WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Comprehensive Proteomic and Metabolomic Analysis of Novel Substituted Fluoroquinolone Derivatives in Escherichia Coli Isolates(John Wiley and Sons Ltd, 2026) Nigiz Ş.; Kulabaş N.; Türe A.; Kablan S.; Koçak E.; Özkul C.; Küçükgüzel İ.; Koçak, Engin; Nigiz, Şeyma; Kablan, Sevilay Erdoğan; Özkul, Ceren; Kulabaş, Necla; Küçükgüzel, İlkay; Türe, AslıAntimicrobial resistance is one of the most important global problems, and new antibiotic requirements have been emerging as a key point in this issue. In the present work, we focused on the efficiency of two novel promising fluoroquinolone derivatives on resistant Escherichia coli isolates at the molecular level. Their mode of action and adaptation process were evaluated by using proteomics and metabolomics analysis. Proteomics analysis showed that two compounds have an effect mainly on the ribosomal process and energy metabolism. Moreover, we observed compounds that affect various important antimicrobial targets, such as ribosomal subunits, phosphotransacetylase, and chaperone proteins. In metabolomics analysis, we found that compounds altered bacterial metabolism directly. Pathway analysis showed that cofactor biosynthesis and energy metabolism were affected mainly by undertreated groups. Our experiments demonstrated that novel fluoroquinolone derivatives have promising results at the molecular level and results will contribute to further studies. © 2026 John Wiley & Sons Ltd.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 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 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 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 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 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 Evaluation of the Effect of Simulation-Based Training Provided to Nurses in the Hospital Environment on Child Neglect and Abuse: Quasi-Experimental Research(Elsevier Science Inc, 2026) Sanci, Yagmur; Genc, Canan; Kokkiz, RukiyeBackground: Child neglect and abuse are major public health concerns, and nurses play a critical role in early recognition. Simulation-based training is a promising method to strengthen knowledge and preparedness. Methods: This quasi-experimental pretest-posttest study was conducted with 20 nurses working in a pediatric emergency unit of a state hospital between March and April 2024. Data were collected using a socio-demographic form and the "Scale for Determining the Knowledge Level of Nurses and Midwives in Diagnosing the Symptoms and Risks of Child Abuse and Neglect." Nurses participated in simulation-based training with a structured scenario, followed by debriefing and posttest. Results: Knowledge scores significantly increased after training, particularly in recognizing physical and behavioral symptoms of abuse. However, improvements were limited in identifying children at higher risk of neglect and abuse. Conclusion: Simulation-based training enhances nurses' knowledge of child abuse recognition and should be integrated into nursing education and in-service programs to improve clinical preparedness. (c) 2026 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.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 Effect of Gender Equality Education on Health Students Gender Perceptions and Roles: A Randomized Controlled Trial(Routledge Journals, Taylor & Francis Ltd, 2026) Isbay Aydemir, Beyzanur; Sahin Tokatlioglu, Tugba; Kuru Akturk, Nur Bahar; Dikec, GulAim To evaluate the impact of community gender equality education program on health sciences students' perceptions of gender, gender roles, and their awareness of social norms and gender inequality. Design A single-blind, two-arm, parallel-group randomized controlled trial. Methods Conducted with 70 students at a foundation university in Istanbul (2024-2025). The intervention group received two weeks structured training. Data were collected using the Perception of Gender Scale (PGS) and Gender Roles Attitude Scale (GRAS). Results No significant differences were observed at baseline. Post-intervention, the intervention group showed significant improvements in PGS and GRAS scores, while no change was found in the control group. Conclusion Short-term gender equality education program effectively improved students' gender perceptions and attitudes.