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 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 Evaluation of Barriers Toward Data-Driven Supply Chain Sustainability Via Single-Valued Pythagorean Piprecia(Amer Inst Mathematical Sciences-AIMS, 2026) Turan, Hakan; Buyukselcuk, Elif CalogluSustainable supply chain management (SSCM) is a holistic approach that encompasses economic, social, and environmental dimensions, enabling firms to enhance their long-term competitiveness by meeting legal requirements and strengthening brand equity. The effective implementation of this approach necessitates a strong emphasis on data-driven decision-making. Accordingly, we aimed to identify the key barriers hindering the implementation of data-driven sustainable supply chain practices and to explore potential strategies to overcome these challenges. In the initial phase of the study, a comprehensive literature review was conducted to identify the major barriers to implementing data-driven sustainable supply chains. Subsequently, the relative importance of these barriers was assessed with input from top and mid-level managers working in manufacturing sector enterprises. The identified barriers were then prioritized using the Pivot Pairwise Relative Criteria Importance Assessment (PIPRECIA) method based on Pythagorean fuzzy numbers. Finally, solution proposals were developed to address the most critical barriers. The study revealed that organizational barriers constitute the most prominent category, representing 29.86% of the total identified obstacles. Closely following are technical barriers, which account for 26.41% and reflect the difficulties associated with implementing and integrating digital technologies. Internal and external environmental barriers are similarly substantial, comprising 25.87% of the total. In comparison, economic barriers make up the smallest share, with a relative weight of 17.86%. The number of researchers analyzing the importance weights of barriers in the context of SSCM 4.0 remains limited. The utilization of a more contemporary and robust method compared to previously applied techniques for determining these weights enhances the originality of this study.Conference Object Comparison of the Effectiveness of Connective Tissue Massage and Classical Massage in Patients with Migraine(Elsevier, 2025) Ozdincler, Arzu Razak; Kaya, Begum Kara; Kahleogullari, ElifConference Object The Homeostasis-Enrichment (HEP®) Approach: A Novel Early Intervention Model for OT(Amer Occupational Therapy Assoc, Inc, 2025) Balikci, Aymen; Sirma, Gamze Cagla; May-Benson, Teresa A.Article Denta-Hybridonet: A Hybrid CNN-Transformer Architecture for Automated Detection of Developmental Dental Anomalies in Pediatric Panoramic Radiographs(Elsevier Sci Ltd, 2026) Eskibaglar, Busra Karaagac; Yavuz, Yelda Polat; Dogan, Gizem Karagoz; Algarni, Ali; Cakmak, Yigitcan; Pacal, IshakAccurate identification of developmental dental anomalies (DDAs) in children is clinically important; however, interpreting panoramic radiographs can still vary across readers because of mixed dentition, anatomical overlap, and variable image quality. This variability may delay recognition and complicate early interventional planning. In this study, we curated a pediatric panoramic dataset of 2,001 radiographs (ages 6-14 years) spanning five categories: Dilaceration, Ectopy, Hypodontia, Taurodontism, and Healthy. All images were independently labeled by three experienced pediatric dentists. To avoid patient-level leakage, the dataset was divided into training, validation, and held-out test sets using a patient-wise split. We propose Denta-HybridoNet, a hybrid convolution-transformer architecture designed to capture both fine-grained tooth morphology and broader, arch-wide contextual patterns. Its InceptionNeXt-gMLP block supports multi-scale local representation learning, which helps the model focus on subtle morphological cues, whereas the Swin-gMLP block provides efficient global context modeling across the dental arch. In addition, a gated multilayer perceptron (gMLP) module refines the feature transformation through context-dependent modulation, strengthening diagnostically relevant signals while reducing the influence of irrelevant variation and radiographic noise. To ensure a fair comparison, we benchmarked Denta-HybridoNet against 22 recent convolutional and transformer-based models under the same training protocol and evaluation conditions. On the held-out test set, the proposed method achieved 91.15% accuracy and 91.20% F1 score, representing the best overall performance among the compared architectures. Ablation studies quantified the contributions of hybrid design and gMLP, and Grad-CAM analyses supported interpretability by highlighting clinically meaningful regions.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 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 Investigation of the Susceptibility Rates to Ceftazidime-Avibactam and Colistin, Clonal Relationships, and Clinical Data of Patients with Carbapenem-Resistant Klebsiella Pneumoniae Isolates Detected in the ICUs of a Hospital in İstanbul(K Faisal Special Hospital Research Centre, 2026) Akkaya, Yuksel; Aydin, Irfan; Harmankaya, Sebile; Karakul, Mehmet; Aydin, Mehtap; Erdin, Begum Nalca; Kilic, Ibrahim Halil; Karakuş, MehmetBACKGROUND: The increase in carbapenem-resistant K. pneumoniae (CR-Kp) in intensive care units (ICUs) causes treatment difficulties and increases risk in mortality. OBJECTIVES: The aim of this study was to investigate the susceptibility rates of CR-Kp isolates obtained from ICUs to ceftazidime-avibactam (CAZ-AVI) and colistin, carbapenem resistance genes, clonal relationships and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center, University of Health Sciences, & Uuml;mraniye Training and Research Hospital MATERIALS AND METHODS: This study was conducted between June 2023 and December 2024. Isolates were identified using VITEK MS v.3.2, and antibiotic susceptibility testing was performed using the VITEK 2 Compact system. CAZ-AVI susceptibility was determined using disk diffusion, and colistin susceptibility was determined using broth microdilution to determine minimum inhibitory concentration (MIC) values. Carbapenem resistance genes were determined using multiplex real-time polymerase chain reaction (RT-PCR) and clonal relationship arbitrarily primed-polymerase chain reaction (AP-PCR). MAIN OUTCOME MEASURES: Resistance genes of CR-Kp isolates, clonal relationships, CAZ-AVI and colistin resistance, and clinical characteristics of patients SAMPLE SIZE: Ninety-seven isolates from 76 patients RESULTS: Among patients with CR-Kp isolates, central venous catheter use was detected in 59 cases (78%), ventilator-associated pneumonia in 44 cases (58%), and bacteremia in 39 cases (51%), respectively. It was determined that 53 of the patients (70%) died. Using the AP-PCR method, 60 different genotypes were identified among 97 isolates, and clustering was determined in 42 of the isolates (46%). It was determined that 36 (37%) of the isolates were resistant to colistin and 42 (45%) were resistant to CAZ-AVI. NDM+OXA-48, OXA-48, KPC, KPC+NDM, and NDM genes were detected in 40 (43%), 32 (35%), 10 (11%), 2 (2%), and 3 (3%) isolates, respectively. It was determined that 30 (75%) of the isolates with NDM+OXA-48 and only 4 (12%) of the isolates with OXA-48 were resistant to CAZ-AVI. CONCLUSION: In addition to OXA-48, an increase in the frequency of CR-Kp isolates containing the NDM, NDM+OXA-48, KPC+NDM, and OXA-48+KPC genes were also detected. It was also determined that resistance to colistin and CAZ-AVI is increasing. The AP-PCR method can also be used to investigate infections. LIMITATIONS: Single center,Pulsed Field Gel Electrophoresis (PFGE) could not be performed together with AP-PCRArticle Does Localization Change Management in Complicated Right and Left-Sided Diverticulitis(Baishideng Publishing Group Inc, 2025) Acar, Turan; Sur, Yunus; Acar, Nihan; Tekindal, Mustafa Agah; Dilek, Osman NuriBACKGROUND Distribution of the colonic diverticula differs in different populations, and right-sided colon diverticulitis (RCD) and left-sided colon diverticulitis (LCD) manifest distinct clinical features. Complicated diverticulitis (CD) mostly requires hospitalization and can be treated within a spectrum from observation to surgery. Treatment choice is formed depending on the patient's general condition, the presence of diffuse peritonitis, the localization of diverticulitis, Hinchey stage, and responsiveness to the prior treatment. Clinical disparities regarding right and LCD also led to the differences in the incidences of both emergency surgery and future elective surgery. AIM To evaluate the clinical features of CD, display the differences according to colonic localizations, and present treatment approaches. METHODS This was a retrospective study from a single centre analysing data from a prospective database. The 253 patients with history of hospitalization for CD were included and divided into two groups: RCD and LCD. To compare the differences between the two groups, the Student's t-test was used when the parametric test prerequisites were fulfilled, and the Mann-Whitney U test was used when such requirements were not fulfilled. RESULTS The 208 (82.2%) patients were found to have LCD, and 45 (17.8%) had RCD. The majority of the patients had Hinchey 1A diverticulitis (49.8%). Male gender was significantly more common in patients who underwent surgery for LCD. While persistent abdominal pain was the main prior finding in the conservative treatment of both localizations, surgery was most performed due to abscess in RCD and perforation in LCD. The presence of an accompanying malignancy during colonoscopy was significantly more common in LCD cases who underwent surgery. Hartmann's procedure was the most performed technique in emergency settings (56.3%), while laparoscopic colectomy with anastomosis was in elective settings (53.9%). In addition, surgery was found to prolong the mean length of hospital stay in LCD patients. CONCLUSION Although diverticulitis is a benign condition, the need for an individualized and evidence-based approach makes management challenging. Localization of the disease has an important role in determining the appropriate treatment.