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Comprehensive analyses of sox7 provide novel insights on its tumor suppressor role and its target genes with therapeutic implications in multiple myeloma
(MDPI Publishing, 2026) Ceylan, Arda; Hu, Xiaozhou; Hatipoğlu, Tevfik; Nainkwi, Fenangi Chiara; Payzın, Kadriye Bahriye; Özsan, Güner Hayri; Şirinoğlu Demiriz, Itır; Şeker, Ömer; Kakçı, Merve; Küçük, Can
Multiple myeloma (MM) is an incurable hematological malignancy. SOX7, located within the recurrently deleted 8p23.1 region in MM, is suggested to act as a tumor suppressor. We characterized SOX7 through genetic, epigenetic, and functional analyses in MM cell lines. SOX7 was frequently silenced due to deletion and/or promoter hypermethylation. Ectopic SOX7 expression in KMS-18 and MM.1S cell lines caused a progressive decline in SOX7-transduced cells and induced G1 cell cycle arrest and/or apoptosis. Although SOX7 re-expression did not enhance bortezomib efficacy, treatment with the pan-histone deacetylase inhibitor panobinostat induced G1 arrest, promoted apoptosis, and increased SOX7 expression in MM.1S cells. Whole-transcriptome sequencing identified G1/S progression-related Wnt/β-catenin pathway genes as major SOX7-regulated targets, while ChIP-Seq analysis revealed widespread genomic SOX7 occupancy in MM.1S. Flow cytometric analysis of permeabilized bone marrow tumor cells from newly diagnosed and relapsed MM patients demonstrated generally low SOX7 protein expression. Collectively, these results indicate that SOX7 functions as a tumor suppressor in MM, and its inactivation promotes cell cycle progression. The anti-myeloma effects of panobinostat in MM.1S cells may be partially mediated through SOX7 induction.
Cross-domain generalization of deep learning architectures for cephalometric landmark detection: A dual-dataset and multi-device benchmark
(MDPI Publishing, 2026) Allaf, Ferdi; Özcan, Mustafa
Background/Objectives: Deep learning models for cephalometric landmark detection report near-ceiling accuracy on single benchmarks, yet most are trained and tested on the same dataset. Whether the best in-domain architecture remains best out-of-domain has not been systematically quantified. Methods: Four architecture families (heatmap CNN, two-stage cascade, coordinate-regression Vision Transformer, pretrained ResNet-50) were each trained on two independently sourced datasets—ISBI 2015 (400 images, one device) and Aariz (1000 images, seven devices)—and evaluated on both, over their 19 shared landmarks in millimeters. All axes used three seeds (mean ± SD): the cross-dataset matrix, leave-one-device-out shift, balanced joint training, a pretrained-versus-scratch ablation, and a landmark-level breakdown. Results: In-domain mean radial error (MRE) was 2.47–3.04 mm (Aariz) and 4.12–5.55 mm (ISBI); cross-dataset error rose steeply (Generalization Drop—the relative increase in error out-of-domain—155–426%). The most accurate model in-domain (a from-scratch heatmap CNN, 2.47 mm) showed the largest drop, and every pretrained estimate fell below every from-scratch estimate (family means 248% vs. 380%): in-domain ranking did not predict cross-domain ranking. Leave-one-device-out revealed reproducible device-specific shift (held-out MRE 1.89–7.94 mm). Inter-observer variability was 0.53 mm, so cross-domain errors were 15–44× the human band. Balanced joint training reduced the cross-domain gap for all four architectures (both domains ≈ 2.1–3.5 mm) without harming in-domain accuracy. Pretraining more than halved cross-domain error from Aariz to ISBI (7.73 vs. 16.36 mm) but not in reverse, supporting the mechanism in one direction rather than uniformly. A-point, B-point, Nasion, and Menton all exceeded the 2 mm clinical threshold out-of-domain, including points localized to sub-millimeter accuracy in-domain. Conclusions: Single-dataset accuracy substantially overstates clinical generalizability, and the best in-domain architecture is not the most transferable, so in-domain leaderboards are an unreliable basis for selecting a model for clinical deployment; balanced multi-source training recovers most of the loss across the architectures tested.
Gender-specific cancer-related survival analysis of robotic versus laparoscopic low anterior resection for rectal adenocarcinoma: A multicenter study
(Wiley, 2026) Benlice, Çiğdem; Ramoğlu, Nur; Bilgin, İsmail Ahmet; Kaya, Ayşe Gülşah; Erkaya, Metincan; Kutlu, Burak; Kuzu, Mehmet Ayhan; Baca, Bilgi; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun
Aim: This study compared short‐ and long‐term outcomes of robotic and laparoscopic low anterior resection (LAR) for rectaladenocarcinoma using sex‐stratified analyses.Methods: Patients who underwent elective robotic or laparoscopic LAR for rectal cancer were included. Prospectively main-tained database of outcomes was analysed retrospectively. To minimise selection bias, groups were matched.Results: Of 409 identified patients, 380 met the eligibility criteria (mean age: 61 years, BMI: 26.2 kg/m2). In a matched cohort ofmales (n = 172) and females (n = 114), robotic surgery was associated with significantly shorter hospital stay (p < 0.01).Harvested lymph nodes, margins, morbidity and local recurrence were comparable in males (p > 0.05). Robotic surgery infemales was associated with fewer harvested lymph nodes (p = 0.01). Five‐year disease‐specific survival rates did not signifi-cantly differ between approaches in either gender.Conclusions: Robotics and laparoscopic LAR achieved similar oncologic outcomes. The findings should be interpreted as sex‐stratified comparisons rather than evidence of differential effect of surgical approach according to sex.
Clinical outcomes of robotic and laparoscopic ileal pouch–anal anastomosis in ulcerative colitis: A retrospective cohort from two tertiary referral centers
(SAGE Publications, 2026) Sahar, Ahmet Anıl; Benlice, Çiğdem; Çebi, Orkun Harun; Aghayeva, Afag; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun; Baca, Bilgi
Background: Robotic platforms may facilitate the technically demanding pelvic and multiquadrant components of ileal pouch-anal anastomosis (IPAA), but comparative evidence remains limited. Methods: We retrospectively compared 90-day outcomes after robotic (n = 36) and laparoscopic (n = 24) IPAA for ulcerative colitis performed by one surgical team at two tertiary referral centers between 2014 and 2025. The primary outcome was postoperative morbidity. Logistic regression adjusted for operative staging; an exploratory model additionally adjusted for age, sex, and body mass index. Results: Ninety-day morbidity occurred in 30.6% of robotic and 41.7% of laparoscopic patients (P = .377). Major morbidity, operative time, blood loss, length of stay, readmission, and reoperation did not differ significantly. The robotic approach was not associated with morbidity in the primary model (adjusted OR, 0.60; 95% CI, 0.20–1.80; P = .361). Conclusions: Robotic IPAA showed no evidence of increased short-term morbidity compared with laparoscopy in this single-team cohort.
Peroneus longus tendon autograft for anterior cruciate ligament reconstruction: Current evidence, donor‐site complications and patient selection
(Wiley, 2026) Okutan, Ahmet Emin; Budhiparama, Nicolaas; Herbort, Mirco; Köse, Özkan; Petersen, Wolf; Wierer, Guido; Erden, Tunay; Herbst, Elmar; Tischer, Thomas; Kayaalp, Mahmut Enes
The search for the ideal autograft for anterior cruciate ligament (ACL) reconstruction (ACLR) remains a longstanding challenge in orthopaedic surgery, as each available graft possesses distinct advantages and inherent limitations. The peroneus longus tendon (PLT) has emerged as an alternative autograft, expanding graft options without further compromising the injured knee. Initially regarded with caution because of con cerns regarding its role in foot and ankle biomechanics, the PLT has evolved into an increasingly recognised alternative autograft option supported by a growing body of anatomical, biomechanical and clinical evi dence. The accumulating evidence suggests that the PLT provides reliable graft characteristics, while avail able comparative studies report broadly similar short to mid‐term clinical outcomes to established autografts and generally favourable donor‐site function. However, the predominantly retrospective and heterogeneous evidence base does not establish graft equivalence or noninferiority. Although important questions remain, particularly regarding sport‐specific ankle performance in high‐demand athletes, long‐term donor‐site conse quences and optimal harvest techniques, the available evidence supports consideration of the PLT as an additional autograft option for ACLR. Rather than es tablishing graft superiority, this editorial synthesises the current evidence, highlights the strengths and limita tions of the PLT, and provides a practical framework for individualised ACL graft selection.
Prognostic nutritional index versus cally, conut, and car for predicting restenosis after endovascular treatment of superficial femoral artery chronic total occlusion
(Elsevier, 2026) İskender, Hakan; Kılıç, Ömer Abdulbaki; Jabrayilzade, Jabrayil; Veyisoğlu, İbrahim; Toprak, Cüneyt; Çakmak, Ender Özgün
Background: Inflammation- and nutrition-based indices have been associated with adverse outcomes after peripheral endovascular interventions, but their comparative performance re mains unclear. We compared the associations and discriminatory performance of the prognostic nutritional index (PNI), C-reactive protein—albumin—lymphocyte (CALLY) index, controlling nutritional status (CONUT) score, and C-reactive protein-to-albumin ratio (CAR) in relation to 6-month restenosis after endovascular treatment of superficial femoral artery chronic total occlu sion (SFA CTO). Methods: This retrospective cohort included 227 technically successful SFA CTO procedures performed between 2015 and 2021 with imaging-based 6-month restenosis assessment. The 4 indices were compared using receiver operating characteristic analysis and separate multivari able logistic regression models adjusted for clinical and lesion-related factors. Multiplicity correc tion and patient-cluster bootstrap internal validation were performed. Results: Restenosis occurred in 79 procedures (34.8%). PNI showed the highest discrimination (area under the curve [AUC] 0.728; 95% confidence interval [CI]: 0.662—0.794), compared with CONUT (0.625), CALLY (0.582), and CAR (0.568). After multivariable adjustment and multiplic ity correction, PNI (adjusted odds ratio [OR] 2.72 per 1-SD worsening; 95% CI 1.78—4.14) and CONUT (adjusted OR 1.61; 95% CI 1.17—2.22) remained independently associated with reste nosis, whereas CALLY and CAR did not. Adding PNI to the clinical base model increased the AUC from 0.670 to 0.782 and reduced the Brier score from 0.209 to 0.178. The improvement persisted after bootstrap validation (optimism-corrected AUC 0.740).
Solid lipid nanoparticles based dry powder inhalers for enhanced drug delivery against lung diseases
(Springer Nature Link, 2026) Önel, Çağla; Pirinçci Tok, Yağmur; Özsoy, Yıldız
The global incidence of lung diseases associated with high mortality and morbidity rates is projected to rise in the coming years. Conventional therapies face limitations such as low bioavailability and systemic side effects with oral administration, as well as poor patient compliance and frequent dosing with traditional inhalers. These shortcomings have created an urgent need for novel pulmonary drug delivery systems. In recent years, nanoparticulate drug carriers have gained significance for their potential to enable targeted lung delivery and reduced dosing frequency. Among them, solid lipid nanoparticles (SLNs) have attracted considerable attention due to their biocompatible and biodegradable structures, controlled release capabilities, organic solvent-free production processes and favorable aerodynamic behavior. This review provides a comprehensive per spective to guide the rational design of SLN-based dry powder inhaler (DPI) systems by integrating formulation strategies, production techniques, surface functionalization, and DPI development, with the goal of enhancing therapeutic outcomes in respiratory diseases such as cancer, infections, chronic obstructive pulmonary disease, and cystic fibrosis.
Clinically relevant depression in patients with type 1 and type 2 diabetes; A nationwide study (TEMD-2 depression)
(Springer Nature Link, 2026) Yüksel Güler, Bağdagül; Demirci, İbrahim; Haymana, Cem; Akbay, Esen; Evren, Bahri; Dizdar, Oğuzhan Sıtkı; Demir, Orhan; Ağbaht, Kemal; Salman, Serpil; Sönmez, Alper
Purpose Depression is a common but underrecognized comorbidity in individuals with diabetes and is associated with adverse clinical outcomes. This nationwide study aimed to determine the prevalence of clinically relevant depression (CRD) among adults with type 1 and type 2 diabetes in Türkiye and to identify clinical and metabolic factors independently associ ated with CRD. Methods This cross-sectional analysis was conducted within the Turkish nationwide survEy of glycemic and other Meta bolic parameters of patients with Diabetes mellitus-2 (TEMD-2), a multicenter study including adults followed in tertiary endocrinology centers across Türkiye. CRD was defined as a Patient Health Questionnaire-9 score ≥ 10 and/or current anti depressant use. Results A total of 5.266 patients were included. The prevalence of CRD was similar in type 1 and type 2 diabetes (29.4% vs. 27.6%, p = 0.345). In both diabetes types, CRD was significantly more common among women. Patients with CRD had higher body mass index, poorer glycemic control, higher rates of hypoglycemia, and lower achievement of metabolic targets. Microvascular and macrovascular complications were more frequent in patients with CRD. In multivariable analyses, female sex, smoking, and polypharmacy were independently associated with CRD in both diabetes types, while obesity, poor glyce mic control, and vascular complications were additional independent associates in type 2 diabetes. Conclusion CRD affects nearly one-third of adults with diabetes, regardless of diabetes type, and is associated with greater comorbidity burden and suboptimal metabolic control. These findings support routine depression screening as an integral component of comprehensive diabetes care. The study is registered at ClinicalTrials.gov (NCT06347445).
Utilization of terephthalic acid obtained from textile waste for environmental detection of mitoxantrone using molecularly imprinted electrochemical sensor technology
(Wiley, 2026) Bakırcı, Meysera; Kaya, Beril Sena; Al Faysal, Abdullah; Erdoğan, Taner; Gölcü, Ayşegül
The global textile industry generates substantial amounts of waste, much of which originates from polyethylene terephthalate (PET). Due to its resistance to natural degradation, PET accumulates in the environment and contributes to pollution and landfill growth. Chemical depolymerization offers a sustainable strategy for mitigating these impacts while recovering valuable monomers such as terephthalic acid (TPA) for high-value applications. In this study, five textile waste materials with varying PET content were subjected to alkaline hydrolysis using sodium hydroxide in a methanol–water medium. Pre-treated fabrics were cut into 2 mm pieces and reacted at 80◦C for 10–65 min. The recovered products were isolated by acidification and subsequently characterized by Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopy, with the obtained spectra confirming the successful recovery of TPA and its expected molecular structure. The efficiency of TPA recovery was strongly influenced by fabric composition and reaction time. Fabric 5, containing 50% PET, produced the highest yield (27.91%) at 50 min, followed by Fabric 4 (24.77%). Fabrics 1–3 yielded between 20.61% and 23.77%, with optimum recovery occurring between 20 and 60 min. Prolonged reaction times led to reduced yields, suggesting partial degradation or re-dissolution of the product. To demonstrate value-added utilization, the recovered TPA was employed as a functional monomer in the synthesis of a molecularly imprinted polymer (MIP) for the selective electrochemical detection of the anticancer drug mitoxantrone (MTX) in tap water. Density functional theory (DFT) calculations were performed to investigate MTX–TPA interactions at template-to-monomer ratios from 1:1 to 1:5. Both computational and experimental results identified the 1:1 ratio as optimal. The developed MIP-based sensor achieved a detection limit of 2.13 × 10− 13 M. These findings demonstrate the potential of converting textile waste into high-value functional materials for advanced environmental monitoring and analytical applications.
Effects of yoga-based and conventional physiotherapy programs on functional, respiratory, and psychosocial outcomes in stage II sarcoidosis: A randomized controlled trial
(Mattioli 1885, 2026) Yıldız, Şeyda; Kavas, Murat; Takinacı, Zuhal Didem; Aydoğan Eroğlu, Selma
Background and aim: Sarcoidosis, a multisystemic granulomatous disease, presents with various clinical symp toms such as deterioration in respiratory functions, decreased exercise capacity, fatigue, sleep disorders, anxiety depression, and consequently reduced quality of life. A standard rehabilitation protocol has not been defined for sarcoidosis, and due to the nature of the disease, holistic approaches are crucial in this group, which is known to have multisystem involvement. Therefore, this study aims to contribute to the development of future rehabilitation protocols by comparing the effectiveness of yoga and conventional physiotherapy programs delivered via telereha bilitation, in addition to standard aerobic training, in sarcoidosis patients with pulmonary involvement. Methods: Thirty-four Stage II sarcoidosis patients were included in this study, and the participants were randomly divided into two groups (conventional physiotherapy, n=16, yoga, n=18). Before and after the 8-week programs, participants completed the following questionnaires: Fatigue Assessment Scale (FAS), Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index (PSQI), and St. George Respiratory Questionnaire (SGRQ). Furthermore, the 6MWT, Body Oxygen Level Test (BOLT), spirometric measurements, DLCO, Maximum inspiratory pressure (MIP), and dyspnea (mMRC score) measurements. Results: Programs significantly improved exercise capacity, inspiratory muscle strength, fatigue (FAS), dyspnea, PSQI scores, anxiety-depression levels, quality of life (SGRQ), and BOLT time in both groups. While similar improvements were observed overall in intergroup comparisons, the increase in MIP and BOLT time was more pronounced in the conven tional physiotherapy group. Neither program resulted in significant changes in spirometric parameters or DLCO values. Conclusions: This study found that both 8-week telerehabilitation-based yoga and conventional physiotherapy programs were effective for patients with Stage II sarcoidosis. The similar effects observed between yoga and con ventional physiotherapy suggest that yoga, a holistic mind-body approach, may be an effective alternative in the treatment of sarcoidosis.
Air ticket sales forecasting for B2B travel agencies
(Emerald Publishing, 2026) Uzun-Per, Meryem; Akkaya, Ümit Murat; Kalkan, Habil
Purpose – This study addresses the air ticket sales forecasting problem for business-to-business (B2B) travel agencies, a largely unexplored area compared to airlines and business-to-consumer agencies. To meet guarantee deposit requirements and manage financial risk exposure, B2B agencies require accurate demand estimation for budget planning and revenue management. The study proposes a hybrid deep learning forecasting model integrating recurrent neural network (RNN), long short-time memory (LSTM) and bidirectional long short-term memory (BiLSTM) architectures to capture both short-term fluctuations and long-term temporal dependencies in ticket sales data. Design/methodology/approach – Approximately eight years (from 3 August 2014 to 2 June 2022) of daily search and ticket sales data from a B2B travel consolidator agency were combined with external variables, including holidays, weather conditions, exchange rates, gross domestic product per capita and COVID-19 cases. Two datasets (with and without pandemic data) were constructed. After preprocessing and Random Forest feature selection, seasonal autoregressive integrated moving average (SARIMA), Prophet, RNN, LSTM and BiLSTM models were implemented and compared with the proposed hybrid architecture using a sliding window forecasting framework. Performance was evaluated using mean absolute percentage error (MAPE) and root mean squared error (RMSE). Findings – The proposed hybrid model achieved the highest forecasting accuracy across both datasets, outperforming statistical and individual deep learning models. It obtained MAPE values of 5.83% and 6.16% and RMSE values of 0.0379 and 0.0411, respectively. BiLSTM ranked as the second-best method, while SARIMA and Prophet showed substantially lower accuracy. Results also indicated that excluding pandemic variables did not significantly reduce predictive performance, but still, pandemic-related volatility increased the error rate of most of the methods and increased forecasting difficulty. Originality/value – This research is the first to examine ticket sales forecasting specifically for B2B travel agencies. It introduces a novel hybrid sequential deep learning architecture and evaluates the role of pandemic and macroeconomic variables in forecasting performance. The findings demonstrate the effectiveness of hybrid recurrent models for complex real-world demand forecasting problems.
Professional grief and the second victim experience in neurosurgery: An international cross-sectional study on professional sustainability and educational implications
(Elsevier, 2026) Şanlıer, Nafiye; Flora Göy, Defne; Sulaimanov, Umid; Moniri, Ariorad; Akbaş, İbrahim Halil; Ismayilova, Gular; Demir, Hüseyin; Öztürk, Öykü; Nizzola, Mariagrazia; Hatipoğlu Majernik, Gökçe
OBJECTIVE Adverse events are inevitable in neurosurgical practice and may have significant emotional and professional implications for surgeons. While second victim experiences have been increasingly recognized, the role of professional grief remains insufficiently characterized within the field of neurosurgery. This study aimed to examine professional grief as a component of the second victim experience and its associations with distress, support dimensions, educational needs, and professional sustainability. METHODS We conducted an international, cross-sectional, anonymous web-based survey among neurosurgeons and neurosurgical trainees. Professional grief related to a personally impactful adverse event was assessed retrospectively using the Professional Bereavement Scale-Short-term Bereavement Reactions Subscale (PBS-Acute); scores therefore reflect retrospectively recalled acute grief responses rather than contemporaneously measured reactions. Second victim dimensions were evaluated with the Second Victim Experience and Support Tool-Revised (SVEST–R). Associations among grief severity, second victim dimensions, and professional sustainability indicators were analyzed using correlation and multivariable regression. RESULTS Of 465 respondents from 49 countries, 314 completed the survey and were included in the analysis. A total of 240 participants (76.4%) reported a personally impactful adverse event. Professional grief severity was substantial among respondents (PBS-Acute mean 37.9 ± 13.8) and was strongly correlated with psychological distress (ρ = 0.71, p < 0.001). Higher grief severity was independently associated with increased turnover intention (β = 0.026, p < 0.001). Perceived preventability and primary surgeon role were associated with higher grief severity, while event timing and seniority were not. Supervisor support was inversely associated with grief severity. Participants reported substantial unmet educational needs related to medicolegal processes, communication with patient families, and grief coping skills. CONCLUSIONS Among surveyed neurosurgeons who described a personally impactful adverse event, professional grief was frequently reported. Professional grief in this sample was associated with second victim experiences, psychological distress, and indicators of professional vulnerability. These cross-sectional associations suggest that professional grief may warrant consideration in structured educational models and tiered support systems within neurosurgical training and institutional practice. Prospective work is needed to clarify the direction and durability of these relationships and their implications for professional sustainability.
Laparoscopic resection–rectopexy with natural orifice specimen extraction (NOSE): In a male with recurrent internal rectal prolapse—A video vignette
(Wiley, 2026) Arslan, Çiğdem; Yıldırım, Yasemin; Ermeç, Elif Diler; Erenler Bayraktar, İlknur
Laparoscopic sigmoid resection and suture rectopexy (LRR) is a well- established option for overt rectal prolapse; however, evidence for its role in internal rectal prolapse (IRP) and obstructed defecation syn drome (ODS) remains limited, and the potential impact on functional and sexual outcomes—particularly in young males—often prompts caution [1–3].
HIV Infection HIV/AIDS in Türkiye: Current challenges and strategic solutions
(Springer Nature Link, 2026) Başarı Omak, Tuğçe; Seydaliyeva, Aytan; Madran, Bahar; Önal, Uğur; Ertürk Şengel, Buket; Tükenmez Tigen, Elif; Sayın Kutlu, Selda; Turan, Janet M.; Korten, Volkan; Ergönül, Önder
Purpose of Review This review aims to present the current status of the HIV epidemic in Türkiye, to identify the barriers to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95–95–95 targets, and to propose strategies to overcome these challenges. Recent Findings In Türkiye, HIV-related diagnostic and treatment services are integrated into the general health insurance system, and most contemporary antiretroviral therapy (ART) are available.Treatment initiation and virological suppression rates that approach international targets. However, challenges remain in early diagnosis and prevention, particularly among key populations. Recent epidemiological data also indicate a marked increase in HIV diagnosesamong women and young people while stigma, discrimination, limited access to testing, and low awareness among both the public and healthcare professionals continue to hinder progress. Summary Controlling the HIV epidemic in Türkiye requires strengthening early diagnosis, ensuring equitable access to ART, expanding prevention strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and implementing multisectoral approaches to reduce stigma and discrimination. Coordinated actions among policymakers, healthcare providers, and community stakeholders will be critical for achieving national and global HIV targets. Highlights ● The number of HIV cases in Türkiye is increasing, with a notable rise among women and young people. ● According to ECDC 2024 data, Türkiye and Poland together reported 70% of all cases in the subregion. ● Reporting on the transmission route is lacking both in Türkiye and Poland. ● Awareness on HIV testing is low among the population and health care professionals. ● Access to HIV testing is limited. ● Access to the newest ART regimens is delayed. ● Among people living with HIV, refugees and irregular migrants are not covered by the national health insurance system.
Long-term microbiome and clinical effects of a microbiome-guided personalized diet versus low-FODMAP diet in irritable bowel syndrome: A 12-month follow-up randomized controlled trial
(Taylor & Francis, 2026) Tunalı, Varol; Arslan, Çiğdem; Derviş Haki̇m, Gözde; Gündoğdu, Aycan; Ermi̇ş, Beyza Hilal; Hora, Mehmet; Nalbantoğlu, Özkan Ufuk
Dietary therapy is central to irritable bowel syndrome (IBS) management, yet the long-term durability of the low-FODMAP diet (LFD), and of microbiome-guided personalization, remains unclear. We assessed the long-term clinical and gut-microbiome effects of a microbiome-guided personalized diet (PD) compared with a standard LFD in adults meeting Rome IV criteria for IBS. In this multicenter, open-label randomized controlled trial with blinded outcome assessment, participants who completed a 6-week dietary intervention (PD or LFD) were followed at 6 and 12 months without further dietary intervention. Outcomes included the IBS Severity Scoring System (IBS-SSS), IBS Quality of Life (IBS-QOL), and the Hospital Anxiety and Depression Scale (HADS); gut microbiota were profiled by 16S rRNA sequencing. Longitudinal changes were evaluated using linear mixed-effects models, responder analyses, PERMANOVA, and PERMDISP. Both diets reduced IBS-SSS at 6 weeks. PD maintained symptom improvement at 6 and 12 months (−82.0 and −78.3 points from baseline), whereas LFD benefits regressed by 12 months (+29.3 points; between-group p = 0.001). At 12 months, IBS-SSS responder rates were higher with PD than LFD (62.5% vs 34.5%; absolute risk difference +28.0%, 95% CI 4.2–47.7; Fisher p = 0.029), and IBS-QOL, HADS-anxiety, and HADS-depression showed more favourable trajectories with PD. PD was associated with sustained Shannon alpha-diversity gains (+0.488 at 6 weeks; +0.205 at 12 months; both p < 0.01). A modest between-group beta-diversity difference at 6 months (R2 = 0.035; p = 0.011) was not significant at 12 months. This hypothesis-generating follow-up suggests more durable benefit with PD; larger trials powered for long-term clinical and microbiome outcomes are warranted.
A clinical mirage: The peril of improving laboratory markers in meningococcal-induced cardiac tamponade
(Elsevier, 2026) Özyüksel, Arda
In this issue of JACC: Case Reports, Pagotan et al describe a compelling case of immune-mediated meningococcal pericarditis progressing to car diac tamponade despite apparent microbiological resolution and improving laboratory parameters.
Bilateral circumferential ınternal jugular vein decompression for atlanto-styloid compression syndrome: Report of 14 cases
(Lippincott Williams and Wilkins Ltd., 2026) Aghayev, Kamran; Demir, Hüseyin; Özdöl, Çağatay; Comella, Zachary; Vrionis, Frank D.
BACKGROUND AND OBJECTIVES: External compression of the internal jugular vein (IJV) between the transverse process of the atlas (C1TP) and the styloid process is an emerging nosological entity. Various surgical treatment methods have been used, yet there is no consensus regarding the optimal surgical strategy. In this article, we present a novel surgical technique and clinical outcomes of 14 patients treated with circumferential decompression. METHODS: A retrospective chart review of 14 patients (9 men, 5 women) diagnosed with IJV stenosis between the C1TP and the styloid process was performed. The surgical technique included styloidectomy, C1 transversectomy, myectomy of the styloid muscles and posterior belly of the digastric muscle, transection of the occipital artery, and wide opening of the carotid sheath around the IJV. All but 1 patient underwent bilateral decompression. Clinical evaluation included self-reported improvement on a subjective improvement scale. Radiological assessment was performed by comparison of pre-and postoperative IJV cross-sectional area (CSA) at the point of maximal stenosis. A paired t-test was used for statistical analysis. RESULTS: The mean age was 44.7 yr (25-60), and the mean follow-up duration was 488 days (range 329-761). The right mean IJV CSA increased from 18.3 to 46.1 mm 2 (P = .0058). The left mean IJV CSA increased from 10.1 to 28.8 mm 2 (P = .000076). The IJVs shifted and expanded posteriorly toward the C1TP resection cavities in all cases. Nine patients reported significant and 5 moderate improvements. One patient developed transient trapezius muscle weakness because of XI nerve palsy. CONCLUSION: Bilateral circumferential IJV decompression is a feasible and safe technique and provides maximal IJV decompression.
Robotic eTEP-TAR abdominal wall reconstruction for complex post liver transplant incisional hernia with concomitant inguinal hernia repair: A video vignette
(Springer Nature Link, 2026) Bayrakçeken, Serra; Benlice, Çigdem; Aghayeva, Afag; Kudsi, Omar Yusef; Baca, Bilgi
Introduction Complex incisional hernias after major upper abdominal surgery are technically challenging because of altered anatomical planes, multiple fascial defects, and expected adhesions. Robotic enhanced-view totally extraperitoneal repair with transversus abdominis release may provide a minimally invasive option for selected patients by enabling retromuscular dissection, fascial closure, and wide extraperitoneal mesh reinforcement while limiting intraperitoneal manipulation. Case presentation This video vignette presents an 84-year-old man with multiple incisional hernia defects along a previous Mercedes incision after liver transplantation and a concomitant left direct inguinal hernia. Preoperative imaging demon strated a wide subxiphoid abdominal wall defect and a fat-containing left inguinal hernia. Surgical technique A robotic eTEP-TAR approach was performed. Bilateral retromuscular dissection was completed, the inguinal and incisional hernia contents were reduced, and bilateral transversus abdominis release was performed to facilitate medial fascial advancement and lateral extension of the working space. The fascial and peritoneal defects were closed intra corporeally, and wide mesh reinforcement was achieved using a 30 × 30 cm polypropylene mesh, with additional meshes placed for the inguinal and lower quadrant defects. The postoperative course was uneventful, and the patient was discharged on postoperative day 2. At postoperative day 7 follow-up, he had no complaints, and the wounds were clean. Conclusion This case demonstrates the feasibility of robotic eTEP-TAR abdominal wall reconstruction with concomitant inguinal hernia repair in a selected post-transplant patient with complex abdominal wall defects.
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.
Multicenter machine learning model using clinical and radiomic features for prediction of postoperative residual status in meningioma
(American Association of Neurological Surgeons, 2026) Şanlıer, Nafiye; Yüce, Murat; Sulaimanov, Umid; Ismayilova, Gular; Hüryol, Çağın; Bozkurt, Hüseyin; Öztürk, Öykü; Öztürk, Fikret; Demir, Hüseyin; Başkaya, Mustafa K.
OBJECTIVE Gross-total resection is the primary surgical objective in meningioma management; however, predicting re sectability preoperatively remains challenging, particularly for meningiomas located in the skull base that exhibit complex anatomical relationships. There is a lack of validated reproducible models that integrate known anatomical factors for surgery; similarly, the value of radiomics as a stand-alone predictor is still unclear. The aim of this study was to develop a machine learning model that combines clinical and radiomic features to estimate early postoperative residual menin gioma. METHODS This retrospective multicenter study included 369 patients who underwent meningioma resection from 2020 to 2024 and had available preoperative contrast-enhanced T1-weighted MRI. Patient data from 3 centers (n = 307) were used to develop the model using leave-one-center-out cross-validation, and an independent cohort (n = 62) was used for external validation. Radiomic features were derived from manually segmented meningiomas, filtered for reproducibility, and integrated with 6 predefined clinical variables. The clinical-only, radiomics-only, and combined models were trained using 4 machine learning classifiers. Model performance was assessed through cross-validation, independent external validation, and receiver operating characteristic analysis. Formal incremental benefit analyses were performed on the common overlap external subset, with predictions available for all compared models. RESULTS Residual meningioma occurred in 23.5% of patients in the development cohort and 14.5% in the external cohort. Lesion location and venous sinus involvement were significantly associated with residual status. Following the feature selection, 2 stable radiomic texture features were retained. In external validation, the combined radiomics-clinical k-nearest neighbors model achieved the highest area under the curve (0.821), with sensitivity of 0.889, specificity of 0.706, and accuracy of 0.733. Clinical variables provided most of the predictive value, whereas radiomic features provided only limited incremental value when added to the clinical model. Decision curve analysis revealed net benefit for the combined model within a narrow range of low thresholds. CONCLUSIONS In this multicenter study, which included external validation, clinical variables provided most of the predictive value for postoperative residual meningioma. Radiomic features alone showed limited discrimination and only modest added value beyond clinical predictors. These combined models could serve as decision-support tools for preoperative risk assessment in meningioma surgery but are not yet suitable for routine stand-alone clinical use.

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