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Yayınlar
- ArticleAçık Erişim2026A Novel Protective Strategy Against Metformin-Induced Renal Injury Involving Adenosine Triphosphate and Thiamine Pyrophosphate
Kocaturk, Huseyin; Bedir, Fevzi; Yavuzer, Bulent; Sezgin, Esra Tuba; Mammadov, Renad; Suleyman, Bahadir; Sarigul, Cengiz; Cimen, Ferda Keskin; Altay, Mehmet Sefa; Suleyman, Halis
Metformin is widely used in type 2 diabetes, but its effects on oxidative and inflammatory pathways remain controversial. Beyond glycemic control, it may promote lactic acidosis by impairing mitochondrial metabolism and pyruvate flux. The potential renoprotective roles of adenosine triphosphate (ATP) and thiamine pyrophosphate (TPP) remain poorly defined. This study aimed to evaluate whether ATP and TPP mitigate metformin-induced renal injury through biochemical and histopathological assessments. Wistar rats were randomly divided into six groups: control, ATP, TPP, metformin, ATP + metformin, and TPP + metformin. Metformin (50 mg/kg, oral), ATP (4 mg/kg, intraperitoneal), or TPP (20 mg/kg, intraperitoneal) was administered daily for 10 days. Oxidative stress markers, inflammatory cytokines, renal histopathology, and serum creatinine, BUN, lactate, and LDH levels were evaluated. Metformin induced significant oxidative stress, inflammation, metabolic disturbance, and renal injury. ATP provided partial protection, whereas TPP markedly restored redox balance, reduced inflammation, and preserved renal histology. TPP confers superior protection against metformin-induced renal injury compared with ATP by modulating oxidative, inflammatory, and metabolic pathways, highlighting its therapeutic potential in preventing metformin-related nephrotoxicity.
- ArticleAçık Erişim2026Attention Enhanced Deep Learning for MRI-Based Brain Tumor Classification: A Comparative Ablation Study
Taş, Mehmet Bilge Han; Öztepe, Muhammet Fırat
Objective: The performance of models was evaluated using an ablation-based approach employing attention mechanisms and transfer learning for tumor classification in brain magnetic resonance imaging images. Methods: The glioma, meningioma, no tumor, and pituitary classes from the BRISC2025 public dataset were used. ResNet50, DenseNet121, EfficientNetB0, Xception, and InceptionResNetV2 models were tested using a baseline and the squeeze-and-excitation (SE) attention, spatial attention, and convolutional block attention module attention constructs. The models were trained in two phases: frozen backbone training and fine-tuning, with each experiment repeated three times. Performance was evaluated using accuracy, precision, recall, F1-score, area under the curve (AUC), and loss values. Results: The most successful model was EfficientNetB0 + SE Attention. This model achieved an accuracy of 0.9580 ± 0.0062, an F1-score of 0.9580 ± 0.0057, and an AUC of 0.9949 ± 0.0012 on the test set. Class-based results showed particularly high success rates for the no-tumor and pituitary classes. The most challenging class was meningioma. Conclusion: Transfer learning models supported by attention mechanisms have yielded successful results in brain tumor magnetic resonance classification. The EfficientNetB0 + SE Attention model stood out as the most balanced and successful architecture among the evaluated methods.
- ArticleYalnız künye2026Cobalt oxide nanoparticles as a promising antifungal agent for Candida species: Eco-friendly synthesis from Platanus orientalis L. leaf extract and its applications
Gür, Bahri; Gülhan, Barış; Akkaş, Önder; Akgöz, Melek; Vejselova Sezer, Canan; Cengiz, Mustafa; Kutlu, Hatice Mehtap; Alma, Mehmet Hakkı
The development of environmentally compatible nanomaterials with biomedical potential has garnered increasing interest. In this study, cobalt oxide nanoparticles (Co3O4-NPs) were synthesized by an eco-friendly method using Platanus orientalis L. leaf extract as a reducing and stabilizing agent. Structural and physicochemical characterizations confirmed the successful formation of spinel-type Co3O4-NPs with controlled size and morphology. Synthesis at pH 12 resulted in smaller (22.70 nm) and more stable nanoparticles which showed increased anticandidal activity. The minimum inhibitory concentrations (MIC: 3.91, 7.81, and 1.95 mg/mL) and the minimum fungicidal concentrations (MFC: 15.63, 62.50, and 7.81 mg/mL) indicated a strong antifungal effect against Candida albicans, Candida tropicalis , and Candida glabrata , respectively. In addition, Co3O4-NPs showed concentration-dependent cytotoxicity on MDA-MB-231 breast cancer cells with the inhibition concentration 50 value (IC50: 0.07 mg/mL 24-h) indicating potential anticancer effect. These results highlight the dual antifungal and cytotoxic capabilities of biogenically synthesized Co3O4-NPs, making them strong candidates for future biomedical applications.
- LetterYalnız künye2026Reply to: “Inflammatory Indices and Pediatric Emergence Delirium: Predictive Signal or Statistical Artifact”
Altıparmak, Serkan; Kars, Ayhan; Salcan, Sara; Koç, Alparslan
- ArticleYalnız künye2026Bioactive properties of Vicia canescens subsp. variegata (Willd.) P.H. Davis, Fabaceae: antioxidant, antiparkinsonian and relevance to food and agriculture use
Aydın, Bilge; Ertuğrul, Muhammed Sait; Aydın, İsmail Çağrı; Uğan, Rüstem Anıl; Özkaraca, Mustafa; Yuca, Hafize; Özbek, Hilal; Kazaz, Cavit; Okkay, Ufuk; Karakaya, Songül
BACKGROUND: Various Vicia species belonging to the Fabaceae family are known to be used in different parts of the world both in human nutrition and as animal feed, and also have pharmacological potential in the prevention and treatment of various diseases. With this perspective, in the present study, the possible antiparkinsonian effects of extracts prepared from Vicia canescens subsp. variegata were investigated in cell culture and on 6-hydroxydopamine (6-OHDA)-induced Parkinson's model rats. The effects of the plant on the pathophysiology of Parkinson's disease were evaluated by biochemical and histopathological analyses; in addition, the structures of the compounds isolated from the active extracts were elucidated and the in vitro antioxidant and antiparkinsonian activities of these compounds were determined. RESULTS: Methanol and n-butanol extracts prepared from the aerial parts of V. canescens subsp. variegata showed significant antiparkinsonian effects both in cell culture and in a rat model. Histopathological and biochemical analyses were also parallel to in vivo experiments. As a result of the isolation studies, six flavonol glycosides were obtained from the plant, and their antioxidant capacities as well as antiparkinsonian effects were subsequently evaluated. The highest biological effect was observed in quercetin-3-O-α-l-rhamnopyranoside (quercitrin, VCB-3). CONCLUSION: In the light of the studies, the antiparkinsonian effects of V. canescens subsp. variegata was evaluated. It was seen that they prevented neurodegeneration and the oxidative stress that occurred, and the most effective compounds were determined. Two new compounds named viciacoside A and B have been added to the literature as a result of this research.
- ArticleAçık Erişim2026The effect of the liquid motion bubbler timer soothing sensory toy on children’s fear and anxiety levels during blood sampling: a randomized clinical trial
Sariali̇oğlu, Arzu; Oluç, Tuğba
Background: Blood sampling is one of the invasive procedures in a hospital setting that can cause fear, anxiety, and stress in children. Aim: The study aimed to determine the effect of the Liquid Motion Bubbler Timer Soothing Sensory Toy on children’s fear and anxiety levels during blood sampling. Methods: The study was conducted with a total of 90 children aged 4–6 years, divided into two groups (45 in the intervention group and 45 in the control group). The data were collected by face-to-face interviews using the “Questionnaire Form”, “Children’s Fear Scale”, and “Children’s State Anxiety”. Children in the intervention group were made to play “Liquid Motion Bubbler Timer Soothing Sensory Toy” before and during the blood sampling procedure. The Dependent Groups T-Test, the Wilcoxon Test, the Independent Groups T-Test, and the Mann-Whitney U-Test were used in the analysis of the data. Results: The Liquid Motion Bubbler Timer Soothing Sensory Toy group had significantly lower fear and anxiety scores compared to the control group (p<0.05). The Liquid Motion Bubble Timer Soothing Sensory Toy has a significant effect on children’s fear and anxiety. Conclusion: The innovative “Liquid Motion Bubble Timer Soothing Sensory Toy” is effective against fear and anxiety in children, and can be used by healthcare professionals working in pediatric units during invasive procedures with children. Trial registration: ClinicalTrials.gov (No: NCT06476418, Date: 03/05/2024, https://clinicaltrials.gov/study/NCT06476418?locStr=Erzurum,%20T%C3%BCrkiye&country=T%C3%BCrkiye&state=Erzurum&city=Erzurum&viewType=Card&cond=child&rank=17)
- ArticleAçık Erişim2026The Effect of Age and Tooth Loss on Articular Eminence Slope: An Orthopantomographic Study; [Yaş ve Diş Kaybının Eklem Eminens Eğimi Üzerindeki Etkisi: Ortopantomografik Bir Çalışma]
Çelik, Fatih; Özsoy, Elif; Oktay, Fatih; Taşkesen, Fatih; Diyarbakır, Samih
Objective: To investigate whether morphologic changes in the cranial component of the temporomandibular joint are associated with aging or tooth loss and, if so, whether articular eminence flattening is more associated with age or edentulism. Methods: Ortopantomographs of patients admitted to the hospital for routine dental treatment were retrospectively analyzed. Patients were divided into 4 groups according to their age and edentulous status. Group1: 49 patients aged 18-35 years with occlusal support, Group2: 46 patients aged 36-59 years with occlusal support, Group3: 43 patients over 60 years with occlusal support, and Group4: 42 patients over 60 years with lost occlusal support. The Frankfort horizontal plane and the articular eminence slope were drawn on the radiographs and the angle between them was measured and the differences between the groups were analyzed. Results: There was no significant correlation between age and flattening of the articular eminence angle (P=.645). A statistically highly significant difference was observed between Group 4 and all other groups in terms of articular eminence angles (P=.01). Conclusion: Since there was no significant correlation between age and articular eminence angle, and since the articular eminence angle was significantly different in Group 4, which consisted of completely edentulous patients, compared to all other groups, it was concluded that AEA may be related to edentulism rather than age. Study emphasizes the importance of occlusion by identifying tooth loss as a possible cause of the decrease in AE slope.
- ArticleAçık Erişim2026Gingival inflammation and plaque accumulation affect therapeutic outcomes in patients with acne vulgaris
Okumuş, Ömer Faruk; Yazıcı, Mustafa; Kantarci, Alpdoğan
Background: We hypothesized that acne vulgaris (AV) and gingivitis were associated through systemic inflammatory mechanisms, sharing common etiological factors. This study aimed to identify the association between AV and gingivitis and to assess changes in acne severity in relation to changes in the plaque index (PI). Methods: This prospective, observational study included 150 patients aged 13 to 19 years, divided into three equal groups based on acne severity. The PI and the gingival index (GI) of all participants were recorded, followed by oral hygiene instruction and scaling. The severe acne group was re-evaluated after 1.5 months, constituting the follow-up stage of the study. These patients were then divided into two subgroups based on the degree of change in their acne scores. Changes in PI and GI were calculated from repeated measurements. Results: At baseline, although no significant difference was observed between the groups in terms of PI scores (p > 0.05), the GI scores were significantly higher in the severe acne group compared with the mild acne group (p < 0.001). At the re-evaluation, the subgroup with more pronounced improvement in acne scores showed significantly greater changes in both GI and PI values (p < 0.001), and the magnitude of these changes demonstrated good discriminative performance for acne improvement (AUCs = 0.896–0.903; p < 0.001). Conclusions: The findings suggested that gingival inflammation was associated with the severity of AV lesions, independent of plaque accumulation. Thus, improvements in gingival inflammation and plaque accumulation were associated with AV-associated symptom improvement. Trial registration: This study was registered in ClinicalTrials.gov under the number NCT06237387 on May 24, 2024. Plain language summary: Acne vulgaris and gingivitis are common inflammatory diseases. Etiological factors such as nutrition, hormonal changes associated with puberty, and hygiene habits are effective in both diseases. This study aimed to examine the relationships among plaque accumulation, gingivitis, and acne vulgaris. A total of 150 adolescents were included in the study, and participants were divided into three groups based on acne severity: mild, moderate, and severe. All participants were assessed for plaque and gingival inflammation, and all received oral hygiene instruction and dental scaling. Greater reductions in plaque levels and gingival inflammation were observed in patients who showed more pronounced regression of acne lesions.
- ArticleAçık Erişim2026Ultrasound-Guided Transversalis Fascia Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia After Repeat Cesarean Delivery: A Prospective Observational Study
Ötügen, Taha Emre; Akyol, Fethi; Karataş, Talha; Ataş, Gamze; Taş, Hakan Gökalp; Kuyrukluyıldız, Ufuk
Background: Effective postoperative pain control after cesarean delivery is essential for facilitating early mobilization and reducing analgesic requirements. Ultrasound-guided fascial plane blocks, such as the transversus abdominis plane (TAP) and transversalis fascia plane (TFP) blocks, are increasingly used as components of multimodal analgesia; however, direct comparative data between these techniques remain limited. Methods: In this prospective observational study, 90 patients undergoing repeat cesarean deliveries under spinal anesthesia were administered either a bilateral ultrasound-guided transversus abdominis plane (TAP) block or a transversus fascia plane (TFP) block in accordance with standard clinical practice. The intensity of postoperative pain, assessed both at rest and during movement, was determined using VAS scores at 3, 6, 12, and 24 h after surgery. The time until first ambulation and additional postoperative analgesic consumption beyond the standardized baseline analgesic regimen over the first 24 postoperative hours were also evaluated. Results: The patients who were administered a TFP block had diminished postoperative pain levels, reduced additional postoperative analgesic requirements, and expedited mobilization relative to those administered a TAP block. The TFP group had considerably lower movement-related pain levels within the first 24 h following surgery. Opioid-related adverse effects were comparable between groups. Conclusions: After a repeat cesarean delivery, applying a TFP block was linked to better postoperative analgesia and fewer analgesic requirements than applying a TAP block. These findings suggest that TFP blocks may represent an effective component of multimodal analgesia in obstetric anesthesia.
- ArticleYalnız künye2026Pro-oxidant effect of lobaric acid as a therapeutic strategy against breast cancer: a molecular perspective
Toraman, Emine; Kalın, Şeyda Nur; Bayındırlı, Kübra Nur; Günaydın, Şükran; Keleş, Fatmanur; Altay, Ahmet; Budak, Harun
Background: This study aimed to investigate the anticancer effects of lobaric acid (LA), a lichen acid, in MCF-7 cells. Our previous study demonstrated that LA exhibits anticancer effects by triggering apoptosis in MCF-7 cells. However, the relationship between this anticancer effect and the oxidative pathway and apoptosis mechanism has not been explained. In this study, the cytotoxic and anticancer effects of LA on MCF-7 cells were investigated through oxidative stress and thioredoxin system pathways. Methods and results: For this purpose, reactive oxygen species (ROS), reduced glutathione (GSH), and malondialdehyde (MDA) levels were measured in MCF-7 cells exposed to LA at a concentration of 44.21 µg/mL (IC50). Additionally, the activities, gene, and protein levels of SOD, CAT, GPx, GST, GR, and TrxR enzymes were evaluated. In addition, the expression levels of TXN and TXNIP genes were also analyzed. The results showed that LA increased ROS and MDA levels and decreased GSH levels. Antioxidant enzyme activities (SOD, CAT, GR, TrxR) and protein levels decreased compared to the control, while heterogeneous changes were observed in gene expression levels. Despite increased GPX gene expression, a decrease in enzyme activity and protein levels was observed. While no change in TXN gene expression was observed, protein levels were decreased. TXNIP protein levels were also decreased. Conclusions: The findings provide important data for evaluating lichen-derived compounds as potential anticancer agents targeting redox balance.
- ArticleAçık Erişim2026Impact of Injection Level on Analgesic Efficacy of Adductor Canal Block Following Total Knee Arthroplasty: A Prospective Observational Study
Karatas, Talha; Akyol, Fethi; Tas, Hakan Gokalp; Karakurt, Tulay Ceren Olmezturk; Aydin, Seyma Selin; Isik, Onur; Otugen, Taha Emre; Kuyrukluyildiz, Ufuk
Background/Objectives: Following total knee arthroplasty (TKA), adductor canal block (ACB) is usually used for postoperative analgesia; however, the optimal injection level is yet unclear. This study tried to determine how the injection level of the ACB had an impact on postoperative analgesic efficacy and functional results after total knee arthroplasty. Methods: A total of 108 patients undergoing unilateral total knee arthroplasty under spinal anesthesia were included in this prospective observational study and were categorized according to the level of ultrasound-guided adductor canal block performed (proximal [Group I], mid [Group II], or distal [Group III]). The visual analog scale (VAS) was used to measure postoperative pain at 1, 4, 8, 12, and 24 h. Additionally, functional pain throughout 24-h standardized static and dynamic tests was assessed. We noted 24-h opioid consumption, motor strength levels, and sensory and motor block features. Results: During each time point, the distal group’s VAS scores were considerably higher than those of the proximal and mid groups (e.g., 8th hour: 40.69 ± 10.50 vs. 26.94 ± 8.72 and 23.47 ± 7.64, p < 0.001), whereas there was no difference between the proximal and mid groups (p > 0.05). At 24 h, the distal group had significantly higher functional pain scores on all dynamic and static measures (p < 0.001). The proximal and mid groups had longer sensory block durations (5.38 ± 1.33 and 5.03 ± 1.29 h) than the distal group (2.95 ± 0.95 h, p < 0.001). While mid-level ACB maintained motor function, 13.9% of patients receiving proximal ACB experienced transient motor block. Conclusions: After TKA, injection level has a major impact on postoperative analgesia. Mid-level ACB supports the employment of multimodal analgesia techniques by offering the best possible compromise between efficient pain management and motor function maintenance.
- ArticleAçık Erişim2026Discordance Between FIB-4 and BAST Fibrosis Risk Classifications in Obese Patients with MASLD: Results from the OBREDI-TR Study
Kama Basci, Ozge; Oral, Alihan; Kirik, Ali; Sen, Hacer; Solmaz, Ihsan; Topaloglu, Ulas Serkan; Demir, Ismail; Dundar, Ahmet; Binnetoglu, Emine; Okuroglu, Nalan
Background/Objectives: Non-invasive fibrosis scores are widely used for risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD); however, their performance in obese individuals remains controversial. The Fibrosis-4 (FIB-4) index is commonly recommended as a first-line tool, yet it may underestimate fibrosis risk in severe obesity. The BAST score, which incorporates metabolic and anthropometric parameters, has been proposed as an alternative. This study aimed to characterize both the degree and direction of discordance between FIB-4 and BAST in obese patients with MASLD. Methods: This predefined secondary analysis included 2950 adults with obesity (BMI ≥ 30 kg/m2) and MASLD from the multicenter OBREDI-TR cohort. Fibrosis risk categories were assigned using standard cut-offs for FIB-4 and BAST, and agreement was assessed using weighted Cohen’s kappa. Associations among discordance patterns, obesity class, and the visceral adiposity index (VAI) were evaluated using chi-square tests and general linear models. Results: Overall agreement between FIB-4 and BAST was very poor (κ = 0.041, p < 0.001). Discordance was observed in 22.3% of patients and increased markedly with obesity severity. In class III obesity, discordance was predominantly driven by low-risk classification according to FIB-4 despite high-risk classification according to BAST. Patients with this discordant pattern exhibited significantly higher VAI values than concordant cases (p < 0.001), independently of the study center. Conclusions: In obese patients with MASLD, particularly those with morbid obesity, FIB-4 frequently classifies patients as low risk, while BAST identifies elevated fibrosis risk. This systematic discordance suggests that FIB-4 may underestimate fibrosis burden in the context of severe obesity and visceral adiposity, supporting the need for a phenotype-oriented, multimodal approach to fibrosis risk assessment.
- ArticleAçık Erişim2026Diarrhea, Rotavirus, and the Nursing Research Gap: A Bibliometric Analysis of Global Research and Implications for Public Health Nursing
Aydin, Muhammet Ali; Adiyaman, Abdullah; Kasimoğlu, Necla; Gürol, Ayşe
Background: Rotavirus is a leading cause of severe diarrhea in children and continues to contribute significantly to childhood morbidity and mortality. While significant research has been conducted on the epidemiology and vaccination of rotavirus, the contributions of nursing to its prevention, management, and family-centered care are insufficiently documented. This study analyzes global research trends to identify gaps in nursing scholarship and emerging opportunities related to rotavirus. Methods: A bibliometric analysis was performed using Web of Science and Scopus (1966–2024). Co-occurrence, co-citation, and thematic mapping techniques were applied to examine research productivity, influential contributors, collaboration patterns, and thematic evolution. Results: The analysis included 210 publications from 146 sources authored by 1170 researchers. The most productive countries were the United States (18.7%), China (7%), and Canada (5.7%), while Brazil, India, and Australia demonstrated strong international collaboration. The dominant themes were immunization, infection control, and epidemiology. Emerging areas focused on zoonotic transmission and gut microbiota. Despite their importance in caregiver education, hydration management, and community prevention, nursing-led interventions were markedly underrepresented. Conclusions: Rotavirus research continues to grow, yet nursing contributions remain limited within the broader scientific landscape. Despite their importance in caregiver education, hydration management, and community-level prevention, nursing-led interventions remain markedly underrepresented in the global literature. Advancing nursing-led preventive strategies, vaccine advocacy, and community-based interventions represent a critical opportunity to strengthen public health responses to rotavirus. Clinical Trial Registration: No clinical trial number is required.
- Review ArticleAçık Erişim2026Chitosan and Chitin-Derived Biomaterials in Orthopedics: A Structured Narrative Review of Polymer Design, Quantitative Performance, and Clinical Translation
Yapıcı, Furkan
Chitosan and chitin-derived biomaterials, including native chitosan and chemically modified derivatives, have been widely investigated across orthopedic tissue engineering, implant functionalization, infection control, local delivery, and interface repair, but the evidence is dispersed across heterogeneous formats and indications. This single-author structured narrative review synthesizes 258 unique publications and interprets chitosan through a polymer design, quantitative performance, and clinical translation framework. Literature was identified (January–May 2026) using PubMed/MEDLINE as the primary database, with targeted verification in Web of Science, Scopus, and Google Scholar; no formal risk-of-bias or certainty grading was performed. Chitosan was studied as scaffolds, hydrogels, coatings, nanoparticles, microspheres, fibers, bioadhesives, bone-cement additives, cartilage adjuncts, tendon-to-bone systems, and intervertebral disk biomaterials. The highest human clinical evidence supported BST-CarGel/chitosan–blood implant augmentation of knee marrow stimulation, where randomized, 5-year, and biopsy data favored structural repair over microfracture alone; most other applications—bone regeneration, coatings, osteomyelitis hydrogels, bone cements, tendon/rotator cuff systems, and disk biomaterials—remain preclinical or translational-preclinical. Chitosan should be interpreted as a tunable polymer platform, not a single material; translation requires chemistry-defined formulation, indication-specific mechanical qualification, clinically relevant comparators, and standardized reporting.
- ArticleAçık Erişim2026Testicular toxicity of Aroclor 1254 in selenium-deficient and selenium-supplemented rats; [Toksičnost Aroclora 1254 u testisa štakora s manjkom selena i u onih na nadomjesnom selenu]
Erkekoğlu, Pınar; Balcı-Özyurt, Aylin; Zeybek, Naciye Dilara; Tezel-Yalçın, Hülya; Yaman, Ünzile; Yildiztekin, Gizem; Aydın-Dilsiz, Sevtap; Kızılgün, Murat; İşcan, Evin; Batur, Tuğçe
Aroclor 1254 (A1254) is a mixture of polychlorinated biphenyl (PCB) congeners known to induce testicular toxicity through oxidative stress, apoptosis, and hormonal disruption. Selenium (Se), an essential trace element for male reproduction, contributes to antioxidant defence, DNA repair, and spermatogenesis. Given the worldwide prevalence of Se deficiency and its potential impact on reproductive health, this study investigated the effects of A1254 exposure on testicular function in Sprague-Dawley rats with different Se status. Rats assigned to the Se-deficient group were receiving a ≤0.05 mg/kg Se diet, while those assigned to the Se-supplemented group were receiving 1 mg/kg Se for five weeks. A1254-treated groups were receiving 10 mg/kg/day of A1254 by oral gavage for 15 consecutive days. A1254 exposure caused significant reductions in testis weight, sperm count, motility, and plasma testosterone levels, accompanied by extensive germ cell apoptosis and enhanced lipid and protein oxidation. Total antioxidant capacity also dropped significantly, confirming redox imbalance in A1254-exposed testes. These adverse effects were substantially exacerbated in the Se-deficient group, whereas Se supplementation ameliorated but did not fully prevent histological and biochemical changes induced by A1254. Our findings demonstrate that Se plays a crucial protective role against PCB-associated testicular injury, primarily by mitigating oxidative stress and apoptotic pathways. However, Se supplementation alone may not completely counteract the reproductive toxicity caused by persistent environmental contaminants such as A1254.
- ArticleAçık Erişim2026Beyond awareness: analyzing the incomplete integration and barriers to POCUS implementation: a nationwide study
Tazegul, Gokhan; Guven, Alper Tuna; Serin, Sibel Ocak; Yalçın, Nazif; Kaya, Zeynep Irmak; Konur, Kâmil; Ayaz, Teslime; İşsever, Kubilay; Kayhan, Sanem; Yaylaci, Selcuk
Point-of-care ultrasound (POCUS) is increasingly recognized as an essential tool in internal medicine; however, its real-world adoption remains variable. This study aimed to evaluate the current landscape of POCUS use, training, and barriers among internal medicine physicians in Türkiye. We conducted a nationwide, cross-sectional survey between January and June 2025, including 1678 physicians across diverse healthcare settings. The questionnaire assessed POCUS availability, training, clinical use, perceptions, and barriers. POCUS was perceived as necessary by 98.7% of participants; however, 73.4% reported no personal implementation, and only 50.3% reported any lifetime POCUS experience. Prior training was reported by 12.8% and was associated with higher self-reported competency (median score 3 [2–5] vs. 1 [1, 2], p < 0.001). A substantial perception–practice gap was observed across all domains, particularly in abdominal (− 62.7%) and thyroid applications (− 58.0%). Clinical observation was limited, with 54.4% of participants never having witnessed POCUS being performed. When present, it was positively correlated with both personal implementation (r = 0.500, p < 0.001) and self-reported competency (r = 0.450, p < 0.001). The most frequently reported barriers were lack of qualified trainers (65.8%), limited access to equipment (56.4%), and time constraints (41.5%). Multivariable analysis linked prior training and career stage to integration readiness, whereas actual implementation was associated with clinical observation, prior training, equipment availability, and inversely with seniority. These findings suggest that similar gaps may exist in other healthcare systems undergoing POCUS integration, highlighting the importance of structured education and system-level support.
- ArticleAçık Erişim2026Isolating cancer stem cells in breast cancer models: a study of CD marker expression and Rhodamine 123 as predictors of chemoresistance
Okşak, Nilgün; Korkut, Işık Neslişah; Erol-Bozkurt, Ayşe; Danışman-Kalındemirtaş, Ferdane; Özerkan, Dilşad; Süleymanoğlu, Mediha; Erdem-Kuruca, Serap
It is believed that CSCs, which are resistant to chemotherapy and radiation, develop in certain situations, stay in the tissue niche after treatment, and cause disease recurrence. Targeting these cells, which are thought to be chemoresistant, may enable treatment to eliminate metastasis or recurrence. For this reason, we aimed to isolate CSCs from various breast cancer cell lines using a drug selection method in this study and then identify them via flow cytometry and fluorescent staining. MDA-123, MCF-7, and 4T1 were used as in vitro models, with HUVEC as controls. After isolation of stem cells from these cells by incubation with 5-fluorouracil (5-FU) and cisplatin (Cis), CSCs were identified by flow cytometry using CD24/CD44/CD133/EPCAM by assessing the rhodamine 123 (Rho 123). The results showed that 5-FU and Cis reduced the CD24 receptor in both cancer and normal cells, while the others showed varying expression levels. Administration of 5-FU and Cis significantly decreased Rho 123 fluorescence intensity in MDA-MB-231, MCF-7, 4T1, and HUVEC cells compared to the untreated group. A subpopulation of breast cancer cells with low CD24 and Rho123 expression was cancer stem cells. The 4T1 cells, which expressed low levels of CD24/CD133/EpCAM expression, had significantly lower Rho 123 levels than MDA-MB-231 and MCF-7 cells. This suggests that 4T1 cells may have greater chemoresistance and more aggressive properties. In conclusion, studying surface receptors and rhodamine uptake for the identification of CSCs is a powerful and valuable method for evaluating the efficacy of chemotherapy. The discovery of CSC markers that indicate therapeutic strategies could lead to clinical trials of medicines with potentially better therapeutic outcomes, particularly for recurring malignancies.
- ArticleAçık Erişim2026A Novel Approach to Determining Bone Loss Through Serum Uric Acid Levels: A Retrospective Multicenter Cohort Analysis
Aydin, Ahmet; Pasali Kilit, Turkan; Kir, Seher; Arac, Esref; Ozudogru, Osman; Bicer, Nazmiye Serap; Cetinkaya, Gulbin Seyman; Mamis, Mehmet Selim; Arslan, Kadem; Bas, Suleyman
Background: Osteoporosis has a rising global incidence and social burden. Serum uric acid’s dual roles in oxidative stress and inflammation may influence bone health, but findings are inconsistent and require further research. This study aimed to evaluate the relationship between SUA levels and osteoporosis in a multicenter cohort obtained from different regions of Türkiye. Methods: This multi-center retrospective study included 3280 individuals, postmenopausal women and men aged 45 and older, from 16 centers in Türkiye. Individuals were excluded if they recently consumed alcohol, had severe renal dysfunction, certain hormonal or mineral disorders, specific medications, or certain menopausal statuses. Bone mineral density (BMD) at the hip and lumbar spine was measured using dual-energy X-ray absorptiometry (DXA), and participants were classified as normal or having osteopenia or osteoporosis based on T-score thresholds. Results: Overall, 34.8% were male, and 65.2% were female. For the lumbar spine, 36.8% had osteopenia, and 13.5% had osteoporosis; similarly, for the total hip, 40.8% had osteopenia, and 7.9% had osteoporosis. ROC analysis identified a threshold of 3.9 mg/dL serum uric acid (SUA) (AUC 0.374; p < 0.001), which was positively associated with both lumbar and total hip BMD. Osteoporosis rates were higher in patients with SUA < 3.9 mg/dL compared to those with SUA ≥ 3.9 mg/dL at the lumbar spine (29.1% vs. 14.2%, p < 0.001) and total hip sites (23.6% vs. 15.9%, p = 0.003). After adjustment for potential confounders, SUA was a significant independent predictor of osteoporosis in the lumbar spine (OR 0.70; p < 0.001) and the hip (OR 0.80; p < 0.001). Conclusions: Serum uric acid levels are inversely linked to bone mineral density and osteoporosis risk, indicating a potential role in bone health. However, due to study limitations, causal relationships remain unproven, and further research is needed.
- ArticleAçık Erişim2026How does servant leadership affect unethical pro-organizational behaviors: examining a moderated mediation model
Gül, Emre; Timuroglu, Muhammed Kürsat
Background: Servant leadership in the healthcare sector can lead to negative outcomes in certain contexts, such as encouraging unethical pro-organizational behavior (UPB) for the benefit of the organization. The purpose of this study is to examine the mediating role of identification with leader and the moderating role of positive reciprocity belief in the relationship between servant leadership and UPB, drawing on social exchange and social identity theory. In this context, the aim is to highlight not only the generally accepted positive outcomes of servant leadership in literature but also its potentially unknown other outcomes. Methods: Healthcare workers employed at healthcare institutions in a province located in Türkiye’s Eastern Anatolia Region were selected as the working sample. Data was collected from 456 nurses using the convenience sampling method. Scales whose validity and reliability were confirmed by other investigations were employed in this cross-sectional study. Results: When the findings of the study were evaluated, a positive and significant relationship was found between servant leadership and UPB. However, it was determined that identification with leader mediating role in the relationship between servant leadership and UPB. Furthermore, the results supported the moderated mediation model and showed that the indirect effect of servant leadership on UPB through identification with leader was stronger in situations where positive reciprocity belief was high compared to situations where it was low. Conclusions: This study has revealed a positive relationship between servant leadership and UPB in the healthcare sector, and that this relationship involves the mediating role of identification with leader and the moderating role of positive reciprocity belief. Consequently, this research provides some theoretical and practical implications for practitioners by revealing that servant leadership may lead to unethical behaviors that could be detrimental to the organization in the long term, that identification with leader in the healthcare sector may have dark or potentially negative aspects, and that it is extremely important to know the levels of positive reciprocity belief among employees in healthcare organizations.
- ArticleAçık Erişim2026Anatomical Variations of Axillary Lymph Nodes Affect the Accuracy of Preoperative Breast MRI Nodal Staging
Bingöl, Koray; Acar, Tunç Batuhan
Objective: To determine whether anatomical nodal distribution patterns of axillary lymph nodes influence the accuracy of breast magnetic resonance imaging (MRI) nodal staging in patients with breast cancer. Methods: This retrospective study included 156 consecutive patients with newly diagnosed breast cancer who underwent contrast-enhanced breast MRI followed by histopathological nodal evaluation. Two experienced breast radiologists, blinded to pathology results, independently reviewed all MRI examinations. The axillary nodal distribution pattern, the presence of interpectoral (Rotter) lymph nodes, the presence of internal mammary lymph nodes, and the clustered nodal pattern were recorded. MRI-based clinical nodal staging was compared with histopathological nodal status. Multivariable logistic regression identified independent predictors of false-negative MRI nodal staging. Results: Histopathological nodal metastases were identified in 58 patients (37.2%). Breast MRI demonstrated a sensitivity of 70.7% [95% confidence interval (CI), 57.3-81.9%] and a specificity of 84.7% (95% CI, 76.0-91.2%) for detecting nodal metastases. False-negative MRI staging was significantly more frequent among patients with a level II/III-dominant nodal distribution than among those with a level I-dominant pattern (33.3% vs. 25%, P=0.02). Patients with interpectoral (Rotter) lymph nodes had a higher false-negative rate than patients without Rotter lymph nodes (50% vs. 20%, P=0.01). Both a level II/III-dominant nodal distribution [adjusted odds ratio (OR), 2.6; 95% CI, 1.1-6.4] and the presence of interpectoral (Rotter) lymph nodes (adjusted OR, 2.9; 95% CI, 1.2-7.1) independently predicted false-negative MRI nodal staging. Conclusion: Anatomical distribution patterns of axillary lymph nodes influence the accuracy of MRI nodal staging. Assessing nodal distribution, particularly a level II/III-dominant pattern and interpectoral (Rotter) lymph nodes, may improve nodal evaluation and reduce false-negative rates in MRI staging.
