PubMed İndeksli Yayın Koleksiyonu
Bu koleksiyon için kalıcı URI
Güncel Gönderiler
Öğe Real-world data on Empagliflozin and Dapagliflozin use in patients with HEART failure: The RED-HEART study(Wiley Periodicals, 2024) Kocabas, Umut; Ergin, Isil; Yavuz, Veysel; Altin, Cihan; Kaplan, Mehmet; Yilmaz Oztekin, Gulsum Meral; Turk, Ugur OnselAims We aimed to determine the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and to identify clinical factors associated with their use in patients with heart failure (HF) in a real-life setting. Methods Real-world data on Empagliflozin and Dapagliflozin use in patients with HEART failure: The RED-HEART study is a multicentre, cross-sectional and observational study that included HF patients in the outpatient setting regardless of ejection fraction from 19 cardiology centres between August 2023 and December 2023. Results The study population consisted of 1923 patients with HF, predominantly men (61.2%), with a median age of 66 (range: 19-101) years. Overall, 925 patients (48.1%) were receiving SGLT2is. Among the study population, 22.1% had HF with preserved ejection fraction, 21.5% had HF with mildly reduced ejection fraction, 56.4% had HF with reduced ejection fraction and the use of SGLT2is was 42.0%, 47.9% and 50.6% in each group, respectively (P = 0.012). The use of SGLT2is was 76.6% in patients with HF and diabetes, 19.8% in patients with HF and chronic kidney disease and 26.8% in patients without diabetes and chronic kidney disease (P < 0.001). Higher education level [odds ratio (OR): 1.80; 95% confidence interval (CI): 1.06-3.05; P = 0.027], higher household income (OR: 3.46; 95% CI: 1.27-9.42; P = 0.015), New York Heart Association functional class IV (OR: 2.72; 95% CI: 1.16-6.35; P = 0.021), diabetes (OR: 9.42; 95% CI: 6.72-13.20; P < 0.001), the use of angiotensin receptor-neprilysin inhibitors (ARNis) (OR: 4.09; 95% CI: 2.39-7.01; P < 0.001), the use of mineralocorticoid receptor antagonists (MRAs) (OR: 2.02; 95% CI: 1.49-2.75; P < 0.001), the use of loop diuretics (OR: 1.62; 95% CI: 1.18-2.22; P = 0.003) and the use of thiazide diuretics (OR: 1.72; 95% CI: 1.30-2.29; P < 0.001) were independently associated with the use of SGLT2is. Conversely, atrial fibrillation (OR: 0.63; 95% CI: 0.45-0.88; P = 0.008), chronic kidney disease (OR: 0.53; 95% CI: 0.37-0.76; P = 0.001), the use of dihydropyridine calcium channel blockers (OR: 0.68; 95% CI: 0.48-0.98; P = 0.042) and the use of statins (OR: 0.67; 95% CI: 0.49-0.91; P = 0.010) were independently associated with the non-use of SGLT2is. Conclusions The RED-HEART study provided comprehensive real-world data about implementing SGLT2is in patients with HF. These results suggest that there is a need for organized action and close collaboration between healthcare providers to improve the implementation of SGLT2is, especially in patients with HF with preserved ejection fraction and chronic kidney disease.Öğe The assessment of attentional bias to cleanliness stimuli in different versions of the dot-probe task: Evidence for a motivational account(Sage Publications Ltd, 2024) Boga, Merve; Wentura, DirkVogt et al. (2011) investigated the role of goal-relevance in attention. Specifically, they induced the emotional state of disgust and showed an attentional bias (AB) to goal-related stimuli (i.e., cleanliness pictures) using the dot-probe task. In two experiments, we tested (a) an alternative interpretation and (b) the role of an important methodological feature of the dot-probe task. As the effect can be interpreted alternatively as affective counter-regulation (i.e., cleanliness-related pictures attracted attention because they are positive in the negative disgust state), we added positive stimuli to test whether the AB in the disgust state extends to these stimuli. In Experiment 1, we used the location dot-probe task. That is, participants had to categorise the location of the target. It can be argued that this task confounds attentional processes with response priming processes. In Experiment 2, we used a discrimination dot-probe task, that is, participants had to categorise a target feature that varied orthogonally to location, thus eliminating the confound. In Experiment 1, we did not replicate the effect of emotional state on AB for cleanliness stimuli, whereas in Experiment 2, we did. Mean AB scores for positive stimuli were not affected by emotional state. Two conclusions were drawn: First, the result of Experiment 2 supports the motivational account of Vogt and colleagues. Second, the results support the use of the discrimination task for both theoretical reasons (i.e., effects can be more clearly interpreted as based on attentional processes) and empirical reasons (i.e., the location task did not replicate the expected pattern).Öğe Cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS): a family with five affected sibs from Turkey(BMC, 2024) Gokcay, Figen; Baskan, Gulcan Nesem; Sahbaz, Irmak; Koc, Muge Kovancilar; Basak, A. Nazli; Celebisoy, NeseBackgroundCerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS), a relatively common cause of late-onset progressive ataxia, is a genetic disease characterised by biallelic pentanucleotide AAGGG repeat expansion in intron 2 of the replication factor complex subunit 1 gene. Herein, we describe the first molecularly confirmed CANVAS family with five affected siblings from Turkey.Case presentationThe family comprised seven siblings born from healthy non-consanguineous parents. CANVAS phenotype was present in five of them; two were healthy and asymptomatic. Chronic cough was the first symptom reported in all five siblings, followed by the development of sensory symptoms, oscillopsia and imbalance. Clinical head impulse test (HIT) was positive in all cases and video HIT performed on three patients revealed very low vestibulo-ocular reflex gains bilaterally. Magnetic resonance imaging and nerve conduction studies revealed cerebellar atrophy and sensory neuronopathy, respectively. RP-PCR confirmed the homozygous presence of the AAGGG repeat expansion in all five cases.ConclusionGenetic screening for CANVAS should be considered in all patients with late-onset ataxia, sensory disturbances and vestibular involvement, especially in the presence of chronic cough.Öğe Acute Suppurative Perichondritis After Helix Piercing in a Child(Lippincott Williams & Wilkins, 2024) Ozer, Emine Cigdem; Avcu, Gulhadiye; Arslan, Asli; Ekemen, Coskun; Sahbudak Bal, ZumrutTranscartilaginous ear piercing has be come increasingly popular among teen agers in the last decade. Because of the unique avascular nature of ear cartilage, it re ceives its nutrition from the perichondrium.Öğe First-Drug Efficacy and Drug-Resistant Epilepsy Rates in Children With New-Onset Epilepsies: A Multicenter Large Cohort Study(Sage Publications Ltd, 2024) Gencpinar, Pinar; Arican, Pinar; Dundar, Nihal Olgac; Kilic, Betul; Sarigecili, Esra; Okuyaz, Cetin; Tekgul, HasanObjective: This study aimed to assess the first-drug efficacy rate in newly diagnosed children with epilepsies treated with antiseizure medications. Methods: This retrospective study was conducted on 1003 children (age range: 3-10 years, and the mean duration of follow-up: 22 +/- 13 months) with newly diagnosed epilepsy. The following parameters were evaluated: first-drug efficacy rate, first-drug-failure rate, and drug resistance rate in the cohort. Results: The first-drug-failure rate was defined in 335/1003 (33%) of the patients, no seizure control in 315 (31%), and drug withdrawal in 20 (2%). There was no significant difference between the group with focal-onset seizures and the group with generalized onset seizures. The first-drug efficacy rate was 67% in children with focal-onset seizures and 66% in children with generalized-onset seizures. Adjunctive antiseizure medication therapy was initiated in 335 patients-dual therapy with 180 patients (18%) and polytherapy with 155 (15%). Drug-resistant epilepsy was defined as 15% in the follow-up period. Etiology-specific diagnoses of the cohort were structural (n = 165, 17%), genetic (n = 25, 3%), metabolic (n = 15%), immune-infectious (n = 17 (2%), and unknown (n = 781, 77%). With a comparison of the 2 most common etiology subgroups (structural versus unknown), a first-drug efficacy rate of 53% and a higher prevalence of drug-resistant epilepsy at 30% were observed in children with structural etiology. First-drug efficacy was statistically lower in children without well-defined epilepsy syndromes (65%) compared with the rate of those with well-defined epilepsy syndrome (79%). Conclusion: This study revealed a first-drug failure rate (33%) in the presented cohort with a drug-resistance epilepsy rate (15%).Öğe Phenotypic variations in knee osteoarthritis: insights from MRI and radiographic comparisons(Springer, 2024) Tosun, Ozgur; Sinci, Kazim Ayberk; Baysan, Caner; Kucukciloglu, Yasemin; Aksit, Mehmet; Kazimoglu, Cemal; Cilengir, Atilla HikmetObjective To investigate the correlation between MRI-based phenotypes (cartilage-meniscus, subchondral bone, and inflammatory) and radiography-based atrophic and hypertrophic phenotypes, aiming to demonstrate MRI's diagnostic capability in identifying complex osteoarthritis phenotypes that radiography cannot fully capture. Materials and Methods This single-center retrospective study examined knee radiographs and MRIs of patients from November 2021 to April 2023 to identify osteoarthritis phenotypes. Radiographs were staged by the Kellgren-Lawrence system, and both modalities were classified into atrophic or hypertrophic phenotypes. MRIs were further classified into three phenotypes: cartilage-meniscus, subchondral bone, and inflammatory. Associations between phenotypes, Kellgren-Lawrence stage, age, and gender were analyzed with Pearson chi-square test and student T-test. Reliability measurements were evaluated using kappa statistic. Results A total of 214 knees from 187 individuals (73.3% women, 26.7% men; mean age 57.1 +/- 9.1 years) were included. The hypertrophic MRI phenotype was significantly associated with cartilage-meniscus and subchondral bone phenotypes (p < 0.001). Cartilage-meniscus and subchondral bone phenotypes were less prevalent in Kellgren-Lawrence stage 2 than in stages 3 and 4 (p < 0.001 and p = 0.004, respectively). The subchondral bone phenotype was more common in men (p = 0.022), and the cartilage-meniscus phenotype in the elderly (p < 0.001). Radiography and MRI had substantial agreement (Kappa = 0.637, p < 0.001) in diagnosing hypertrophic and atrophic phenotypes. Conclusion The hypertrophic phenotype was associated with cartilage-meniscus and subchondral bone phenotypes, with lower prevalences in Kellgren-Lawrence stage 2 knees. MRI offers enhanced phenotypic characterization, which facilitates more precise and individualized management in osteoarthritis care. Despite limitations compared to MRI, radiography remains valuable for the evaluation of hypertrophic and atrophic phenotypes.Öğe Diagnostic yield of exome sequencing-based copy number variation analysis in Mendelian disorders: a clinical application(BMC, 2024) Atik, Tahir; Avci Durmusalioglu, Enise; Isik, Esra; Kose, Melis; Kanmaz, Seda; Aykut, Ayca; Cogulu, Ozgur; Durmaz, Asude; Ozkinay, FerdaNext-generation sequencing (NGS) coupled with bioinformatic tools has revolutionized the detection of copy number variations (CNVs), which are implicated in the emergence of Mendelian disorders. In this study, we evaluated the diagnostic yield of exome sequencing-based CNV analysis in 449 patients with suspected Mendelian disorders. We aimed to assess the diagnostic yield of this recently utilized method and expand the clinical spectrum of intragenic CNVs. The cohort underwent whole exome sequencing (WES) and clinical exome sequencing (CES). Using GATK-gCNV, we identified 12 pathogenic CNVs that correlated with their clinical findings and resulting in a diagnostic yield of 2.67%. Importantly, the study emphasizes the role of CNVs in the etiology of Mendelian disorders and highlights the value of exome sequencing-based CNV analysis in routine diagnostic processes.Öğe Nursing Students' Operating Room Experiences: A Qualitative Metasynthesis(Elsevier Science Inc, 2024) Taylan, Secil; Ozkan, Ilknur; Yavuz van Giersbergen, MeryemPurpose: This study was conducted to analyze the findings of qualitative studies about nursing students' experiences with operating room (OR) practices. There is a need to conduct metasynthesis studies to highlight the overarching dimensions of nursing students' experiences in the OR learning environment, identify and summarize key elements, draw attention to the professional implications of the experience, and then help define the future research agenda. This original study is the first metasynthesis of qualitative studies focusing on nursing students' OR practice experiences. Design: A qualitative metasynthesis. Methods: This metasynthesis study was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and registered with PROSPERO (International prospective register of systematic reviews) (CRD42021252129). This metasynthesis consists of qualitative studies that included themes, were conducted with nursing students with OR experience, and were published in English between December 2000 and June 2022. Data were analyzed using the two-step metasynthesis procedures proposed by Sandelowski and Barroso. Findings: This metasynthesis study was carried out by analyzing 12 qualitative studies that met the inclusion criteria, reflected the results of a total of 244 nursing students, and were conducted in 7 different countries. As a result of the analysis of the studies, two main themes and seven subthemes were determined about the OR experiences of nursing students. The main themes of the study included (1) the OR environment and (2) professionalism and career choices. Conclusions: The synthesis of studies in this research revealed nursing students' OR experiences and provided evidence about the association between these experiences and their professionalism and career goals. The research drew attention to the limitations and facilitators of the OR learning environment for nursing students and provided guidance for a positive interactive learning environment. (c) 2024 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Öğe Spatio-temporal assessment of landscape ecological risk using spatial statistical analysis in a basin of Turkiye(Springer, 2024) Senay, Diba; Nurlu, EnginMonitoring the land use/land cover (LU/LC) changes that have occurred with rapid population growth and urbanization since the Industrial Revolution is important for the optimal configuration of landscape patterns and ensuring the sustainability of ecological functions. Spatiotemporal dynamic pattern of LU/LC change using high-resolution land use data is an indicator to evaluate the landscape ecological risk through landscape pattern index analysis. In this study, the landscape ecological risk index (LERi) based on LU/LC change was calculated using remote sensing images of Landsat TM (Thematic Mapper) and OLI (Operational Land Imager) Rdata of a Gediz Mainstream Sub-basin in Turkiye between 1992 and 2022, and the spatial distribution regularity of LERi values was determined with spatial statistical analysis. According to the results, it was determined that the LERi values of the study area changed by 45% in 30 years. The highest change is in the very high-risk class, with an increase of 10.96%, and the least change occurred in the very low-risk class, with a decrease of 1.29%. According to the obtained statistical analysis results, it was determined that the global spatial autocorrelation values analyzed at different grain levels showed positive autocorrelation for both years and that the LERi values tended to have strong spatial clustering. As a result, it is emphasized that strict control measures should be taken for areas showing High-High (HH) autocorrelation type located in the southeast and north-southwest line of the study area at the local level, and ecological restoration applications should be given priority in these areas.Öğe The effects of aromatherapy and music on pain, anxiety, and stress levels in palliative care patients(Springer, 2024) Akbas Uysal, Duygu; Senuzun Aykar, Fisun; Uyar, MeltemAimPain and anxiety levels in palliative care patients negatively impact their quality of life, highlighting the need for research on non-pharmacological methods. This study aimed to evaluate the effects of music and aromatherapy interventions on pain, anxiety, and stress levels in these patients. Material and MethodsThe research was designed as a single-blind, four-group, randomized controlled trial. The sample consisted of 88 patients hospitalized in a palliative care center (receiving palliative care services with terminal or advanced diseases). Patients were randomly assigned to four groups (n = 22, music, aromatherapy, music and aromatherapy, and control group). Patients in the experimental groups received the intervention to which they were assigned for 20 min each day for three consecutive days: music, aromatherapy, or music accompanied by aromatherapy. No intervention was applied to the control group. The patients' levels of pain, anxiety, and stress were assessed before and after the intervention using the Visual Analog Scale (VAS), the Facial Anxiety Scale (FAS), and the Distress Thermometer. ResultsNo significant differences were found in the demographic characteristics of the groups (p > 0.05). The Wilcoxon Signed-Rank and Kruskal-Wallis tests indicated statistically significant differences in pre- and post-intervention scores for VAS, FAS, and Distress across all experimental groups on all follow-up days (p < 0.05). ConclusionImplementing music, aromatherapy, and their combination effectively reduced pain, anxiety, and stress levels in palliative care patients, suggesting these non-pharmacological interventions can improve their quality of life. Trial registrationClinicalTrails.gov (Registration number: NCT06024954) at 05-SEP-2024.Öğe A comprehensive review on organ-on-chips as powerful preclinical models to study tissue barriers(IOP Publishing Ltd, 2024) Filiz, Yagmur; Esposito, Alessio; De Maria, Carmelo; Vozzi, Giovanni; Yesil Celiktas, OzlemIn the preclinical stage of drug development, 2D and 3D cell cultures under static conditions followed by animal models are utilized. However, these models are insufficient to recapitulate the complexity of human physiology. With the developing organ-on-chip (OoC) technology in recent years, human physiology and pathophysiology can be modeled better than traditional models. In this review, the need for OoC platforms is discussed and evaluated from both biological and engineering perspectives. The cellular and extracellular matrix components are discussed from a biological perspective, whereas the technical aspects such as the intricate working principles of these systems, the pivotal role played by flow dynamics and sensor integration within OoCs are elucidated from an engineering perspective. Combining these two perspectives, bioengineering applications are critically discussed with a focus on tissue barriers such as blood-brain barrier, ocular barrier, nasal barrier, pulmonary barrier and gastrointestinal barrier, featuring recent examples from the literature. Furthermore, this review offers insights into the practical utility of OoC platforms for modeling tissue barriers, showcasing their potential and drawbacks while providing future projections for innovative technologies.Öğe Concentrations of radionuclides and trace elements in wetlands(Springer, 2024) Akakce, Nurdan; Erdemir, Umran Seven; Gorgun, Aysun Ugur; Sert, Ilker; Sac, MuratEnvironmental risks in wetlands are considered with radionuclides and trace elements to understand pollution accumulation. In this study, we aimed to determine the levels of radiation and heavy metals in water systems and assess pollution configurations. Radionuclides (222Rn, 210Pb and 210Po) and trace elements (Ag, As, Ba, Be, Cd, Co, Cr, Cu, Fe, Li, Mo, Ni, Pb, V and Zn) were measured to evaluate anthropogenic factors. Water pollution in wetlands was indicated by mean concentrations of 66.2 mBq/L for 222Rn, 3 mBq/L for 210Pb, 42 mBq/L for 210Po, 41 ppb for Zn, 37 ppb for Ba, 190 ppb for Fe and 481 ppb for Sr. These pollutants may be related to industrial facilities in K & imath;rklareli city, T & uuml;rkiye.Öğe Composite Reconstruction With Irradiated Autograft Plus Total Hip Replacement After Type II Pelvic Resections for Tumors Is Feasible but Fraught With Complications(Lippincott Williams & Wilkins, 2024) Vahabi, Arman; Tosyali, Hakan Koray; Kececi, Burcin; Sabah, Dundar; Kaya, HuseyinBackgroundMalignancies involving the pelvic ring present numerous challenges, especially in the periacetabular area. Extensive resection of the pelvic region without reconstruction can lead to severe functional impairment. Numerous reconstructive options exist, but all have drawbacks. Extracorporeally irradiated autografts are one option for reconstruction after periacetabular resections; they offer the potential advantages of eliminating the risk of allogeneic reactions associated with allografts and preserving local anatomy. However, little is known about the durability and risks of this approach in pelvic reconstruction.Questions/purposes(1) What are the survival rates of the autograft used, and if there is graft loss, what is the extent of this loss? (2) What are the functional outcomes after the implementation of this method? (3) What is the rate and nature of complications associated with this approach?MethodsThis is a retrospective case series from one subspecialty tumor unit that evaluated patients treated between January 2005 to January 2022. During that time, three surgeons treated 48 patients with Type II resections (defined as resection of periacetabular area). Patients treated with isolated Type II resections were eligible, as were those treated either with Type I+II resections, Type II+III resections, Type I+II+III resections, and Type I+II+III+IV resections. Of those, 21% (10 of 48) were treated primarily with a cone prosthesis, 13% (6 of 48) were treated without femoral reconstruction, 10% (5 of 48) were treated with resection without reconstruction, and 6% (3 of 48) had a THA on the sacrum, leaving 50% (24 of 48) of patients who were treated with femoral and acetabular reconstruction using extracorporeally irradiated autograft and total hip replacement; those patients were potentially eligible for this study. During that time span, we used this approach in all Type II pelvic resection procedures, when a part of the hemipelvis could be preserved without resection (other than Type I+II+III+IV) and where we predicted that there would be sufficient bone stock after tumor removal. Of those, 21% (5 of 24) were lost to follow-up before 2 years, and 13% (3 of 24) died within 2 years with the reconstruction intact and without any reoperation or graft loss, leaving 67% (16 of 24) for analysis here. Demographic characteristics, type of tumor, tumor origin site, type of applied resection, and extent of applied surgical procedure were noted. Of 16 patients, 12 were male, with a mean age of 38 +/- 21 years. Tumor types included chondrosarcoma in eight patients, malignant mesenchymal tumor in four patients, osteosarcoma in two patients, and Ewing sarcoma in two patients. Among these, 10 patients had tumors originating from the pelvis, whereas six patients had tumors originating from the proximal femur. We used a Kaplan-Meier estimator to calculate survivorship free from total or partial graft removal at 72 months. To measure functional results, the Musculoskeletal Tumor Society (MSTS) scoring system was utilized at most recent follow-up so as to be able to evaluate the impact of complications (if any) on the ultimate result. The MSTS score ranges from a minimum of 0 points to a maximum of 30 points, where a higher score reflects lower pain and higher functional and emotional capacity. Related complications, time of complications, secondary interventions, and mortality rates were also ascertained from chart review. ResultsGraft survival rate at 72 months after initial reconstruction, free from partial or total graft removal, was 50% (95% CI 26% to 75%). Kaplan-Meier analyses revealed estimated mean time of graft removal as 43 months (95% CI 28 to 58). The graft was protected in eight patients on their final follow-up radiographs. The median (range) MSTS score was 18 (6 to 25) of 30 points at most-recent follow-up (these scores include patients who have had their grafts removed). In all, 15 of 16 patients had 17 complications; 16 were major complications (defined as those substantial enough to result in further surgery or a life- or limb-threatening event). A total of 14 of those 15 patients underwent one or more secondary procedures (a total of 21 unplanned additional procedures were performed in those patients). Deep infection was the most common complication, occurring in eight patients. Prosthesis dislocation occurred in four patients. Three patients developed aseptic acetabular component loosening, two had graft fractures, and one patient developed heterotopic ossification.ConclusionComposite reconstruction with extracorporeal irradiated autografts plus total hip replacement is a feasible reconstruction technique after Type II pelvic resections, although complications and reoperations were common. Although no reconstruction technique has been proven superior to other alternatives, the high risk of complications and reoperations associated with this technique should be considered when selecting from among possible alternative reconstruction methods.Level of EvidenceLevel IV, therapeutic study.Öğe The Effects of Telerehabilitation-Based Exercise Therapy on Motor and Non-Motor Clinical Outcomes in Adults With Facial Palsy: A Randomized Controlled Trial(Sage Publications Ltd, 2024) Ozden, Fatih; Golcuk, Yalcin; Tumturk, Ismet; Ozkeskin, MehmetRecent case reports have emphasized the essential clinical contribution of telerehabilitation in the treatment of facial palsy. However, no randomized controlled trial has yet demonstrated the effects of telerehabilitation-based facial exercise therapy. Thus, we aimed to investigate the effectiveness of video exercise-based telerehabilitation on motor and non-motor clinical outcomes in adults with facial palsy. We conducted a randomized controlled trial with 40 peripheral facial palsy patients. Those in the experimental group (EG) received four weeks of telerehabilitation-based video exercises and routine care. Those in the control group (CG) received only routine care. All participants were evaluated with the Facial Disability Index (FDI), the Facial Clinimetric Evaluation Scale (FaCE), Short Form-12 (SF-12), the Hospital Anxiety and Depression Scale (HADS), the House-Brackmann Scale (H-B) and the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), both before and after the interventions. Both groups demonstrated a significant improvement in FDI, FaCE, and SF-12 PCS scores (p < .05). In addition, there was a significant improvement only in EG on the SF-12 MCS score (p < .05), and there was a significant gain only in CG on the HADS-Depression score (p < .05). While these results provide a further contribution to our understanding of telerehabilitation benefits in mental health variables related to quality of life for facial palsy patients, we found no EG and CG differences on the physical components of treatment.Öğe Development of transition metal oxide platforms for aptasensing of PSA in cell cultures(Springer Heidelberg, 2024) Kirlangic, Irem Aydin; Uner, Goklem; Kara, Pinar; Kirmizibayrak, Petek Ballar; Ertas, Fatma NilIn this study, a novel aptasensor based on a transition metal oxide-modified pencil graphite electrode (PGE) was developed for the diagnosis of early-stage prostate cancer (PCa) via monitoring the prostate-specific antigen (PSA), which is the main biomarker for PCa. Single-use PGEs modified with pulsed deposited manganese oxide (MnOx) film were used to attach the amino-terminated aptamer specific to the PSA via carbodiimide chemistry. The designed aptasensor was placed in an electrochemical cell containing ferri/ferrocyanide ions as a redox probe to measure the charge transfer resistances (Rct) of the electrode surface by electrochemical impedance spectroscopy (EIS) to follow the response of each modification step. The effect of the medium pH on the ionic structure of the aptamer molecule according to its pI value and, thus, the reversing of the direction of the response (Delta Rct) by the pH change was also discussed. The level of PSA secreted from PCa cells was investigated using impedimetric transduction. The specificity of the aptasensor was validated through selectivity studies against non-specific tumor markers like VEGF and different cancer cell lines including breast cancer and androgen-insensitive prostate cancer. The developed system showcases a label-free, fast, specific, and cost-effective approach for PSA detection, highlighting the importance of medium pH and the electrostatic environment on the aptamer's response. Our work emphasizes the potential for such aptasensors in clinical diagnostics and paves the way for further exploration into using transition metal oxides in biosensing applications.Öğe Comparison of Heart Rate Variability Psychological Responses and Performance in Virtual and Real Archery(Wiley, 2024) Dal, Nihal; Tok, Serdar; Balikci, Ilker; Yilmaz, Said Enes; Binboga, ErdalBackgroundThis study examines the psychophysiological differences between virtual reality (VR) and real archery. It explores whether VR archery induces heart rate (HR), heart rate variability (HRV), and breathing rates similar to those experienced in real archery. Additionally, the study assesses differences in perceived anxiety, difficulty, confidence, rate of perceived exertion (RPE), and shooting performance between the two modalities, providing insights into the efficacy of VR as a training tool for archery.MethodsTwenty-two (women: 8) individuals aged 20-24 participated in the study. We first recorded individuals' resting HR, HRV, and breathing rates during baseline. Afterward, participants shot 10 real and virtual arrows from 18 m, whereas their HR, HRV, and breathing rate were measured, each lasting 4 min. Performance in VR and real archery was determined separately as the sum of the shots. We performed paired sample t-tests to compare individuals' performance, psychological, and psychophysiological responses recorded during VR and real arrow shooting. Afterward, we compared percentage changes between VR and real archery.ResultsResults showed that HR and root mean square of successive differences (RMMSD) were significantly higher during real archery compared to virtual archery. In addition, VR archery led to a greater percentage change in RMSSD compared to real archery. Participants reported greater RPE and perceived difficulty after real archery. Performance was also higher during VR archery than real archery.ConclusionsConsequently, the results of the present study illustrated that VR, and real archery might lead to different autonomic response patterns in terms of vagal activity.Öğe Machine learning in oncological pharmacogenomics: advancing personalized chemotherapy(Springer Heidelberg, 2024) Avci, Cigir Biray; Bagca, Bakiye Goker; Shademan, Behrouz; Takanlou, Leila Sabour; Takanlou, Maryam Sabour; Nourazarian, AlirezaThis review analyzes the application of machine learning (ML) in oncological pharmacogenomics, focusing on customizing chemotherapy treatments. It explores how ML can analyze extensive genomic, proteomic, and other omics datasets to identify genetic patterns associated with drug responses. This, in turn, facilitates personalized therapies that are more effective and have fewer side effects. Recent studies have emphasized ML's revolutionary role of ML in personalized oncology treatment by identifying genetic variability and understanding cancer pharmacodynamics. Integrating ML with electronic health records and clinical data shows promise in refining chemotherapy recommendations by considering the complex influencing factors. Although standard chemotherapy depends on population-based doses and treatment regimens, customized techniques use genetic information to tailor treatments for specific patients, potentially enhancing efficacy and reducing adverse effects.However, challenges, such as model interpretability, data quality, transparency, ethical issues related to data privacy, and health disparities, remain. Machine learning has been used to transform oncological pharmacogenomics by enabling personalized chemotherapy treatments. This review highlights ML's potential of ML to enhance treatment effectiveness and minimize side effects through detailed genetic analysis. It also addresses ongoing challenges including improved model interpretability, data quality, and ethical considerations. The review concludes by emphasizing the importance of rigorous clinical trials and interdisciplinary collaboration in the ethical implementation of ML-driven personalized medicine, paving the way for improved outcomes in cancer patients and marking a new frontier in cancer treatment.Öğe Long-term outcomes of mitral valve repair in children(Frontiers Media SA, 2024) Tuncer, Osman Nuri; Ertugay, Serkan; Akhundova, Mahsati; Levent, Erturk; Atay, YukselBackground Mitral Valve Disease in children presents unique challenges due to the wide range of associated pathologies and the complexities of pediatric cardiac anatomy. Mitral valve repair in this demographic is preferred over replacement due to the drawbacks associated with prosthetic valves in young patients, such as the need for long-term anticoagulation and issues with prosthetic size and growth.Methods This retrospective study reviewed pediatric patients under 18 years who underwent mitral valve repair between January 2002 and December 2023. Exclusion criteria included patients with atrioventricular septal defects or single-ventricle physiology. Surgical outcomes were assessed using preoperative and postoperative transthoracic echocardiography, with follow-up data analyzed via Kaplan-Meier survival estimates.Results The study included 47 patients with a median age of 4 years. Surgical techniques varied based on the specific mitral valve pathology. The overall early mortality was 6.3%, and the one and ten-year survival rates were 93.6 +/- 3.6% and 91.4 +/- 4.1%, respectively. Most patients showed improved or stable postoperative cardiac function during a median follow-up of 105 months. Notably, the rate of freedom from re-operation at ten years was 85.1 +/- 6.9%, highlighting the durability of the surgical interventions.Conclusions Mitral valve repair in children demonstrates favorable long-term outcomes with low mortality and reoperation rates, particularly when performed at an older age to accommodate growth and avoid the complexities of smaller, more delicate cardiac structures. These findings suggest that mitral valve repair should be considered a viable and effective option for managing pediatric MVD, with a personalized approach essential for optimizing outcomes.Öğe Clinical perspective on innovative insulin delivery technologies in diabetes management(Frontiers Media SA, 2024) Kockaya, Guvenc; Battelino, Tadej; Petrovski, Goran; Jendle, Johan; Sarman, Beatrix; Elbarbary, Nancy; Goksen, DamlaIntroduction The primary objective of this study is to report the results of an online questionnaire and the in-person discussion sessions of physicians specializing in diabetes care in which their opinions about current diabetes management was obtained.Methods The Diabetes Innovation Summit 2023 drew attendance from a diverse group of specialized physicians from multiple countries. A comprehensive literature review was conducted to examine the technologies and medical needs associated with diabetes management. Using the results of the review, a questionnaire was developed by three experts from the steering committee to solicit feedback from specialized physicians. The online survey was made accessible between 10th December 2022 and 10th January 2023. Following the online survey, six structured in-person discussion sessions were conducted with specialized physicians from the Middle East, Central-Eastern Europe, and North Africa regions.Results The study revealed that about 59% of survey requests were answered, with many participants being pediatric endocrinologists from North Africa. Around 60% of diabetes patients followed Multiple Daily Injections (MDI) according to specialized physicians. Among MDI users, 62% employed Blood Glucose Monitors (BGM), 31% used intermittent-scanning Continuous Glucose Monitors (isCGM), and 23% used CGM. In North Africa, nearly 90% of patients used MDI due to financial constraints. While physicians focused on both Time in Range (TIR) and HbA1c for MDI-treated patients, satisfaction with TIR achieved was expressed by 31%, while 741% believed Real-Time CGM (rtCGM) was effective. Concerns arose about potentially misleading HbA1c results and the relatively low patient achievement of target TIR despite CGM usage. The Smart MDI System was seen favorably compared to other applications. The system's affordability was a significant barrier, particularly in the Middle East and Africa.Conclusion The present study highlights that physicians are generally supportive of utilizing new technology. The questionnaires and the open discussion revealed the expectation that the Smart MDI technology provides better control, primarily by identifying missed boluses, while expressing concerns on the use of the technology by teenagers and children, who might forget the device and be reluctant to use in public, and by the older population, who might be challenged by the technology.Öğe Preparation and Characterization of Cumin Essential Oil Nanoemulsion (CEONE) as an Antibacterial Agent and Growth Promoter in Broilers: A Study on Efficacy, Safety, and Health Impact(MDPI, 2024) Jabbar, Muhammad; Baboo, Irfan; Majeed, Hamid; Farooq, Zahid; Palangi, Valiollah; Lackner, MaximilianSimple Summary Broiler meat is widely consumed around the globe. To fulfill consumer demand, broiler farmers are using antibiotic growth promoters for improved efficiency. However, these antibiotics have been banned in developed countries due to antimicrobial resistance. Therefore, plant supplements in the form of essential oils (EOs) have gained acceptability due to their excellent antibacterial properties. The next step is to encapsulate the EO for better delivery to target organs in broilers, which was investigated in vivo. The novelty of this study is to encapsulate volatile compounds of EOs in nanoemulsion (NE). This study has observed a positive effect of NE in terms of broiler growth performance, suggesting that cumin EO NE (CEONE) can be used as a substitute for the prophylactic administration of synthetic antibiotics.Abstract This research characterized and explored the effect of cumin essential oil nanoemulsion (CEONE) on broiler growth performance, serum biochemistry, hematological parameters, and cecal microbial count. Day-old (n = 96) broilers (Ross 308) were randomly assigned to six treatments with five replicates of three broilers each. The dietary treatments consisted of negative control (only basal diet), positive control (basal diet + 200 mu L of enrofloxacin), 25 mu L (basal diet + 25 mu L of CEONE), 50 mu L (basal diet + 50 mu L of CEONE), 75 mu L (basal diet + 75 mu L of CEONE), and 100 mu L (basal diet + 100 mu L of CEONE). The broiler's body weight gain (BWG) after 42 days of treatment exhibited increased weight in the CEONE group (976.47 +/- 11.82-1116.22 +/- 29.04). The gain in weight was further evidenced by the beneficial microbe load (107 log) compared to the pathogenic strain. All the biochemical parameters were observed in the normal range, except for a higher level of HDL and a lower LDL value. This safety has been validated by pKCSM toxicity analysis showing a safe and highly tolerable dose of cuminaldehyde. In conclusion, this research observed the potential of CEONE as a multifunctional agent. It is a valuable candidate for further application in combating bacterial infections and enhancing animal health and growth. on
