WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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 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 Pathologies of the Modern Paradigm and the Refugee Question: A Critical Analysis(Springer Nature, 2026) Yamaner, Onur; Ozalp, AhmetThis article examines the internal contradictions and social pathologies generated by the modern paradigm, focusing especially on the issue of migration. Using epistemological critiques from thinkers like Adorno, Kuhn, Popper, Hayek, and the Frankfurt School, the paper argues that modernity's promise of universal rationality and scientific progress has frequently resulted in structures that are exclusionary, homogenizing, and sometimes even totalitarian. The paper then links these theoretical debates to contemporary migration. It emphasizes how refugee women-especially those facing the combined challenges of gender and displacement-experience complex layers of social invisibility and discursive erasure. By critically applying recognition theory and discourse analysis, the study highlights how modernity's promise of inclusion frequently hides the actual mechanisms of marginalization. In this part, the article demonstrates that these marginalization processes are linked to the scientific premises of the modern paradigm and considers the migration problem as an example of the pathology of the modern paradigm.Correction Diagnostic Utility of Smartphone-Integrated Gait Analysis in the Assessment of BPPV (Vol 16 , 1728659 , 2025)(Frontiers Media S.A., 2026) Durmus, Kasim; Bora, Adem; Sapci, Baris; Al-Hazzar, Marwan Khaled; Akti, Kerem; Sapci, Melek Kekul; Altuntas, Emine ElifArticle Advances and Strategies in Biosensor-Based Diagnostics for Parasitic Infections: A Comprehensive Scoping Review(Springer, 2026) Aminizadeh, Selva; Alizadeh, Gita; Alizadeh, Zahra; Khalilzadeh, Balal; Abidin, Zurina Zainal; Marzi, Mahdi; Rafiei-Sefiddashti, RahelehParasitic diseases are among the most widespread infections worldwide, causing millions of deaths and illnesses each year. So rapid and accurate diagnosis is essential, requiring highly sensitive and specific tests. Biosensors can provide significant advantages over traditional diagnostic methods because of their specificity, sensitivity, speed, simplicity, ease of use, repeatability, and capacity for early-stage disease detection. Recent advances in modern diagnostic tools for detecting parasitic infections use nanomaterials such as gold nanoparticles, carbon nanofibers, and carbon nanotubes. These developments have significantly lowered detection limits to the picogram and femtogram levels. This review will cover recent advancements in biosensor-based diagnostic techniques in parasitology.Article From Data to Autonomy: Integrating Demographic Factors and AI Models for Expert-Free Exercise Coaching(MDPI, 2026) Ozbalkan, Ugur; Turna, Ozgur CanThis study investigates the performance of three deep learning architectures-LSTM with Attention, GRU with Attention, and Transformer-in the context of real-time, self-guided exercise classification, using coordinate data collected from 103 participants via a dual-camera system. Each model was evaluated over ten randomized runs to ensure robustness and statistical validity. The GRU + Attention and LSTM + Attention models demonstrated consistently high test accuracy (mean approximate to 98.9%), while the Transformer model yielded significantly lower accuracy (mean approximate to 96.6%) with greater variance. Paired t-tests confirmed that the difference between LSTM and GRU models was not statistically significant (p = 0.9249), while both models significantly outperformed the Transformer architecture (p < 0.01). In addition, participant-specific features, such as athletic experience and BMI, were found to affect classification accuracy. These findings support the feasibility of AI-based feedback systems in enhancing unsupervised training, offering a scalable solution to bridge the gap between expert supervision and autonomous physical practice.Article Montelukast Attenuates Abdominal Aortic Aneurysm in Rats: Anti-Inflammatory and Antioxidant Effects(Elsevier, 2026) Tekin, Gozde; Cevik, Ozge; Cetinel, Sule; Sener, Goksel; Kizilay, MehmetObjective: Oxidative stress and inflammation are widely recognized as central mechanisms in the pathogenesis of abdominal aortic aneurysm. This study sought to examine the potential protective properties of montelukast in a rat model of aortic aneurysm. Methods: Male Sprague-Dawley rats were randomly allocated into three experimental groups. Abdominal aortic aneurysm was induced using the calcium chloride (CaCl2) model, in which gauze soaked in 0.5 M CaCl2 was placed directly onto the adventitial surface of the infrarenal abdominal aorta for 15 minutes. After induction, the treatment group received daily intraperitoneal injections of montelukast (10 mg/kg) for 4 consecutive weeks. At the study end point, animals were euthanized, and infrarenal aortic tissues were harvested for biochemical and histological evaluations. Measured parameters included matrix metalloproteinase (MMP)-2 and MMP-9 expression, myeloperoxidase (MPO) activity, and 8-hydroxy-2 '-deoxyguanosine levels. Antioxidant capacity was assessed through superoxide dismutase (SOD) activity assays. Histopathological examinations were performed, and statistical analysis was conducted using GraphPad Prism v.5. Results: Exposure to CaCl2 triggered pronounced oxidative injury and inflammation, as evidenced by elevated 8-hydroxy-2 '-deoxyguanosine levels, increased MPO activity, reduced SOD activity, and upregulated MMP-2 and MMP-9 expression. Montelukast administration markedly attenuated these changes, normalizing oxidative and inflammatory markers while improving histopathological architecture. Conclusions: Montelukast effectively counteracted CaCl2-induced aortic damage. The protective effects of montelukast appear to be mediated through suppression of MMP activity, restoration of SOD levels, and reduction of MPO-driven oxidative injury. By mitigating both inflammatory and oxidative mechanisms, montelukast contributes to the preservation of aortic wall structure. Clinical Relevance: Abdominal aortic aneurysm remains a major vascular disorder without an effective pharmacological therapy to slow its progression. In this experimental study, montelukast, a leukotriene receptor antagonist widely used in asthma, attenuated abdominal aortic aneurysm formation in rats and was associated with increased superoxide dismutase activity, reduced myeloperoxidase levels, and suppressed matrix metalloproteinase activation. These combined antioxidant, anti-inflammatory, and matrix-stabilizing effects preserved aortic wall integrity. Given montelukast's established safety and clinical availability, these findings support its potential for future clinical investigation as a pharmacological approach to limit aneurysm progression. (JVS-Vascular Science 2026;7:100405.)Article Harnessing Adaptive Urban Service Frameworks and Smart Technologies for Sustainable Urban Development in Rapidly Urbanising Cities(Elsevier, 2026) Agboola, Oluwagbemiga Paul; Uzun, Turkan Irgin; Cakir, Hulya Soydas; Soydaş Çakır, HülyaRapid urbanisation and escalating climate change impacts pose significant challenges for sustainable urban governance in developing nations, particularly where infrastructural inadequacies and resource inefficiencies persist. This study examines how urban systems in rapidly growing cities in Nigeria can utilise smart technologies to enhance resilience, inclusivity, and environmental sustainability. The study's aim is to develop and evaluate an Adaptive Urban Service Framework (AUSF) that integrates digital innovations to foster low-carbon, climate-resilient, and inclusive cities. Objectives of the study include (i) identifying adaptive urban service models that improve resource efficiency, environmental sustainability, and quality of life, and (ii) assessing the extent to which these services strengthen urban resilience and social inclusivity under demographic and infrastructural pressures. A structured survey involving 286 respondents from selected Nigerian cities was conducted, and the data were analysed using SPSS Version 22. The correlation results reveal a positive relationship between adaptive urban service mechanisms and sustainability outcomes (r = 0.987, p < 0.001), indicating that improvements in smart technologies, resource efficiency, environmental sustainability, and quality of life strongly reinforce sustainable urban performance. Similarly, experts' evaluations demonstrate a positive correlation between Adaptive Urban Services (AUS) and the enhancement of resilience and inclusivity within smart urban environments (r = 0.865, p < 0.001). These findings collectively underscore that adaptive, smart-driven frameworks exert substantial synergistic effects on environmental sustainability, social inclusivity, and urban resilience, confirming that the effective integration of smart technologies serves as a strong determinant of sustainability outcomes in rapidly urbanising Nigerian cities. The paper offers a methodology that integrates digital innovation with climate-responsive planning, which theoretically advances urban systems theory. In practical terms, it provides policymakers and urban planners with a scalable road map for implementing adaptive service solutions that connect sustainability, equity, and technology. Overall, within similar emerging urban environments, the study highlights the transformative potential of adaptive urban services in furthering climate adaptation, fostering inclusion, and attaining sustainable urban development.Article Turkey on the Fault Line: The Impact of the Earthquake on the Labor Market(Wiley, 2025) Demirkilic, Serkan; Ozbay Das, Zuhal; Aydin, GuneyWe assess the impact of the 2011 earthquakes of eastern Turkey on the labor market and the potential resilience strategy by exploring heterogeneity among subgroups. Our findings indicate a rise in low-skilled employment and an increase in the wage rates for low-skilled women following the earthquake. The instant response to earthquakes varies according to the residents' education level. The manufacturing sector was significant in enhancing the workers' resilience. The results further reveal that the return to the family business may have helped to mitigate the negative economic conditions created by the earthquakes.Article Effectiveness of Individual Psychoeducational Interventions for Caregivers of Stroke Patients: A Systematic Review and Meta-Analysis(Springer/Plenum Publishers, 2025) Kelani, Hesham; Ali, Hossam Tharwat; Naeem, Ahmed; Salamah, Hazem Mohamed; Ismail, Ali; Younes, Youmna Atef; Khandelwal, PriyankStroke is a major cause of disability, and patients who suffer strokes have limited mobility and functional tasks, necessitating daily reliance on caregivers. However, caregivers of stroke patients often experience depression and anxiety, negatively impacting their mental health and reducing their quality of life. Psychoeducational interventions may be a solution to support the well-being of stroke caregivers. This study is performed to assess the overall effectiveness of individual psychoeducational interventions for caregivers of stroke patients. A thorough search of Scopus, PubMed, Web of Science, and Cochrane databases was performed for published studies in English up to June 2023. Clinical trials assessing the efficacy of psychoeducational interventions on quality of life, depression, or care burden among stroke caregivers compared to usual care were included. A total of 18 clinical trials, 16 randomized clinical trials (RCTs), and two non-RCTs, with a total of 2007 patients, were included. The study's pooled results revealed a significant increase in the quality of life in the group receiving psychoeducational interventions compared to the comparison group (SMD = 0.34, 95% CI 0.13-0.55, p value = 0.002), while no significant difference was found in terms of depression (SMD = - 0.05, 95% CI - 0.23 to 0.14, p value = 0.62) or caregiver burden (SMD = - 0.61, 95% CI - 1.65 to 0.44, p value = 0.25). Psychoeducation programs should be considered as a supportive intervention to improve quality of life in caregivers; however, their impact on depression and caregiver burden remains inconclusive. However, further studies with a larger sample size are needed to confirm the results.