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Sex differences in ambulatory blood pressure among patients referred for 24-hour monitoring a retrospective cross-sectional study
(Lippincott Williams and Wilkins Ltd., 2026) Atmaca, Hasan; Gürbüz, Doğaç Çağlar; Erol, Mustafa Kemal; Yetkin, Ertan
Few studies have addressed the differences between hypertensive women and men regarding the diagnosis and control of blood pressure (BP). Accordingly, we aimed to assess the possible discrepancies in BP values between women and men who underwent 24-hour ambulatory blood pressure monitoring. The study population comprised all patients who underwent 24-hour ambulatory blood pressure monitoring, which was retrospectively screened and recorded. Demographic and clinical characteristics of 1204 patients were included in the analysis. Sex-specific analyses of all patients, including those with and without a former diagnosis of hypertension (HT), were performed. Two-thirds of the patients were women. In the general population, both systolic and diastolic BP levels in women were significantly lower than those in men. BP in women was also significantly lower than that in men, both in patients with and without a former diagnosis of HT. Our study demonstrated that women exhibited significantly lower systolic and diastolic BP values than men in this referral cohort, irrespective of a prior diagnosis of HT. While the exact mechanisms remain to be elucidated, this difference highlights the necessity for further research into sex-specific hemodynamic profiles. Consequently, further research is necessary to establish diagnostic thresholds and BP targets to achieve effective and targeted management of BP abnormalities in women.
Risk factors for human papillomavirus positivity in a tertiary care center: A case–control study incorporating genotype distribution, co-infection patterns, and quantitative viral load analysis
(MDPI Publishing, 2026) Karalök, Mete Hakan; Dündar, Bağnu; Parmaksız, Ayhan; Gök Yurttaş, Asiye
Background/Objectives: Human papillomavirus (HPV) is the leading cause of cervical cancer and anogenital malignancies, yet its clinical presentation, genotype distribution, co-infection patterns, and viral load are poorly characterised in tertiary-care referrals. This study aimed to identify predictors of HPV positivity and describe genotype, co-infection, and relative viral copy number (Cq values) in this setting. Methods: A retrospective case–control study of 234 patients (97 HPV-positive, 137 HPV-negative) used a 37-genotype qPCR platform at a tertiary-care hospital between January-December 2025. Demographic data, clinical diagnosis categories, genotype profiles, co-infection patterns, and cycle quantification (Cq) values were recorded, and multivariable logistic regression identified independent predictors of HPV positivity. Results: HPV positivity was 41.5% (97/234). Only the clinical diagnosis category independently predicted HPV status. Compared with non-specific presentations, patients with anogenital or viral warts (aOR: 4.25; 95% CI: 1.49–12.14; p = 0.007) and vaginal or vulvar inflammation (aOR: 2.08; 95% CI: 1.19–3.63; p = 0.010) had higher odds of positivity. High-risk genotypes were the second most frequently detected category (40.00% of detections), after low-risk genotypes (48.21%), with HPV-16 leading among high-risk types. Co-infection occurred in 44.3% of HPV-positive patients, mostly involving mixed-risk genotypes. Patients with anogenital warts had lower Cq values than those with urinary tract complaints (p = 0.011), reflecting higher relative viral copy numbers per swab. Conclusions: HPV positivity and relative viral copy number (as approximated by Cq values) tracked more closely with clinical presentation than with demographic background. The dominance of low-risk and high-risk genotypes and the prevalence of mixed-risk co-infections were consistent with the symptomatic profile of the cohort. These findings support interpreting HPV results in light of clinical presentation and extended genotyping with relative viral copy number quantification in tertiary settings.
Extreme lean hydrogen combustion in SI engines: NOx emissions and exergy destruction analysis
(Inderscience Enterprises Ltd., 2026) Karagöz, Yasin; Pusat, Şaban; Teksan, A. Emre; Tunçer, Erdal; Tetik, Tuğba
This study examines the effects of excess air coefficient (lambda) and late ignition timing on NOx emissions and exergy destruction in a hydrogen-fuelled internal combustion engine converted from a conventional diesel engine. Experiments are conducted at 1,500 rpm and 3.5 kW using two ignition timings [10 degrees and 0 degrees before top dead centre (BTDC)] and three excess air coefficients (lambda = 1.05, 2.15, and 3.75). Results indicate that late ignition (0 degrees BTDC) and ultra-lean operation (lambda = 3.75) significantly reduce NOx emissions. The impacts on brake thermal efficiency (BTE), brake specific energy consumption (BSEC), and exergy destruction are also evaluated.
Green extraction of lycopene and volatile compounds from solanum lycopersicum (tomato) peel and products
(Elsevier, 2026) Özdemir Olgun, Fatoş Ayça; Özel, Mustafa Zafer
The primary aim of this study is the quantitative determination of lycopene and volatile composition in tomato peel and commercial tomato products using subcritical ethanol extraction. Box- Behnken Response Surface Methodology was conducted in order to evaluate the key operational parameters of the extraction process. The priority of the current study was to determine the lycopene efficiency; however, antioxidant activity and total volatile analysis of the extracts were also further evaluated using spectroscopic and chromatographic assays. AGREE-Analytical greenness metric software was applied to evaluate the greenness of the proposed extraction process. These findings demonstrate the efficiency of the proposed procedure in achieving the highest extraction yield (6.51 mg g⁻¹) from tomato peel in the literature. The study emphasises the significance of advanced extraction technologies in converting agricultural raw material or waste into value-added products, thereby promoting the advancement of a green circular economy.
Long-term seizure outcomes in patients with drug-resistant mesial temporal lobe epilepsy due to hippocampal sclerosis
(Elsevier, 2026) Gül, Günay; Eren, Fulya; Kandemir Yılmaz, Melek; Yandım Kuşcu, Demet; Keskinkılıç, Cahit; Tuğcu, Bekir
Objective: Resective surgery is a significant therapeutic option for patients with drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). Numerous studies have demonstrated the efficacy of epilepsy surgery in the short to median term. However, studies on long-term outcomes are limited in number. The objective of this study was to document the long-term prognosis and associated factors of patients under going resective surgery for MTLE. Methods: A retrospective analysis was conducted on the data of patients with drug-resistant MTLE due to HS who underwent resective surgery between 2001 and 2013 at our epilepsy centre. The demographics and clinical variables of the patients were documented and analysed in order to ascertain their long-term prognosis. The postoperative outcomes were evaluated in accordance with the Engel classification system. Results: Of the 45 patients (mean age: 44.64 ± 8.96, range: 31–67), 31 (68.89%) were male. The age at onset of epilepsy, age at surgery, and the duration of epilepsy at the time of surgery ranged from 0.25 to 26 years (11.51 ± 7.07), from 12 to 47 years (26.82 ± 8.14), and from 2 to 33 years (16.03 ± 7.85), respectively. The patients were followed up for 10–23 years (17.73 ± 2.96). HS was identified in 23 (51.11%) of the patients on the right side and 22 (48.89%) on the left. The pre-operative EEG recordings revealed temporal discharges in 40 (88.89%) patients unilaterally. 22 patients (48.89%) underwent amygdalohippocampectomy with a temporal lobectomy (AH+ATL), while 23 patients (51.11%) underwent selective amygdalohippocampectomy (SAH). 28 (62.22%) patients were classified as Engel I. The patients did not have any statistically significant difference in terms of gender, age at epilepsy onset, age at surgery, duration of epilepsy at surgery, side of HS, and surgical procedure according to Engel classification (p = 0.64, 0.08, 0.60, 0.25, 0.67, 0.10, respectively). Executive and memory functions were improved after surgery at 5th year. Conclusion: 62% of the patients were classified as Engel I. Although previous studies have suggested that certain factors may influence prognosis, our findings did not yield any statistically significant results in this regard. It is crucial that patients undergo surgical evaluation without delay to achieve seizure control and improve cognitive function.
Investigation of effects of hybrid hyrax-mentoplate treatment in high-angle class III patients: A three-dimensional, retrospective study
(Wiley, 2026) Yıldırım, Gamze; Önem Özbilen, Elvan; Özdemir, Fulya
Objective: This retrospective study evaluated three-dimensional effects of hybrid hyrax-mentoplate (HH-M) orthopaedic treat-ment in high-angle Class III individuals using Cone Beam Computed Tomography (CBCT) images.Materials and Methods: Pre-treatment (T0) and post-treatment (T1) CBCTs of 17 fully compliant high-angle Class III patients(7 males, 10 females, age: 11.7 ± 1.32 years, treatment duration: 12.62 ± 1.7 months) treated with HH-M were analysed. T0 andT1 CBCTs were superimposed from the cranial base using artificial intelligence-based AMASSS module of the 3D Slicer version5.8.1 software (www.slicer.org). Linear and angular changes were analysed in the sagittal, vertical and transverse planes, along-side three-dimensional landmark displacements and volumetric airway measurements. Significance level was set at p < 0.05.Results: Significant increases occurred in SNA, ANB and Occlusal Plane (OP) to Mandibular Plane (MP) angle (p < 0.001,p < 0.001, p = 0.001, respectively), while Sella-Nasion to OP and Palatal Plane (PP) to OP decreased (p = 0.008, p = 0.008, re-spectively). Vertical linear measurements remained stable (p > 0.05). All transverse linear measurements increased (p < 0.05).Upper Molar (UM) to PP, Upper Incisor to PP, Lower Incisor to MP and overjet have significantly increased (p < 0.001, p = 0.018,p = 0.048, p < 0.001, respectively). Overbite remained unchanged (p > 0.05). Nasopharynx (p = 0.008) and Middle Pharynx(p = 0.003) volumes significantly increased.Conclusion: Despite the significant alterations observed in OP and UM-PP, this technique effectively managed to maintain over-all vertical skeletal dimensions without inducing a significant change in other facial height parameters and enhanced the airwayvolume. Significant expansion occurred across maxillary, nasal and zygomatic levels. HH-M represents an effective orthopaedictreatment approach for high-angle Class III patients.
DNA methylation of ANKRD23 as a novel biomarker for early diagnosis of ovarian cancer
(Women's Health and Action Research Centre, 2026) Alizada, Aydan; Şükrüoğlu Erdoğan, Özge; Kılıç Erciyas, Seda; Çelik Demirbaş, Betül; Pasin, Özge; Dinç, Ahmet; Saip, Pınar; Yazıcı, Hülya; Tuncer, Şeref Buğra
Ovarian cancer (OC) is a leading cause of gynecologic cancer-related mortality and is frequently diagnosed at advanced stages due to the absence of effective early detection tools. Epigenetic alterations, particularly DNA methylation, play a critical role in tumorigenesis and represent promising non-invasive biomarkers. This study investigated the methylation status of the ANKRD23 gene in OC and evaluated its diagnostic potential using peripheral blood samples. A total of 385 serous OC patients, 50 individuals with benign ovarian conditions, and 99 healthy controls were included. DNA methylation was assessed using methylation-sensitive restriction enzymes followed by real-time PCR. ANKRD23 methylation was significantly associated with clinical stage (p = 0.029), histological grade (p = 0.009), and ethnicity (p = 0.024). Moreover, methylation levels differed significantly among OC patients, benign cases, and healthy controls (p = 0.026). These findings support blood-based ANKRD23 methylation as a promising biomarker for non-invasive ovarian cancer diagnosis and risk stratification. (Afr J Reprod Health 2026; 30 [15] 16-25).
Effects of rifaximin in fructose-induced steatohepatitis in rats
(Kare Publishing, 2026) Kıyak, Mevlüt
To the Editor, I read with interest the recently published article titled “Effects of rifaximin in fructose-induced steatohepatitis in rats.” The article dis cusses how rifaximin may protect against early liver damage caused by fructose. The researchers showed that rifaximin helps reduce cer tain biochemical markers and promote healing in inflamed tissue, providing insight into the interaction between the gut and liver in fatty liver disease, which plays a role in metabolic disorders.
Coronary heart disease in patients with type 2 biabetes: The role of traditional, behavioral and atherogenic risk factors in a large multicenter study
(Oxford University Press, 2026) Telci Çaklılı, Özge; Demirci, İbrahim; Haymana, Cem; Hacışahinoğulları, Hülya; Kılınç, Faruk; Karakoç, Ayhan; Sarı, Ramazan; Taşçı, İlker; Salman, Serpil; Ersoy, Canan; Bayram, Fahri; Satman, İlhan; Sönmez, Alper
Background Type 2 diabetes mellitus (T2DM) substantially increases the risk of coronary artery disease (CAD) through insulin resistance, inflammation, and related complications. In this large, nationally representative multicenter study, we investigated behavioral and metabolic risk factors associated with CAD in T2DM. Materials and Methods This cross-sectional study was conducted across Türkiye, including 70 endocrine clinics in 36 cities. Adults with T2DM followed at the same center for at least one year were included. Sociodemographic, anthropometric, clinical, laboratory, and lifestyle data were recorded using a standardized web-based system. Results A total of 5707 patients with diabetes were recruited, of whom 4956 (86.8%) had T2DM (mean age 58.9 ± 10.0 years; 59.8% women). CAD status was available in 4750 patients, among whom 1061 (22.3%) had CAD. CAD was more frequent in men than women (30.4% vs 16.9%, P < .001). Patients with CAD were older (62.8 ± 8.6 vs 57.8 ± 10.2 years, P < .001) and had longer diabetes duration (16.1 ± 8.8 vs 12.2 ± 7.7 years, P < .001). Body mass index was lower (31.2 ± 5.8 vs 31.8 ± 6.8 kg/m2, P = .005), whereas waist circumference was higher (106.7 ± 13.7 vs 105.1 ± 14.1 cm, P = .004). Lower income was associated with CAD (23.4% vs 19.5%, P = .003), whereas smoking and exercise were not (P = .219 and P = .977). Hypertension was associated with CAD (28.2% vs 14.5%, P < .001). Systolic blood pressure was higher (126.1 ± 13.6 vs 124.3 ± 13.6 mmHg, P = .004), while diastolic pressure did not differ (P = .603). HbA1c was higher in the CAD group (8.27 ± 1.94 vs 7.84 ± 1.89%, P < .001), and hypoglycemia was more frequent (24.6% vs 20.8%, P = .002). In multivariable logistic regression, independent predictors of CAD were older age (OR 1.04, 95% CI 1.03-1.05, P < .001), male sex (OR 0.39, 95% CI 0.33-0.46, P < .001), current smoking (OR 1.37, 95% CI 1.12-1.66, P = .002), hypertension (OR 2.00, 95% CI 1.68-2.38, P < .001), microvascular complications (OR 1.48, 95% CI 1.26-1.74, P < .001), higher HbA1c (OR 1.12 per %, 95% CI 1.07-1.17, P < .001), longer diabetes duration (OR 1.04 per year, 95% CI 1.02-1.05, P < .001), and lower income (OR 0.74, 95% CI 0.62-0.88, P = .001). Exercise, diet, hypoglycemia, education, and body mass index were not independently associated with CAD (all P > .05). Conclusion In this large national cohort of T2DM patients, CAD was independently associated with classical cardiometabolic risk factors, microvascular complications, and lower income, whereas lifestyle factors were not independently associated after adjustment. These findings highlight dominant role of cumulative metabolic burden and vascular damage in determining CAD risk and emphasize the importance of early, sustained, risk factor–targeted management.
Heterogeneous fatty acid-binding protein 4 (FABP4) responses after Roux-en-Y gastric bypass reveal adipokine remodeling dissociated from weight loss, inflammation, and incretin dynamics
(Oxford University Press, 2026) Çalıkoğlu, Bedia Fulya; Örskaya, Handan Hanım; Yenidünya Yalın, Gülşah; Barbaros, Umut; Bingül, İlknur; Aydın, Fatih
Background Fatty acid–binding protein 4 (FABP4) is an adipokine closely linked to adipose tissue mass, low-grade inflammation, and cardiometabolic risk. Following bariatric surgery, FABP4 is generally expected to decrease in parallel with weight loss and improvements in inflammation. However, whether postoperative FABP4 dynamics uniformly reflect these changes or exhibit heterogeneous patterns independent of anthropometric and hormonal adaptations remains unclear. Methods Twenty-eight adults undergoing Roux-en-Y gastric bypass (RYGB) were prospectively followed at baseline, 3 months, and 6 months. Anthropometric measures, body composition, metabolic indices, hsCRP, IL-6, fasting GLP-1 and PYY, and serum FABP4 were assessed. The 3-month time point was included to capture early postoperative metabolic and adipokine dynamics, whereas primary analyses focused on baseline-to-6-month changes to reflect more stable biological adaptations. Patients were classified as FABP4 responders (decrease from baseline to 6 months) or rebound/non-responders. Longitudinal changes were analyzed using Friedman tests, and between-group comparisons were performed using nonparametric methods. Results RYGB induced early and progressive anthropometric improvement, with BMI decreasing from 51.5 [48.1-55.2] kg/m2 at baseline to 42.8 [39.6-46.9] at 3 months and 35.6 [32.4-38.9] at 6 months (P < .001). Systemic inflammation improved in parallel: IL-6 declined from 3.18 [2.27-4.44] pg/mL at baseline to 2.95 [2.31-3.82] at 3 months and 1.68 [0.96-2.95] at 6 months (P = .00015), while hsCRP decreased significantly over time (P < .001). In contrast, FABP4 trajectories demonstrated marked inter-individual variability. At 3 months, FABP4 changes showed no consistent directional pattern, despite early weight loss and improvement in inflammation. By 6 months, 46% of patients exhibited no decrease or a rebound in FABP4 levels. FABP4 responders experienced less pronounced BMI reduction compared with rebound/non-responders (ΔBMI −14.2 [−16.8 to −11.9] vs −18.6 [−21.4 to −15.1] kg/m2; P = .03). Changes in FABP4 were not significantly correlated with changes in BMI, fat mass, hsCRP, or IL-6 (all P > .05). Fasting GLP-1 and PYY levels did not differ between FABP4 response groups. Conclusions Despite expected improvements in weight and systemic inflammation after RYGB, FABP4 responses are heterogeneous and only weakly related to anthropometric, inflammatory, or fasting incretin changes. These findings suggest that FABP4 reflects individualized adipose tissue–specific adaptive remodeling rather than a simple surrogate of weight loss or of improvements in inflammation following bariatric surgery.
Gray zone of hypertension thresholds values can be overcome by individualized symptom-oriented approaches
(Lippincott Williams and Wilkins Ltd., 2026) Yetkin, Ertan; Atmaca, Hasan; Gürbüz, Dogaç Çağlar; Yalta, Kenan; Erol, Mustafa Kemal
Dear Editor, We have read with great interest the recently published article of Chung et al. [1]. Briefly, they reassessed the sensitivity, specificity and diagnostic accuracy of home blood pressure monitoring (HBPM) by changing threshold values for the diagnosis of hypertension from 135/85 to 130/80 mmHg in 646 participants who were suspected of having hypertension (office blood pressure ≥140/90 mmHg). Eventually, they have found that lowering the diagnostic threshold of home hypertension from 135/85–130/80 mmHg significantly enhances the diagnostic sensitivity of HMBP.
Does thermoforming setup affect thickness in thermoplastic orthodontic appliances? A comparison of single vs. dual-model fabrication
(MDPI Publishing, 2026) Allaf, Ferdi; Arslan, Meriç; Özcan, Mustafa; Erdem, Buket
Thermoforming remains the predominant fabrication route for clear thermoplastic orthodontic appliances, yet it reduces and redistributes sheet thickness, which governs force delivered to teeth. Simultaneous thermoforming of two models may reduce fabrication time and material waste; however, its effect on final appliance thickness has not been evaluated. This in vitro study compared appliance thickness after thermoforming over a single model or two models simultaneously, using ten commercial aligner brands with different polymer composition and initial thickness. Thickness was measured with a digital caliper at anterior, canine and posterior sites, and analyzed using three-way ANOVA with Tukey post hoc tests. A significant three-way interaction (measurement point × number of models × brand; p < 0.001) was found. Significant single- versus dual-model differences emerged in some brand–region combinations; in most, dual-model appliances were thicker than single-model appliances. Four brands showed no significant difference at any site. Within the limits of this study, simultaneous fabrication of two appliances in a single thermoforming cycle produced appliances with thicknesses comparable to, and often slightly greater than, those fabricated over a single model. Simultaneous thermoforming maintained comparable appliance thickness and may improve manufacturing efficiency.
University-industry collaboration and sustainable organizational resilience: The mediating role of relationship quality and the moderating effect of institutional alignment
(MDPI Publishing, 2026) Gemici, Evrim
As firms increasingly rely on external partnerships to navigate complex and volatile envi ronments, understanding the distinct pathways through which such collaborations may relate to resilience has become essential. However, despite growing interest in interorgani zational collaboration, limited research has explicitly examined how university–industry collaboration relates to organizational resilience, as prior studies have predominantly fo cused on innovation and performance-related consequences. This study examines whether university–industry collaboration is associated with organizational resilience, conceptu alized as a micro-foundation of sustainable development. Specifically, it investigates the mediating role of relationship quality within the university–industry collaboration and re silience nexus and the moderating effect of institutional alignment. The proposed research model and hypotheses were tested using survey data collected from 220 firms operating in science and technology parks (STPs) in Türkiye through partial least squares structural equation modeling (PLS-SEM) with SmartPLS. The results indicate that university-industry collaboration exhibits a significant association with organizational resilience, which is also linked to long-term sustainability at both firm and systemic levels. Furthermore, relationship quality serves as a distinct mediating pathway linking university–industry collaboration with organizational resilience. In addition, institutional alignment shows a significant moderating role in this relationship, such that higher alignment between university and industry partners strengthens the collaboration–resilience linkage. This study offers an early empirical attempt to conceptualize university–industry collaboration as an external driver associated with organizational resilience while delineating the distinct processes of mediation and moderation. Drawing on institutional theory and relational coordination theory, the findings elucidate the distinct institutional and relational pathways through which collaborations are associated with organizational resilience. For managers and policymakers, the study underscores the importance of investing in high-quality re lationships and institutional congruence to better leverage collaborative partnerships for sustainable organizational resilience.
Experimental sciatic nerve neuropathy caused by diclofenac sodium in rats
(Kare Publishing, 2026) Aykut, Ali Maksut; Kaya, Mustafa Emrah; Oral, Şükrü; Serarslan, Yurdal; Aras, Mustafa; Yılmaz, Atilla; Özgür, Tümay; Doğan, Serdar
OBJECTIVE: Our aim in this study is to investigate the total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values of diclofenac sodium, which is a non-steroidal anti-inflammatory analgesic, after sciatic nerve injury, to examine the histopathological changes in the sciatic nerve, and to examine the results and enable important changes in treatment. It is one of the rare studies conducted histopathologically on post-injection sciatic nerve damage of diclofenac sodium, and the parameters of our biochemical approach have not been evaluated before in the literature. METHODS: study was divided into 5 main groups as control, sham, trauma, isotonic fluid, and diclofenac sodium. Sham, trauma, isotonic fluid, and diclofenac sodium groups were divided into four subgroups as early stage (day 1, day 3) and late stage (day 7 and day 14). Subjects in each group were evaluated daily by neurological examination according to the Tarlov scale. In all groups except the control group, the sciatic nerve was exposed through appropriate surgical procedures. TAS, TOS, and OSI were run on blood samples biochemically. Nerve tissue samples were evaluated histopathologically and immunohistochemically. RESULTS: There was a significant difference in pairwise comparison of the groups in terms of CASPASE-3 values. A statis tically significant difference was found between the groups in terms of myelin thickness and axon diameter. A statistically significant difference was found between the groups in terms of nerve diameter values. CONCLUSION: Our study demonstrates that intramuscular injections of diclofenac sodium have potential harmful ef fects. We recommend that alternative methods of using diclofenac sodium intramuscularly be preferred whenever possi ble due to the potential complications associated with this drug, that healthcare professionals receive necessary training on intramuscular administration, that the procedures be performed more carefully, and that patients be informed about these complications.
Fracture resistance of 3D printed resin-based permanent ceramic fixed dental prostheses after thermocycling
(Elsevier, 2026) Özer, Safa; Atasoyu Akgün, Begüm; Çakan, Umut
Objectives: Three-dimensionally (3D) printed resin-based permanent ceramics produced using additive manufacturing have recently gained considerable interest as potential restorative materials for fixed prostheses. However, limited evidence is available regarding their long-term mechanical performance following thermo cycling. The aim of this study was to evaluate the effect of different thermocycling durations on the fracture resistance of 3D-printed bar-type fixed dental prosthesis (FDP) specimens. Methods: Forty-eight bar-shaped, three-unit FDP specimens (5 × 5 × 30 mm), each containing a 4 × 4 mm² U- shaped connector, were fabricated using 3D-printed resin-based permanent ceramic. The specimens were divided into four groups according to ageing duration: unaged, 1, 3, and 12 months of thermocycling. Fracture load (N) data were analysed using non-parametric statistical methods. Group comparisons were performed using the Kruskal–Wallis test with epsilon-squared ( ε ²) effect size estimation, and the Jonckheere–Terpstra test was applied to evaluate the ordered trend across thermocycling durations. Results: Group comparisons showed no statistically significant differences in fracture load among ageing dura tions (Kruskal–Wallis, p = 0.168), with a small effect size ( ε ² = 0.047). However, the Jonckheere–Terpstra test indicated a significant decreasing trend in fracture load with an increase in thermocycling duration (Z = 2.135, p = 0.033). Conclusions: Although no statistically significant group differences were observed, effect size analysis and regression trends indicated that long-term thermocycling may gradually reduce the fracture resistance of 3D- printed resin-based permanent ceramic FDPs. Clinical significance: 3D-printed resin-based permanent ceramic FDPs can provide satisfactory initial fracture resistance; however, the mechanical strength reduction tendency following long-term ageing should be considered for clinical applications over extended durations.
Age-adjusted associations between routine systemic inflammatory markers and anti-müllerian hormone in reproductive-age women: A retrospective cross-sectional study
(MDPI Publishing, 2026) Karalök, Mete Hakan; Dündar, Bağnu; Parmaksız, Ayhan; Elgün, Tuğba; Gündoğan, Gül İpek; Gök Yurttaş, Asiye
Background: Anti-Müllerian hormone (AMH) is widely used as a marker of ovarian reserve and is strongly influenced by chronological age. Although inflammation has been implicated in ovarian aging and follicular dysfunction, whether routinely measured peripheral inflammatory markers provide additional information regarding AMH concentrations remains unclear. Objective: This study aimed to evaluate the age-adjusted associations of C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR) with serum AMH concentrations in reproductive-age women. Methods: This retrospective cross-sectional study included women aged 18–45 years with available AMH, complete blood count, and CRP measurements. After reapplying the prespecified eligibility criteria and excluding confirmed data-entry or analytical errors, 819 women were included in the final analysis. NLR was calculated from absolute neutrophil and lymphocyte counts. Because CRP and NLR showed right-skewed distributions, Box–Cox transformations were applied. Associations with Box–Cox-transformed AMH were evaluated using an age-adjusted left-censored Tobit regression model. Results: The mean age of the participants was 34.07 ± 6.94 years, and the median AMH concentration was 1.07 ng/mL (interquartile range, 0.29–2.50). Chronological age was inversely associated with AMH (β = −0.123, 95% CI: −0.135 to −0.111, p < 0.001). After adjustment for age, neither CRP (β = −0.038, 95% CI: −0.085 to 0.009, p = 0.114) nor NLR (β = −0.012, 95% CI: −0.222 to 0.198, p = 0.912) was independently associated with AMH. Conclusions: In this retrospective outpatient cohort, routine peripheral inflammatory markers did not explain additional variation in AMH beyond chronological age. These results do not exclude a potential role for local ovarian inflammation, which may not be adequately captured by peripheral CRP or NLR measurements.
Anatomical location is associated with clinicopathological features and long-term oncological outcomes in mucinous colorectal adenocarcinoma: A population-based analysis of 40,698 patients from the SEER database
(MDPI Publishing, 2026) Kutlu, Burak; Benlice, Çiğdem
Background: Mucinous adenocarcinoma (MAC) of the colorectum is a biologically distinct histological subtype whose prognostic significance may vary substantially according to primary tumor location. The impact of anatomical site on clinicopathological characteristics and long-term survival in MAC remains incompletely characterized. This study aimed to evaluate the influence of tumor location on oncological outcomes in patients with mucinous colorectal cancer using a large population-based dataset. Methods: Patients diagnosed with mucinous colorectal adenocarcinoma between 2000 and 2023 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Operated patients were stratified by anatomical location into three groups: right colon (cecum, ascending colon, hepatic flexure, transverse colon), left colon (splenic flexure, descending colon, sigmoid colon, rectosigmoid junction), and rectum. The primary endpoints were overall survival (OS) and cancer-specific survival (CSS). Survival analyses were performed using the Kaplan–Meier method with log-rank testing. Multivariable Cox proportional hazards regression was used to assess the independent association of tumor location with survival outcomes, adjusting for age at diagnosis, year of diagnosis, sex, AJCC (American Joint Committee on Cancer) stage, tumor grade, receipt of radiotherapy and chemotherapy. Temporal trends in survival were evaluated across four consecutive diagnostic periods: 2000–2005, 2006–2011, 2012–2017, and 2018–2023. Results: A total of 40,698 patients with mucinous colorectal cancer were identified, of whom 40,174 underwent cancer-directed surgery (right colon n = 25,317; left colon n = 10,408; rectum n = 4449). The right colon was the predominant site of disease (62.9%). Median age was highest in the right colon group (74.0 years) and lowest in the rectum (65.0 years), while female sex predominated in right-sided tumors (55.7%) and male sex in rectal tumors (61.1%). Chemotherapy and radiotherapy utilization were markedly higher in the rectal group (68.6% and 64.5%, respectively) compared with the right colon (28.8% and 1.1%). Median OS was equivalent in the right and left colon groups (87.0 months each) but declined to 80.0 months in the rectal group. All pairwise CSS comparisons were statistically significant (all p < 0.001). On multivariable analysis, using the right colon as reference, the adjusted hazard ratios for CSS were 1.33 (95% CI: 1.28–1.39) for the left colon and 1.45 (95% CI: 1.34–1.57) for the rectum (both p < 0.001). Despite receiving the highest rates of multimodal therapy, rectal MAC demonstrated the worst long-term CSS across all anatomical groups. Temporal analyses revealed consistent CSS improvements in right-sided and left-sided MAC over the study period, whereas rectal MAC showed a non-linear trajectory with a plateau in the most recent diagnostic cohort (2018–2023). Conclusions: Mucinous colorectal adenocarcinoma demonstrates substantial biological and prognostic heterogeneity according to anatomical tumor location. Right-sided MAC was the most prevalent subtype and exhibited superior cancer-specific survival despite older patient age and lower treatment intensity. Rectal MAC demonstrated the worst long-term outcomes despite high utilization of multimodal neoadjuvant therapy, consistent with the established reduced responsiveness of mucinous tumors to conventional chemoradiotherapy. These findings underscore the necessity of incorporating anatomical location and tumor biology into individualized risk stratification and therapeutic planning for patients with mucinous colorectal cancer.
Blood-based RBBP7 and RIBC1 methylation as a candidate epigenetic biomarker for ovarian cancer epigenetic markers RBBP7 and RIBC1 in ovarian cancer
(Springer Nature Link, 2026) Şükrüoğlu Erdoğan, Özge; Kılıç Erciyas, Seda; Çelik Demirbaş, Betül; Dinç, Ahmet; Ünal, Elif; Güngör Uğurlucan, Funda; Akdeniz Ödemiş, Demet; Pasin, Özge; Saip, Pınar Mualla; Yazıcı, Hülya; Tuncer, Şeref Buğra
Background: Ovarian cancer (OC) remains one of the leading causes of gynecological cancer-related mortality, with limited biomarkers for early detection and prognosis. Changes in DNA methylation-stable and detectable in blood-are potential candidates for clinical application. In our earlier genome-wide methylation study involving monozygotic twins where one had ovarian cancer and the other did not, we identified two genes, RBBP7 and RIBC1, as differentially methylated. These findings laid the groundwork for further targeted investigation. Methods and results: Peripheral blood methylation of RBBP7 and RIBC1 was evaluated in 387 ovarian cancer patients, 50 benign ovarian disease patients, and 100 healthy controls using a bisulfite-free, methylation-sensitive restriction enzyme (MSRE)-based qPCR assay. In this approach, DNA is divided into digested and undigested reactions, and methylation levels are calculated from Ct differences. Methylation levels differed across groups, with RBBP7 showing a clearer discriminatory pattern (p < 0.001) and associations with disease severity (p < 0.001) and CA125 levels (p = 0.05). RIBC1 also differed between ovarian cancer and healthy controls (p < 0.001) but showed no significant associations with clinicopathological parameters. Conclusion: RBBP7 methylation appears to be a potential candidate biomarker associated with disease characteristics and progression patterns of ovarian cancer. These findings suggest that RBBP7 methylation may have potential for integration into future multi-marker diagnostic and risk-stratification approaches, pending further validation. While RIBC1 methylation also showed differential patterns, its clinical relevance appears limited and requires further investigation. These findings support the integration of RBBP7 methylation assessment into early-stage diagnostic workflows and risk-stratification strategies for ovarian cancer, enabling more precise clinical decision-making. Future multicenter prospective studies are warranted before clinical implementation.
Reliable interpretation of extreme-heat energy response for sustainable campus management: Baseline, calendar, and chilled-water metering controls
(MDPI Publishing, 2026) Cihangir, Cenk; Özyılmaz, Lale; Coşkun, Yusuf
Open hourly meter data are often used to infer how buildings respond to extreme heat, but the interpretation can depend on the analytical baseline, institutional calendar, and meter configuration. We examined 60 education and office buildings in the Building Data Genome Project 2 using repeated whole-week validation, temperature-matched placebo tests, 13 academic-calendar definitions, and same-building, common-hour carrier com parisons. A leakage-resistant change-point model that incorporated a previous-day, load derived operating-regime proxy reduced blocked-validation error relative to a conventional model in 58 of 60 buildings; temperature binning provided no additional predictive benefit after regime control. Recovery-related signals were uncommon: rebound was significant in 2 of 49 eligible buildings, load-shape disruption in 1 of 49, and the 72 h duration diagnostic in 3 of 60. At Fox, the BASE calendar supported term and break comparisons through 39–42 ◦C, but neither building-use group differed significantly after false-discovery-rate ad justment; estimates above 42 ◦C were inconclusive. In the matched sample of 13 education and 10 office buildings, no electricity-only, chilled-water-only, or weighted specification provided robust evidence of a between-group difference. Across 99 combinations of carrier weight, normalization, and temperature bin, every 95% interval included zero. Reliable campus benchmarking therefore requires out-of-sample baseline assessment, explicit calen dar sensitivity, common-hour meter matching, and carrier-specific uncertainty reporting before building-use rankings or resilience-related interpretations are made.
Between symphony and jungle: Nursing students’ metaphorical representations of teamwork
(Elsevier, 2026) Aydoğdu, Ana Luiza Ferreira; Cortez, Elaine Antunes
Aim: To explore undergraduate nursing students’ perceptions of teamwork through metaphor analysis and discuss the implications for nursing education and collaborative practice. Background: Teamwork is a core competency in nursing education; yet, little is known about how students conceptualise it and how these perceptions shape their readiness for practice. Design: Qualitative descriptive study. Methods: The study was conducted with 68 undergraduate nursing students from Brazil. Data were collected between March 10 and 31, 2026, through an online survey where students were invited to describe teamwork using metaphors. Data were analysed using reflexive thematic analysis, supported by Conceptual Metaphor Theory. Results: Three interrelated themes were identified: (1) Functional and systemic integration: the team as a mechanism; (2) Harmonisation and coordinated leadership: the team as a performance; and (3) Identity, connection and livelihood: the team as a foundation, a shield and a means of survival. These metaphors suggest that students simultaneously conceptualise teamwork as a structured system, a coordinated practice and a source of both support and emotional demand. Conclusions: Undergraduate nursing students develop an early, complex understanding of teamwork that in tegrates technical, relational and emotional dimensions. While this may reflect the effectiveness of educational approaches in fostering teamwork, care coordination and patient safety, metaphors associated with stress and undervaluation may suggest a need to address the emotional and psychosocial dimensions of teamwork within nursing curricula.

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