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ArticleAçık Erişim2026/r/ebyu/10109
Anatomical Variations in Major Abdominal Aortic Branches and Sex-Related Differences: A Large-Scale Analysis of 1174 Patients
Tokur, Oguzhan; Bingol, Koray
Background: This study aims to evaluate the prevalence, spectrum, and coexistence of anatomical variations in the major branches of the abdominal aorta using Multidetector Computed Tomography (MDCT) angiography, with a specific emphasis on analyzing sex-related differences in a large-scale cohort. Methods: A retrospective analysis was conducted on 1174 patients (63.8% male, 36.2% female; mean age 60.54) who underwent abdominal CT angiography between January 2023 and June 2024. Images were acquired using a 128-slice MDCT scanner and reconstructed for detailed vascular assessment. Statistical comparisons between genders were performed using Chi-square and Fisher–Freeman–Halton tests, with p < 0.05 considered significant. Results: The celiac trunk (93.3%), superior mesenteric artery (SMA) (97.1%), and inferior mesenteric artery (IMA) (98.5%) predominantly showed classical patterns. However, significant sex-related differences were identified. Females exhibited significantly higher rates of classical patterns for the celiac trunk (96.2% vs. 91.7%), IMA (99.1% vs. 98.1%), right hepatic artery (RHA) (91.5% vs. 82.6%), and left hepatic artery (LHA) (95.8% vs. 85.4%). Conversely, males showed a higher prevalence of complex variations, including replaced/accessory hepatic arteries and the absence of the common hepatic artery. The number of right and left renal arteries was similar between sexes and did not show a significant difference, while horseshoe kidney was detected only in males. Conclusions: Abdominal vascular structures adhere to classical anatomy more frequently in females, while males exhibit greater morphological variability. These findings emphasize the necessity of gender-specific preoperative vascular mapping to optimize surgical outcomes and reduce morbidity.
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ArticleAçık Erişim2026/r/ebyu/10107
Reduction in peripheral expression of the TMLHE gene in Turkish youth with autism spectrum disorder
Özücer, İpek Kuşcu; Alnak, Alper; Akköprü, Hilal; Karadoğan, Zeynep Nur; Çağlayan, Ahmet Okay; Selman, Saliha B.; Coskun, Murat
Background: Trimethyllysine Hydroxylase, Epsilon (TMLHE) gene mutations have been clinically associated with an increased risk of autism spectrum disorder (ASD). This study aimed to evaluate the peripheral expression profile of the TMLHE gene and its association with ASD phenotype in a clinical sample of youth diagnosed with ASD. Methods: The study sample included 205 participants (ASD: n = 100; controls: n = 105, Mage = 9.25 years, SD = 3.74). The Childhood Autism Rating Scale and the Aberrant Behavior Checklist were administered to assess the severity of ASD and associated symptoms. Peripheral blood samples were collected from all participants, and TMLHE gene expression levels were analyzed using quantitative reverse transcription PCR (RT-qPCR). Results: TMLHE gene expression was significantly downregulated in the ASD group compared to controls (p < .001). Notably, significant correlations were identified between TMLHE expression levels and the CARS subscales for object use (p = .043) and listening response (p = .038). Conclusion: This study represents the first case-control investigation of peripheral TMLHE gene expression in ASD, revealing that TMLHE expression is reduced in children with ASD compared to typically developing peers. These findings contribute to a deeper understanding of the potential implications of TMLHE gene mutations in the etiology of ASD.
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ArticleAçık Erişim2026/r/ebyu/10105
The effects of color therapy on depression, stress, anxiety, and quality of life in hemodialysis patients: A randomized controlled trial
Turan, Gülcan Bahçecioğlu; Özer, Zülfünaz; Yanmış Karaca, Safiye; Mollooğlu, Mukadder; Ersöz, Kübra
Introduction: This study was conducted to examine the effects of color therapy on depression, anxiety, stress levels, and quality of life in individuals receiving hemodialysis treatment. Methods: This study was designed as a two-arm, parallel-group randomized controlled trial with baseline and post-intervention assessments. The study sample consisted of a total of 60 patients receiving hemodialysis treatment at a university hospital dialysis unit. The intervention group received color therapy for eight weeks, while the control group received no intervention. Data were collected before and after the color therapy intervention using Personal Information Form, Depression Anxiety Stress Scale-21, and the Quality of Life Index Dialysis Version III. Results: At the end of the 8-week study period, the color therapy group showed greater improvements than the control group in depression, anxiety, and stress scores. The between-group differences favored color therapy for depression [MD = −6.27, 95% CI −7.29 to −5.25, Cohen's d = 3.175], anxiety [MD = −6.50, 95% CI −7.68 to −5.32, Cohen's d = 2.843], and stress [MD = −7.70, 95% CI −8.73 to −6.67, Cohen's d = 3.870]. Quality of life also improved more in the color therapy group than in the control group [MD = 7.60, 95% CI 6.15 to 9.05, Cohen's d = 2.697]. No intervention-related adverse events were reported. Conclusion: Color therapy is an effective, safe, and feasible complementary nursing intervention that reduces depression, anxiety, and stress levels and improves quality of life in hemodialysis patients. These findings indicate that color therapy can be used as part of holistic nursing care in hemodialysis units and integrated into the nursing process. Clinical Trial Registration: NCT06879808
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ArticleAçık Erişim2026/r/ebyu/10102
Vestibular Dysfunction and Disease Activity in Rheumatoid Arthritis: A Controlled cVEMP Study
Kars, Ayhan; Atalay, Fatma; Kocaer, Sinem Burcu; Anbar, Sezai Sacid; Altıparmak, Serkan; Kılıc, Korhan; Topal, Kübra
Objective: This study aimed to evaluate vestibular function and the relationship between vestibular dysfunction, if present, and disease activity in rheumatoid arthritis (RA) patients without vestibular symptoms, using the cervical vestibular evoked myogenic potentials (cVEMP) test. Materials and methods: This prospective study was conducted with 44 RA patients without vestibular symptoms and 26 healthy volunteers. All participants underwent a detailed ENT examination and the cVEMP test. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were recorded on the date of the test, and disease activity score (DAS)28-CRP values were calculated. cVEMP recordings were then compared with ESR, CRP, and DAS28-CRP values. Results: A cVEMP response was observed in 29.6% of the RA group, a unilateral cVEMP loss being determined in 22.7% and bilateral loss in 47.7%. All members of the control group achieved a response. This difference was statistically significant (p < 0.001). When disease activity was compared with cVEMP response status, no statistically significant differences were observed in terms of remission, or of low and moderate activity rates (p > 0.05). Conclusion: This study showed that vestibular dysfunction is widespread among RA patients, but no statistically significant relationship was determined between cVEMP findings and DAS28-CRP, ESR, or CRP values reflecting disease activity. These findings suggest that vestibular system involvement in RA may be independent of acute disease activity and more related to chronic inflammatory and immune-mediated processes.
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ArticleAçık Erişim2026/r/ebyu/10092
Double-Convex Peroneal Tubercle Morphology and MRI-Detected Peroneal Tendon Abnormality in a Non-Lateral Referral Cohort
Gür, Volkan; Gökgöz, Mehmet Burak; Aydın, Abdurrahman; Issın, Ahmet; Can, Muhammet Ali; Yanmaz, Oğuzhan; Koçkara, Nizamettin; Yapıcı, Furkan
Background: The peroneal tubercle demonstrates substantial morphologic variability and may influence peroneal tendon mechanics. This study evaluated whether peroneal tubercle morphology and size are associated with MRI-detected peroneal tendon abnormality in patients undergoing ankle MRI for ankle pain without documented lateral malleolar/retromalleolar or peroneal tendon-specific symptoms. Methods: In this retrospective cross-sectional study, 487 ankle MRI examinations obtained between 2020 and 2023 were analyzed after excluding cases with lateral ankle/peroneal symptoms, clinically significant acute trauma, prior ankle surgery, or systemic inflammatory disease. Two orthopedic surgeons independently classified peroneal tubercle morphology (single-convex vs. double-convex) and measured tubercle height and anteroposterior length. Peroneal tendon abnormality was defined as MRI features consistent with tendinopathy and/or tenosynovitis. Inter- and intraobserver reliability were assessed using intraclass correlation coefficients and Cohen’s kappa. Unadjusted associations were assessed using Fisher’s exact test and point-biserial correlation. Multivariable logistic regression was performed to evaluate independent associations after adjustment for age, sex, BMI, and hindfoot alignment. Results: Mean age was 43.6 ± 15.6 years; 226 participants were male, and 261 were female. Peroneal tendon abnormality was present in 227/487 examinations (46.6%). Double-convex morphology showed a higher prevalence of abnormality than single-convex morphology (69.6% vs. 43.6%; unadjusted OR 2.97, 95% CI 1.63–5.41; p < 0.001). In the adjusted model, double-convex morphology remained independently associated with peroneal tendon abnormality (OR 2.85, 95% CI 1.52–5.34; p = 0.001). Tubercle height showed a modest independent association (OR 1.12 per mm, 95% CI 1.04–1.20; p = 0.002), whereas tubercle length was not associated (OR 1.008, 95% CI 0.981–1.036; p = 0.541). Reliability was excellent for tubercle height, tubercle length, and hindfoot alignment measurements and substantial to excellent for categorical ratings. Conclusions: In this non-lateral referral cohort, double-convex peroneal tubercle morphology was independently associated with higher odds of MRI-detected peroneal tendon abnormality. These findings reflect cross-sectional imaging associations rather than causation and should be interpreted with caution, given the heterogeneous MRI endpoint and the routine clinical MRI protocol.
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ArticleAçık Erişim2026/r/ebyu/10090
An in-depth examination of variations in cerebral venous sinuses and the occurrence of sinovenous thrombosis
Bingol, Koray; Ozdemir, Hatice Kubra
Background: Pediatric cerebral sinovenous thrombosis (CSVT) is an uncommon yet serious cause of stroke in children. Although cerebral venous anatomical variations (AVs) are frequently encountered on MR venography (MRV), their potential contribution to CSVT remains unclear. Only one prior study has explored the relationship between AVs and CSVT, highlighting the need for larger population-based investigations. This study aimed to examine the prevalence of AVs in pediatric CSVT and non-CSVT populations and to assess their potential association with thrombosis and CSVT-related complications. Methods: This retrospective study included 124 children who underwent MRV between January 2020 and November 2025. Sixty-two patients diagnosed with CSVT were age- and sex-matched with 62 controls. MRV examinations were evaluated for the presence and subtype of AVs. Clinical presentation, complications, and demographic characteristics were recorded. Results: AV prevalence did not differ significantly between CSVT and control groups (46.7% vs. 50%, p = 0.67). The most common variation in both groups was left hypoplastic transverse sinus. AV rates were also similar between complicated and uncomplicated CSVT cases (44.4% vs. 47.1%, p = 0.92). Headache was the predominant presenting symptom (70.1%). Complications—including papilledema, elevated intracranial pressure, and venous infarction—were more common in younger patients (p = 0.01). Conclusions: AVs are common findings on pediatric MRV; however, their presence does not appear to influence CSVT development or complication risk. This study represents the largest cohort evaluating AVs in pediatric CSVT and contributes valuable evidence suggesting that AVs are incidental rather than pathogenic in this context.
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ArticleAçık Erişim2026/r/ebyu/10071
Experimental Investigation of Fentanyl Analgesic Potency and Its Relationship with Endogenous Adrenaline Levels in Rats
Ates, Irem; Isik, Bahar; Sezgin, Esra Tuba; Altuner, Durdu; Coban, Taha Abdulkadir; Suleyman, Halis
Purpose: Fentanyl is a synthetic opioid analgesic widely used in perioperative medicine due to its high analgesic potency and short duration of action. Previous studies suggest that the analgesic and anesthetic effects of fentanyl may be associated with endogenous catecholamine levels. This study aimed to evaluate the relationship between fentanyl’s analgesic potency and anesthesia duration and endogenous levels of adrenaline (ADR) and noradrenaline (NDR) in rats, as well as changes in oxidative stress and inflammation markers including malondialdehyde (MDA), total glutathione (tGSH), and interleukin-6 (IL-6). Patients and Methods: Three groups of six rats each were formed: an intact group receiving fentanyl, an intact group treated with metyrosine, and an adrenalectomized group receiving fentanyl. Fentanyl was administered at doses of 2, 15, 30, and 75 µg/kg, and anesthesia duration was recorded following intraperitoneal injection. Analgesic activity was assessed by measuring pain threshold using the paw pressure method, and immobility in the supine position was evaluated as an observational parameter. ADR, NDR, MDA, tGSH, and IL-6 levels were biochemically measured in blood and tissue samples. Results: Fentanyl produced analgesic effects in all experimental groups. However, no distinct anesthetic effect sufficient for surgical procedures was observed. Although the durations of immobility in the supine position were recorded, these observations were not evaluated as a direct measure of anesthetic duration. Different doses of fentanyl did not lead to significant alterations in oxidative stress parameters, antioxidant capacity, or anti-inflammatory cytokine levels across the groups. Conclusion: In conclusion, although the analgesic effect of fentanyl increased in a dose-dependent manner, it was found to be independent of serum ADR and NDR levels. High-dose fentanyl (75 µg/kg) did not induce anesthesia and did not significantly affect oxidative stress markers (MDA, tGSH) or IL-6 levels. The increase in MDA and the decrease in tGSH observed in the absence of adrenal hormones support their indirect antioxidant role. Overall, the findings indicate that fentanyl modulates catecholamine responses depending on dose and hormonal status, while its analgesic effect appears to be primarily mediated through µ-opioid receptor activation.
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ArticleAçık Erişim2026/r/ebyu/10069
Three-dimensional finite element analysis of temporomandibular joint stresses following botulinum toxin injection and occlusal splint therapy in bruxism
Haşimoğlu, Elif; Balaban, Emre; Halat, İsmail Burak; Akın, Muhammet
Background: Bruxism-related clenching can impose excessive mechanical loads on the temporomandibular joint (TMJ), particularly in the presence of anterior disc displacement (ADD). Understanding how different therapeutic strategies influence joint stress under these conditions can support exploratory, hypothesis-generating assessment of biomechanical unloading within patient-specific models. Therefore, this study aimed to evaluate TMJ stress distributions under normal and displaced disc conditions and to assess the biomechanical effects of simulated treatment strategies using a patient-specific finite element framework. Materials and methods: A patient-specific three-dimensional finite element model derived from clinically acquired computed tomography (CT) data was constructed to simulate TMJ biomechanics during clenching. Stress patterns were analyzed under three disc conditions: normal disc position, unilateral ADD, and bilateral ADD. Intervention scenarios included simulated reductions in masticatory muscle forces representing botulinum toxin Type-A (BoNT-A) therapy and occlusal splint therapy, applied individually and in combination. Peak von Mises stresses within the articular disc and joint structures were compared across all conditions. Results: ADD increased peak stresses within the articular disc and adjacent joint surfaces and shifted stress concentration toward the posterior region of the disc. Simulated reductions in muscle force resulted in progressive decreases in peak joint stresses as additional muscle groups were targeted, whereas splint therapy alone provided moderate stress reduction. The greatest biomechanical unloading was observed when occlusal splint therapy was combined with BoNT-A–related muscle force reduction. Notably, a strategy targeting the masseter and temporalis muscles combined with splint therapy produced lower peak disc stresses than a three-muscle reduction strategy without splint across all disc conditions. Conclusion: In this exploratory single-patient finite element model, ADD increased predicted TMJ stresses during clenching, whereas simulated muscle-force reduction and splint-related changes in occlusal load transmission reduced peak stress metrics, with the largest reductions observed in combined scenarios. These results are hypothesis-generating and intended for relative, within-model comparisons under stated assumptions rather than clinical treatment recommendations.
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ArticleAçık Erişim2026/r/ebyu/10067
Radiographic root pulp visibility of the mandibular left second molar as an indicator of legal adulthood (≥ 18 Years): a panoramic study
Akyuz, Mehmet; Magat, Guldane
This study aimed to evaluate the diagnostic performance of mandibular left second molar root pulp visibility (RPV) for legal age classification (≥ 18 years) using panoramic radiographs. A total of 983 orthopantomograms (492 males, 491 females) were retrospectively analyzed. Root pulp visibility was classified according to the staging system described by Olze et al. Diagnostic performance measures, logistic regression analysis, and receiver operating characteristic (ROC) analysis were performed. A p-value < 0.05 was considered statistically significant. A statistically significant association was observed between pulp stage and legal age classification (p < 0.001). Logistic regression analysis demonstrated a stage-dependent increase in the odds of being classified as ≥ 18 years, with Stage 2 and Stage 3 showing strong predictive effects (OR = 6.04 and OR = 19.13, respectively). Diagnostic performance analysis indicated that Stage ≥ 2 demonstrated high specificity (0.94). ROC analysis revealed moderate discriminatory performance (AUC = 0.676; 95% CI: 0.647–0.705). Mandibular second molar root pulp visibility may serve as a useful radiographic marker for legal age threshold assessment, particularly at higher pulp stages.
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ArticleYalnız künye2026/r/ebyu/10065
Postoperative Complications of Percutaneous Tracheostomy in a Tertiary Anesthesia Intensive Care Unit: A 10-Year Retrospective Observational Study
Tas, Hakan Gokalp
Intensive care units (ICUs) frequently perform percutaneous tracheostomy (PDT) on patients who need continuous mechanical ventilation. Percutaneous dilatational tracheostomy has a number of postoperative complications that vary in intensity and time, although being less invasive than surgical tracheostomy. This retrospective observational study looked at complication rates in adult patients who had PDT in a tertiary anesthetic ICU between January 2015 and December 2024. Patients who spent <30 days in the hospital overall were not included. The mean age of the 647 patients who were included was 67.1 ± 17.1 years. A total of 139 patients (21.5%) experienced complications following surgery. Minor bleeding and subcutaneous emphysema were among the minor complications (12.2%). Pneumothorax, bleeding requiring transfusion, and deep tissue infection were among the major complications (10.5%). Life-threatening complications (2.3%) included tracheoesophageal and tracheoarterial fistulas. There were no documented deaths from the surgery. Early postoperative surveillance is crucial, as the majority of problems (89.9%) happened within 7 days of surgery. Patients who developed complications had prolonged ICU stays and more complex treatment requirements during hospitalization. The results highlight the necessity of systematic postoperative care and surveillance by confirming that, despite PDT’s general safety, considerable morbidity can occur. These findings back up upcoming multicenter research aimed at improving patient outcomes and complication management procedures.
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ArticleAçık Erişim2026/r/ebyu/10063
Preparation and comparative evaluation of ondansetron hydrochloride loaded liposomes and lipid polymer hybrid nanoparticles
Ozdal, Zeliha Duygu; Recber, Tuba; Demirel, Murside Ayse; Gultekin, Yakup; Nemutlu, Emirhan; Vural, Imran; Takka, Sevgi
Chemotherapy-induced nausea and vomiting (CINV) typically occurs in two distinct phases: an acute phase, which arises within the first 24 h following chemotherapy, and a delayed phase, which develops between 24 and 120 h afterward. While acute CINV is now effectively controlled using 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, managing delayed CINV remains a significant clinical challenge. This study was aimed to develop Ondansetron hydrochloride (OND), loaded nanocarriers featuring high encapsulation efficiency (EE), to enable sustained drug release over several days. OND loaded sustained release liposome and lipid polymer hybrid polymeric nanoparticle (LPHNP) were prepared. The prepared formulations were characterized in terms of particle size and distribution, zeta potential, encapsulation efficiency and drug release in an in vitro study. The effects of the type of phospholipids, phospholipid/cholesterol molar ratio, and pH of hydration medium on liposome formulations were examined. In LPHNP formulations, the effect of external water phase volume, phospholipid type, preparation method, and pH of the aqueous phase was evaluated. In vitro cytotoxicity of the formulations was determined using L929 fibroblast cells. Optimum LPHNP formulation and the commercial product (Zofer®) were administered subcutaneously in a single dose to Wistar albino rats. It was found higher Cmax and MRT in LPHNP formulations than Zofer®. In this study, the effectiveness and safety of Ondansetron hydrochloride loaded LPHNP formulations were determined.
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ArticleAçık Erişim2026/r/ebyu/10058
A Rare Case: Septic Arthritis of The Wrist
Keleş, O; Öztürk, A; Taş, M
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Review ArticleAçık Erişim2026/r/ebyu/10057
Metagenomic next-generation sequencing in the diagnosis of viral encephalitis
Binay, UD; Karakeçili, F; Barkay, O; Sümer, B
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ArticleAçık Erişim2026/r/ebyu/10053
Association Between Patellar Morphology and Chondromalacia Patellae: A Magnetic Resonance Imaging Study
Kızılgöz, Volkan; Memis, Kemal Bugra
Objective: Chondromalacia patellae (CP) is a common cause of anterior knee pain and is considered a multifactorial disorder involving mechanical, anatomical, and biomechanical factors. This study aimed to evaluate magnetic resonance imaging (MRI)-derived patellar morphological parameters in patients with and without CP. Methods: This retrospective single-center study included 889 patients who underwent knee MRI from January 2024 to May 2026. Patients were divided into two groups according to the presence or absence of MRI findings compatible with CP. The Wiberg classification, Wiberg index, Wiberg angle, and patellar linear dimensions were evaluated. Results: CP was detected in 278 patients (31.3%), while 611 patients (68.7%) constituted the non-CP group. No significant difference was observed in gender distribution between groups (P =0.151). The CP group was significantly younger than the non-CP group (40.15 ± 10.8 vs. 45.8 ± 12.4 years, P <0.001). The distribution of Wiberg patellar types differed significantly between groups (P=0.021), and type III morphology was more frequent in patients with CP. The Wiberg index was significantly lower in the CP group compared with the non-CP group (0.61 ± 0.08 vs. 0.73 ± 0.07, P<0.001). The anteroposterior diameter was significantly larger (21.18 ± 2.3 mm vs. 19.74 ± 2.1 mm, P <0.001), whereas the transverse diameter was significantly smaller in the CP group (40.33 ± 3.4 mm vs. 41.68 ± 2.9 mm, P <0.001). No significant difference in craniocaudal diameter was found between groups (P=0.137). Conclusion: Several MRI-derived patellar morphological parameters were independently associated with CP after adjustment for age and sex. These findings provide additional information regarding patellar morphology in patients with CP; however, further prospective studies incorporating clinical symptoms and outcomes are required to determine their value in routine MRI interpretation
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ArticleAçık Erişim2026/r/ebyu/10027
Are Smartphones Associated With Stress and Poor Sleep Quality? The Perspective of Dental Students
Şanlıdağ, Ahmet; Aydın, Tuğba; Uzel, Melih Can; Navruz, Çiğdem Yıldırım
Objective: This study aimed to examine the association between problematic smartphone use, sleep quality and psychosocial factors among dental students, and to identify key behavioural and psychological predictors of high-risk smartphone use within this academically demanding population. Materials and Methods: A cross-sectional survey was conducted during the 2024–2025 academic year at Faculty of Dentistry, Atatürk University including 485 students from all academic years (mean age = 22.31 ± 1.77; 63.1% female). Participants were classified into low- and high-risk groups based on gender-specific Smartphone Addiction Scale–Short Version (SAS-SV) cut-offs (≥ 31 for males; ≥ 33 for females). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). For the separate analysis of sleep disturbance, the raw sum of PSQI items 5b–5j was used, with a theoretical range of 0–27, rather than the conventional 0–3 PSQI sleep disturbance component score. Psychosocial status was evaluated using the Depression Anxiety Stress Scales-21 (DASS-21). Group comparisons were performed using appropriate parametric or non-parametric tests, and predictors of high-risk smartphone use were identified through binary logistic regression analysis. Results: Overall, 54.5% of participants were classified as high-risk users (mean SAS-SV = 33.26 ± 10.57). Demographic variables such as age, sex and class year were not associated with risk classification (all p > 0.90). Sleep onset latency was significantly shorter in the high-risk group (19.90 ± 17.53 min) compared to the low-risk group (24.50 ± 18.36 min; p = 0.005), while total sleep duration showed no difference (p = 0.531). Among PSQI subcomponents, only sleep disturbance was significantly associated with high-risk smartphone use (OR = 1.05, 95% CI: 1.01–1.09, p = 0.029). Categorical analyses further showed that poor subjective sleep quality, sleep disturbance, daytime dysfunction and elevated stress, anxiety and depression were significantly more frequent among high-risk users, whereas sleep medication use did not differ between groups. In the psychosocial model, stress scores predicted high-risk smartphone use (OR = 1.09, 95% CI: 1.02–1.17, p = 0.015), whereas anxiety and depression scores were non-significant (p ≥ 0.62). Conclusion: While sleep disturbance and stress predicted high-risk PSU in domain-specific models, sleep disturbance lost significance in the fully adjusted combined model, where daytime dysfunction emerged as the primary sleep-related predictor and stress remained only marginally significant (p = 0.049). These findings should therefore be interpreted with caution.
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ArticleAçık Erişim2026/r/ebyu/10025
Finite Element Analysis of Dentoalveolar Stress in Combat Sports Using Hybrid and Conventional Mouthguards
Kalafat, Çağla Nur; Yeşil, Zeynep
Aim: This study aimed to contribute to the development of modern mouthguards by evaluating the stresses generated by hook and uppercut punches applied during combat sports on dentoalveolar structures and mouthguards, the protective effectiveness of different mouthguard designs, and the resulting deformations using three-dimensional finite element analysis. Materials and Methods: Three-dimensional solid models of the maxilla, mandible, teeth, alveolar bone, and mouthguards were constructed using an anatomical head model with Class I occlusion and complete permanent dentition. A conventional mouthguard with a uniform thickness of 4 mm made of ethylene vinyl acetate and a hybrid mouthguard consisting of a 3 mm polycarbonate occlusal surface with EVA axial walls were modeled. Hook and uppercut punch loads were simulated at an impact velocity of 12 m/s with an effective mass parameter of 5 kg. Von Mises equivalent stresses and displacement values occurring in the jaws, teeth, alveolar structures, and mouthguards were analyzed using three-dimensional finite element analysis. Results: During hook and uppercut punch application, the highest von Mises stress values in the mandible were observed in the model without a mouthguard (200 and 520 MPa, respectively), while the lowest values were detected in the model with a hybrid mouthguard (170 and 260 MPa). Similarly, mandibular teeth exhibited the highest stress values in the model without a mouthguard (1100 and 1600 MPa) and the lowest values in the hybrid mouthguard model (300 and 500 MPa). Stress transmission to the maxilla and maxillary teeth was minimal in all models. For both punch types, the hybrid mouthguard demonstrated higher stress values than the conventional mouthguard. In models using mouthguards, maximum displacement occurred later after impact, and deformation was distributed over a wider surface area rather than being localized. Conclusion: Hybrid mouthguards demonstrated superior biomechanical performance compared with conventional mouthguards by reducing stress transmission to dentoalveolar structures. The combination of a rigid occlusal component and flexible axial walls enabled more effective energy distribution, particularly under high-energy vertical loading. These findings suggest that hybrid mouthguards represent an effective option for preventing dentoalveolar trauma in combat sports.
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ArticleAçık Erişim2026/r/ebyu/10015
Design and Synthesis of 4-Arylazo Pyrazole Carboxamides as Dual AChE/BChE Inhibitors: Kinetic and In Silico Evaluation
Akocak, Suleyman; Lolak, Nebih; Duran, Hatice Esra; Demir Çetinkaya, Büşra; Hashem, Hamada; Bräse, Stefan; Türkeş, Cüneyt
Background/Objectives: Pyrazole carboxamides are widely used as adaptable medicinal-chemistry scaffolds and have been explored as cholinesterase (ChE) inhibitor chemotypes. In this work, we prepared a new series of 4-arylazo-3,5-diamino-N-tosyl-1H-pyrazole-1-carboxamides 5(a–m) and evaluated their inhibitory activity against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), supported by structure-based computational analyses. Methods: Thirteen derivatives 5(a–m) were synthesized, fully characterized with analytical techniques (FT-IR, H NMR, and C NMR), and tested in vitro against AChE and BChE, with tacrine (THA) used as the reference inhibitor. Docking calculations were used to examine plausible binding modes. The top-ranked complexes (7XN1–5e and 4BDS–5i) were further examined by 100 ns explicit-solvent molecular dynamics (MD) simulations in Cresset Flare, followed by RMSD/RMSF analysis and contact-persistence profiling. Predicted ADME/Tox. properties were also assessed to identify potential developability issues. Results: The series showed strong ChE inhibition, and several compounds were more potent than THA. Compound 5e (4-nitro) was the most active AChE inhibitor (KI = 20.86 ± 1.61 nM) compared with THA (KI = 164.40 ± 20.84 nM). For BChE, the KI values ranged from 31.21 to 87.07 nM and exceeded the reference compound’s activity. MD trajectories supported stable binding in both systems (10–100 ns mean backbone RMSD: 2.21 ± 0.17 Å for 7XN1–5e; 1.89 ± 0.11 Å for 4BDS–5i). Most fluctuations were confined to flexible regions, while key contacts remained in place, consistent with the docking models. ADME/Tox. predictions suggested moderate lipophilicity but generally low aqueous solubility; all compounds were predicted as non-BBB permeant, and selected liabilities were flagged (e.g., carcinogenicity for 5e/5g/5h/5i; nephrotoxicity for 5f/5g). Conclusions: The 4-arylazo-3,5-diamino-N-tosyl-1H-pyrazole-1-carboxamide scaffold delivers low-nanomolar ChE inhibition, with docking and MD supporting stable binding modes. Future optimization should prioritize solubility improvement and mitigation of predicted toxicities and metabolic liabilities, especially given the predicted lack of BBB permeability for CNS-directed applications.
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ArticleAçık Erişim2026/r/ebyu/10013
PathSepsisNet: a pathway-aware temporal graph attention network integrating inflammatory crosstalk dynamics for early prediction of multi-organ dysfunction in sepsis
Ustundag, Hilal; Doganay, Songul
Sepsis-induced multi-organ dysfunction syndrome (MODS) remains a leading cause of intensive care unit (ICU) mortality worldwide. The complex interplay among inflammatory signaling pathways TLR4/NF-κB, NLRP3/P2X7 and Nrf2/HO-1 plays a critical role in determining organ damage trajectories, yet existing artificial intelligence (AI) models fail to capture these molecular dynamics. We propose PathSepsisNet, a pathway-aware temporal graph attention network that integrates biological pathway crosstalk knowledge into a deep learning architecture for early MODS prediction. We developed a biologically-informed graph neural network in which six nodes represent molecular pathway activation states (estimated from routine clinical biomarkers) and twelve directed edges encode established crosstalk relationships. A dual spatial–temporal attention mechanism with gated fusion captures inter-pathway crosstalk dynamics and within-pathway temporal evolution simultaneously. A novel Pathway Divergence Score (PDS) quantifies the imbalance between pro-inflammatory and cytoprotective pathways. The model was trained and validated on 29,765 adult patients with sepsis (Sepsis-3) from the Medical Information Mart for Intensive Care IV (MIMIC-IV) v3.1 using only the first 12 h of ICU data to predict MODS development at 12-36 h, with strict data leakage prevention (no SOFA sub-scores as inputs). PathSepsisNet achieved area under the receiver operating characteristic curve (AUROC) 0.895 and an area under the precision-recall curve (AUPRC) of 0.901 for MODS prediction, outperforming bidirectional long short term memory (BiLSTM) (0.886), Transformer (0.890) and logistic regression (0.876), while providing unique pathway-level interpretability. Gradient boosting methods (XGBoost: 0.906; LightGBM: 0.905) achieved marginally higher raw AUROC, but lack mechanistic insight. The PDS demonstrated remarkable standalone discriminative ability (MODS + : 0.596 ± 0.185 vs. MODS − : 0.299 ± 0.163; PDS AUROC: 0.872). Node importance analysis identified CytokineStorm (0.290), NLRP3/P2X7 (0.212) and mitochondrial dysfunction (0.211) as the most influential pathway modules. MODS + patients exhibited significantly higher lactate (2.34 vs. 1.63 mmol/L), CRP (123.5 vs. 97.2 mg/L), bilirubin (2.91 vs. 0.97 mg/dL) and lower albumin (2.82 vs. 3.04 g/dL) and platelets (160 vs. 207 K/μL), validating pathway-specific hypotheses. PathSepsisNet demonstrates that integrating biological pathway knowledge into graph neural network architectures yields predictive performance competitive with state-of-the-art methods, while uniquely providing pathway-level mechanistic insights. The PDS represents a novel computational biomarker bridging molecular pathway biology and clinical decision support. These findings support the paradigm that biologically informed AI can close the gap between predictive accuracy and clinical interpretability in sepsis management.
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ArticleYayıncıda açık erişim2026/r/ebyu/10010
Oral microbiota member Neisseria elongata exosomes-Cassia fistula association targets PTEN/AKT/IL10/IL1β/BAX/BCL-2 signaling pathway in pancreatic cancer immunotherapy
Celebi, Demet; Celebi, Ozgur; Baser, Sumeyye; Ari, Betul; Dabanlioglu, Bulent; Genc, Sıdıka; Taghizadehghalehjoughi, Ali
Pancreatic cancer, characterized by its aggressive progression and limited therapeutic options, remains a malignancy with high mortality rates. This study evaluates the potential of bacterial extracellular vesicles (EVs) as immunotherapeutic carriers, focusing on Neisseria elongata-derived exosomes conjugated with a methanol extract of Cassia fistula, a plant with known anticancer properties. The cytotoxic and apoptotic effects of this complex were systematically analyzed using the PANC-1 pancreatic cancer cell line. MTT and LDH assays revealed a concentration-dependent reduction in cell viability and enhanced cytotoxicity. Mechanistic analyses demonstrated upregulation of pro-apoptotic BAX/BCL-2 ratio and modulation of PTEN/AKT signaling pathways, indicating activation of intrinsic apoptosis. Furthermore, increased levels of the pro-inflammatory cytokine IL-1β and suppression of anti-inflammatory IL-10 suggested immunomodulatory effects. Elevated reactive oxygen species (ROS) levels corroborated the induction of oxidative stress-mediated apoptosis. These results underscore the dual functionality of Neisseria elongata exosomes as both drug carriers and biological response modifiers. The biocompatibility and targeting efficiency of bacterial EVs position them as a novel therapeutic platform for gastrointestinal cancers. This study provides the first preclinical evidence supporting the use of non-pathogenic bacterial exosomes in oncology, highlighting their translational potential for improving treatment outcomes in pancreatic cancer.
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ArticleAçık Erişim2025/r/ebyu/22792
Psychiatric correlates of child marriage before age 15: A case-control study from Turkiye
Karadogan, ZN; Kaan, H; Karayagmurlu, A; Soylu, N
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