Therapy(Elsevier B.V., 2026) Arda Ozturk N.Z.; Majchrzak O.B.; Ulivi G.; Kirmizibayrak P.B.; Borchard G.; Patrulea V.; Ozer O.; Ozturk, Nahide Zeren Arda; Borchard, Gerrit; Ozer, Ozgen; Patrulea, Viorica; Majchrzak, Oliwia Barbara; Arda Ozturk, Nahide Zeren; Kirmizibayrak, Petek Ballar; Ulivi, GianlucaFully synthetic exosome-mimetics (FSEMs) represent a nature-inspired drug delivery system designed to replicate the key physicochemical and biological properties of natural exosomes, while offering the potential to address limitations in scalability and reproducibility associated with natural exosomes. In this study, we prepared FSEMs at the laboratory scale. We loaded them with (–)-epigallocatechin-3-gallate (EGCG) and microRNA-23a (miR-23a), aiming to co-deliver therapeutic small molecules and nucleic acids for the treatment of melanoma. FSEMs were fabricated using three methods: thin-film hydration, ethanol injection, and microfluidics. They were surface-functionalized with either CD9, a tetraspanin involved in membrane fusion, or TSP-1, an adhesion protein promoting cellular interactions. Through physicochemical characterization via dynamic light scattering, we found that FSEMs were ∼ 100 nm in size, of low polydispersity (∼0.2) and showed a negative zeta potential (∼–55 mV). Both EGCG and miR-23a were efficiently encapsulated. SDS-PAGE analysis confirmed successful protein incorporation and correct positioning. In vitro release studies showed minimal premature leakage, supporting their suitability for cellular uptake-mediated delivery. When tested on melanoma cells (MDA-MB-435) and progenitor human dermal fibroblasts (FE002-SK2), FSEMs selectively killed melanoma cells while sparing fibroblasts. Importantly, EGCG within FSEMs was more effective than the free compound. Compared to conventional DOTAP-based liposomes, FSEMs were more selective and induced less off-target cytotoxicity. This study presents a proof-of-concept for fully synthetic, protein-functionalized FSEMs as dual carriers for both chemical and gene-based agents, offering a safer and potentially more effective alternative to traditional cationic liposomes. These results lay the groundwork for future in vivo validation and translational cancer research. © 2026 The Author(s)Article Integrating 3D-Printed Task-Specific Terminal Devices with a Standard Myoelectric Prosthesis in a Patient with Systemic Scleroderma and Transradial Amputation: A Case Report(Lippincott Williams and Wilkins, 2025) Öztürk B.; Öztürk, BaşarABSTRACT – Objective – The aim of the study was to evaluate the effectiveness of personalized task-specific 3D-printed terminal devices integrated with a standard myoelectric prosthesis in improving functional independence and comfort in a patient with systemic scleroderma and transradial amputation. Methods – A 57-year-old female patient with systemic scleroderma and a left transradial amputation used the following three task-specific 3D-printed adaptive terminal devices—a sock aid, buttoning tool, and jar opener—developed using Tinkercad and fabricated with PLA via FDM printing. These devices were integrated into her pre-existing standard myoelectric prosthesis (Ottobock MyoFacil, four-channel transradial model), which the patient had already been using for daily activities. Functional outcomes were assessed using the Canadian Occupational Performance Measure, Functional Independence Measure (FIM), and visual analog scale (VAS) for pain. Results – Canadian Occupational Performance Measure scores increased from 2/10 to 7–8/10 in performance and satisfaction. Functional Independence Measure scores improved from 4 to 6, reflecting reduced need for assistance in self-care. VAS scores decreased from 7/10 to 3/10, indicating reduced pain during activities of daily living. Conclusions – The integration of low-cost, patient-specific 3D-printed terminal devices with an existing myoelectric prosthesis significantly improved function, independence, and comfort. This case supports further exploration of additive manufacturing as a complementary strategy to enhance prosthetic function in individuals with rare and complex impairments. Clinical Relevance – 3D printing offers a scalable, adaptable solution for task-specific 3D-printed terminal devices, particularly in patients with systemic comorbidities. © 2025 Lippincott Williams & WilkinsArticle Development and Preliminary Psychometric Properties of the Adolescent Sleep Health Belief Scale(Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, 2025) Dikici H.; Kadıoğlu H.; Dikici, Hasret; Kadıoğlu, HasibeAIM: This study aimed to develop a scale based on the Health Belief Model that can reliably and validly evaluate adolescents’ beliefs toward sleep. METHODS: This study was conducted using a methodological design with 494 adolescents between September and October 2022 in Antalya, Türkiye . Eighty-one items about sleep were created according to the Health Belief Model. Validity was assessed in terms of content and construct validity, and reliability was assessed through internal consistency. Content validity was evaluated by ten expert opinions. The scale was tested for construct validity with exploratory factor analysis, after which the scale’s reliability was evaluated by examining item-total correlations using Pearson’s correlation analysis and assessing internal consistency with Cronbach’s Alpha. RESULTS: Item-level content validity index scores ranged between 0.80 and 1. The scale-level content validity index value was found to be 0.94. In the exploratory factor analysis of the 46-item scale, six factors were found with an eigenvalue greater than 1, explaining 57.7% of the total variance. The scale’s itemtotal correlations ranged from 0.26 to 0.79. Cronbach’s alpha coefficients for the subscales were 0.92 for perceived susceptibility, 0.90 for perceived severity, 0.90 for perceived benefits, 0.81 for self-efficacy, 0.79 for motivation, and 0.69 for perceived barriers. CONCLUSION: The Adolescent Sleep Health Belief Scale demonstrated good validity and reliability in adolescents. Its cross-cultural adaptation for use with adolescents in other countries is recommended. © 2025, Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing. All rights reserved.Article Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial(BMC, 2026) Akinci, Naile; Eren, EsraBackground Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.Article Ramadan Fasting and Seizure Activity in Adults with Epilepsy: A Systematic Review and Meta-Analysis(Academic Press Inc Elsevier Science, 2026) Ibrahim, Ismail A.; Shaaban, Sally; Elewa, Mandy; Rahman, Muhammad Samir Haziq Bin Abd; Mohamed, Lobna Ahmed; Talaia, Ahmed M.; Khoo, Ching Soong; Haziq bin Abd Rahman, Muhammad SamirPurpose: Ramadan fasting in Muslims entails abstaining from food and fluids from dawn to sunset, which can influence sleep patterns, medication timing, and food intake. Building on evidence that ketogenic diets and intermittent fasting may improve seizure control, we aim to analyze the link between intermittent Ramadan fasting in adults with epilepsy and seizure activity. Method: We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase between 2000 and January 2025 for articles that appeared between these dates. The terms used for searching included fasting in Ramadan with epilepsy or seizures. The seizure frequency and seizure status of the participants are the outcomes that we analyzed. Two reviewers independently screened and extracted data, with a third resolving any differences that arose between them. Meta-analysis was done using the random-effects model with statistical heterogeneity using the I2 statistic. Results: Of the 1485 articles, only eight were found to be relevant, and 4 of these included 564 patients who met the inclusion criteria. The analysis of the pooled data demonstrated that 61.1% of patients remained seizure-free throughout Ramadan (95% CI: 38.8%-83.4%), with considerable heterogeneity (I2 = 87.7%). Seizure risk was higher in patients on polytherapy with poor baseline seizure control, increased fasting times, or high potassium levels. In contrast, extended seizure-free intervals and increased sleep duration pre-Ramadan were good predictors of safe fasting, and each seizure-free week increased the chance of remaining seizure-free by 10%, as did each extra hour of sleep by 30%. Seizure frequency increases were caused by interruption of daily rhythms, psychological tension, tiredness, and extended fasting. Conclusion: While many patients remained seizure-free during Ramadan, high study variability highlights the need for standardized research. With proper medical supervision, fasting may be safely practiced for selected epilepsy patients.Article The Relationship Between Nurses Anxiety and Attitudes Towards Artificial Intelligence and Examination of Influencing Factors(BMC, 2026) Nirgiz, Cansu; Sari, Merve Kiymac; Cayli, NazanAim to explore the relationships between nurses'anxiety and attitudes toward artificial intelligence (AI) and the factors associated with them. Background Although AI technologies are increasingly integrated into healthcare, research exploring nurses ' psychological readiness and emotional responses to AI remains limited. Existing studies have primarily focused on nursing students or general healthcare professionals, leaving a gap in understanding how practicing nurses perceive and emotionally adapt to AI within real clinical environments-particularly in T & uuml;rkiye, where digital transformation in healthcare is accelerating. Addressing this gap is essential, as nurses play a pivotal role in ensuring the safe and ethical implementation of AI-driven tools in patient care. Methods This descriptive and correlational study included 562 nurses from 14 branches of a private hospital chain across seven Turkish cities between November 2024 and January 2025.This sample was selected because it represents nurses actively engaged in clinical decision-making within healthcare systems that are rapidly adopting AI technologies. According to a power analysis performed in G*Power (rho = 0.25, alpha = 0.05, power = 0.95), the required sample size was 202 participants. Data were collected through an online questionnaire comprising a Descriptive Information Form, the AI Anxiety Scale, and the General Attitudes toward AI Scale. Descriptive statistics, independent samples t-tests, ANOVA (F), Tukey post hoc test, Pearson correlation, and multiple regression analyses were conducted. Ethical approval was obtained from the Fenerbah & ccedil;e University Ethics Committee, and informed consent was obtained digitally. Results Nurses reported moderate anxiety levels and generally positive attitudes toward AI. Male nurses showed an association with lower anxiety levels and higher positive attitude scores than female nurses. Single individuals and those with higher levels of education showed higher positive attitudes toward AI. Those with 0-3 years of experience in the profession were associated with lower anxiety and higher positive attitude scores. Nurses who used AI in practice, were knowledgeable about its use, or perceived it as reliable showed a relationship with lower anxiety and more positive attitudes. Regression analysis showed that each one-unit increase in the learning and AI configuration subscales of the AI Anxiety Scale was associated with a 0.740-and 0.716-point lower score in the total attitude score, respectively. Conclusion The findings suggest that lower levels of anxiety related to learning and AI configuration are associated with more positive attitudes toward AI. Addressing these specific anxiety domains may be related to the successful integration of AI technologies into clinical practice and could be linked to the digital transformation in healthcare.Article Telerehabilitation Transforms Recovery: Elevating Outcomes for Lower Limb Amputees(Wolters Kluwer Health, 2026) Ozturk, BasarBackground: Telerehabilitation provides a viable alternative for individuals facing barriers to in-person rehabilitation because of transportation issues and physical limitations. It enables remote monitoring and guidance, allowing patients to continue rehabilitation at home. Objective: This study aimed to assess the effectiveness of a telerehabilitation program in improving physical and psychological outcomes for lower limb amputees and to evaluate adherence to a home-based exercise program delivered via video. Study design: A randomized controlled trial. Methods: Sixty participants with lower limb amputations were randomized to an experimental group (telerehabilitation) or a control group (standard care). The intervention involved a 4-week supervised phase followed by a 4-week unsupervised phase. Primary outcomes were physical capacity, measured by the Six-Minute Walk Test (6MWT), and psychological status, assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes included adherence rates and patient satisfaction. Results: The experimental group showed significant improvements in 6MWT distance and Hospital Anxiety and Depression Scale scores compared to the control group. The mean 6MWT distance increased by 20% from baseline to the end of the supervised phase (P < 0.01) and was maintained during the unsupervised phase. Anxiety and depression scores significantly decreased (P < 0.05). Adherence was higher during the supervised phase (85%) but dropped during the unsupervised phase (60%). Conclusions: Telerehabilitation significantly improved physical and psychological outcomes for lower limb amputees. High adherence during the supervised phase emphasizes the importance of clinician support, whereas strategies are needed to sustain long-term engagement during the unsupervised phase.Article Mapping the Evolution of Stigmatization in Mental Disorders: A Bibliometric Analysis From 1974 to 2024(Springer Heidelberg, 2026) Goktas, Polat; Dikec, GulBackgroundThis bibliometric study scrutinizes the thematic evolution of research on stigma and discrimination in mental disorders, covering a span of five decades. It reflects on the shifting paradigms within the stigma-focused mental health research community from 1974 to 2024.MethodsA comprehensive bibliometric analysis was employed using the Bibliometrix R package and VOSviewer software, analyzing 1,892 articles from databases like Scopus, Web of Science, PubMed Central, and APA PsycInfo. Adherence to PRIBA guidelines ensured a holistic representation of the evolving research narrative.ResultsThe analysis outlined three distinct periods: the Genesis Period (1974 - 2007), focusing on foundational concepts of mental disorders and stigma; the Growth Period (2008 - 2015), which experienced a broadening into themes of discrimination and diagnostic refinement; and the Rapid Growth Period (2016 - 2024), characterized by a surge in research on child mental disorders and the impacts of posttraumatic stress disorder. Network analyses highlighted significant journals, key authors, and international collaborations that have shaped this field.ConclusionsThe study maps a significant transformation in stigma-focused mental health research themes over fifty years, highlighting the growing complexity and the need for ongoing research into stigma and discrimination. It calls for interdisciplinary approaches to tackle these enduring challenges effectively.