PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8
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Article Machine Learning Model for Predicting Multidrug Resistance in Clinical Klebsiella pneumoniae Isolates(MDPI, 2026) Akkaya, Yuksel; Aydin, Irfan; Tanyildizi-Kokkulunk, Handan; Erturk, Ayse; Kilic, Ibrahim HalilBackground/Objectives: Klebsiella pneumoniae is an opportunistic pathogen increasingly resistant to carbapenems and broad-spectrum antibiotics, complicating timely infection management. In critical cases like septic shock, where initiating effective antibiotics within 3 h improves survival, culture-based resistance testing is often too slow. This study evaluates machine learning (ML) algorithms for faster antimicrobial resistance prediction than conventional methods. Methods: In this retrospective study, antibiogram results of 607 Klebsiella pneumoniae isolates collected between 2017 and 2024 were combined with demographic and clinical information of the patients from whom the isolates were obtained. Four different ML algorithms, namely Decision Tree (DT), Support Vector Classifier (SVC), K-Nearest Neighbors (KNN) and Random Forest (RF), were applied to classify the resistance status for 22 antibiotics. Model performances were evaluated using accuracy, precision, recall, F-score, AUC and feature importance metrics. Results: The RF model showed the highest overall performance in accurately predicting resistance to 22 antibiotics, achieving an average AUC value of 0.96. In particular, it predicted resistance to treatment-critical antibiotics such as Ertapenem (100%), Imipenem (93%) and Meropenem (95%) with high accuracy. Conclusions: ML models, especially RF, offer a powerful tool for rapid antibiotic resistance prediction, supporting accurate empirical treatment decisions and antimicrobial stewardship.Article Investigating Text Neck Syndrome and Duration of Mobile Phone Use, Muscle Activity, Hand Grip Strength, Posture, and Disability(Elsevier Sci Ltd, 2026) Yasaci, Zeynal; Zirek, Emrah; Mustafaoglu, Rustem; Ozdincler, Arzu RazakNeck and shoulder musculoskeletal symptoms related to smartphone use are becoming increasingly prevalent, yet the underlying mechanisms including smartphone usage duration, muscle activity, hand grip strength, posture, and disability remain incompletely understood. This study examined the interaction between text-neck syndrome and factors such as smartphone usage duration, muscle activity, hand grip strength, posture, and disability. Forty participants (Text Neck group: n = 18; 14 females or Control group: n = 22; 15 females) underwent neuromuscular assessment. Surface electromyography measured bilateral muscle activity in the upper trapezius (UT) and abductor pollicis brevis (APB) muscles during smartphone use. Secondary outcomes included the Visual Analogue Scale (VAS) to assess pain intensity, hand grip strength, New York Posture Rating Scale (NYPRS), Neck Disability Index (NDI), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The Text Neck group demonstrated significantly higher smartphone use (p < 0.001), higher texting time (p = 0.006), and lower muscle activation at activity in the dominant APB (p = 0.011), dominant UT (p < 0.001), and non-dominant UT (p = 0.008). These findings provide novel insights into how excessive smartphone use alters muscle function and postural alignment in individuals with text-neck syndrome. Understanding these mechanisms may inform targeted prevention and rehabilitation strategies to mitigate musculoskeletal risk associated with modern technology use.Article Burn Rehabilitation: Evaluation of Physiotherapists' Knowledge and Awareness Levels(Elsevier Sci Ltd, 2025) Seyyah, Mine; Akkurt, Mustafa Ferit; Yilmaz, NergisObjective: The aim of this study was to evaluate the level of knowledge and awareness of physiotherapists working in Turkey about burn rehabilitation. Method: This was a cross-sectional study conducted between March and June 2025 and data were collected using Google Form. A total of 324 people were included in the study. The level of knowledge and awareness of the participants about burn rehabilitation was evaluated with 28 questions created by taking expert opinion. Results: While 25.6 % of participants had experience in burn rehabilitation, only 1.2 % frequently encountered burn patients. Although 60.5 % had taken courses on burn rehabilitation, only 15.1 % considered their knowledge sufficient. Correct response rates to key knowledge questions were 78.7 % for exercise applicability, 79.6 % for timing, 54.6 % for the most common burn type in Turkey, 35.8 % for edema management, and 13 % for pressure garment duration, revealing gaps in clinical knowledge. Additionally, 92.9 % believed early physiotherapy improves recovery, and 98.4 % reported positive effects on quality of life. Discussion: Our results indicate that although most physiotherapists had taken courses on burn rehabilitation, their knowledge remains insufficient, whereas their awareness is high, underscoring the need for targeted training and certification programs.Article Investigation of Novel Nimesulide Derivatives Against Breast Cancer(Academic Press Inc Elsevier Science, 2025) Birgul, Kaan; Atlihan, Irem; Dere, Damla; Yelekci, Kemal; Tiber, Pinar Mega; Orun, Oya; Kucukguzel, S. GunizThis 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 mu M). Cytotoxicity assays revealed that compound 5e had the lowest IC50 values (11.77 +/- 0.26 mu M in MCF-7; 20.72 +/- 0.25 mu M 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.Article 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, TugbaBackground: 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.Article Citation - WoS: 1Citation - Scopus: 2Investigating the Relationship Between Caregiver Burden and Quality of Life in Burn Care(Elsevier Sci Ltd, 2025) Seyyah, Mine; Reyhanioglu, Duygu Aktar; Kardas, Ayse Sena YumbulAim: 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.Article 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; Coskunsu, Dilber KaragozogluBackground 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.Article The Effect of Mirror Therapy on Spasticity in Adult Patients With Stroke: a Systematic Review and Meta-Analysis(Taylor & Francis Ltd, 2025) Tosun, Anil Tekeoglu; Isiklar, Cagdas; Yeldan, Ipek; Tekeoğlu Tosun, AnılObjective This study aims to investigate the effects of Mirror Therapy (MT) on spasticity and related parameters in stroke patients Methods A systematic review was performed in databases PubMed, Web of Science, Science Direct, Cochrane, and Scopus databases for published RCTs (Randomized Controlled Trials) from the date of each database's inception to May 2021. Modified Ashworth Scale (MAS) in adult patients with stroke compared to conventional therapy, sham, and additional therapy control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study. Results The overall effect of MT on MAS was statistically significant and beneficial when studies were analyzed in terms of both upper and lower extremities (p < 0.001). MT demonstrated a large and beneficial overall effect on the Brunnstrom Assessment compared to conventional therapy (p < 0.001). The overall impact of MT on Fugl-Meyer Assessment (FMA) was large and statistically significant (p < 0.001). However, a meta-analysis of three studies using the 10-meter walk test showed that the overall effect of MT was not statistically significant (p = 0.258). Conclusion This systematic review and meta-analysis demonstrates reductions in upper and lower extremity spasticity and improved motor recovery with MT, both isolated and combined with other treatments, in adults with stroke. PROSPERO registration number CRD42021255154.Article Does Prolotherapy Have an Effect on the Care of Pressure Injuries? a Pilot Study(Elsevier Sci Ltd, 2025) Eroglu, Nermin; Kokkiz, Rukiye; Eroglu, Hatice Eda; Kocoglu, HasanBackground: This study contributes to wound healing with prolotherapy in people with pressure injuries. The study was planned and conducted as a randomized controlled trial to determine the effect of prolotherapy on the care of pressure injuries. Methods: The study was carried out with patients with pressure injuries in the intensive care unit of a city hospital between April and June 2023. A power analysis was performed, and the sample size was calculated as 20 patients, including 10 in the intervention and 10 in the control group. The patients in the experimental group were given wound care with gelofusine as prolotherapy in the morning and evening for three days, and the injury site was covered with a sterile sponge and fixation tape. The patients in the control group were treated with saline in the morning and evening for three days. In both groups, the wound width, depth, and length were measured and evaluated prior to each intervention for three days. Results: In the study, a significant difference was found between the mean ages of the participants in the experimental and control groups (p < 0.05). The decrease in width measurements in the experimental group was found to be statistically significant compared to the previous measurements, while the increase in width measurements in the control group was significant compared to the previous measurements (p < 0.05). Depth measurements decreased statistically significantly in the experimental group, while they increased significantly in the control group compared to previous measurement values (p < 0.05). Conclusion: In conclusion, it was determined that the administration of gelofusine for pressure injuries as prolotherapy in the experimental group may be more effective in wound healing than saline treatment applied in the control group. Further studies are warranted.Article Citation - WoS: 2Citation - Scopus: 2Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (icu): a Delphi Study From Multidisciplinary Experts in Turkey(Springer, 2024) Umay, Ebru; Eyigor, Sibel; Demirag, Kubilay; Kaymak Karatas, Gulcin; Gundogdu, Ibrahim; Giray, Esra; Adiguzel, EmreThere is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0-10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU.