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 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 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.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 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 Past and Present of Nation-Building: Ideological Instrumentalization of Ministry of Youth and Sports of Turkey(Routledge Journals, Taylor & Francis Ltd, 2026) Erturan-Ogut, Esin EsraWhen Erdogan declared in 2012, 'We will raise a pious generation', Turkey already had a national identity rooted in secularism and Turkism since the early Republic. His statement signalled an attempt to reshape identity along the AKP's anti-Kemalist lines. This study examines shifting nation-building agendas in state-run youth and sports institutions, comparing the early Republican era with the AKP period. Early programmes emphasized Turkism, secularism, and paramilitarism, reflecting the ideological imperatives of the time. Under the AKP, however, programmes increasingly promoted Islamism and neo-Ottomanism, opposing earlier values. The study argues that AKP-era youth policies deliberately sought to replace Kemalist principles, with the Ministry of Youth and Sports serving as a channel for ideological nation-building absent in formal education.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.