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Nio nanoflower based sorbent extraction for a novel HPLC–UV method for the determination of solifenacin in human plasma and its application to a prototype pharmacokinetic study
(Springer Nature Link, 2025) Ceylan, Burhan; Önal, Cem; Kurnaz Yetim, Nurdan; Hasanoğlu Özkan, Elvan; Önal, Armağan
Solifenacin is an active pharmaceutical product used in overactive therapy. The main goal of this work was to develop a high-performance liquid chromatographic (HPLC) method with ultraviolet detection for measuring the amount of quanti fied solifenacin in human plasma samples that is rapid, straightforward, and accurate. Prior to chromatographic analysis, a nanomaterial-based sorbent extraction technique utilizing NiO nanoflowers was employed for plasma sample preparation. In this method, NiO nanoflowers were employed, and the adsorption process underwent optimization. Chromatographic separation was carried out using a reversed-phase C18 analytical column (5 µm×4.6 mm×150 mm) with a mobile phase composed of water (0.2% triethylamine) and acetonitrile (30:70 v/v), and the pH was adjusted to 3.5 with ortho-phosphoric acid. The flow rate was set at 1.0 mL/min, and the investigation was performed using UV at 220 nm. The retention time of solifenacin is 3.10±0.01 min. The linear behaviour of the proposed approach was examined in the 0.01–30 ng/mL range (r 2=0.9995). The proposed method is in alignment with the criteria established by the European Medical Agency (EMA) about the accuracy, precision, repeatability, specificity, robustness and detection and quantification. Limit of detection and limit of quantification are determined to be 0.003 and 0.01 ng/mL, whereas relative standard deviation was determined to be less than 2.75% for intra-run and inter-run measurements. The plasma concentration–time profile and pharmacokinetic parameters such as AUC0–t , AUC0–∞, Cmax, tmax, and t1/2, were calculated according to the assays. The proposed method is feasible to investigate the bioequivalence, bioavailability, and routine analysis of the drug in plasma.
Enhancing home-based exercise therapy with telerehabilitation in mild adolescent idiopathic scoliosis: A randomized controlled trial
(MDPI Publishing, 2025) Takinacı, Zuhal Didem; Çelik, Meltem; Yıldız, Şeyda; Talmaç, Mehmet Ali; Dut, Raziye
Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that affects postural alignment, function, and quality of life. Telere habilitation has emerged as a promising approach to enhance accessibility and conti nuity of exercise-based treatment in AIS. This study aimed to compare the effects of telerehabilitation-supported home exercise programs with standard home exercises on posture, pain, body image, and quality of life in adolescents with mild AIS. Materials and Methods: Forty adolescents aged 10–18 years with mild AIS (Cobb angle 10–25◦ , Risser 0–3) were randomly assigned to two groups: study (n = 20) and control (n = 20). Both groups performed an 8-week home-based exercise program. The study group addition ally received weekly online supervision by a physiotherapist. Outcomes included pain severity (VAS), posture (New York Posture Assessment Scale), body image (Walter Reed Visual Assessment Scale), and quality of life (SRS-22 questionnaire). Statistical analyses were performed using non-parametric tests, with a significance level of p < 0.05. Results: Twenty-nine participants completed the study (15 in the study group, 14 in the control group). Significant improvements were observed in the study group in SRS-22 total, pain, and function subscores, as well as posture scores (p < 0.05). In the control group, only the satisfaction subscore improved significantly (p < 0.05). No significant changes were detected in body image (WRVAS) in either group. Between-group comparisons showed greater overall clinical gains in the study group despite similar exercise adherence rates. Conclusions: Supervised telerehabilitation enhances the effectiveness of home-based exer cise programs in adolescents with mild AIS by improving postural alignment, reducing pain, and increasing functional capacity and quality of life. Telerehabilitation represents an accessible and efficient complementary strategy for managing AIS when in-person supervision is limited.
Green light and intermittent lighting modulate testicular gonadotropin inhibitory hormone without central or morphological effects in broiler chickens
(Islamic Azad University, 2025) Aykoç Göçer, Miray; Akın, S. G.; Özel Armutoğlu, Emine; Koç Yıldırım, Ece
Environmental factors, especially light duration and wavelength (colour), affect reproductive physiology in broilers. In birds, light is perceived especially by extraretinal photoreceptors in the brain, including the hy pothalamus, which regulates reproductive function. Gonadotropin-inhibitory hormone (GnIH), expressed in both the hypothalamus and gonads, suppresses gonadotropin release and modulates reproductive activity. Its expression is influenced by photoperiod and light colour. Rooster fertility is economically important, as one male can inseminate many females. This study investigated how green light and intermittent lighting affect GnIH levels and testicular development in prepubertal broiler males. 288 one-day-old male commer cial broilers (Ross-308) were divided into four groups (n=12) and exposed to: Group I, 18 hours light - 6 hours dark (18L:6D) with white light; Group II, 18L:6D with green light; Group III, 17L:3D:1L:3D with white light; and Group IV, 17L:3D:1L:3D with green light. The study was conducted in four identical ex perimental rooms, each consisting of six pens (replicates). Two male broilers were randomly selected from each pen. A total of 48 chickens, 2 males from each pen (replicate group), were randomly selected for analysis. After 42 days under standard conditions, GnIH levels were measured in the hypothalamus and testes via ELISA. Testicular development was assessed histologically by evaluating seminiferous tubule diameter and epithelial height. Results showed that intermittent lighting and green light significantly in creased testicular GnIH levels but had no effect on hypothalamic GnIH. The most pronounced increase in testicular GnIH was observed in Group IV, which received both intermittent lighting and green light. No significant differences were observed in testicular morphology. These findings suggest that intermittent lighting and green light may selectively influence gonadal GnIH levels without affecting central GnIH or morphology, offering insight into how lighting strategies may be optimized in poultry production.
Interoceptive alterations in post-stroke individuals: A comparative cross-sectional study
(SAGE Publications, 2025) Özgün, Mete; Akanyeti, Otar; Povina, F. Villagra; Dal Koyuncuoğlu, Beyza
Background and Aims: Interoception refers to the complex neuro physiological process of sensing, integrating, and modeling visceral and somatic inputs to generate real-time internal state monitoring which is crucial for homeostasis and adaptive cognitive-emotional responses. Within the framework of the allostatic interoception model, this internal sensing system not only reacts to current physiological demands but also predicts and prepares for anticipated needs. Discrepancies between pre dicted and actual interoceptive signals may cause allostatic overload, dis rupting neural signalling. So far, very few studies have investigated whether stroke impairs interoceptive networks and how these impairments are associated with cognitive and motor functions. This study, therefore, aimed to investigate interoceptive capacity in post-stoke individuals. Methods: Forty stroke patients with Mini-Mental Test scores of >25 were compared with forty healthy controls with similar age and sex dis tribution. Interoceptive dimensions were assessed through Heartbeat Detection Task for interoceptive accuracy, Interoceptive Sensory Scale for subjective sensitivity, and Toronto Alexithymia Scale for interoceptive awareness. Cognitive performance was evaluated with Trail-Making Test, while motor functioning was assessed with Fugl-Meyer Motor Scale. Results: demonstrated significantly reduced interoceptive accuracy, sen sitivity and elevated alexithymia scores in the stroke group compared to controls (p=0.018, p=0.043, p=0.038 respectively). No significant associa tion was observed between interoception and motor performance. However, interoceptive accuracy was positively correlated with cognitive function (r=0.248, p=0.037). Conclusions: Our findings indicate that stroke-related neurophysiologi cal alterations may deteriorate interoceptive function. Incorporating interoceptive assessments and targeted interventions into clinical reha bilitation may improve recovery outcomes. Further research is needed to clarify the contribution of interoceptive dysfunction to post-stroke cogni tive and emotional impairments (versus SNF) care was consistently associated with higher HT and decreased odds of mortality and readmission (Table 2). IRF (versus SNF) was associated with higher mean difference in HT percentage ranging from 21% to 23% in PS matched cohorts, IPTW analyses generated more modest estimates of mean HT difference (10.6%).
Classifying stroke recovery profiles based on living environment: A latent class analysis
(SAGE Publications, 2025) Özgün, Mete; Akanyeti, Otar; Povina, F. Villagra; Rahman, R.; Saybaşılı, Hale; Atalar, Deniz
Background and Aims: Post-stroke recovery is influenced by multiple factors including living environment. While skilled nursing homes may offer more comprehensive care, including physiotherapy, dietary support, and psychological counseling, many family caregivers remain concerned that such settings may lead to loneliness and a sense of abandonment in stroke survivors, which may negatively impact their recovery. This study investigates how different living environments influence functional and psychological outcomes. Methods: A total of 278 stroke survivors living either in their homes or nursing homes in Istanbul,Turkey were assessed. Patient outcomes were evaluated using Stroke Impact Scale, Stroke Specific Quality of Life Scale, Tampa Scale for Kinesiophobia, Geriatric Depression Scale, UCLA Loneliness Scale, and Tinetti Gait and Balance Test. Covariates included age, stroke years, education, medical history, treatments received and caregiver support. Results: Latent Class Analysis identified two distinct patient class, as shown in figure. Class 2 demonstrated significantly better outcomes char acterized by greater independence, improved quality of life, lower depres sion and loneliness scores, reduced kinesiophobia, lower fall risk, healthier exercise routines and sleep quality. While the overall sample included more individuals receiving home care, the class which exhibited better functional and psychological outcomes contained a higher proportion of nursing home residents. Results: Of the 382 patients, 78 were analyzed (31 stable/35 unstable plaques/12 acute occlusions). When analyzing early radiological changes, there was no significant difference between the three studied plaque types (p>0.05), while when monitoring early neurological changes (NIHSS), significant decrease in deficit was noted in stable (p=0.012) and unstable (p<0.001) plaques. A significant decrease in all groups was noted in late clinical changes (mRS, always p<0.001). However, no significant difference was found between studied plaque types and stroke severity (p>0.05) Conclusions: No significant association was found between carotid plaque morphology detected on CT and early/late stroke severity in carotid territory. Patients with stable plaques showed milder events and had better overall 3-month outcome.
Sahin transvaginal extracorporeal myomectomy as a novel minimally‑invasive technique for the management of uterine myomas: A retrospective cohort analysis
(Medycyna Praktyczna, 2025) Şahin, Turan; Şahin, Eda A.; Şahin, Hanifi
Introduction: Vaginal myomectomy (VM) is a minimally-invasive surgery to remove uterine fibroids; however, limited exposure, difficulties in suturing, and challenges in achieving hemostasis restrict its wider adoption. To address these limitations, the Sahin transvaginal extracorporeal (STVEC) technique was developed, allowing for complete uterine exteriorization for extracorporeal reconstruction. Aim: We aimed to evaluate the safety, feasibility, and perioperative outcomes of the STVEC technique in women undergoing surgery for symptomatic uterine myomas. Materials and methods: This retrospective cohort included 200 consecutive patients who underwent VM using the STVEC technique between February 2021 and October 2024. Demographic characteristics, myoma features according to the International Federation of Gynecology and Obstetrics (FIGO) classification, operative variables, postoperative outcomes, and complications were analyzed. The complications were graded using the Clavien–Dindo system. Conversion to laparotomy was performed when safe continuation of the STVEC approach was not feasible. Results: Mean (SD) age of the study cohort was 39.1 (6.5) years and mean (SD) body mass index was 27.5 (5.8) kg/m². Mean (SD) myoma count was 1.8 (1.4; range: 1–5) and mean (SD) diameter was 6.7 (2.4; range, 5–10) cm. Intramural myomas (FIGO type 2–5) were the most common (55%). Conversion to laparotomy occurred in 8 patients (4%) due to adenomyotic uteri, adhesions, prior vaginal surgery, or altered cervical anatomy. Median (interquartile range [IQR]) hemoglobin decrease was 1.7 g/dl, median (IQR) estimated blood loss was 180 ml, and mean (SD) operative time was 71.9 (19.5) minutes. Blood transfusion was required in 18 patients (9%). Early complications occurred in 7 participants (3.5%), and all were minor. Conclusions: The STVEC technique appears safe and feasible, offering good bleeding control, low complication rates, and rapid recovery. Further multicenter studies are needed to confirm our findings.
Radiographic medial posterior tibial slope ≥16° predicts multiple revisions after anterior cruciate ligament reconstruction
(Wiley, 2026) Kayaalp, Mahmut Enes; Inoue, Jumpei; Konstantinou, Efstathios; Kahraman, Hamit Çağlayan; Erden, Tunay; Musahl, Volker
Purpose: An increased posterior tibial slope (PTS) has been implicated as a risk factor for anterior cruciate ligament (ACL) graft failure. This matched case–control study aimed to compare radiographic and magnetic reso nance imaging (MRI)‐based PTS measurements between patients under going multiple revision anterior cruciate ligament reconstruction (ACLR) and those with successful primary ACLR and to identify thresholds predictive of high revision risk. Methods: In this matched case–control study, 156 patients were analysed: 78 patients undergoing multiple revision ACLR and 78 patients with suc cessful primary ACLR. Medial PTS was measured on radiographs, while medial, lateral and PTS difference (PTS asymmetry) were measured on MRI. Group differences were assessed using independent t tests and χ2 tests. Receiver operating characteristic (ROC) analysis identified optimal thresholds, and logistic regression quantified odds ratios (ORs) for multiple revisions per 1° increase in radiographic medial PTS, adjusting for body mass index (BMI), sex, side, height and weight. Results: Radiographic medial PTS was significantly higher in the multiple‐ revision group (12.5 ± 3.5° vs. 11.2 ± 3.0°, p = 0.016). ROC analysis identi fied an optimal medial PTS cutoff of 13° (area under the curve = 0.58, sensitivity = 0.49, specificity = 0.65), but only a PTS ≥ 16° was significantly associated with increased multiple revision risk (OR = 3.10, 95% confidence interval [CI]: 1.14–8.40; p = 0.037; specificity = 0.91; positive predictive value [PPV] = 0.70). MRI‐based medial and lateral PTSs, as well as PTS asymmetry, did not differ significantly between groups. Univariate logistic regression demonstrated a 10% increase in odds per 1° increase in radio graphic PTS (OR = 1.10, 95% CI: 1.00–1.22, p = 0.049), remaining signifi cant after adjustment for BMI, sex, side, height and weight (adjusted OR = 1.11, 95% CI: 1.01–1.23, p = 0.034). Radiographic medial PTS cor related moderately with MRI‐based medial PTS (r = 0.49, p < 0.001), but not with lateral PTS (p: n.s.). Conclusion: Radiographic medial PTS showed the strongest differentiation between successful primary ACLR and multiple‐revision ACLR. A PTS ≥ 16° identifies patients at significantly higher risk of multiple revisions, whereas MRI‐based medial PTS, lateral PTS and PTS asymmetry provide no addi tional discriminatory value. Radiographic medial PTS appears practical for preoperative risk stratification, whereas MRI‐based measures do not show similar utility. Level of Evidence: Level III.
PCOS phenotypes and hematological immune-inflammatory indices: A comparative evaluation
(Elsevier, 2025) Kından, Aykut; Kından, Goncagül; Soysal, Çağanay; Turan, Volkan
To evaluate hematological immune-inflammatory indices across different polycystic ovary syndrome (PCOS) phenotypes and assess their potential as diagnostic biomarkers. This retrospective cross-sectional study included 89 women aged 18–40 years diagnosed with PCOS according to the Rotterdam criteria, stratified into four phenotypes (A–D). Demographic, anthropometric, reproductive, biochemical, and hormonal data were extracted from clinical records. Hematological indices were calculated from complete blood counts. Group comparisons were performed using appropriate statistical tests, correlations with metabolic and hormonal parameters were assessed, and logistic regression analyses were conducted to identify independent predictors. Phenotype A demonstrated significantly higher body mass indeks (BMI), waist circumference, fasting glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) values compared with other phenotypes (all p < 0.01). Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Systemic Immune-Inflammation Index (SII) differed significantly across phenotypes, whereas Platelet-to-Lymphocyte Ratio (PLR) did not. ROC analysis revealed that SII had the highest discriminative ability (AUC=0.822, p < 0.001). NLR (AUC=0.663, p = 0.020) and MLR (AUC=0.642, p = 0.043) also showed moderate predictive value. Correlation analyses indicated positive associations of NLR and SII with total testosterone and Free Androgen Index (FAI), and negative correlations with Sex Hormone-Binding Globulin (SHBG) and High-Density Lipoprotein (HDL) cholesterol. Logistic regression identified BMI, SII, and LH/FSH ratio as independent pre dictors of specific phenotypes, further supporting their role as clinically relevant biomarkers. Hematological immune-inflammatory indices, particularly SII, may serve as cost-effective and accessible biomarkers for dis tinguishing PCOS phenotypes.
Under-resourced EFL students’ perceptions about the causes and consequences of unfair AI-mediated education
(Taylor & Francis, 2025) Wanga, Yongliang; Lib, Hang; Savaş, Hasan
The use of Artificial Intelligence (AI) technologies in education imposes various social influences on different stakeholders across diverse contexts. However, the voices of under-resourced second language (L2) learners have remained unheard regarding the fairness of AI adoption. To fill this gap, the present qualitative study examined 33 Chinese English as a foreign language (EFL) students’ perceived causes and consequences of unfair AI-mediated education. Thematic analysis of online interviews indicated four causes and four consequences for unfair AI adoption in under-resourced communities. The causes included biased algorithms and databases, digital divide and unequal access, lack of AI-related training and support, and sociocultural mismatch and inappropriateness of AI tools in poor settings. Regarding consequences, it was found that unfair AI adoption may lead to educational inequality, diminished motivation, academic deskilling, and technophobia among under-resourced EFL students. The findings are discussed, and implications for raising AI literacy and readiness of L2 educators and policymakers are enumerated.
Women’s experiences of breastfeeding during pregnancy: A Turkish descriptive study
(Springer Nature Link, 2025) Bayraktar, Sema; İnce, Zeynep; Yıldız, Nevin; Eski, Nuray; Çoban, Emine Asuman
Background Breastfeeding is generally terminated when the mother becomes pregnant again within two years because there is no clear consensus on how to manage breastfeeding during pregnancy. Additionally, health professionals may not have accurate information about this issue. This study aimed to determine women’s attitudes towards breastfeeding during pregnancy and why they stopped breastfeeding when they became pregnant. Methods This study is a descriptive one, involving pregnant mothers with a breastfeeding infant under 2 years old (n=101). The participants were followed up regarding those who had given birth to a new child and chosen the BDP. The researchers surveyed them after birth. The data were collected using a survey form that included a total of 26 questions created by the researchers, which aligned with the existing literature. Data were collected using a questionnaire that included information about maternal, neonatal, and obstetrical data, as well as breastfeeding experience and problems encountered during pregnancy. Data were handled and analyzed using IBM SPSS Statistics v22.0 (SPSS Inc., Chicago, IL, USA). Results The mean age of the mothers was 29.3 years (SD±4.9), gravidity was 3.2 (SD±1.7), and parity was 2.5 (SD±1.1). The mean age of the breastfed children was 12.6 months (SD±5.3) when the mothers became pregnant again. The reasons for stopping breastfeeding were professional advice (35%, n=34), their own decision (30%, n=30), believing that breastfeeding could have adverse effects on the unborn baby, and social pressure (16%). Only 5% (n=5) of mothers continued breastfeeding between 7 and 9 months after pregnancy. Conclusions Our results indicate that when a mother wishes to breastfeed during pregnancy, providing breastfeeding counseling by healthcare professionals with accurate information is essential to sustain lactation and maintain the well-being of the breastfeeding child without harm to the unborn baby.
Taxonomic description and phylogenetic placement of a new xanthogalum species (Apiaceae) from Turkey
(Taylor & Francis, 2025) Tuncay, Hüseyin Onur; Ekici, Miraç; Uzun, Fatma Selin; Lyskov, Dmitry; Akalın, Emine
The genus Xanthogalum, represented by the species X. purpurascens and X. turcicum in Turkey, forms a small but taxonomically significant group characterized by decurrent leaves and large fruits with broad, undulate wings. During extensive field surveys (2020–2025) in northeastern Turkey, a distinctive population was discovered exhibiting a combination of morphological characters not found in any previously described Turkish species. Xanthogalum ozlemiae Tuncay & Akalın sp. nov. is described herein based on comprehensive morphological, anatomical, and molecular evidence. The new species is distinguished from its Turkish congeners by white petals with brownish lines (vs. yellow to yellow – green), densely hairy rays and pedicels, shorter pedicels (0.5–2.5 mm), amphisto matic leaves with sparse hairs restricted to upper surface veins, and distinctly unequal mericarps with markedly different wing widths (1.9–3.5 mm vs. 0.5–1 mm). Phylogenetic analyses based on ITS sequences support its placement within Xanthogalum and indicate close affinity with a white – petaled lineage. A detailed morphological description, anatomical characterization, comparisons with related species, an identification key, and a preliminary conservation assessment are provided. Given its extremely restricted distribution and ongoing habitat threats from tourism development, the species is assessed as Endangered (EN) under IUCN criteria.
SFNN: A secure and diverse recommender system through graph neural network and regularized variational autoencoder
(Elsevier, 2025) Bahi, Abderaouf; Gasmi, Ibtissem; Bentrad, Sassi; Azizi, Mohamed Walid; Khantouchi, Ramzi; Uzun-Per, Meryem
Recommender systems are frequently improved to filter information and provide users with the most relevant items. However, they face limitations in balancing appropriate and diverse recommendations while ensuring the security and integrity of user data. A new recommender system based on secure fusion neural network is pre sented in this paper. It guarantees data integrity and confidentiality while balancing accuracy and diversity. It integrates a graph neural network that models user-item interactions to improve accuracy, with a regularized variational autoencoder whose evidence lower bound loss function is enhanced by a diversity-promoting regu larization term that favors latent-space dispersion, thereby improving recommendation diversity. To optimize the combination of the two neural networks scores, an adaptive fusion mechanism is introduced to generate final predictions that consider diverse user preferences while maintaining relevance. Furthermore, our approach uses blockchain technology to encrypt and secure data storage, ensuring the integrity and confidentiality of users’ data. The experiments conducted on three datasets show that the proposed model can achieve an accuracy of 78.13 % with an intra-list diversity of 46.82 % for Retail Rocket dataset, an accuracy of 82.44 % with an intra-list diversity of 37.78 % for clothing dataset, and an accuracy of 86.16 % with an intra-list diversity of 47.65 % for MovieLens-1 M dataset.
Impact of lightness differences in digitally simulated composite resin restorations on perceived smile attractiveness
(Wiley, 2025) Ntovas, Panagiotis; Ünal, Tuna; Korkut, Bora; Ferraris, Federico; Fehmer, Vincent; Sailer, Irena
Objectives: To investigate the effect of lightness differences between digitally simulated composite restorations and anterior maxillary teeth, in combination with restoration type, and clinical experience on perceived smile attractiveness. Materials and Methods: An imaging software program (Adobe Photoshop CC 2023) was used to digitally manipulate a frontal full-face portrait of a smiling female model, to create five types of moderate-sized composite resin restorations of moderate size. For each restoration 14 lightness differences were simulated. The image was digitally modified to simulate five different types of composite resin restorations (Class III, Class IV, Class V, diastema closure (bilateral and unilateral approach)). Each restoration was adjusted through 7 incremental increases and 7 incremental decreases of 1 unit in lightness (L* value), yielding a total of 70 images. The smile attractiveness of each picture was rated by 80 dentists and 80 laypersons, ranged from 21 to 77years using a visual analog scale. The Wilcoxon signed-rank test was employed to assess whether the mean of a sample significantly differed from the control (p<0.05). Results: Among the different restoration types, crown fracture repairs (Class IV) had the greatest negative impact, followed by proximal restorations (Class III), diastema closures (Bilateral approach), diastema closures (Unilateral approach), and, lastly, cervical restorations (Class V), which had the least impact on perceived smile attractiveness (p≤0.05). The influence of lightness differences, whether toward a darker or lighter restoration, was dependent on both the type of restoration and the observer's experience. Conclusions: The effect of lightness difference on perceived smile attractiveness was significantly influenced by both the type of composite resin restoration and the observer's experience. Dental professionals perceived lightness discrepancies as less attrac tive compared to laypersons, suggesting that experience plays a key role in the perception of esthetic outcomes. Clinical Significance: The repositioning of an esthetic direct dental restoration is highly influenced by the dentist's chromatic perception which is more sensitive than that of a layperson who evaluates its matching with the natural tooth. The findings of the present study can support evidence-based clinical decision-making.
Complementary and integrative medicine for the treatment of tourette’s syndrome
(Wiley, 2025) Pringsheim, Tamara; Deans, Catherine; Anis, Saar; Bhatia, Poonam; Black, Kevin; Değirmenci, Yıldız; Gilbert, Donald; Hartmann, Andreas; Hull, Mariam; Malaty, Irene
Background: There is widespread interest in complementary and integrative medicine (CIM) among people with Tourette's syndrome (TS). Objective: To perform a systematic review of evidence on the use of CIM to reduce tics and improve tic-related quality of life. Methods: We included clinical studies of CIM in children, adolescents and adults with TS and chronic tic disorders, and assessed the change in tic severity and/or tic-related quality of life using validated scales. Risk of bias of randomized controlled trials was assessed using the risk of bias tool of the American Academy of Neurology, which classifies studies into Class I, II, III or IV based on quality criteria. Results: 49 clinical studies and three systematic reviews were included. Most studies were rated Class IV and therefore at high risk of bias. Class I studies demonstrated efficacy of functional MRI neurofeedback, 5-Ling granule, Jingxin Zhidong formula, and Ningdong granule in reducing tic severity. Class II studies suggest efficacy of mindfulness-based intervention for tics, acupuncture combined with atlantoaxial joint bone setting therapy, and art therapy. Systematic reviews summarizing the Chinese literature on acupuncture, acupuncture with herbal medicine and massage therapy suggest greater reduction in tics compared to conventional treatments but there is low confidence in the evidence due to poor methodological quality of included studies. Conclusions: Evidence to support the use of complementary and integrative medicine for TS is limited in methodological quality and widespread applicability. These limitations prohibit evidence-based recommendations for general use among individuals with TS.
Decoding surgical proficiency and complexity: A machine learning framework for robotic herniorrhaphy
(Springer Nature Link, 2025) Shin, Thomas H.; Fanta, Abeselom; Gökçal, Fahri; Shields, Mallory; Benlice, Çiğdem; Kudsi, Omar Yusef
Objective To evaluate the predictive value of objective performance indicators (OPIs) for case complexity assessment and explore their role in quantifying skill acquisition during robotic ventral herniorrhaphy. Summary background data Despite advances in herniorrhaphy techniques, unclear metrics of case complexity have signifi cant implications for operative planning, resource allocation, and patient outcomes. While existing complexity definitions rely primarily on clinical factors external to operator behavior, the expanding adoption of robotic platforms in ventral her nia repair provides unprecedented access to quantifiable surgical performance metrics. However, the relationship between these objective performance indicators and both case complexity and skill development remains incompletely understood, representing a gap that machine learning approaches may help address. Methods OPI and clinical data from 561 consecutive robotic ventral hernia repairs over eight years were analyzed using iterative ensemble machine learning models to predict case complexity. Dimensional reduction analyses using t-distributed stochastic neighbor embedding tracked skill evolution, with Euclidean distances calculated between successive cases to quantify skill acquisition over time. Results Gradient boosting models integrating clinical and OPI variables achieved F1 score of 0.87, while OPIs alone scored 0.58. Longitudinal analysis revealed high OPI variability during early cases, stabilizing within 10 months despite increas ing case complexity, indicating skill acquisition may compensate for procedural difficulty. Dimensional reduction analyses captured this evolution through weighted Euclidean distances. Conclusions Objective performance indicators poorly predict case complexity independently, yet their temporal evolution reveals surgical skill acquisition. The concurrent stabilization of OPI stochasticity and progression to more complex cases demonstrates that surgical proficiency and complexity assessment are interdependent phenomena, establishing digital metrics as tools for understanding the dynamic relationship between surgeon learning and case difficulty.
Change in the concentration of interleukin-10 and tumor necrosis factor-α in gingival crevicular fluid after probiotic use in patients undergoing treatment with fixed orthodontic appliances
(Springer Nature Link, 2025) Erdemir, Cihan; Alkumru, Pınar; Çıracı, Enver; Ekenoğlu Merdan, Yağmur; Gök Yurttaş, Asiye; Amasya, Hakan; Elgün, Tuğba
Purpose This study aimed to evaluate the effect of the use of chewable probiotic tablets on interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) levels in gingival crevicular fluid (GCF) in patients undergoing treatment with fixed orthodontic appliances. Methods This prospective case–control study involved 60 patients undergoing treatment with fixed orthodontic appliances. Participants were divided into two groups. The test group was administered probiotic chewable tablets (Motiflor AS, Abfen Farma, Ankara, Turkey) once daily for 15 days, and the control group received routine orthodontic treatment without probiotics. GCF samples were collected from each participant at two time points: at the beginning of the treatment (T0) and on the 21st day (T1). Samples were obtained separately from all four canines using collection strips. The levels of IL-10 and TNF-α in GCF were analyzed using the enzyme-linked immunosorbent assay (ELISA) method. Statistical tests were performed to assess the normality of the distribution of quantitative variables. All analyses were performed using GraphPad Prism (version 9.1.1, GraphPad Software, San Diego, CA, USA). Data normality was assessed using the Kolmogorov–Smirnov test. Friedman’s test for repeated measures was employed, followed by Dunn’s post hoc test. Results The variability that was observed for the IL-10 cytokine levels in the control group was significantly higher than that for the test group (p< 0.05). IL-10 levels in the test group increased while the TNF-α levels decreased. T1/T0 ratio for TNF-α was found to be lower in the test group compared to the control group (p= 0.002). Conclusion The results suggest that probiotic tablets may play a role in modulating IL-10 and TNF-α levels during orthodontic tooth movement. However, the current study was limited to the first 21 days of mechanical force application to the teeth, and it is recommended to investigate the long-term effects or other factors affecting cytokine changes in future studies.
Waste toner particles based dispersive solid phase extraction for the trace determination of cadmium in cinnamon tea samples by flame atomic absorption spectrometry
(Elsevier, 2026) Ali, Büşra; Büyük, Muhammed Ali; Bayraktar, Ahsen; Serbest, Hakan; Bakırdere, Sezgin
This study presents a dispersive solid phase extraction (DSPE) protocol for the sensitive and accurate determi nation of trace levels of cadmium ions (Cd2+) by flame atomic absorption spectrometry (FAAS). Toner particles obtained from used printer cartridges were used as sorbent material for preconcentration of Cd2+ ions. Opti mization studies were performed univariately for the achievement of the highest extraction efficiency and the limit of detection (LOD) was found to be 0.55 µg L-1 under optimal operating conditions. By comparing the slopes of the linear plot equations for FAAS and waste toner-based DSPE-FAAS systems, the increase in sensitivity was calculated to be 40.9 times. The feasibility of the developed method was evaluated by spiking recovery studies on cinnamon tea samples and good recovery results between 90.4 % and 119.0 % determined by the matrix matching calibration strategy showed that the method is applicable to cinnamon tea and similar matrices.
NiO-SnO2 nanocomposite as an adsorbent for the preconcentration of manganese ions in chamomile tea extract
(Elsevier, 2026) Şaylan, Meltem; Gürsoy, Selim; Zaman, Buse Tuğba; Bakırdere, Sezgin
Matricaria chamomilla L., referred to as chamomile, is a well-known medicinal plant that is widely distributed throughout the world. In this study, a novel NiO-SnO2 nanocomposite- assisted preconcentration method was established for efficient extraction and separation of manganese ions from chamomile tea extract. This pre concentration method was coupled with flame atomic absorption spectroscopy (FAAS). NiO-SnO2 nano composites were synthesized using simple one-pot co-precipitation procedure and calcined at 650 ◦C to obtain nanoparticles with sizes below 100 nm. X-ray diffraction (XRD) analysis indicated that the crystallite size of NiO SnO2 nanocomposites was estimated to be 46.03 nm using the Monshi–Scherrer equation. The LOD (limit of detection) and linear working range were determined as 3.6 μg/L and 10–100 μg/L, respectively. The proposed method was successfully validated, and recoveries ranged from 87.2 %–117.0 %. NiO-SnO2 nanocomposites represent a promising low-cost adsorbent for the preconcentration and subsequent determination of other heavy metal ions in diverse herbal extracts.
Feeding the mind: Preliminary insights into the effects of anthocyanin-rich extract from black carrots on brain activity and gut microbiota in patients with cognitive impairments
(Nature Research, 2025) Müdüroğlu Kırmızıbekmez, Aynur; Önder, Alparslan; Özdemir, Mustafa Yasir; Gürerk, Gamze; Aydın, Sevcan; Eryiğit, Önder Yüksel; Güloğlu, Mehmet Oktar; Kara, İhsan
Anthocyanins, known for their antioxidant and anti-inflammatory properties, have been associated with cognitive benefits, potentially mediated by gut-brain axis interactions. This study investigates the effects of a 12-week Anthocyanin-Rich Extract (ARE) intervention on brain activity and gut microbiota composition in older adults with neurocognitive impairments. In this study, 50 participants underwent electroencephalography (EEG) recordings and gut microbiota analyses before and after the intervention. EEG data were analyzed using connectivity and entropy metrics across multiple frequency bands. Gut microbiota composition was assessed via 16S rRNA sequencing to evaluate taxonomic shifts. Results revealed increased EEG connectivity, particularly in alpha, beta, and gamma frequency bands, suggesting improved neural communication and complexity following ARE consumption. Significant changes in nonlinear EEG metrics were observed, consistent with previous findings in the literature. Microbiota analysis indicated non-significant alterations in overall diversity but revealed increases in Alistipes, Streptococcus thermophilus, and Flavonifractor, alongside a decrease in Hungatella, potentially implicating SCFA metabolism and inflammatory regulation. These findings suggest ARE may enhance cognitive health by modulating neural activity and gut microbiota composition. While these results provide preliminary evidence of neuroprotective effects, further research with larger, disorder-specific cohorts and placebo-controlled designs is necessary to validate outcomes and explore gut-brain axis mechanisms in cognitive decline.
Computational insights into iron coordination disruption in the human transferrin–neisseria meningitidis bacterial protein complex
(MDPI Publishing, 2025) Dervişoğlu Özdemir, Celile; Duran, Gizem Nur; Fındık, Volkan; Özbil, Mehmet; Sağ Erdem, Safiye
Among many metal ions in biological systems, iron plays a fundamental role. Transferrins are iron-binding glycoproteins responsible for transporting Fe3+ in vertebrate blood. Neisse ria meningitidis, a Gram-negative pathogen causing meningitis, relies on iron for survival and acquires it from human transferrin (hTf) using two surface proteins, TbpA and TbpB. These proteins interact with hTf to form a ternary TbpA–TbpB–hTf complex, enabling iron capture from the host. The absence of an experimental crystal structure for this complex has hindered computational studies, a detailed understanding of Fe3+ dissociation, and designing efficient therapeutics. This study presents the first computational model of the ternary complex, its validation, and molecular dynamics simulations. Structural analyses revealed key electrostatic interactions regulating Fe3+ coordination and essential contact regions between proteins. The role of Lys359 from TbpA was investigated via QM/MM calculations by evaluating Fe3+ binding energies of isolated hTf, the ternary complex, and Lys359Ala, Lys359Arg, Lys359Asp mutant models. Results revealed that the proton trans fer from Lys359 leads to disruption of Tyr517–Fe3+ coordination, facilitating iron transfer to the bacterial system. Natural bond orbital analysis confirmed this mechanism. The findings provide new molecular insight into N. meningitidis iron acquisition and identify Lys359 as a potential target for covalent inhibitor design, guiding the development of novel therapeutics against meningococcal infection.

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