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 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 Effects of Left and Bilateral Transcutaneous Auricular Vagus Nerve Stimulation on Pain, Mood, and Autonomic Nervous System in Female Patients With Fibromyalgia: a Randomized Controlled Trial(Taylor & Francis Inc, 2025) Akkurt, Mustafa Ferit; Ozden, Ali Veysel; Akkurt, Halil Ekrem; Akkurt, Burcu; Bildik, CelaleddinIntroduction: Fibromyalgia Syndrome (FMS) is a complex disease characterized by widespread pain, fatigue, emotional disturbances, and autonomic dysfunction. Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) has emerged as a potential noninvasive approach to modulate FMS-related symptoms. Purpose: To compare the effects of left and bilateral taVNS on pain, mood, functionality, and autonomic nervous system (ANS) activity in individuals with FMS. Methods: Forty female individuals with FMS were assigned to either a left (n = 20) or a bilateral (n = 20) taVNS group. Both received 11 sessions of taVNS targeting the tragus and concha regions (30 minutes each, 25 Hz, 300 mu s) over nonconsecutive days, excluding weekends and menstrual periods. Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ) were assessed. ANS activity was evaluated via heart rate variability (HRV). After 11 sessions of taVNS, a 2-week follow-up was performed. Results: No significant differences were observed between groups except for FIQ and BAI on day 28 (p = .002-0.008). Both groups showed significant within-group improvements in VAS (r = 0.87-0.94; p < .001), BDI (r = 0.46-0.71; p < .001), FIQ (r = 0.95-0.99; p < .001), and BAI (r = 0.69-0.94; p < .001) scores. Parasympathetic Nervous System (PNS) (p = .365-0.776) and Sympathetic Nervous System (SNS) (p = .598-0.880) indices, which are the subparameters of HRV, showed no significant between-group differences, with small effect sizes (r < 0.15). Conclusion: Both stimulation protocols effectively reduced pain and improved mood and functionality in fibromyalgia, indicating a safe, noninvasive adjunctive treatment option. Clinicaltrials.gov: (Identifier: NCT06871306).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 Citation - WoS: 1Post-Truth Populism as an Emerging Electoral Strategy: The Case of Turkey's 2023 Elections(Routledge Journals, Taylor & Francis Ltd, 2025) Eldem, TubaThis article develops a new theoretical framework to explain how right-wing populist incumbents mobilise electoral support in competitive authoritarian regimes. It argues that post-truth populism, defined as the strategic fusion of securitised discourse and emotionally charged identity appeals with epistemic manipulation, enables populist leaders to shape the political battlefield through affective and symbolic narratives rather than policy content. Drawing on discourse analysis of President Recep Tayyip Erdo & gbreve;an's 2023 campaign in Turkey, the article shows how the ruling coalition reframed the elections as an existential struggle against internal and external enemies while simultaneously offering emotionally resonant promises of national revival. Rather than focus solely on institutional advantages or voter grievances, this study foregrounds the discursive agency of populist leaders and their ability to manufacture fear, pride and loyalty. By analysing how Erdo & gbreve;an's campaign displaced economic accountability with emotionally saturated, post-factual narratives, the article contributes to literatures on populism, post-truth politics and securitisation. It argues that the convergence of post-truth politics and populist securitisation forms a powerful mechanism for authoritarian endurance in hybrid regimes, transforming elections into moralised referenda on identity and national survival.Article New Diclofenac Hydrazones: Design, Synthesis, in Silico Studies and Anticancer Evaluation Against Breast Cancer(Elsevier, 2026) Birgul, Kaan; Oktay, Lalehan; Bekci, Hatice; Cikla-Suzgun, Pelin; Durdagi, Serdar; Kucukguzel, S. GunizBreast cancer remains one of the most prevalent and lethal malignancies among women, highlighting the urgent need for novel therapeutic strategies that can overcome resistance mechanisms. The p38 alpha mitogen-activated protein kinase (MAPK14) plays a key role in inflammation-associated oncogenic signaling, making it an attractive molecular target for drug development. In this study, a novel series of diclofenac-based hydrazone derivatives (4a-4o) were designed, synthesized, and characterized using FT-IR, 1H- and 13C-NMR spectroscopy, thin-layer chromatography, and elemental analysis. Computational target profiling using SwissTargetPrediction identified MAPK14 as the primary predicted target. Molecular docking against the MAPK14 crystal structure (PDB ID: 1WBS) revealed high binding affinities (-11.41 to -8.34 kcal/mol), supported by MM/GBSA free energy calculations and molecular dynamics simulations, which confirmed stable ligand-protein interactions through hydrogen bonding with Asp168 and Glu71. In vitro cytotoxicity assays on MCF-7 (luminal A) and MDA-MB-231 (triple-negative) breast cancer cell lines demonstrated low-micromolar IC50 values, with compounds 4c, 4d, and 4e showing the strongest activity (2.1-4.5 mu M), surpassing the reference drug Tamoxifen. Overall, the results indicate that diclofenac hydrazones represent promising candidates anticancer properties through MAPK14 inhibition, providing a foundation for the development of next-generation therapeutics against breast cancer.