WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Fully Synthetic, Nature-Inspired Exosome-Mimetics for Melanoma Therapy(Elsevier B.V., 2026) Arda Ozturk N.Z.; Majchrzak O.B.; Ulivi G.; Kirmizibayrak P.B.; Borchard G.; Patrulea V.; Ozer O.; Ozturk, Nahide Zeren Arda; Borchard, Gerrit; Ozer, Ozgen; Patrulea, Viorica; Majchrzak, Oliwia Barbara; Arda Ozturk, Nahide Zeren; Kirmizibayrak, Petek Ballar; Ulivi, GianlucaFully synthetic exosome-mimetics (FSEMs) represent a nature-inspired drug delivery system designed to replicate the key physicochemical and biological properties of natural exosomes, while offering the potential to address limitations in scalability and reproducibility associated with natural exosomes. In this study, we prepared FSEMs at the laboratory scale. We loaded them with (–)-epigallocatechin-3-gallate (EGCG) and microRNA-23a (miR-23a), aiming to co-deliver therapeutic small molecules and nucleic acids for the treatment of melanoma. FSEMs were fabricated using three methods: thin-film hydration, ethanol injection, and microfluidics. They were surface-functionalized with either CD9, a tetraspanin involved in membrane fusion, or TSP-1, an adhesion protein promoting cellular interactions. Through physicochemical characterization via dynamic light scattering, we found that FSEMs were ∼ 100 nm in size, of low polydispersity (∼0.2) and showed a negative zeta potential (∼–55 mV). Both EGCG and miR-23a were efficiently encapsulated. SDS-PAGE analysis confirmed successful protein incorporation and correct positioning. In vitro release studies showed minimal premature leakage, supporting their suitability for cellular uptake-mediated delivery. When tested on melanoma cells (MDA-MB-435) and progenitor human dermal fibroblasts (FE002-SK2), FSEMs selectively killed melanoma cells while sparing fibroblasts. Importantly, EGCG within FSEMs was more effective than the free compound. Compared to conventional DOTAP-based liposomes, FSEMs were more selective and induced less off-target cytotoxicity. This study presents a proof-of-concept for fully synthetic, protein-functionalized FSEMs as dual carriers for both chemical and gene-based agents, offering a safer and potentially more effective alternative to traditional cationic liposomes. These results lay the groundwork for future in vivo validation and translational cancer research. © 2026 The Author(s)Article The Relationship Between Nurses Anxiety and Attitudes Towards Artificial Intelligence and Examination of Influencing Factors(BMC, 2026) Nirgiz, Cansu; Sari, Merve Kiymac; Cayli, NazanAim to explore the relationships between nurses'anxiety and attitudes toward artificial intelligence (AI) and the factors associated with them. Background Although AI technologies are increasingly integrated into healthcare, research exploring nurses ' psychological readiness and emotional responses to AI remains limited. Existing studies have primarily focused on nursing students or general healthcare professionals, leaving a gap in understanding how practicing nurses perceive and emotionally adapt to AI within real clinical environments-particularly in T & uuml;rkiye, where digital transformation in healthcare is accelerating. Addressing this gap is essential, as nurses play a pivotal role in ensuring the safe and ethical implementation of AI-driven tools in patient care. Methods This descriptive and correlational study included 562 nurses from 14 branches of a private hospital chain across seven Turkish cities between November 2024 and January 2025.This sample was selected because it represents nurses actively engaged in clinical decision-making within healthcare systems that are rapidly adopting AI technologies. According to a power analysis performed in G*Power (rho = 0.25, alpha = 0.05, power = 0.95), the required sample size was 202 participants. Data were collected through an online questionnaire comprising a Descriptive Information Form, the AI Anxiety Scale, and the General Attitudes toward AI Scale. Descriptive statistics, independent samples t-tests, ANOVA (F), Tukey post hoc test, Pearson correlation, and multiple regression analyses were conducted. Ethical approval was obtained from the Fenerbah & ccedil;e University Ethics Committee, and informed consent was obtained digitally. Results Nurses reported moderate anxiety levels and generally positive attitudes toward AI. Male nurses showed an association with lower anxiety levels and higher positive attitude scores than female nurses. Single individuals and those with higher levels of education showed higher positive attitudes toward AI. Those with 0-3 years of experience in the profession were associated with lower anxiety and higher positive attitude scores. Nurses who used AI in practice, were knowledgeable about its use, or perceived it as reliable showed a relationship with lower anxiety and more positive attitudes. Regression analysis showed that each one-unit increase in the learning and AI configuration subscales of the AI Anxiety Scale was associated with a 0.740-and 0.716-point lower score in the total attitude score, respectively. Conclusion The findings suggest that lower levels of anxiety related to learning and AI configuration are associated with more positive attitudes toward AI. Addressing these specific anxiety domains may be related to the successful integration of AI technologies into clinical practice and could be linked to the digital transformation in healthcare.Article Mapping the Evolution of Stigmatization in Mental Disorders: A Bibliometric Analysis From 1974 to 2024(Springer Heidelberg, 2026) Goktas, Polat; Dikec, GulBackgroundThis bibliometric study scrutinizes the thematic evolution of research on stigma and discrimination in mental disorders, covering a span of five decades. It reflects on the shifting paradigms within the stigma-focused mental health research community from 1974 to 2024.MethodsA comprehensive bibliometric analysis was employed using the Bibliometrix R package and VOSviewer software, analyzing 1,892 articles from databases like Scopus, Web of Science, PubMed Central, and APA PsycInfo. Adherence to PRIBA guidelines ensured a holistic representation of the evolving research narrative.ResultsThe analysis outlined three distinct periods: the Genesis Period (1974 - 2007), focusing on foundational concepts of mental disorders and stigma; the Growth Period (2008 - 2015), which experienced a broadening into themes of discrimination and diagnostic refinement; and the Rapid Growth Period (2016 - 2024), characterized by a surge in research on child mental disorders and the impacts of posttraumatic stress disorder. Network analyses highlighted significant journals, key authors, and international collaborations that have shaped this field.ConclusionsThe study maps a significant transformation in stigma-focused mental health research themes over fifty years, highlighting the growing complexity and the need for ongoing research into stigma and discrimination. It calls for interdisciplinary approaches to tackle these enduring challenges effectively.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 Early Detection of Lower Adherence to Long-Term E-Diary Recording: A Checkpoint to Target Early Educational Intervention in Seasonal Allergic Rhinitis(Wiley, 2026) Dramburg, S.; Hernandez Toro, C. J.; Grittner, U.; Tripodi, S.; Arasi, S.; Acar Sahin, A.; Matricardi, P. M.Background: Digital symptom monitoring via e-Diary apps can support the diagnosis and management of chronic diseases with trigger-induced exacerbations such as pollen allergies. Attrition is a major challenge for continuous e-Diary usage with an unsupervised approach. Objective: To investigate adherence to e-Diary reporting, its early determinants and predictors in a blended care setting among pollen allergic patients with heterogeneous cultural backgrounds. Methods: The @IT.2020 observational multicenter study recruited patients with diagnosed seasonal allergic rhinitis from seven Southern European/Mediterranean countries. Baseline characteristics were investigated through questionnaires, skin prick tests and serum specific IgE measurements. The study doctors asked patients to record their allergy symptoms via e-Diary (AllergyMonitor, TPS) daily during the clinically relevant season of pollination and increased mould concentrations. Results: Among 815 patients (467 adults, 348 children), the average prescribed e-Diary recording period was 106 (SD 47.1) days, with an average completion rate of 75.2% (SD 21.2%). Children (>= 10 years) filled 73.8% (95% CI 68.1-79.4) of prescribed days without parental support. We identified a stable 'higher' and a more variable 'lower' adherence cluster. Adherence was weakly associated with disease severity, but not with age, gender, country, education or digital literacy. Short-term (first 3 weeks) adherence was strongly associated with long-term adherence (partial R-2 = 0.387, p < 0.001), with 87.6% of lower adherent patients remaining poorly adherent beyond 3 weeks. Conclusion: In a blended care setting, adherence to e-Diary compilation among pollen allergic patients is high, irrespective of age and cultural background. Early identification of lower adherence is possible and might inform early interventions to improve patient adherence.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.Article Evaluation of Octenidine Dihydrochloride-Induced Cytotoxicity, Apoptosis, and Inflammatory Responses in Human Ocular Epithelial and Retinal Cells(MDPI, 2025) Ciftci, Ihsan Hakki; Deveci Ozkan, Asuman; Erman, Gulay; Kilbas, Imdat; Aydemir, OzlemBackground/Objectives: Octenidine dihydrochloride (OCT-D) is a broad-spectrum antiseptic with high chemical stability, low toxicity, and no reported microbial resistance, making it a strong candidate for use on mucosal surfaces. Despite increasing interest in its potential ophthalmic applications, limited data exist regarding its cellular effects on ocular tissues. This study aimed to investigate the cytotoxic, apoptotic, inflammatory, and transcriptional responses induced by OCT-D in human conjunctival (IOBA-NHC) and retinal pigment epithelial (ARPE-19) cells. Methods: Cells were exposed to varying concentrations of OCT-D, and viability was assessed using the WST-1 assay to determine IC50 and IC50/2 values. These concentrations were subsequently used in molecular assays. Pro-inflammatory cytokines (IL-6, IL-1 beta, TNF-alpha, IFN-gamma) were quantified by ELISA. Apoptotic activation was evaluated through caspase-3/7 activity assays. Gene expression analysis of apoptotic (Bax, Bcl-2), DNA damage-related (ATM, Rad51), and inflammatory markers was performed using RT-qPCR. Results: OCT-D induced a marked, dose-dependent reduction in cell viability in both cell lines, with ARPE-19 showing greater sensitivity. Caspase-3/7 activity increased significantly at IC50 and IC50/2, confirming intrinsic apoptotic activation. OCT-D markedly suppressed the release of key inflammatory cytokines and downregulated transcription of inflammatory genes. RT-qPCR revealed upregulation of pro-apoptotic and DNA damage-associated genes, demonstrating coordinated activation of apoptotic and genomic stress pathways. Conclusion: OCT-D triggers integrated cytotoxic, apoptotic, and immunomodulatory responses in conjunctival and retinal epithelial cells. While these findings provide important mechanistic insights into OCT-D's cellular effects, further studies using primary cells, advanced 3D ocular models, and disease-relevant systems are required to support its potential translational use in ophthalmology.Article Low Dose Ionising Radiation Elicits MPTP Comparable Alterations in Locomotor Function, Oxidative Balance and Mitochondrial Homeostasis in Zebrafish Embryos(Nature Portfolio, 2025) Cahide, Ezgi; Bayramov, Aydas; Beler, Merih; Cansiz, Derya; Unal, Ismail; Egilmezer, Gizem; Yalcinkaya, Sebnem ErcalikPrenatal exposure to environmental factors including low-dose ionising radiation and neurotoxins may disrupt the oxidant-antioxidant balance. Our aim was to assess the effects of exposure to low-dose ionising radiation (LDIR) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which is a neurotoxin used to model Parkinson's disease (PD), on developing zebrafish embryos, focusing on the oxidant-antioxidant system and markers of mitochondrial damage associated with PD. Zebrafish embryos were divided into four groups: control, LDIR, MPTP, and LDIR combined with MPTP (LDIR + MPTP). A dental x-ray unit (60 kVp, 7 mA) was used for the exposures. The 0.08 s LDIR exposure was measured as 0.065 mGy using optically stimulated dosimeters. At the end of 72 h after fertilization, locomotor activities, acetylcholine esterase (AChE) activity, oxidative stress and antioxidant status were assessed. Expressions of genes associated with in PD as markers of mitochondrial damage (pink1, parkin, dj1 and lrrk2) were determined by RT-PCR. Developmental toxicity was observed in all exposure groups as evidenced by pericardial edema, yolk sac edema and spinal curvature. LDIR exposure in zebrafish embryos affected oxidative and mitochondrial stress markers, as well as locomotor activity and AChE as a marker of cognitive function at levels comparable to the MPTP exposure. Our study is the first to determine the effects of LDIR from a dental x-ray unit on the response to MPTP, and we aim to further elucidate the mechanism of these changes observed particularly in the LDIR + MPTP group.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.Conference Object The Relationship Between Internalized Stigmatization and Depression Among Adolescents With Substance Use: A Cross-Sectional Study(Cambridge University Press, 2025) Demir, M.; Gumus, F. C.; Dikec, G.