WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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 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 Assessment of the Nutritional Status of Syrian Refugee Women in the Lactation Period(Sage Publications Inc, 2026) Isik, Tulay; Garipagaoglu, MuazzezBackground: The Syrian civil war has caused large-scale displacement, with many Syrian refugee women migrating to T & uuml;rkiye. Lactation is a critical period requiring adequate nutrition for maternal and infant health. However, data on the nutritional status of lactating Syrian refugee women are limited. Aim: This study aimed to assess the nutritional status of lactating Syrian refugee women who migrated to T & uuml;rkiye due to the Syrian civil war. Methods: A cross-sectional study was conducted between October 5, 2017, and January 29, 2018, with 102 lactating Syrian refugee women with infants aged 0-6 months attending the Istanbul Al Farah Child and Family Support Center. Participants were selected using convenience sampling. Inclusion criteria were being a Syrian refugee woman in the lactation period, having an infant aged 0-6 months, and volunteering to participate in the study. Women with chronic illnesses or metabolic disorders were excluded. Data were collected through face-to-face interviews with the assistance of a translator, using a structured Turkish questionnaire covering demographic information, anthropometric measurements, and 3-day dietary records. Dietary intake was analyzed with the BEBIS9 program and compared to the T & uuml;rkiye Nutrition Guide recommendations. Although the dietary data were collected in 2017-2018, the analysis was conducted using the most up-to-date national guidelines to reflect current public health priorities. Results: Participants (n = 102) had an average age of 27.9 +/- 5.7 years, BMI of 27.3 +/- 4.6 kg/m(2), and monthly income of 1267 TL. Their daily energy intake was 1593.7 +/- 556.5 kcal/day. A large proportion of participants had inadequate intake of micronutrients, with the highest insufficiency observed for pyridoxine (88.2%), followed by vitamin A (81.4%), vitamin C (76.5%), thiamine (71.5%), riboflavin (63.7%), folic acid (81.4%), vitamin B12 (72.6%), iron (62.8%), and zinc (68.6%). Women with higher BMI in early lactation consumed more fat (p < 0.05). Significant associations were found between micronutrient intake and sociodemographic factors (p < 0.05). However, due to the small sample size and use of convenience sampling, the generalizability of the findings is limited. Future studies with larger and more representative samples are needed to confirm these results. Conclusion: Syrian refugee women in the lactation period showed inadequate intake of energy and essential micronutrients, likely due to poor socioeconomic and living conditions. Interventions such as culturally sensitive nutrition education, postpartum micronutrient supplementation, and improved access to migrant-friendly healthcare services are needed. Additionally, targeted policies and sustainable public health nutrition programs-such as food voucher schemes, fortified food distribution, and maternal support groups-should be developed in collaboration with health institutions and NGOs to improve maternal and infant health outcomes in this vulnerable population.Article Nurses on the Frontline of Disaster: A Qualitative Metasynthesis of Post-Earthquake Care Experiences(Wiley, 2026) Kolac, Nurcan; Taylan, Secil; Eroglu, NerminBackground Earthquakes generate urgent and complex care needs, positioning nurses as key responders. Exploring their post-earthquake care experiences is vital for strengthening disaster preparedness and nursing practice.Aim This study aimed to synthesise qualitative evidence on nurses' experiences of providing care in the aftermath of earthquakes.Study Design This research was conducted through a systematic review and meta-synthesis of qualitative studies. The data were analysed using thematic analysis. The qualitative systematic review was conducted using Sandelowski and Barroso's four-step meta-synthesis methodology. This metasynthesis study, conducted in accordance with the PRISMA statement, is registered in PROSPERO. The following electronic databases and platforms were used for the literature review: MEDLINE, Academic Search Ultimate, CINAHL Complete, Complementary Index, Supplemental Index, Directory of Open Access Journals and WOS.Findings Based on 27 included studies, the research identified four main themes and 13 sub-themes related to nurses' post-earthquake care experiences. These themes were: (1) early post-earthquake nursing challenges, (2) conflict experiences, (3) valued experiences and methods of coping with challenges and (4) impact of rescue experiences.Conclusions This research highlighted nurses' post-earthquake care experiences, emphasising how they overcame challenges, redefined their profession and emerged stronger. It also identified the limitations and facilitators within the post-earthquake care environment, providing valuable insights for enhancing care settings during future earthquakes.Relevance to Clinical Practice This study identified limitations and facilitators in the post-earthquake care environment of clinical settings, providing valuable insights to improve care environments during future earthquakes.Article Verification Trials Can Create the Illusion of VO2max in Addition to Contributing to Its Confirmation(Wiley, 2026) Cabuk, Refik; Alp, Egemen; Murias, Juan Manuel; Karsten, BettinaThis study examined whether constant-workload verification trials performed at intensities below, at, and above the ramp-incremental peak power output (PPO) contribute to confirming maximal oxygen uptake (VO2max). Fifteen trained to well-trained male cyclists (VO2max: 63.6 +/- 5.6 mL & centerdot;kg(-1)& centerdot;min(-1)) completed maximal ramp testing followed by seven randomized verification trials (80%-110% PPO at 5% intervals) on separate days. Differences in VO2 responses were analyzed using linear mixed-effects models. Effect size was calculated using Hedges' g. The peak VO2 attained during the verification trials was expressed relative to the ramp-derived VO2max and classified as lower (< 95%), within normal variability (95%-105%), or higher (> 105%). The peak VO2 values at 80%, 105%, and 110% PPO were significantly lower than ramp-derived VO2max (p < 0.05), whereas no significant differences were observed at 85%, 90%, and 95% PPO. Effect sizes were small at 85%-95% PPO (Hedges' g = 0.29-0.32), medium at 100%-105% PPO (Hedges' g = 0.63-0.66), and large at 80% and 110% PPO (Hedges' g = 1.21-1.34). Of 105 verification trials, 81 were within +/- 5% of ramp VO2max, 22 were lower (mainly at 80% and 110% PPO), and two exceeded ramp VO2max (at 85% and 95% PPO). Although verification trials did not meaningfully contribute to the verification of VO2max, trials performed at 85%-95% PPO provided the best chances of confirming VO2max in trained individuals. Interpretation of verification trials relative to ramp-derived PPO is protocol dependent, which may limit generalizability across different ramp designs.Article 1,2,4-Triazole Conjugates as HEGFR Inhibitors: Synthesis, Anticancer Evaluation, and in Silico Studies(Wiley-V C H Verlag GmbH, 2026) Bulbul, Bahadir; Kulabas, Necla; Gurboga, Merve; Ozakpinar, Ozlem Bingol; Cakmak, Ummuhan; Tuncay, Fulya Oz; Kucukguzel, IlkayA series of novel 1,2,4-triazole-acetamide derivatives was synthesized and evaluated for anticancer and hEGFR inhibitory activity. The compounds were obtained via multistep synthesis and characterized by spectroscopic methods. Cytotoxicity was tested against PC-3, MCF-7, A549, and K562 cell lines. Compounds <bold>18</bold>, <bold>19</bold>, and especially <bold>24</bold> showed notable antiproliferative effects, with compound <bold>24</bold> exhibiting higher selectivity and potency than gefitinib. It also induced apoptosis and inhibited migration in A549 and PC-3 cells, while selectively promoting invasion in PC-3, suggesting EMT-related behavior. In vitro kinase assays revealed compound <bold>20</bold> as the most potent hEGFR inhibitor (IC50 = 43.8 +/- 1.3 nM). Molecular docking and 200 ns molecular dynamics simulations confirmed its stable interaction with EGFR, particularly involving Cys797. These findings highlight compounds <bold>20</bold> and <bold>24</bold> as promising candidates for further development as EGFR-targeted anticancer agents.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 Effect of Inspiratory Muscle Training on Diaphragm Function and Activity Performance in Subacute Ischemic Stroke Patients: A Single-Blind Randomized-Controlled Trial(SAGE Publications Inc., 2026) Akçay S.; Akyol D.K.; Erkut Ü.; Karagözoğlu Coşkunsu D.; Kunduracilar Z.; Bajrami A.; Dinç Yavaş A.; Kunduracilar, Zuhal; Coskunsu, Dilber Karagozoglu; Bajrami, Arsida; Akçay, Sümeyye; Akyol, Dudu Kübra; Erkut, Ümit; Karagözoğlu Coşkunsu, Dilber; Yavas, Arzu Dinc; Dinç Yavaş, ArzuBackground: Respiratory dysfunction is common after stroke and may negatively affect functional recovery. Inspiratory muscle training (IMT) has been proposed to enhance diaphragmatic function and activity performance in this population. Objective: To investigate the effects of IMT on diaphragm function and activity performance in patients with subacute ischemic stroke. Methods: In this randomized controlled, single-blind trial, 26 patients with subacute ischemic stroke (>1 month post-onset) were randomly allocated to an intervention group (IG, n = 13) or control group (CG, n = 13). Both groups received standard neurorehabilitation, aerobic training, and the Active Cycle of Breathing Technique (ACBT). The IG additionally underwent IMT, 5 days per week for 6 weeks (30 sessions). Assessments included maximal inspiratory and expiratory pressures (MIP, MEP), diaphragmatic thickness (Ti, Te) and excursion via ultrasonography, 6-minute walk test (6MWT), and Canadian Occupational Performance Measure (COPM). Results: Twenty-two participants completed the study (IG = 11; CG = 11). Significant within-group improvements were observed in both groups for MIP, MEP, Ti, TF, excursion, 6MWT, and COPM scores (P < .05). Between-group analyses showed significantly greater improvements in the IG for ΔMIP (P < .001), ΔMEP (P = .003), affected-side ΔTi (P = .007), ΔTF (P = .008), and Δexcursion (P = .005). No significant differences were found for 6MWT and COPM (P > .05). Conclusions: IMT effectively improves respiratory muscle strength, diaphragmatic thickness, and excursion in subacute ischemic stroke and may be a valuable addition to post-stroke rehabilitation programs. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT06210516. © The Author(s) 2026Article The Relationship Between Spiritual Well-Being, Resilience, and Adherence Among Patients Receiving Hemodialysis Treatment in Türkiye(Springer, 2026) Bulbul, Elif; Sukut, Ozge; Dikec, GulThis study examined the relationship between spiritual well-being, resilience, and adherence of hemodialysis patients and the factors affecting them. The data were collected from 182 hemodialysis patients receiving treatment in a dialysis center who met the inclusion criteria by purposive sampling method in Istanbul. The data were collected with the patient description questionnaire, which measures patient sociodemographic characteristics and characteristics related to the medical diagnosis, the Spiritual Well-Being Scale, the Brief Resilience Scale, and the End-Stage Renal Failure-Adherence Questionnaire. Gender, educational status, employment status, and mean age of patients were found to be correlated with psychological resilience. Marital status, employment status, cohabitants, and mean age of patients were found to be correlated with spiritual well-being. Gender, number of weekly dialysis sessions, and dialysis competencies were found to be correlated with hemodialysis patients' adherence to their treatment. Hemodialysis patients' adherence was positively correlated with both the faith subscale of spiritual well-being and psychological resilience. According to regression analysis, gender and resilience explained 12.8% of the total variance of adherence. This study determined that resilience is an essential factor in increasing the adherence of hemodialysis patients.Article Metformin Attenuates PTZ-Induced Seizures and Cognitive Impairment and Is Associated with Altered NOS/NO Signaling: Combined in Vivo and in Silico Evidence(Taylor & Francis Ltd, 2026) Ciltas, Arzuhan Cetindag; Sahin, Bilal; Hacisuleyman, Levent; Çetindağ Çiltaş, ArzuhanBackground: Epilepsy remains a major neurological disorder with high rates of drug resistance and cognitive decline. Repurposing neuroprotective drugs offers a promising approach. Metformin, a widely used antidiabetic agent, has shown anticonvulsant effects, yet its impact on nitric oxide synthase (NOS) isoforms in distinct brain regions remains unclear. Methods: Adult male Wistar rats were allocated into control, pentylenetetrazole (PTZ), or metformin+PTZ groups. Metformin (200 mg/kg, i.p.) was administered for 7 days before induction of acute PTZ seizures (45 mg/kg, i.p.). Seizure severity and latency were assessed using Racine's scale, and cognition was evaluated by the passive avoidance test (PAT). Nitric oxide (NO) and the expression of its synthesizing enzymes, inducible (iNOS), neuronal (nNOS), and endothelial (eNOS), were quantified in the cortex and hippocampus via enzyme-linked immunosorbent assay (ELISA). In silico analyses included target prediction and molecular docking to assess metformin - NOS interactions. Results: Metformin significantly reduced seizure severity, prolonged latency to the first myoclonic jerk, and prevented PTZ-induced memory impairment (all p < 0.001). These behavioral effects were accompanied by reductions in cortical and hippocampal nNOS and iNOS expression, decreased cortical eNOS levels, and lower NO accumulation. TargetNet predicted NOS isoforms among potential metformin targets, and docking indicated moderate binding affinity (-5.2 to -5.9 kcal/mol). Conclusion: Metformin exerted seizure-suppressing and cognition-preserving effects in an acute PTZ model, associated with reductions in NOS isoform expression and NO levels, suggesting altered NOS/NO signaling and supporting its potential as an adjunctive candidate for mitigating seizure-related neuronal dysfunction.