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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.
Understanding of the roles of CD4+ CD25+ T cells and tregs in development of anti-FVIII in hemophilia a: Insights for inhibitor development prevention
(Lippincott Williams and Wilkins Ltd., 2025) Akkaya, Emre; Koç, Başak S.; Küçüksezer, Umut C.; Kökoğlu, Ayşenur; Çetin Aktaş, Esin; Deniz, Günnur; Genç, Nilgün Sema; Zülfikar, Bülent
Hemophilia A, characterized by factor VIII (FVIII) deficiency, can be managed with factor replacement therapy. However, FVIII-neutralizing antibodies developed in people with hemophilia A (PwH) can reduce treatment efficacy. This study investigated the impact of FVIII inhibitors on immunity in PwH. Twenty PwH (with the presence and absence of inhibitors) and 10 healthy individuals have participated. CD4+, CD4+CD25+, Treg cell percentages, proliferation levels, and cytokine levels in cell-culture supernatants were evaluated. An increased CD4+CD25+ T-cell subset was noted in PwH without inhibitors. CD4+ and CD4+CD25+ T cells showed increased proliferation, while Treg cells had decreased proliferation in PwH without inhibitors compared to controls. With rFVIII added to cell culture, CD4+CD25+ proliferation decreased and Treg proliferation increased in PwH with inhibitors, while it remained unchanged in other groups. IL-10 was reduced in both PwH groups. TGF-b was decreased in PwH with inhibitors compared to those without inhibitors. IL-10/TGF-b ratio was reduced in both PwH groups compared to controls. rFVIII in culture conditions significantly reduced TNF-a only in PwH with inhibitors, while TGF-b was decreased in PwH without inhibitors and healthy controls. Monitoring T-cell immunity in PwH before anti-FVIII antibody development may improve treatment success and help prevent antibodies and related complications.
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.
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.
Clinical outcomes following medial patellofemoral ligament reconstruction using ultra high-strength 2-mm-wide tape in non-elite athletes
(Elsevier, 2025) Erden, Tunay; Ağır, Muzaffer; Ali, Jotyar; Çelik, Malik; Batar, Suat; Toprak, Ali; Toker, Berkin; Taşer, Ömer
Background: The medial patellofemoral ligament (MPFL) reconstruction is commonly conducted using gracilis, semitendinosus, quadriceps or tensor fascia lata tendon autografts or allografts. This approach, however, can sometimes lead to complications or morbidity at the site from which the graft is harvested. This study reports the clinical outcomes of non-elite competitive athletes who undergone MPFL reconstruction using an ultrahigh strength 2-mm-wide tape. Patients and methods: This retrospective cohort study included 67 non-elite athletes with acute or recurrent lateral patellar instability who underwent surgical treatment between December 2015 and December 2020. Athletes who underwent tibial tubercle osteotomy due to severe patellofemoral arthritis or severe osteochondral damage (kissing lesions or >2.5cm2 ) (1), trochlear dysplasia (Dejour type D dysplasia) (5), open physis (19) and revison MPFL reconstruction (8), were excluded. The remaining 34 athletes were followed postoperatively for a mini mum of 48 months. Results: During the follow-up period, there was only one case and which was revised by adding Fulkerson Osteotomy. Two patients had limited range of motion and joint mobilization was performed under general anesthesia at the end of the second month. The International Knee documentation Committee (IKDC), Kujala, and visual analog scale (VAS) scores showed improvement postoperatively (p < 0.001). Moreover, the mean im provements in IKDC (≈+41), Kujala (≈+33), and VAS (≈− 3.8) scores exceeded the established minimal clini cally important difference (MCID) thresholds, indicating that the outcomes were not only statistically significant but also clinically meaningful for patients. When comparing the pre- and postoperative radiological measure ments, the mean tilt angle and mean congruence angle showed a significant decrease (p < 0.001) Conclusion: Suture tape may be a good alternative to autograft, as it does not cause donor site morbidity. However, its most important disadvantage is its higher cost. Level of evidence: IV; Retrospective case series.
Effect of magnification and press-on force on resin composite polishing
(BioMed Central, 2025) Ünal, Tuna; Korkut, Bora; Tağtekin, Dilek
Objective To evaluate surface roughness (Ra) and gloss (GU) of two resin composites after polishing with two systems, using a novel press-on force guided (PFG) polishing simulator. Materials and methods Eighty specimens were prepared using Essentia Universal (EU) and G-aenial Universal Injectable (GUI) composites. Surface roughness and gloss were assessed by a profilometer (Marsurf Ps10), and a glossmeter (Novo-Curve). They were polished with Sof-Lex and Twist Dia systems with or without magnification and PFG. Each polishing material was used for 30 s. Ra1 and GU1 measurements were repeated by the same operator. Data were analyzed using One-way ANOVA, Three-way ANOVA, and Robust ANOVA with Bonferroni Correction for multiple comparisons and Spearman’s rho Correlation Coefficient (<0.050). Results Higher Ra values were observed in GUI group for Twist Dia (0.33±0.05z ) compared to SofLex (0.22±0.08y ). Roughness was higher when PFG was uncontrolled (0.31±0.07x ), compared to the controlled (0.25±0.09w). No Ra difference was observed in EU group between SofLex (0.33±0.04) and Twist Dia (0.29±0.04)(P=.440). Uncontrolled PFG provided higher gloss for GUI and EU composites (69.7±2.91x , 54.63±18.68x , respectively). Twist Dia presented higher gloss for GUI and EU composites (72.3±2.57z ,58.88±13.73z , respectively). Magnification did not affect the roughness or gloss for both composites (P≥.05). A moderate negative correlation was found between roughness and gloss in GUI (r=-.546)(P<.001), while no correlation was observed in EU (r=-.110)(P=.449). Conclusion Higher surface roughness and gloss were observed with uncontrolled (not constant) press-on force. Even though SofLex may provide a lower surface roughness, Twist Dia can generate a greater surface gloss regardless of the composite type. 3.5X loupe magnification was not effective on surface roughness and gloss within a limited polishing time. Clinical Relevance Press-on force is an important factor affecting the composite polishing quality. Spiral polishing wheels can be advantageous for composite restoration polishing, as they better preserve the secondary and tertiary anatomies and provide a higher gloss. The effect of magnification on composite polishing can be related to the time spent using it.
Long-term outcomes of extended versus segmental resection for transverse colon cancer: A population-based analysis based on the SEER database
(Galenos Publishing House, 2025) Benlice, Çiğdem; Erkaya, Metincan; Aghayeva, Afag; Özben, Volkan; Görgün, Emre; Atasoy, Deniz; Baca, Bilgi
Objective: To investigate long-term cancer-specific outcomes associated with extended versus segmental colectomy (SC) in patients with stage I-III transverse colon adenocarcinoma using a large, population-based cohort. Material and Methods: Patients who diagnosed with transverse colon cancer undergoing curative-intent colectomy were identified from the surveillance, epidemiology, and end results database (2013-2019). Surgical procedures were categorized as extended colectomy (EC) or SC based on standardized procedural coding. 1:1 propensity score matching was performed to reduce selection bias and balance baseline characteristics. Cancer-specific survival (CSS) was analyzed using multivariable Cox proportional hazards regression. Results: Among 18,799 eligible patients, 58% underwent EC. EC was more frequently performed in individuals with higher tumor stage (p<0.01) and those receiving adjuvant chemotherapy (26% vs. 23%, p<0.01). After matching (n=7.904 in each group), EC was associated with a higher rate of adequate lymphadenectomy (>12 lymph nodes retrieved: 94% vs. 89%, p<0.01). Five-year overall survival did not differ significantly between groups (65.6% for EC vs. 66.9% for SC, p=0.074). However, SC was associated with a modest but statistically significant improvement in CSS (84.3% vs. 81.7%, p<0.01). In adjusted analysis, surgical extent (HR=0.8376, p<0.001), along with age, sex, tumor grade, stage, and lymph node yield, were independently associated with CSS. Conclusion: While EC is more commonly utilized in advanced-stage disease and facilitates higher lymph node retrieval, SC offers comparable—and potentially superior—CSS in selected patients. These findings support the consideration of a tailored surgical strategy based on tumor biology and individual patient characteristics.
Small molecule influenza virus fusion inhibitors targeting viral hemagglutinin: Chemical insights and antiviral evaluation
(Bentham Science Publishers, 2025) Çınar, Gözde; Tekin, Mahmut Can; Cihan Üstündağ, Gökçe
Influenza viruses are major human pathogens that cause widespread respiratory infec tions, affecting millions of people globally and contributing to significant morbidity and mortality. Several currently available anti-influenza drugs are facing increasing levels of viral resistance. Therefore, the discovery of therapeutics targeting novel mechanisms of action is becoming increas ingly important. A key viral protein involved in the infection process is the envelope glycoprotein Hemagglutinin (HA), which facilitates both host cell receptor binding and membrane fusion, two essential steps required for viral entry and replication. Due to its central role in the early stages of infection, HA has emerged as a highly promising target for antiviral drug development. Many small molecule HA inhibitors have been identified with potential anti-influenza activity by stabilizing the HA structure and preventing its conformational change during the membrane fusion process. This review presents a detailed chemical evaluation of these HA-targeting compounds based on studies reported in the literature, highlighting their core chemical scaffolds and structural features. The antiviral efficacy of these compounds is discussed based on in vitro and in vivo data, along with insights into their mechanisms of action. A comprehensive literature search was conducted, and studies meeting the predefined inclusion criteria were thoroughly reviewed. By focusing on the chemical structure of these inhibitors, this review provides information for the rational design of new therapeutic agents aimed at preventing or limiting influenza virus infections.
Development and validation of an ICF-based new scale—Atılım Kinesiophobia Scale: A methodological study
(Wolters Kluwer, 2025) Uluğ, Naime; Parmaksız, Ayhan; Begen, Sena Nur; Can Karahan, Zehra; Yılmaz, Seval; Adalı, Mehmet Fatih; Aslan, Sema Nur; Uysal, Özgür Selim; Er, Dudu Melek; Tunca, Öznur; Kılıç, Erden
It is important to assess kinesiophobia, which increases the risk of disability by limiting physical activity. In this cross-sectional study, we aimed to develop a scale that assesses kinesiophobia with the multidimensional structure of International Classification of Functioning, Disability and Health (ICF). Atılım Kinesiophobia Scale (AKS) was developed in Turkish by an expert panel using questionnaires replied by 367 subjects. Finally, 38 questions based on the sub-domains of the ICF described by World Health Organization. In the scope of this cross-sectional study content validity and reliability were assessed; construct validity (both convergent and divergent validity) was checked against Tampa Kinesiophobia Scale-17 and Visual Analog Scale. AKS demonstrated good internal consistency and convergent validity, with significant correlations observed with the Tampa Scale for Kinesiophobia-17 (r = 0.478, P < .001). Divergent validity was supported by insignificant correlations with the Visual Analog Scale (r = 0.019, P = .855). The Cronbach alpha coefficient of 0.862 indicates a high level of internal consistency for the AKS. Based on these findings, the final version of AKS was refined to include 4 factors and 14 items, demonstrating good internal validity. We developed and validated the AKS to assess kinesophobia in patients with acute and/or chronic musculoskeletal pain. This new ICF-based scale can be used to assess kinesiophobia; however further studies are required to prove its validity and reliability in other languages. Abbreviations: AKS = Atılım Kinesiophobia Scale, CFA = confirmatory factor analysis, CFI = comparative fit index, EFA = exploratory factor analysis, ICF = International Classification of Functioning, Disability and Health, KMO = Kaiser–Meyer–Olkin, RMSEA = root mean square error of approximation, SRMR = standardized root mean square residual, TSK = Tampa Kinesiophobia Scale, VAS = Visual Analog Scale.
Safety monitoring of colistin therapy in critically ıll neonates with late-onset sepsis: A retrospective observational study
(British Pharmacological Society, 2025) Acargök, Baran Cengiz; Yaman, Akan; Rzayev, Turkay; Jalalzada, Nazlı; Kandemir, İbrahim; Memişoğlu, Aslı; Bilgen, Hülya Selva
This study aimed to evaluate the safety of colistin therapy by monitoring renal function and electrolyte levels in critically ill neonates with late-onset sepsis (LOS) hospitalized in the neonatal intensive care unit (NICU) between 2015 and 2021. This ret rospective case–control study included 58 critically ill neonates treated with colistin for late-onset sepsis and 22 control neonates with late-onset sepsis who did not receive colistin. Data were analyzed to compare patient outcomes, microbiological profiles, and side effects of treatment. Statistical analyses were performed using repeated-measures ANOVA and Bayesian calculations to evaluate serum creatinine levels and biochemical parameters over time. Serum creatinine levels showed similar alterations within the first 7days of colistin treatment with moderate evidence. However, serum magnesium and sodium levels were lower on the 7th day in the colistin-treated group compared with the control group. Colistin therapy in critically ill neonates with late-onset sepsis appears to be a viable treatment option with an acceptable short-term safety profile. These findings emphasize the importance of routine monitoring of renal function and electrolyte levels during colistin use in neonatal intensive care to minimize potential complications.
The effects of light and vibration on the correction of lower incisor crowding with aligners
(Galenos Publishing House, 2025) Özcan, Mustafa; Nalbantgil, Didem
Objective: To compare the effects of low-frequency vibration (LFV), photobiomodulation (PBM), and their combination (HOT) on the rate of mandibular incisor alignment during clear aligner therapy. Methods: This retrospective study included 89 patients treated with a single clear aligner system for mild-to-moderate mandibular anterior crowding. Patients were assigned to four groups: control (n=19), LFV (n=26), PBM (n=21), and HOT (n=23). LFV [30 Hz, 0.25 N (≈25 g)] and PBM (850 nm, 16×5 mm LEDs, ≈9.5 J/cm2 ) devices were used daily for 20 minutes in relevant groups. The primary outcome was the change in Little’s Irregularity Index at baseline (T0), 28 days (T1), 48 days (T2), and 62 days (T3). Statistical analyses included one-way ANOVA, repeated measures ANOVA, and Pearson’s correlation. Results: The HOT group showed significantly greater crowding reduction compared to all other groups (p<0.05). LFV and PBM alone were not significantly different from the control. Within-group analysis revealed significant reductions in all groups over time, with the HOT group showing consistent improvements at each interval. Correlation analyses revealed no significant associations between device usage or aligner wear time and crowding reduction. Conclusion: Combining LFV and PBM during clear aligner therapy produced greater short-term acceleration of mandibular incisor alignment than either modality alone. Further randomized controlled trials are warranted to confirm long-term efficacy and safety.
Senior nursing students' perspectives on nursing management: A qualitative study
(SAGE Publications, 2025) Aydoğdu, Ana Luiza Ferreira; Dişbudak, Büşra
Background Theoretical and practical classes in nursing management are part of nursing programmes; however, students often state a need for more preparation to apply leadership and management skills in clinical settings, highlighting the need for innovative educational approaches. This gap between theoretical preparation and the practical application of leadership and management skills underscores the importance of understanding students’ views on what constitutes effective nurse management. Aim This study aimed to explore final-year nursing students’ perspectives on the essential skills, practice and attitudes that nurse managers should demonstrate. Methods This is a descriptive qualitative study. It comprises written narratives of 35 senior undergraduate nursing students. Data were collected between 23 November 2023, and 4 December 2023. Descriptive thematic analysis was undertaken. Results Five themes were identified: (1) What makes a successful nurse manager, (2) Perspectives on effective leadership in nursing, (3) Fostering empowerment in the nursing team, (4) Building and strengthening team cohesion in nursing and (5) Effective care delivery models. Students believe nurse managers should take on a more effective leadership role. Conclusions Nursing students’ reflections can be utilised to update nursing curricula, to improve student leadership and managerial knowledge and skills as they enter the workforce.
Association of body mass index with orbital fat volume in lower eyelid blepharoplasty
(Springer Nature, 2025) Solmaz, İskender Alkın; Ertan, Elif
Purpose To investigate the relationship between body mass index (BMI) and the volume of orbital fat excised during lower eyelid blepharoplasty. Methods This retrospective cross-sectional study included 58 patients who underwent bilateral transconjunctival lower eyelid blepharoplasty between January and December 2024. Total orbital fat volume was measured intraoperatively using a graduated cylinder. BMI was calculated from preoperative height and weight and classified according to World Health Organization criteria. Statistical analyses included Pearson correlation, one-way ANOVA with Tukey’s post-hoc test, and univariate and multivariable linear regression. Results The mean age of the patients was 49.2±11.6 years, and the mean BMI was 24.5±3.8 kg/m². The mean total orbital fat volume excised was 2.08 ± 0.94 cc. Fat volume differed significantly across BMI categories (p<0.001), with obese and overweight patients having greater excised fat than normal-weight individuals. Pearson correlation demonstrated a strong positive association between BMI and fat volume (r=0.592, p<0.001). In regression analysis, BMI was the only significant predictor of orbital fat volume, explaining 35.1% of the variance (R²=0.351). Conclusion BMI is strongly associated with orbital fat volume excised during lower eyelid blepharoplasty. These findings suggest that systemic adiposity extends to the periorbital region and highlight the relevance of considering BMI in preoperative planning to optimize surgical outcomes.
Limitations of MRI in differentiating solid and cystic components of craniopharyngiomas
(Springer Nature Link, 2025) Karaalioğlu, Banu; Çakıcı Öksüz, Nazlı; İpek, Veyselkarani; Çakır, Aslı; Kahraman, Osman; Özbek, Muhammet Arif
Purpose Craniopharyngiomas (CP) present with both solid and cystic structures in magnetic resonance imaging (MRI) stud ies. Contrary to MRI appearance, components described as cysts are not infrequently found as non-fluent structures during surgery. This study aims to address the discrepancy between radiology and surgery regarding the nature of these lesions and to evaluate them for their preoperative predictability. Materials and methods Preoperative MRI images of 24 CP patients were analyzed. The cystic components of the tumors were assessed in terms of quantitative and qualitative signal properties and contrast enhancement on conventional pulse sequences, and analyzed based on their macroscopic appearances. Results Thirteen of 31 lesions (42%) that suggested cyst on MRI were solid during surgery, with none showing contrast uptake. MRI demonstrated 100% sensitivity and negative predictive value (NPV), 71.7% specificity, and 58% positive pre dictive value (PPV) in identifying true cysts. Most lesions resembling cysts were hyperintense on FLAIR and T1WI and isointense on ADC maps, suggesting high protein content. However, surgically confirmed fluid-filled cysts exhibited similar signal characteristics in a comparable proportion. The only significant imaging indicator was a hypointense appearance on T2WI, with a mean intensity ratio close to that of the basal ganglia. Conclusion Accurate identification of solid and cystic components in craniopharyngiomas is critical for effective treatment planning. Although MRI is traditionally considered reliable for this purpose, 42% of lesions that appeared cystic without contrast enhancement were ultimately confirmed as non-fluid or solid during surgery. This study was unable to establish definitive MRI characteristics to reliably differentiate between cystic and solid components. Further research with larger cohorts is warranted to validate potential imaging markers and improve diagnostic accuracy.

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