PubMed İndeksli Yayınlar Koleksiyonu

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Emergency Department Nurses’ Knowledge and Practices Related to Extravasation Injuries of Non-Cytotoxic Medications
(Turkish Association of Trauma and Emergency Surgery, 2025) Kuğu, Emre; Akyüz, Nuray
BACKGROUND: Extravasation of non-cytotoxic medications can lead to serious complications such as pain, tissue necrosis, limb loss, and even death. This descriptive cross-sectional study aims to assess the knowledge levels of emergency department (ED) nurses regarding extravasation incidents involving non-cytotoxic medications and to highlight the importance of effective management and prevention. METHODS: The study was conducted in the EDs of three hospitals in Istanbul, Türkiye, between November 19, 2020 and December 31, 2020. A total of 100 ED nurses participated in the study. Inclusion criteria required nurses to be working full-time in the EDs during the study period and to provide written and verbal consent. The study utilized a survey to assess sociodemographic characteristics, knowledge of non-cytotoxic medications (e.g., epinephrine), symptoms of extravasation, prevention strategies, and intervention practices. RESULTS: The mean age of the nurses was 29.43 years, with 57% female and 73% holding a bachelor’s degree. Among participants, 52% had 0-3 years of ED experience. Ninety-one percent reported not receiving education on extravasation after graduation, and 82% indicated no extravasation protocol was in place at their workplace. Knowledge about non-cytotoxic medications causing extravasation significantly increased with ED experience (p=0.035). Nurses in units with an extravasation protocol had significantly higher knowledge levels (p=0.007). Female nurses demonstrated better knowledge of extravasation symptoms than male nurses (p=0.012). Nurses with a bachelor’s or higher degree had significantly better knowledge than others (p=0.015). The knowledge rate for the extravasation care protocol was 64%, with the most recognized protocol item being “immediately stop the infusion” (97%) and the least recognized being “aspirate the medication not to exceed 3-5 mL” (33%). Strong correlations were found between non-pharmacological factors and knowledge of non-cytotoxic medications (r=0.601; p<0.001), as well as between knowledge of extravasation care protocols and non-pharmacological factors (p<0.001). CONCLUSION: The study highlights the need for targeted education and the establishment of institutional protocols for managing and preventing extravasation in EDs. Nurses' knowledge significantly impacts their adherence to prevention and care protocols. To ensure patient safety, it is important to provide ongoing education and implement evidence-based intervention protocols for the management of extravasation in ED settings. © 2025 Elsevier B.V., All rights reserved.
Measuring Shoulder Abduction Strength Using 2 Different Dynamometers: Comprehensive Intrarater and Interrater Reliability and Validity
(2025) Atli, Ecenur; Topaloglu, Mahir; Hoşbay, Zeynep Y.; Razak Özdinçler, Arzu
Objective: The purpose of this study is to investigate the intrarater and interrater reliability of handheld dynamometer (HHD) measurements in assessing isometric muscle strength of the shoulder abductors and to compare these results with those obtained using a fixed dynamometer (FD). Methods: The study involved 25 voluntary participants, all over the age of 18, asymptomatic (with no injuries in the upper extremity), and not engaged in overhead sports. The participants were evaluated twice by 2 di!erent testers who were experienced in orthopedic rehabilitation, at 90 degrees of shoulder abduction in the scapular plane. On the first measurement day, Tester 1 performed measurements using both HHD and FD, while on the second measurement day, both testers used only the HHD. A 3- to 7-day interval separated the 2 measurement sessions. Paired-samples t-tests were used to evaluate the systematic bias between the testers. Spearman's rank correlation coe"cient, intraclass correlation coe"cient, standard error of measurement, and minimal detectable change were calculated. The statistical significance level was accepted as P < .05. Results: Data from 22 participants (15 women, 7 men; mean age: 23.00 ± 3.19 years) were analyzed, as 3 individuals did not attend the final assessment. A strong correlation (r=0.772) was found between Tester 1's HHD measurements and FD, while a similarly strong correlation (r=0.748) was observed for Tester 2's HHD measurements. Excellent intrarater reliability (intraclass correlation coe"cient [ICC]=0.941) was found between Tester 1's measurements, and excellent interrater reliability (ICC=0.889) was found between testers. Conclusion: Handheld dynamometer has demonstrated excellent interrater and intrarater reliability and high validity for assessing shoulder abductor muscle strength in research and clinical use. Since the muscle strength of testers using the HHD may influence the results, the FD may be a more appropriate option when the study population is stronger than the testers. Studies involving di!erent clinical populations and testers with varying experience levels are needed to improve the relevance of the results. Level of Evidence: Level III, Diagnostic Study. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
Consensus Paper on Candida Auris by Türkiye EKMUD, ID-IRI, THSK of Ministry of Health of the Republic of Türkiye, KLIMUD, TMC, TARD, and TYBD
(Tubitak Scientific & Technological Research Council Turkey, 2025) Agalar, Canan; Erdem, Hakan; Cag, Yasemin; Arda, Bilgin; Balik, Recep; Bastug, Aliye; Arikan Akdagli, Sevtap
Candida auris is an emerging fungal pathogen that has become a critical global health concern due to its high antifungal resistance and potential to cause nosocomial outbreaks. Since its initial identification in Japan in 2009, C. auris has spread rapidly, posing significant treatment challenges across various healthcare settings worldwide. The biofilm formation ability of C. auris enhances its resilience against disinfectants and antifungal agents, complicating infection control in healthcare environments. This consensus report was developed by a collaboration between several Turkish medical societies including the Turkish Society of Infectious Diseases and Clinical Microbiology Specialty (EKMUD), the Turkish Society of Anesthesiology and Reanimation (TARD), the Turkish Intensive Care Society (TYBD), the Infectious Diseases-International Research Initiative (ID-IRI), the Clinical Microbiology Specialist Society (KLIMUD), the Turkish Microbiology Society (TMC), and the Public Health Institution of T & uuml;rkiye (PHIT) under the Ministry of Health. The report provides a comprehensive overview of C. auris and its management, with a focus on the epidemiology, antifungal resistance mechanisms, recommendations for diagnostic and therapeutic challenges, infection control and prevention measures, and surveillance of C. auris. This consensus report aims to establish standardized diagnostic protocols, improve national surveillance systems, and promote effective infection control measures to mitigate C. auris-related health risks in T & uuml;rkiye. It also offers comprehensive national recommendations and addresses the need for interinstitutional collaboration, improve public health, and strengthen the healthcare response to this pathogen.
Effect of Progressive Muscle Relaxation on Postoperative Pain in Laparoscopic Living Kidney Donors: A Randomized Controlled Trial
(BMC, 2025) Akinci, Naile
Aim This study aimed to evaluate the effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors. Design This was a randomized controlled, single-blind trial. This study was conducted in accordance with the CONSORT statement. Methods This study was conducted between January and September 2023 and included 62 patients (study group = 31, control group = 31) who met the inclusion criteria and underwent laparoscopic living donor nephrectomy in the transplant service of a private hospital in Istanbul province. A power analysis was performed to calculate the sample size and the power of the study (G*Power 3.1). Study data were collected using a patient information form, a postoperative patient follow-up and evaluation form to record the total number of bolus requests and administrations via of boluses with the PCA device and additional analgesic needs, and the Visual Analog Scale (VAS). The data obtained in the study were analyzed on the SPSS 22.0 statistical software. Results Additional analgesic requirements did not differ significantly between groups where progressive muscle relaxation exercises were applied and the VAS score and bolus requirement were significantly lower than in the control group (p < 0.05). Anxiety levels were also significantly reduced in the experimental group compared to both their pre-test scores and the control group (p < 0.05). Although the time to resume oral intake did not differ significantly between the groups (X-2 = 5.020; p = 0.170 > 0.05), the time to start mobilization was significantly earlier in the experimental group (X-2 = 8.808; p = 0.012 < 0.05). As a result of the study, it was found that progressive muscle relaxation exercises reduced postoperative pain, bolus requirements, and anxiety in patients undergoing living donor nephrectomy. Additionally, these exercises facilitated earlier mobilization following surgery.
Turkish Translation and Cross-Cultural Adaptation of the Pelvic Floor Dysfunction-SENTINEL Screening Tool: A Methodological Study
(Springer London Ltd, 2025) Celenay, Seyda Toprak; Dusgun, Elif Sena; Arslan, Mesut; Kaya, Derya Ozer
Introduction and Hypothesis To translate and perform cultural adaptation of the Pelvic Floor Dysfunction-SENTINEL (PFD-SENTINEL) screening tool into Turkish and to establish its reliability and validity for female athletes. Methods The study included 200 female athletes (mean age 22 +/- 4 years). The translation of the PFD-SENTINEL, which comprised the symptoms related to PFD and item sections related to general risk factors and sports-related risk factors, was performed in accordance with international recommendations. The severity of PFD symptoms was assessed with the Pelvic Floor Distress Inventory-20 (PFDI-20). Psychometric analyses consisted of assessing the following: internal consistency reliability using the Kuder-Richardson-20 (KR-20) coefficient, construct validity using confirmatory factor analysis, and criterion validity. Results The reliability was acceptable for the PFD-SENTINEL items assessed using the KR-20, at 0.581, indicating moderate internal consistency. All fit indices except standardized root mean square residual indicated a perfect fit for the final models. Criterion validity was supported by positive correlations between the PFD-SENTINEL symptom score and the PFDI-20 score (r = 0.724, p < 0.001) and between the PFD-SENTINEL item score and the PFIQ-20 scores (r = 0.334; p < 0.001). Conclusions The Turkish version of the PFD-SENTINEL is a reliable and valid instrument to screen for PFD in female athletes.
Unraveling the Persistent Renal Impact of Intrauterine Growth Restriction and Catch-Up Growth: Integrating Morphological Insights with Metabolomic Profiling
(Springer, 2025) Esrefoglu, Mukaddes; Koktasoglu, Fatmanur; Bayindir, Nihan; Cimen, Fatma Bedia Karakaya; Kirmizikan, Seda; Hekimoglu, Emine Rumeysa; Selek, Sahabettin
The study aimed to investigate the long-term effects of IUGR and consequent catch-up growth on metabolic health by using a comprehensive approach that included histopathological, immunohistochemical, biochemical, and metabolomics analyses. Sprague-Dawley pregnant rats either undergo bilateral uterine artery ligation or a sham surgery on the 19th day of gestation. The offspring reached catch-up growth, kidney samples were collected at postnatal weeks 2, 4, and 8 for analysis. IUGR rats exhibited a spectrum of changes including reduced glomeruli number, proliferating cell number, altered oxidative stress markers, various enzymes involved in Krebs cycle, mitochondrial dynamics, and energy metabolism. Examination of the 8-week-old cohort identified a broader spectrum of metabolic alterations, notably in the biosynthesis of phenylalanine, tyrosine, and tryptophan, phenylalanine, tyrosine, glyoxylate, dicarboxylate, pyruvate, alanine, aspartate, and glutamate metabolism, glycolysis/gluconeogenesis and citrate (TCA) cycle. Our metabolomics analysis provides insights into the potential disease susceptibility of individuals born with IUGR, including obesity, diabetes, hypertriglyceridemia, cardiovascular diseases, and mental retardation. These findings underscore the intricate interplay between intrauterine conditions and long-term metabolic health outcomes, highlighting the need for further investigation into preventive and therapeutic strategies to mitigate the risk of metabolic diseases in individuals with a history of IUGR.
Synthesis, Characterization, and Antimicrobial Evaluation of Some Novel Hydrazinecarbothioamides
(Galenos Publ House, 2025) Dincel, Efe Dogukan; Kuran, Ebru Didem; Dinc, Harika Oyku; Basoglu, Faika; Guler, Emrah; Ulusoy Guzeldemirci, Nuray
Objectives: This study focused on synthesizing and characterizing novel thiosemicarbazide derivatives containing a 1,2,4-triazole moiety and evaluating their antimicrobial activity against several bacterial strains. The research aimed to identify key structural features that enhance antimicrobial efficacy through structure-activity relationship analysis and identify the minimum inhibitory concentration (MIC) of the most potent compounds to assess their potential for further development as antimicrobial agents. Materials and Methods: Nine novel thiosemicarbazide derivatives containing a 1,2,4-triazole moiety were synthesized by reacting 1,2,4-triazole derivatives with thiosemicarbazide precursors, and the products were characterized using infrared spectroscopy, proton nuclear magnetic resonance (1H-NMR), carbon-13 nuclear magnetic resonance (13C-NMR) spectroscopy, and elemental analysis. The antimicrobial activity of these compounds (5a-i) was tested against Klebsiella pneumoniae (K. pneumoniae), Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa (P. aeruginosa), using microdilution, disk diffusion, and broth microdilution methods. Dimethyl sulfoxide was used as a negative control, and Vancomycin and Meropenem were used as positive controls, with all results converted to mu M for consistent analysis. Results: The synthesized thiosemicarbazide derivatives (5a-i) were confirmed to be structurally correct through Fourier-transform infrared spectroscopy, 1H-NMR, and 13C-NMR spectroscopy. Among the tested compounds, 5e (4-bromophenyl) and 5g (n-propyl) showed significant antimicrobial activity, with 5g exhibiting the strongest effects against S. aureus and P. aeruginosa. Other derivatives, such as 5b (4-NO2Ph), 5c (4FPh), and 5d (4-ClPh), showed moderate activity, while no significant activity was observed against K. pneumoniae or E. faecalis. Conclusion: The study successfully synthesized a series of novel thiosemicarbazide derivatives with a 1,2,4-triazole moiety and evaluated their antimicrobial potential. Compounds 5e and 5g exhibited significant antibacterial activity, particularly against S. aureus and P. aeruginosa, with MIC values in the low micromolar range. These findings suggest that the compounds hold promise as potential antimicrobial agents, and further studies should focus on optimizing their efficacy and exploring their mechanism of action.
Investigation of Novel Nimesulide Derivatives Against Breast Cancer
(Academic Press Inc., 2025) Birgül, Kaan; Atlıhan, İrem; Dere, Damla; Yelekçi, Kemal; Tiber, Pınar Mega; Orun, Oya; Küçükgüzel, Sükriye Güniz
This study focused on the synthesis of novel nimesulide semicarbazone derivatives and the evaluation of their cytotoxic potential against luminal-A (MCF-7) and triple-negative (MDA-MB-231) breast cancer cell lines. Additionally, their effects on mitochondrial membrane potential (MMP), apoptosis, and mitogen-activated protein kinase (MAPK) pathway modulation were investigated. Breast cancer remains the most prevalent malignancy among women, with luminal-A and triple-negative subtypes posing significant therapeutic challenges due to drug resistance and the lack of effective targeted treatments. The MAPK pathway plays a crucial role in breast cancer progression, making its inhibition a promising therapeutic approach. Non-steroidal anti-inflammatory drugs (NSAIDs), particularly nimesulide, have demonstrated anticancer potential beyond their well-established anti-inflammatory properties. Accordingly, the semicarbazone moiety was incorporated into the molecular scaffold to enhance the antiproliferative efficacy of nimesulide derivatives, as it has been reported to exhibit cytotoxic and apoptosis-inducing effects across various cancer cell lines. A series of nimesulide semicarbazone derivatives (5a–m) were synthesized through multi-step reactions and characterized using elemental analysis, FT-IR, 1H NMR, 13C NMR and Mass spectroscopy (5e). In silico studies were performed to predict their binding affinities to MAPK12. The cytotoxic effects of the synthesized compounds were assessed by determining IC50 values in MCF-7 and MDA-MB-231 cell lines (CCK8 test). Compounds exhibiting strong cytotoxic activity were further examined for their impact on MMP depolarization (JC-1 assay), apoptosis induction (Annexin V-FITC/PI staining), and MAPK pathway modulation (Western blotting of p-ERK and ERK protein). Molecular docking results indicated that the synthesized compounds exhibited favorable interactions with MAPK12, with compound 5e showing one of the highest binding affinity (−9.29 kcal/mol, Ki = 0.154 μM). Cytotoxicity assays revealed that compound 5e had the lowest IC50 values (11.77 ± 0.26 μM in MCF-7; 20.72 ± 0.25 μM in MDA-MB-231), demonstrating significantly higher cytotoxicity than nimesulide. JC-1 assays confirmed that compound 5e induced MMP depolarization at higher concentrations, suggesting apoptosis activation. Flow cytometry analysis further validated a substantial increase in apoptotic cell populations following treatment with compound 5e. Western blot results showed a dose-dependent decrease in p-ERK levels in both MCF-7 and MDA-MB-231 cells, confirming MAPK pathway inhibition. These findings support that nimesulide-based semicarbazones, particularly compound 5e, exhibit potent antiproliferative and pro-apoptotic activity via MAPK pathway modulation, offering a promising avenue for the development of targeted breast cancer therapies. © 2025 Elsevier B.V., All rights reserved.
Ludwig's Angina in a 6-Year Child: Case Report
(Wiley, 2025) Akbari, Negarin; Razavi, Ali; Sabzi, Zahra; Parhiz, Jabbar
Ludwig's angina is a rare but potentially fatal cellulitis that affects the submandibular, sublingual, and submental spaces, typically triggered by dental infections. This case report details a severe presentation of Ludwig's angina in a 6-year-old girl who presented with submandibular swelling, fever, voice alterations, and respiratory distress. Diagnosis was based on clinical evaluation, supported by CT imaging, revealing significant airway narrowing and lymphadenopathy. The patient was promptly intubated to secure the airway, followed by emergency surgical drainage and intravenous antibiotics. Postoperative care included sedation, ongoing monitoring in the PICU, and close follow-up by multiple specialties. After a 10-day hospitalization, the patient showed significant recovery with no complications. The case underscores the importance of early diagnosis and intervention in preventing severe complications such as airway obstruction, sepsis, and mediastinal spread. It highlights the critical role of interdisciplinary collaboration, including pediatric infectious disease specialists, surgeons, and anesthesiologists, in managing this life-threatening condition effectively.
Biological Activities of Etodolac-Based Hydrazone, Thiazolidinone and Triazole Derivatives on Breast Cancer Cell Lines MCF-7 and MDA-MB
(Wiley, 2025) Sevinc, Sevgi Kocyigit; Cikla-Suzgun, Pelin; Tiber, Pinar Mega; Kucukguzel, S. Guniz; Orun, Oya
In this study, several etodolac-based hydrazone, thiazolidinone, and triazole derivatives that we synthesized and characterized in our earlier research were tested against the hormone-responsive breast cell line MCF-7 and the triple-negative MDA-MB-231, as well as the murine origin fibroblast cell line L-929, at varying doses for their effects on cell viability and toxicity and for their inhibitory activity on cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) formation. Cell viability and apoptosis tests were utilized to assess the anti-cancer potential of etodolac and its derivatives after the cells were exposed to varied concentrations of synthesized compounds for three different time periods. ELISA and Western blot methods were used to detect protein levels. All synthesized compounds demonstrated higher anti-cancer activity at significantly lower doses compared to etodolac (half-maximal inhibitory concentration [IC50] of 0-50 mu M range in derivatives versus 0.5-1 mM range in etodolac). Except for SGK 242, which had a major toxic effect on all cells, the chemicals SGK 206 and SGK 217 had a twice-less impact on control murine L-929 fibroblasts. Similar to proliferation, low concentrations of SGK 206 and SGK 217 (25-50 mu M) significantly induced apoptosis in breast cancer cells but not in normal cells. Additionally, they inhibited COX-2 protein expression at 50 mu M, and SGK 206 inhibited PGE2 release more effectively than etodolac in cancer cells. The results of this study suggest that, in comparison to a healthy control group, the thiazolidinone derivative SGK 206 and the thiazolidinone derivative SGK 217 are more effective than etodolac when it comes to the breast cancer cell lines MCF-7 and MDA-MB-231. SGK 206 exhibits a low IC50 value, a distinct dose-response relationship, and strong apoptotic effects, particularly on MDA-MB-231 cells.
Prevalence of Fecal Incontinence After Childbirth in Turkey: Systematic Review and Meta-Analysis
(Springer London Ltd, 2025) Kaya, Husniye Dinc; Gunaydin, Sevil; Kilic, Melek; Ozdemir, Iclal Ilknur
BackgroundFecal incontinence (FI), defined as the reduced or lost ability to control the elimination of solid or liquid stool and gas due to anal sphincter dysfunction, is mostly caused by childbirth.AimThis study aimed to determine the prevalence of postpartum fecal incontinence in Turkey.MethodsThis systematic review and meta-analysis were conducted between December 1 and December 31, 2024, considering inclusion and exclusion criteria. The literature search was performed using PubMed, Science Direct, Medline, Ovid, Ebsco CINAHL Plus, and Cochrane Library databases. The methodological quality of the included studies was assessed using the checklist developed by the Joanna Briggs Institute.ResultsA total of six studies were included in this review. The combined results indicated that the prevalence of postpartum fecal incontinence in Turkey is approximately 3%. Women who delivered by cesarean section had significantly lower rates of FI than those who delivered vaginally (z = 3.10, p = 0.002, CI: 0.39 [0.21, 0.71]). Additionally, the combined results of the studies showed no significant relationship between fecal incontinence and menopausal status, indicating that premenopausal and postmenopausal women had similar rates of fecal incontinence (z = 0.02, p = 0.98, CI: 0.97 [0.10, 9.47]).ConclusionFecal incontinence can occur after childbirth. The postpartum fecal incontinence rate in Turkey is 3%, and it is associated with the mode of delivery but not with menopausal status. A thorough postpartum examination is recommended for the early detection of fecal incontinence.PROSPERO Registration No: CRD420250653603.ConclusionFecal incontinence can occur after childbirth. The postpartum fecal incontinence rate in Turkey is 3%, and it is associated with the mode of delivery but not with menopausal status. A thorough postpartum examination is recommended for the early detection of fecal incontinence.PROSPERO Registration No: CRD420250653603.
Synergistic Effects of Amniotic Membrane and Human Milk Exosomes on Burn Wound Healing
(Elsevier Sci Ltd, 2025) Isik, Ferda; Tufan, Elif; Sivas, Guzin Goksun; Ak, Esin; Muhan, Aleyna; Sener, Goksel; Tunali-Akbay, Tugba
Background: Thermal burns are one of the most common burns. Studies are ongoing to develop synthetic or biological wound dressings to ensure painless and scarless healing of burn wounds. Objectives: This study aimed to combine the human amniotic membrane with breast milk-based exosomes and investigate their effects on burn wound healing. Methods: 24 Wistar Albino rats weighing 200-250 g and of both genders were used. Rats were divided into control, burn, burn+human amniotic membrane (hAM) and burn+hAM+Exosomes (hAM+Exo) groups. Burn injury was induced by exposing the back of rats to 90 degrees C water for 10 s. Rats were treated with hAM and hAM+ Exo for seven days after injury. At the end of the 7th day, the skin samples were taken and analyzed biochemically and histologically. TNF-alpha, IL-1(i, type III collagen, malondialdehyde (MDA), glutathione (GSH), total protein, superoxide dismutase (SOD), and tissue factor (TF) activity were determined in skin samples. Results: In the burn group, skin TNF-alpha levels increased, IL-1(i and type III collagen levels decreased. Wound healing therapy reversed these results. In the hAM+Exo group, the TNF-alpha level was lower, and IL-1 beta and type III collagen levels were higher than in the hAM group. MDA and total protein levels increased, and GSH, tissue factor, and SOD activities decreased in the burn group. In hAM and hAM+Exo groups, MDA levels decreased, and GSH and SOD activity increased compared to the burn group. The GSH levels were significantly higher in the hAM+Exo group compared to the hAM group. Conclusion: In conclusion, combining exosomes and amniotic membrane induced changes consistent with better wound healing than amniotic membrane alone.
TiO2@ZIF-8 Hybrid as a Type II Heterojunction Photocatalyst:Adsorption/Photocatalytic Properties, Kinetics, and Effect of Humidity
(Springernature, 2025) Okte, A. Neren; Tuncel, Duygu
TiO2@ZIF-8 hybrid and its humidified forms are synthesized as type 2 heterojunction systems using a facile sol-gel method at different relative humidity (RH) conditions. The hybrids' surface characteristics and optical properties are thoroughly examined, followed by investigations into adsorption capacities and photocatalytic activities using anionic-methyl orange (MO) and cationic-methylene blue (MB) dyes. TiO2@ZIF-8 hybrid generates a mesoporous structure with a higher surface area (135.6 m2 g-1) than bare TiO2 (40.1 m2 g-1). Band gap energies of TiO2@ZIF-8 (3.00 eV) and humidified hybrids (2.95-2.91 eV) decrease compared to the individual phases of TiO2 (3.08 eV) and ZIF-8 (4.9 eV). XPS analysis verifies the electron donation from ZIF-8 to TiO2. Adsorptions of MO and MB differ depending on the affinities of MO or MB's functional groups on the TiO2@ZIF-8 and humidified hybrids. TiO2@ZIF-8 demonstrates 98.7% MO and 89.5% MB degradations within 100 min irradiation. Dark adsorption studies follow Langmuir model with Langmuir constants of KL = 0.445 L mg-1 for MO in the presence of TiO2@ZIF-8 and KL = 0.409 L mg-1 for MB in the presence of TiO2@ZIF-8 (84% RH). Meanwhile, pseudo-second-order kinetic model is applicable for dark experiments with rate constants of k2 = 0.918 g mg-1 min-1 for MO in the existence of TiO2@ZIF-8 and k2 = 0.917 g mg-1 min-1 for MB in the existence of TiO2@ZIF-8 (84% RH). Under irradiation, TiO2@ZIF-8 (84% RH) has higher first-order rate constant 'k' values for both MO (0.0134 min-1) and MB (0.0146 min-1) relative to that of TiO2@ZIF-8 (0.0129 min-1 for MO and 0.0112 min-1 for MB). Based on Langmuir-Hinshelwood model, TiO2@ZIF-8 (84% RH)) shows the highest adsorption coefficients (K) of 0.164 L mg-1 for MO and 0.192 L mg-1 for MB and rate constants (k) of 0.197 mg L-1 min-1 for MO and 0.182 mg L-1 min-1 for MB. Notably, the hybrids maintain high stability and photocatalytic efficiency after four consecutive degradation cycles, highlighting their potential for sustainable environmental remediation.
The Effect of Compulsory Citizenship Behaviors on Subjective Vitality Among Nurses
(Wiley, 2025) Elibol, Esengul; Yildiz, Bora; Seren, Arzu Kader Harmanci
Aim The study aims to assess the extent of compulsory citizenship behaviors (CCBs) and their impact on the nurses' subjective vitality based on self-determination theory. Background CCBs are harmful to both nurses and organizations. These behaviors mean employees are expected to perform additional tasks outside their job descriptions. Although CCBs are highlighted within the recent nursing literature, empirical evidence of their effects is lacking. Methods This is descriptive cross-sectional research. The study included 244 staff nurses using a convenience sampling method who worked in two hospitals in Istanbul. Data were collected via a survey consisting of a personal information form, the compulsory citizenship scale, and the subjective vitality scale. STROBE guidelines were followed when reporting the study. Descriptive statistical analyses, independent samples t-test, one-way ANOVA test, Pearson's correlation, and hierarchical simple linear regression analyses were used. Results The participants' mean scores for compulsory citizenship and subjective vitality were 3.34 out of 5 (SD = 1.05) and 4.15 out of 7 (SD = 1.36), respectively. Nurses' compulsory citizenship scores significantly differed according to their education level, income, and sector. Their subjective vitality scores statistically differed according to their income levels. Regression analysis revealed that CCBs were significant negative predictors of subjective vitality (beta = -0.22, p < 0.01). Conclusion By examining the CCBs and subjective vitality relationship, the current study extended the existing knowledge by drawing attention to the destructive and harmful effects of CCBs on positive psychological sources of nurses' subjective vitality. CCBs negatively predicted subjective vitality. Clinical Relevance Organizational factors such as CCBs, which leads to a lack of autonomy, affect nurses' well-being, thus affecting care quality and patient safety. As the International Council of Nurses mentioned, "Nurses cope with many physical, mental, emotional, and ethical challenges. It is essential that we address these challenges in a way that supports their overall health". In this regard, managers and policymakers in hospitals should develop preventive cautions for CCBs. However, in-service training activities should be carried out to increase awareness about the harmful effects of CCBs on nurses' psychological well-being.
Efficacy of Different Exercises in Women With Fibromyalgia Syndrome: a Randomised Controlled Trial
(Clinical & Exper Rheumatology, 2025) Sevgin, O.; Bugday, B.; Baykara, R. Aydogan; Gunendi, G.; Akkurt, B.; Atasoy, H.; Karamancioglu, B.
Objective The objective of this study was to evaluate the impact of aerobic exercise, resistance exercise combined with aerobic exercise, and yoga exercises combined with aerobic exercise on pain and disease activity in patients with fibromyalgia syndrome (FM). Methods The study population comprised 60 individuals with FM who met the inclusion criteria. The participants were randomly assigned to one of three groups. The first group underwent aerobic exercise (n=20), the second group combined aerobic exercise with yoga (n=20), and the third group engaged in aerobic and resistance exercise (n=20). All exercise interventions were conducted for a total of 12 weeks. Disease activity was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), while pain status was assessed with the Melzack-Melzack Pain Questionnaire (MMPQ). All assessments were conducted before and following the completion of the exercise programme. The clinical trial number of this study is NCT06006494. Results The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic and resistance exercise group. A statistically significant difference was observed between the groups in terms of post-treatment MMPQ scores. The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic exercise only and aerobic and resistance exercise groups. No statistically significant difference was observed between the post-treatment MMPQ scores of the aerobic and aerobic resistance exercise groups. Conclusion The combination of aerobic exercise and yoga is more efficacious in the treatment of FM than aerobic exercise alone or a combination of resistance exercises and aerobic exercise.
Gold Nanoparticle/Silk Fibroin-Based Nanofiber Enhances Skin Regeneration
(Oxford University Press, 2025) Özcan, Ozan; Tufan, Elif; Muhan, Aleyna Tanrıverdi; Çalişkan-Ak, Esin; Şener, Göksel; Tunalı-Akbay, Tuǧba
Objectives The aim of this study was to determine the wound-healing potential of gold nanoparticles and silk fibroin-based nanofiber produced by green chemistry. Methods The electrospinning method was used to prepare the nanofiber. Twenty rats were exposed to a 7-day treatment period and another 20 rats were exposed to a 21-day treatment period. Rat groups were control, silver, silk fibroin, and silk + gold nanoparticle groups for each period. The effect of the gold nanoparticle/silk fibroin-based nanofiber was examined in skin samples by using biochemical and histological analysis. In biochemical analysis, skin oxidant and antioxidant parameters were determined. Key findings Parameters indicating skin damage returned to their previous levels 7 and 21 days after the wound formation using gold nanoparticle/silk fibroin-based nanofiber. Gold nanoparticle/silk fibroin-based nanofiber initiated hair follicle formation at the wound site and accelerated the re-epithelialization process. Conclusions It was found that the nanofiber prepared by adding gold nanoparticles to silk fibroin had better wound-healing properties than silk fibroin nanofibers without gold nanoparticles. © 2025 Elsevier B.V., All rights reserved.
Effects of Motor Imagery Adding To Physiotherapy and Rehabilitation Program in Children With Duchenne Muscular Dystrophy: Does It Make a Difference
(Elsevier Sci Ltd, 2025) Umut, Gulsena Utku; Ozdincler, Arzu Razak; Ulug, Fitnat; Guler, Serhat; Saltik, Sema
Introduction/background: The study aims to investigate the effects of the MI (Motor Imagery) program applied in addition to the PTR (Physiotherapy and Rehabilitation) program on gait and balance in children with DMD (Duchenne Muscular Dystrophy). Methods: The 38 boys with DMD were included in the study and randomized into two groups: the PTR group (mean age: 7.96 +/- 1.94 years) and the MI + PTR group (mean age: 9.03 +/- 1.71 years). In the PTR group, the PTR program was administered 2 days/week for 8 weeks, and in the MI + PTR group, the MI program was administered 5 days/week in addition to the PTR program. Groups were assessed by the Brooke Lower Extremity Functional Classification Scale, Modified Pediatric Mini Mental Scale, Movement Imagery Questionnaire (MIQc), Kinovea (R) Software Program, Timed Up & Go Test (TUG), Timed Function Tests (TFT), Two-Minute Walk Test (2MWT), and Motor Function Measure (MFM-32). Results: As a result of the study, in PTR Group, TFT-Stairs descending (p = 0.049) was improved. In MI + PTR Group, Kinovea (R) Software Program-Walking Speed (p = 0.003), 2MWT (p = 0.037), TFT-Stair descend and 10-m walk (respectively; p = 0.001; p = 0.039), and MFM-32-D1 (p = 0.036) were improved. According to the comparison between groups, the groups were not superior to each other (p > 0.05). Discussion/conclusion: Although the MI program applied in addition to the PTR program contributes to improvements in walking speed, walking distance, and functional performance in children with DMD, it does not demonstrate superiority over the PTR program alone.
Investigating the Relationship Between Caregiver Burden and Quality of Life in Burn Care
(Elsevier Sci Ltd, 2025) Seyyah, Mine; Reyhanioglu, Duygu Aktar; Kardas, Ayse Sena Yumbul
Aim: This study aimed to examine the relationship between caregiver burden and quality of life among primary caregivers of burn survivors receiving inpatient treatment in an acute care setting. Methods: This cross-sectional descriptive and correlational study included 53 primary caregivers of hospitalized burn patients, recruited from the Burn Care Unit of a tertiary hospital in Turkey between August 2022 and January 2023. Participants were aged 18 or older, identified as the primary caregiver, and able to communicate in Turkish. Individuals with psychiatric disorders were excluded. Data were collected through face-to-face structured interviews using the Zarit Burden Interview (ZBI) and the Short Form Health Survey (SF-36), in which higher scores indicate better quality of life. Descriptive statistics, Pearson correlation, and linear regression were used to analyze the data. Results: The caregivers had a mean age of 38.75 +/- 10.76 years; 71.7 % were female, and 50.9 % had completed only primary education. The average caregiving duration was 10.6 days. The mean ZBI score was 22.54 +/- 15.11, indicating moderate burden. Demographic variables did not significantly affect caregiver burden (p > .05). A moderate negative correlation was found between caregiver burden and their emotional (r = -0.367, p = .007), psychological (r = -0.313, p = .023), and physical functioning (r = -0.355, p = .009) subdomains of the SF-36. Conclusion: A inverse relationship was observed between caregiver burden and caregiver quality of life, especially in emotional, psychological, and physical functioning domains. Although demographic factors were not influential, lower quality of life was associated with greater caregiver burden.
Sensory Processing Skills and School Functions in School-Aged Children With Attention Deficit Hyperactivity Disorder: a Gender-Based Analysis
(Routledge Journals, Taylor & Francis Ltd, 2025) Ceyhan, Irem; Akyurek, Gokcen
Sensory processing skills are important for school functioning, learning and school participation. Children with attention deficit hyperactivity disorder (ADHD) may need additional support in the school context. This study aims to assess sensory processing skills and school functions in children with ADHD, focusing on gender differences. We included 118 children of whom 57 had ADHD and 61 were typically developing peers. Sensory processing skills were assessed with the Sensory Integration and Praxis Test subtests (Postrotary Nystagmus, Standing Walk and Balance, Bilateral Motor Coordination), and school functioning was evaluated using the School Function Assessment. Results showed that children with ADHD had worse sensory processing skills and school function, regardless of gender (p < 0.05). In girls with ADHD, Bilateral Motor Coordination emerged as a significant predictor across some sub-parameters of school functioning (Participation: p = 0.022; task supports: p = 0.020; physical tasks: p = 0.012). In boys, balance was particularly significant predictor of physical (p = 0.008) and cognitive functioning (p = 0.008). Boys with ADHD had more difficulty than girls in cognitive/behavioral task adaptations, setup and cleaning, and eating/drinking. Recognizing gender differences among these children is essential for health professionals to deliver more effective and individualized support interventions.
The Effects of Diaphragmatic Breathing Exercises on Individuals with Premature Ejaculation: A Randomized Controlled Trial
(Oxford University Press, 2025) Erkut, Umit; Karagözoğlu Coşkunsu, Dilber; Erkut, Kubra; Özden, Ali Veysel
Background There are no standardized, evidence-based rehabilitation protocols for premature ejaculation (PE) which hinders effective management, the development of validated patient-reported outcomes, regulatory oversight, and the potential benefits of targeted interventions. Aim To investigate the effect of diaphragmatic breathing exercises (DBE) on PE. Methods Sixty-two participants with PE were randomly assigned to Group I (n = 31) or Group II (n = 31). Both groups received behavioral therapy (BT) and pelvic floor muscle training (PFMT) twice daily, three days a week, for eight weeks. Additionally, Group I recieved DBE twice daily, every day, for eight weeks. Intravaginal ejaculation latency time (IELT) was calculated with a stopwatch, at the end of the 8th week (post-treatment), and at 1-year follow-up. Pelvic floor muscle (PFM) strength and endurance were evaluated with ultrasound, and changes in the in the autonomic nerves system (ANS) parameters (including the root mean square of successive differences [RMSSD], proportion of NN50 [PNN50], low-frequency [LF] power, and high-frequency [HF] power) were evaluated with an Elite HRV device at pre-treatment and post-treatment by a blinded assessor. Outcomes Primary outcome measurements were IELT, PFM strength and endurance, and changes in ANS paramaters. Results The study was completed by 29 participants (mean age = 31.4 ± 6.5 years) in Group I and 30 (mean age = 31.3 ± 7.6 years) in Group II. At post-treatment, all outcome measures showed significant improvements in both groups (P <.001 for all). Compared to Gropu II, Group I showed significantly greater improvements in IELT(P=0.12), RMSDD (P<.001), PNN50 (P=.003), LF Power (P<.001), HF Power (P=.003), strength(P<.001), and endurance (P<.001). The median IELT increase from baseline to post-treatment was 283 seconds (range: 84-870; 900%) in Group I and 204 seconds (range: 44- 581; 690%) in Group II. While IELT declined significantly from post-treatment to 1-year follow-up in Group II, no statistically significant change was found in Group I. Clinical Implications The effect of DBE on the ANS may help regulate the ejaculatory reflex. Strengths and Limitations This is the first study to apply breathing exercises with BT and PFMT in men with PE. Limitations include the lack of exercise adherence records beyond 8 weeks and the estimation-based IELT measurement at baseline. Conclusion Adding DBE, to BT and PFMT, yields better results in IELT (at 8 weeks and 1 year) and inreases PFM strength and endurance of PFM (at 8 weeks) in men with PE. © 2025 Elsevier B.V., All rights reserved.

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