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Surgical anatomy of the anterior choroidal artery: Complex morphometry and morphological analysis of its origin and relations
(Springer Nature Link, 2025) Kaçur, İdil; Nteli Chatzioglou, Gkionoul; Nas, Emine; Coşkun, Osman; Gayretli, Özcan
Background The anterior choroidal artery (AChA) and posterior communicating artery (PComA) are critical vessels with significant anatomical variations. Detailed knowledge of their morphometry and origin is essential for neurovascular surgery and understanding cerebrovascular pathology. Methods This study was conducted on 62 fresh cadavers (124 hemispheres). The external diameters of the internal carotid artery (ICA) and PComA were measured. The AChA was clas sified based on its origin: Type 1 (from the ICA), Type 2 (from the ICA bifurcation), or Type 3 (from the PComA). The distance from the AChA origin to the PComA origin was measured for each type. The circumferential origin of the AChA from the ICA was also documented. Results The mean external diameter of the ICA was 3.77±0.77 mm. The proximal, middle, and distal external diameters of the PComA were 1.01±0.49 mm, 0.97±0.48 mm, and 0.90±0.45 mm, respec tively, with a mean length of 14.82±4.74 mm. The AChA originated from the ICA (Type 1) in 76.9% of hemispheres, from the ICA bifurcation (Type 2) in 21.4%, and from the PComA (Type 3) in 1.7%. The distance between the AChA and PComA origins differed significantly between types, being greatest for Type 2 (4.73±1.16 mm) compared to Type 1 (3.98±1.23 mm) (p=0.001). The AChA most commonly arose from the posterior wall of the ICA (84.68%). Conclusion This study provides detailed morphometric data on the AChA and PComA in a Turkish/Caucasian population, revealing a notably high prevalence of the AChA originating from the ICA bifurcation. The significant difference in the AChA-PComA distance based on the origin type may have important implications for surgical planning and hemodynamic modeling, underscoring the clinical relevance of these anatomical variations.
Examination of infant mortality risk in Turkey with spatio-temporal Bayesian models
(PAGEPress, 2025) Kılıç Yıldırım, Sade; Alpar, Celal Reha
The infant mortality rate in Turkey declined from 13.9 deaths per 1,000 live births in 2009 to 9.3 deaths per 1,000 live births in 2017. This study explored the role of spatio-temporal Bayesian models in explaining this decline. Parametric, nonparametric spatio- temporal Bayesian models, and a Bayesian generalized linear model without space, time, and space-time interaction were applied using the Integrated Nested Laplace Approximation (INLA) method. Exceedance probabilities were used for detecting significant risk clusters. The unstructured spatial and structured temporal interaction random effect of the best-fitting spatio-temporal Bayesian model contributed more to explaining variation in the relative risk of infant mortality than the other random effects. From 2009 to 2017, in each year, significant risk clusters were consistently detected in the eastern and south-eastern Anatolia regions. An increase of 1,000 USD in the Gross Domestic Product (GDP) per capita reduced the relative risk of infant mortality by 2.8%. When determining the factors that may affect infant mortality in Turkey, it is also essential to consider the effects of space, time, and space-time interaction. In addition, decision-makers should consider the increase in GDP per capita as a factor in reducing infant mortality in Turkey by focusing on these significant risk clusters in the eastern and south-eastern Anatolia regions.
Logistical requirements for high-resolution anoscopy: Pre-procedure preparation and materials – A video vignette
(Wiley, 2025) Arslan, Çiğdem
High-resolution anoscopy (HRA) is a diagnostic procedure that in-volves examining the anus, anal canal and perianal region with amicroscope, utilizing 5% acetic acid and Lugol's solution to detectabnormal epithelial changes and early precursors of anal cancer.Vital stains cause epithelial and vascular changes that distinguishnormal tissue from lesions, aiding in clinical decision-making forbiopsy.
Gender differences in the distribution of IDL, LDL, and HDL lipoprotein subfractions in MODY compared to type 2 diabetes: Data from the MODY-Ist study
(Elsevier, 2025) Yılmaz Aydoğan, Hülya; Kanca Demirci, Deniz; Gül, Nurdan; Yanar, Fatih; Poyrazoğlu, Şükran; Güleç Yılmaz, Seda; Tüzüner, Mete Bora; İsbir, Turgay; Öztürk, Oğuz; Satman, İlhan
Background: The distribution of intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high density lipoprotein (HDL) subfractions specific to diabetes types and changes under dyslipidemia conditions have been well characterised. Research into the distribution of lipoprotein subfractions in Maturity-Onset Diabetes of the Young (MODY) has hitherto been confined to certain subtypes, with gender-based differences remaining to be elucidated. The objective of this study was to comparatively evaluate the distribution of lipoprotein subfractions according to gender in MODY, T2DM patients, and control groups. Methods: Lipoprotein subfractions in 119 serum samples of the study groups were analyzed using the Lipoprint System. Results: The midbands of IDL (MID-A to C) in female MODY cases, and the HDL-small fraction in male MODY cases, were found to be lower compared to female and male T2DM cases, respectively. In the T2DM group, age was positively correlated with MID-C and MID-B in both genders, while it was negatively correlated with MID-A in female cases. ROC analysis demonstrated that the decrease in the MID-C fraction in female MODY subjects (AUC:0.809, p = 0.0001) and the decrease in the HDL-small fraction in male MODY subjects (AUC:0.818, p = 0.002) were significantly associated with the likelihood of MODY. Conclusion: Given that a considerable proportion of MODY patients are frequently misdiagnosed as T2DM, low levels of MID-C and HDL-small fractions, both of which are triglyceride-rich, may have potential as a diagnostic value for female and male MODY patients, respectively.
Clinical characteristics of peripheral joint disease in axial and peripheral spondyloarthritis: Findings from a multicentre cross sectional study
(2025) Sarıyıldız, Emine; Duruöz, Mehmet Tuncay; Gezer, Halise Hande; Aktaş, İlknur; Akar, Servet; Hizmetli, Sami; Şahin, Nilay; Akgül, Özgür; Alkan Melikoğlu, Meltem; Sezer, İlhan; Ataman, Şebnem; Ural Nazlıkul, Fatma Gülçin; Çapkın, Erhan; Yılmaz, Figen; Kalyoncu, Umut
Peripheral joint disease (PJD) is the most common peripheral manifestation in spondyloarthritis (SpA) patients. This study aimed to determine PJD characteristics and associated factors in patients with axial SpA (AxSpA) and peripheral SpA (pSpA). This cross-sectional and multicenter study involved 13 different rheumatology and physical medicine & reha bilitation clinics, and patients diagnosed with axSpA or pSpA were included in the study. PJD was defined as the ‘ever’ related to SpA according to the physician. Multivariable analyses were conducted to identify factors associated with PJD. A total of 394 patients were enrolled in the study (57.6% male, mean age 40.8 years), of whom 359 (91.1%) were clas sified as AxSpA and 35 (8.9%) as pSpA. Peripheral arthritis was reported in 118 patients (29.9%), comprising 85 (72%) with AxSpA and 33 (28%) with pSpA. Among the whole population with PJD, the main joint involvement pattern was monoarticular (33.9%, n=40) and oligoarticular (49.2%, n=58). The rate of predominantly lower limb and large joint involvement was approximately 60% (n=68) and the major course of PJD was transient (42.4%, n=50) and intermit tent (40.7%, n=48). pSpA patients had a higher rate of persistent (33.3% vs. 14.3%, p=0.021) and progressive arthritis (15.2% vs. 1.2%, p=0.007). The coexistence of PJD with other peripheral involvement and extra-articular manifestations excluding psoriasis was widespread. Dactylitis, enthesitis, and high CRP level were positively associated with PJD; on the contrary, ever alcohol intake, presence of sacroiliitis on MRI, and family history for SpA were negatively associated. PJD was accompanied by both other peripheral involvements and extra-articular manifestations, excluding psoriasis and the course of PJD was more persistent in pSpA patients. This undoubtedly contributes to an increased disease burden.
Insufficient impact of the aldose reductase inhibitor cemtirestat on the skeletal system in type 2 diabetic rat model
(Public Library of Science, 2025) Martiniakova, Monika; Prnova, Marta Soltesova; Kovacova, Veronika; Mondockova, Vladimira; Svik, Karol; Londzin, Piotr; Folwarczna, Joanna; Omelka, Radoslav; Dikmen, Tayfun
Cemtirestat, a multi-target drug combining aldose reductase inhibition with antiox idant properties, is considered a promising therapeutic agent for chronic diabetic complications. Current evidence suggests that long-standing diabetes adversely affects skeletal health, leading to diabetic bone disease. As the impact of cemtirestat on the skeletal system in an animal model of type 2 diabetes mellitus (T2DM) is still unknown, our study first investigated its effect on impaired bone health in Zucker dia betic fatty (ZDF) rats. Adult rats were divided into four groups: L (untreated lean ZDF rats), D (untreated obese ZDF rats), DT2.5 (obese ZDF rats treated with 2.5mg/kg/ day cemtirestat), and DT7.5 (obese ZDF rats treated with 7.5mg/kg/day cemtirestat), with cemtirestat treatment lasting 2 months. Group D had increased levels of plasma glucose, insulin, triglycerides, glycated hemoglobin, total cholesterol, alkaline phos phatase, alanine aminotransferase, C-terminal telopeptide of type 1 collagen, greater body weight, femoral weight, structure model index, reduced cortical bone volume fraction, cortical bone thickness, trabecular bone volume fraction, and trabecular thickness compared to group L. Cemtirestat supplementation only elevated plasma phosphate levels in group DT2.5, trabecular bone volume fraction and trabecu lar thickness in group DT7.5, but the treatment had no effect on other parameters demonstrated in ZDF rats by macroscopic analysis, micro-CT cortical bone analysis, and mechanical testing. These findings indicate that the efficacy of cemtirestat in restoring deteriorated bone health caused by T2DM is not substantiated due to its insufficient effect on the skeletal system in the ZDF rat model.
Challenges and strategies in effective nursing leadership: Viewpoints of nurses in management positions – A qualitative study
(Emerald Publishing, 2025) Aydoğdu, Ana Luiza Ferreira
Purpose – To explore the viewpoints of nurses in management positions on the challenges they face and the strategies they use to promote effective leadership in the nursing workplace. Design/methodology/approach – This qualitative study involved 42 Brazilian nurses in management positions, working in various settings across Brazil, who responded to open-ended online questions between January 1, 2025 and February 15, 2025. Findings – Five themes were identified: (1) highlighted leadership styles, (2) difficulties of leading the nursing team, (3)strategies used to solve problemsin the leadership process, (4) learning to lead and (5) making nursing leadership more effective. Research limitations/implications – The study presents important perspectives from nurses in managerial positions on the key role that effective leadership plays in fostering healthy work environments in nursing. Nevertheless, it hassome limitations, including the use ofself-report questionnaires, regional imbalance among participants, potential bias due to data analysis being conducted by a single researcher and the absence of an assessment based on the leader–member exchange framework. Practical implications – Nurses in management positions recognize the importance of empowering team members. Nurse managersshould receive proper education to competently assume theirleadership responsibilities. Originality/value – The study highlights the need to revise nursing curricula to incorporate early and continuous leadership education, supported by ongoing in-service programs. It also emphasizes the importance of fostering team cohesion through open communication, mutual respect and shared goals. Additionally, it is pointed out that upper managementshould empower nurse leaders at all levels and provide regular, constructive feedback to support effective leadership.
Can neoadjuvant chemoradiotherapy be omitted in cT2N+ and cT3 mid-rectal cancer: Protocol for a prospective, observational, cohort study (CANO)
(Public Library of Science, 2025) Karakayalı, Feza; Arslan, Çiğdem; Bisgin, Tayfun; Erenler Bayraktar, İlknur; Bayraktar, Onur; Canda, Aras Emre
Background Neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) is the standard treatment for locally advanced rectal cancer. However, nCRT is associ ated with significant morbidity, impacting patients’ quality of life. Recent advancements in MRI-based risk stratification have raised the possibility of omitting nCRT in selected patients without compromising oncologic outcomes. This study aims to evaluate whether upfront TME alone achieves similar 3-year disease-free survival compared to the standard approach of nCRT followed by TME in patients with cT2N+ and cT3Nx mid-rectal cancer without MRI-based high-risk features regarding local recurrence. Methods The CANO trial is a prospective, multicenter, observational cohort study involving 436 patients across Türkiye. Eligible patients will be classified into two groups: those undergoing direct TME and those receiving nCRT followed by TME. The primary endpoint is 3-year disease-free survival (DFS), with secondary outcomes including 5-year DFS, overall survival, local recurrence rates, and quality of life assessments using validated questionnaires. Data will be prospectively collected and monitored by the steering committee with predefined interim analyses. Discussion The CANO trial addresses the ongoing debate regarding selective omission of nCRT in low-risk mid-rectal cancer. By leveraging MRI-based risk stratification and PLOS One | https://doi.org/10.1371/journal.pone.0321819 November 5, 2025 2 / 11 a collaborative national network, the study aims to provide high-quality evidence supporting a more personalized treatment approach. The findings have the potential to reduce treatment-related morbidity without compromising oncologic safety, contrib uting to the refinement of current guidelines.
Gender-specific foot morphology and biomechanical patterns in young adults: A combined photogrammetric and plantar pressure analysis
(Springer Nature Link, 2025) Nteli Chatzioglou, Gkionoul; Govsa, Figen; Bedre, Özden; Pınar, Yelda; Hepgüler, Simin
Purpose Understanding gender-based foot morphological differences is critical for ergonomic footwear design. This study investigated these variations in young adults using photogrammetric and plantar pressure analysis. Methods We analyzed 200 healthy participants (100 males, 100 females; aged 19–21 years) through digital photogrammetry and RSscan Footscan pressure mapping. Key parameters included foot length (FL), ball width (BWF), hallux valgus angle (HVd), lateral foot angle (LdF), and Clarke’s Index for arch classification. Plantar pressure distribution was assessed across 10 anatomical zones. Results We revealed significant gender disparities: males had longer (26.6 vs. 25.2 cm) and wider feet (10.2 vs. 9.1 cm), while 75% of participants exhibited HVd (5.1°–6.3°), with no gender difference. Dynamic Clarke’s Index showed 80% had high arches, correlating with lower BMI (p<0.001). Pressure analysis highlighted higher midfoot loading (37.8–41.2 cm2 ) and medial forefoot pressure in HVd cases. Females predominantly wore smaller shoes (sizes 36–38), whereas 89% of males wore sizes 42–44. BMI influenced midfoot pressure (r=0.3) and arch height, with flat arches linked to higher BMI. Foot asymmetry (38%) and HVd prevalence underscored the need for gender-specific shoe designs. Conclusion It emphasize prioritizing ergonomic footwear to mitigate pressure imbalances, HVd progression, and asym metry, particularly in high-BMI individuals. This dual-method approach provides actionable insights for biomechanical applications and footwear customization.
Comparison of short- and long-term outcomes of diode laser vs. crystallized phenol treatment for pilonidal sinus disease: A propensity score-matched multicentre study
(Wiley, 2025) Bilgin, İsmail Ahmet; Ramoğlu, Nur; Saylık, Onur; Benlice, Çigdem; Erkaya, Metincan; Kurtul, İnci; Aghayeva, Afag; Turan, Ersin; Maden, Abdullah Sami; Acar, Fahrettin; Karahasanoğlu, Tayfun; Hamzaoğlu, İsmail; Baca, Bilgi; Doğru, Osman
Aim: Pilonidal sinus disease (PSD) primarily affects young adults; rapid recovery is essential and yet lacks a standardized treatment approach. While excisional techniques delay recovery, minimally invasive options like laser ablation and phenol application are gaining interest, yet comparative long-term evidence is scarce. This study compared short- and long-term outcomes of laser versus phenol treatment in PSD. Method: In this multicentre retrospective cohort study (Nov. 2017–Sep. 2024), patients treated with laser or phenol were included. 1:3 propensity score matching using the nearest neighbour algorithm was performed based on age, gender, prior surgical history and year of operation. Categorical variables were analysed using chi-squared or Fisher's exact tests, whereas continuous variables were compared using Student's t-test or Mann– Whitney U test depending on distribution normality. Results: Out of 897 eligible patients, 644 were included (median age: 26 years, body mass index [BMI]: 26.2 kg/m2 , male-to-female ratio: 4:1). The number of sinuses/pits was 2–3 in both groups. Operating time was significantly longer in the laser group. Complications occurred in 6.8% of laser patients, whereas none were reported in the phenol group. Pain scores were higher in the laser group (2 [1–3] vs. 1 [0–2]). Median follow-up was 45 months (laser) and 40 months (phenol). Return to daily activities was delayed in the laser group, whereas complete healing was slower in the phenol group. Readmission, recurrence and recovery rates were comparable (85%–86%). Conclusion: Both treatments demonstrated low complication and recurrence rates with high recovery rates. Laser favoured faster healing and fewer sessions, whereas phenol allowed for shorter procedures and earlier return to daily life.
Evaluation of management strategies for viral upper respiratory tract infections among pediatricians in Türkiye
(Taylor & Francis, 2025) Yıldız, İsmail; Gönüllü, Erdem; Uçkun, Utkucan; Kandemir, İbrahim; Soysal, Ahmet; Karaböcüoğlu, Metin
Background: To evaluate how pediatricians manage viral upper respiratory tract infections (URTIs) in children and their tendencies about the viral URTIs approaches. Materials and Methods: This study was conducted among pediatricians who participated in a descriptive cross-sectional survey. The survey included pediatricians who were willing to participate and who completed the survey forms between June 2023 and February 2024. The survey gathered data on the demographic characteristics of the pediatricians, as well as their diagnostic and treatment approaches for viral URTIs. Demographic data included the physicians’ gender, age, academic title, province of duty, institution of practice, and duration of experience in pediatrics. Results: This study involved 203 pediatricians. The diagnosis of viral URTI based on clinical findings had a negative correlation with pediatricians’ work experience (OR: 0.96 per year) and was more common among those working in private settings (OR: 0.38). Use of medications for symptomatic cough treatment was 2.72 times higher among pediatricians in private practice. Herbal supplement use was more common among pediatricians in private practice (p = 0.021) and those with ≥10 years of experience (p = 0.010). Systemic decongestant use was more frequent among pediatricians without an academic title (p = 0.030). Pelargonium sidoides root extract was used more often by pediatricians in private practice (p = 0.003), and they also preferred honey-containing supplements more frequently (p < 0.05). There was a negative correlation between experience in pediatric practice and multivitamins and minerals prescriptions for prevention of viral URTIs (OR: 0.97 for each year). Conclusion: Pediatricians in private settings and with more experience tend not to make a diagnosis of viral URTIs solely based on physical examination. Pediatricians working in private settings focus more on treatments that relieve cough symptoms. A viral URTI diagnostic and treatment algorithm with proven validity will help physicians in clinical diagnosis and treatment.
Diffuse alveolar hemorrhage induced by epileptic seizure
(Wiley, 2025) Talibov, Tural; İnci, Meltem; Ismayilov, Rashad; Bebek, Nerses
Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of generalized tonic–clonic seizures. We describe a 28-year-old woman with no prior seizure history who experienced three consecutive generalized tonic–clonic seizures, followed by acute hemoptysis and dyspnea. Imaging confirmed diffuse alveolar hemorrhage, which responded rapidly to corticosteroid therapy. Seizure-induced DAH is an uncommon and underrecognized condition. This case underscores the importance of considering DAH in patients presenting with respiratory symptoms following seizures, even in the absence of underlying systemic disease.
Is digital anesthesia a viable alternative for pain and anxiety control in pediatric dentistry?
(Wiley, 2025) Ateşçi, Alp Abidin; Korkut Işık, Buse; Yılmaz, Dilek Özge; Gergit, Berk; Çoruh Kılıç, Münevver; Önçağ, Rüştü Özant
Background: Pain and anxiety during dental procedures remain major challenges in pediatric dentistry, particularly during local anesthesia administration. Aim: This study compared the effectiveness of digital anesthesia systems versus conventional infiltration and mandibular block techniques in managing pain, anxiety, and behavioral responses in pediatric dental patients. Design: Seventy-nine children aged 6–12 were randomly assigned to receive anesthesia via digital anesthesia system (DAS), infiltration, or mandibular block. Pain was assessed using the Wong-Baker Faces Pain Rating Scale (WBFRPS), anxiety via the Modified Child Dental Anxiety Scale (MCDAS), and behavioral responses through the FLACC scale. Statistical analyses included ANOVA, Kruskal–Wallis, and chi-square tests (p<0.05). Results: Children in the DAS group reported significantly lower pain scores during needle insertion, anesthetic delivery, and treatment. Post-treatment MCDAS scores decreased significantly in the DAS group, especially for items related to “tooth exami nation,” “filling,” and “gingival injection.” FLACC results also indicated more favorable behavioral responses—such as relaxed facial expressions and absence of crying—in the digital group (p<0.05). Conclusion: Digital anesthesia appears to be a highly effective alternative to conventional techniques for minimizing pain, reducing dental anxiety, and improving behavioral cooperation in pediatric patients, supporting its broader implementation in clinical practice.
A novel model for early prediction of in hospital mortality in seawater drowning: The SNOP score
(Springer Nature Link, 2025) Öncü, Kıvanç; Özcan, Özhan; Şi̇mşi̇rgi̇l Kara, Şeyma; Parmaksız, Ayhan; Erşen, Teoman
Background Drowning is a leading cause of preventable mortality worldwide; however, early in-hospital risk stratification remains limited. Although tools such as the Szpilman score assist in early severity assessment, they may not fully capture the evolving clinical status after admission. This study aimed to develop a simplified and objective model based on readily available parameters to predict in-hospital mortality following seawater drowning. Methods This retrospective study was conducted at a referral emergency department (ED) in northern Turkey between July 1, 2011, and December 31, 2024. Of 190 patients initially included, 166 with complete clinical and laboratory data were analyzed. Data were obtained from institutional and national health information systems. Clinical, physiological, and biochemical variables were assessed. Predictors of in-hospital mortality were identified using receiver operating characteristic (ROC) analysis and multivariable logistic regression. Variables with near-perfect discrimination (e.g., GCS, pH, Szpilman score) were excluded to avoid overfitting. Results Among the 166 patients, 34 (20.5%) died during hospitalization. CPR and endotracheal intubation rates were significantly higher among non-survivors (CPR: 97.1% vs. 0%; intubation: 97.1% vs. 2.3%; both p<0.001). Non survivors also presented with lower GCS (median 3 vs. 15), lower arterial pH, and higher Szpilman scores (all p<0.001). ROC analysis identified four potential predictors with AUC values between 0.90 and 0.95—pCO₂, lactate, SpO₂, and sodium—all showing significant discriminatory capacity (p<0.001). These variables were entered into a binary logistic regression model, from which serum sodium (OR=2.110; 95% CI: 1.310–3.401; p=0.002) and SpO₂ (OR=0.902; 95% CI: 0.847–0.961; p=0.001) emerged as independent predictors. These formed the basis of the SNOP score (Saturation and Natremia-based Outcome Predictor), a two-parameter logistic model demonstrating excellent performance: AUC=0.996, sensitivity=99.0%, specificity=96.2%, and overall accuracy=98.4%. Conclusion: The SNOP score is a simple, ED-specific tool for early prediction of in-hospital mortality in seawater drowning. It complements existing assessment systems by incorporating objective, admission-based parameters. Prospective multicenter validation is warranted to confirm its clinical applicability and support broader implementation.
A case of tongue twisting during screening of STN DBS for parkinson’s disease: A unique form of pyramidal tract activation
(Turkish Neurosurgical Society, 2025) Değirmenci, Yıldız; Akram, Harith; Dayal, Viswas; Zrinzo, Ludvic; Hariz, Marwan; Limousin, Patricia
Subthalamic nucleus deep brain stimulation (STN-DBS) is a safe and effective therapy for Parkinson´s disease (PD) in selected patients. However, various side effects such as paraesthesia, diplopia, ataxia, worsened akinesia, emotional changes, dysarthria, and muscle contractions can occur due to the current spread to the adjacent structures during the STN-DBS programming sessions. Muscle contractions result from the corticospinal and corticobulbar side effects, which can manifest due to the current spread to the pyramidal tract during DBS programming. Here, we report a case of tongue-twisting movement as a unique corticobulbar side effect of the STN-DBS programming in a patient with PD.
Integrated use of finite element analysis and gaussian process regression in the structural analysis of AISI 316 stainless steel chimney systems
(Nature Portfolio, 2025) Tanrıver, Kürşat; Etyemez, Ayhan; Ay, Mustafa
This study aimed to conduct a comprehensive structural analysis and machine learning-assisted predictive modelling of a chimney system manufactured from 2 mm thick AISI 316 stainless steel with a diameter of Ø500 mm. The primary motivation of this work was to examine, in detail, the structural behavior of chimney modules under various force and pressure conditions using conventional methods, and to develop a reliable model capable of performing parametric predictions for new scenarios based on the acquired data. The scope of the study encompassed finite element analyses of both the entire chimney system and 3-meter-long intermediate modules, field tests, and the application of the Gaussian Process Regression (GPR) machine learning model. In the analysis of the entire chimney system under an applied force of 22,000 N, a maximum stress of 28 MPa and a safety factor of 8.39 were observed in the chimney clamps. The total deformation was found to be 0.58 mm, which is within acceptable limits. In the structural analysis of the intermediate chimney modules under a force of 1000 N and an internal pressure of 5 MPa, a maximum stress of 11,984 MPa, a safety factor of 1.71, and a total deformation of 0.46 mm were determined, all of which are consistent with the literature. The accuracy of these analyses was validated through pressure and leakage tests conducted in accordance with the EN 1859 standard. The developed GPR machine learning model demonstrated exceptionally high accuracy (R² > 0.999) in predicting Von Mises stress values, providing reliable forecasts with an error rate of less than 3% when compared to ANSYS simulation outputs. However, in predicting total deformation values, error rates exceeded 70%, indicating that the model was less sensitive in low-amplitude deformation cases. These findings suggest that the GPR model can generate reliable predictions for Von Mises stress a more critical parameter than total deformation in chimney design. By integrating conventional structural analysis methods with advanced machine learning techniques, this study demonstrates the potential of predictive modeling as an efficient and reliable tool in engineering design processes, making a significant contribution to the field’s body of knowledge.
Unveiling the interplay of EBV, HSV-1, and ınflammatory biomarkers in psychiatric disorders
(MDPI Publishing, 2025) Akgül, Özer; Demirel, Ömer Faruk; Tosun, İlker; Kavla, Yasin; Kırkpınar, Mehmet Murat; Sapmaz, Burcu; Şenyiğit, Gülçin; Çalışkan, Reyhan; Öner, Yaşar Ali
Background/Objectives: Schizophrenia (SCH), bipolar disorder (BPD), and major depres sive disorder (MDD) are increasingly viewed as neuroimmune disorders shaped by viral exposure and inflammation. Disorder-specific immunovirological profiles, however, re main poorly defined. Methods: In this cross-sectional study, we assessed Epstein–Barr Virus (EBV) and Herpes Simplex Virus type 1 (HSV-1) seropositivity and measured serum CRP, IL-6, and IL-1β in 708 participants: 110 with SCH, 121 with BPD, 135 with MDD, and 342 healthy controls (HC). Statistical analyses included Shapiro–Wilk tests for nor mality; Kruskal–Wallis with Bonferroni-adjusted Dunn post hoc comparisons; and logistic regression adjusted for age, sex, and marital status. Results: EBV seropositivity was higher in SCH (90.9%) than in HC (78.9%) (OR = 3.46, 95% CI: 1.68–7.12; p = 0.001) but not in BPD or MDD. HSV-1 seropositivity was elevated in BPD (83.5%) versus HC (67.0%) (OR = 2.29, 95% CI: 1.34–3.92; p = 0.003), with no differences in SCH or MDD. Inflammatory biomarkers were significantly increased in SCH and MDD compared to HC (p < 0.001), while BPD showed no differences. Conclusions: The findings delineate distinct immunovi rological patterns across major psychiatric disorders. Schizophrenia was characterized by EBV seropositivity accompanied by systemic inflammatory activation, bipolar disorder by HSV-1 seropositivity in the absence of inflammatory changes, and major depressive disor der by inflammatory dysregulation independent of viral exposure. These disorder-specific profiles highlight heterogeneity in neuroimmune pathways and underscore the potential relevance of biomarker-based stratification for generating hypotheses regarding targeted antiviral or anti-inflammatory interventions in psychiatric populations.
Branching patterns and variations of the anterior choroidal artery: A detailed cadaveric morphometric analysis
(Springer Nature Link, 2025) Kaçur, İdil; Nteli Chatzioglou, Gkionoul; Nas, Emine; Gayretli, Özcan
The aim of our study was to investigate the morphometric and morphological characteristics of the anterior choroidal artery (AChA) and its branches. Also, the branching patterns and cortical termination sites of the AChA were examined by detailed morphometric analysis. For this purpose, 62 fresh cadavers (124 hemispheres) were included in the study. AChA diameter, length, and distances of branches to the AChA origin were measured using ImageJ software. The distribution of the branches according to arterial origin and their distances to the target regions was quantitatively defined. Although a total of 594 branches originating from AchA were observed, only 587 of these branches reached or terminated in the regions observed. Accordingly, 220/587 were found to go to the optic tract, 214/587 to the cerebral peduncle, 130/587 to the uncus, and 23/587 to the anterior perforated substance. Our study provides novel morphometric ratios that map the branching architecture of the AChA, confirming that branches originate predominantly from its midpoint (overall ratio:0.45). We found that 73.07% of AChA branches supply the optic tract and cerebral peduncle, highlighting their central role, while a minimal proportion (3.87%) serve the anterior perforated substance. These data elucidate the topo graphical relationships that are crucial for understanding pathologies like Moyamoya disease and proximal aneurysms. The established ratios offer invaluable benchmarks for anatomical navigation, potentially reducing risks in neurosurgical procedures involving the AChA territory.
AI-guided optimization of traditional bulgur pilafs: Enhancing sensory and bioactive properties through rsm-pso modeling
(Frontiers Media S. A., 2025) Yıkmış, Seydi; Türk Aslan, Sinem; Türkol, Melikenur; Şimşek, Mehmet Ali; Aljobair, Moneera; Karrar, Emad; Tokatlı, Nazlı; Mohamed Ahmed, Isam A.
This study aimed to enhance the sensory and bioactive properties of pilafs prepared from three geographically indicated bulgur varieties—Siyez, Firik, and Karakilçik—through an AI-guided optimization approach combining Response Surface Methodology (RSM) and Particle Swarm Optimization (PSO). Different bulgur (130–150 g) and water (350–450 mL) ratios were tested to determine optimal formulations. Sensory evaluation revealed that Firik bulgur pilaf achieved the highest overall acceptability (8.49), while Karakilçik bulgur pilaf scored highest in color (7.68) and aroma (8.58), and Siyez bulgur pilaf received the highest taste score (7.50). In terms of bioactive properties, Karakilçik bulgur pilaf showed the highest antioxidant capacity (75.57% DPPH radical scavenging activity), whereas Firik bulgur pilaf had the highest total phenolic (842.39 mg GAE/kg) and flavonoid contents (6.38 mg CE/g). Color analysis indicated that Siyez bulgur pilaf had the lightest color (L=52.18), while Firik pilaf exhibited the most intense red hue (a=8.12) and Karakilçik pilaf the darkest appearance (L=35.42). PSO-based validation confirmed the accuracy of RSM models by reaching global optima within 40 iterations and minimal deviation from experimental values. This is the first study to apply an integrated RSM–PSO modeling approach to traditional bulgur pilafs, enabling the prediction and optimization of their sensory and bioactive characteristics. The results provide a novel framework for enhancing the nutritional value and consumer appeal of heritage cereal-based foods and support the development of standardized, functional bulgur products for the food industry.
Improving oral health in children with disabilities: A preventive home-based care model from Türkiye
(Wiley, 2025) Tunalı, Esra; Ataş, Cafer; Çağ, Yakup; Orhan, Ahmet Lütfullah; Özen, Buğra; Aydınbelge, Mustafa; Tunalı, Mustafa
Background: Children with Special Health Care Needs (CSHCN) face significant challenges in maintaining oral hygiene and accessing dental services due to disabilities. It has been reported that, because of these disadvantages, individuals with special needs experience oral health problems at a higher rate compared to the general population. This study aimed to assess factors influencing oral health in CSHCN within the dental home framework and propose preventive strategies. Methods: A total of 1229 children aged 0-8 years with disability health reports in Istanbul were examined through home visits by mobile dental teams. Caries experience was evaluated using combined indices (dfs + DMFS and dft + DMFT). Data on oral hygiene habits, dietary patterns, parental education level and dental visit history were collected through structured questionnaires. Statistical analyses included Mann-Whitney U, Kruskal-Wallis, chi-square and Spearman's correlation tests (significance set at p < 0.05). Results: A statistically significant positive correlation was found between age and all caries indices (p < 0.01) 0.57. 1% of children reported brushing their teeth, with irregular brushers showing significantly higher caries indices than regular brushers (p < 0.05). Children requiring > 45 min to eat had significantly higher dfs + DMFS (1 surface) (p = 0.036) and dft + DMFT values (p = 0.019). Those consuming snacks > 3 times daily showed significantly higher caries indices across all measures (p < 0.01). Moderate/severe plaque accumulation was detected in 50.5% of participants. Lower parental education levels were significantly associated with higher caries indices (p < 0.01). Conclusions: This study highlights the necessity of an interdisciplinary approach to protect the oral health of CSHCN. The widespread implementation of the dental home model and regular dental check-ups will be a significant step in addressing oral health needs.

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