Gümüşhane ÜniversitesiGümüşhane ÜniversitesiAçık Erişim Arşivi · RDL Open

Yazarlar

Yayınlar

Yeniden eskiyeEskiden yeniye
  • MakaleAçık Erişim2026
    Comparison of Radiologic and Clinical Results of Short-Long Level Posterior Fusion in Lenke Type 5C Scoliosis

    Tas, Suleyman K.; Aydin, Abdurrahman; Yetkin, Cem; Albayrak, Akif; Kaygusuz, Mehmet A.

    Background: Lenke type 5C scoliosis is treated surgically with long-segment (nonselective) or short-segment (selective) level fusion. For Lenke type 5C scoliosis, no standardized criteria exist for selecting proximal and distal fusion levels. Studies report that short-segment level fusion patients with correct patient selection have a direct effect on the result of a well-balanced spine. Purpose: To compare the midterm and long-term radiologic and clinical outcomes of short-segment (selective) vs long-segment (nonselective) fusion in Lenke type 5C scoliosis. Design: Retrospective cohort study. Patient sample: This retrospective study evaluated patients who underwent posterior instrumentation for Lenke type 5C adolescent idiopathic scoliosis (AIS) at our institution between 2005 and 2016. Outcome measure: Physiologic measures: radiological evaluations included coronal, sagittal, and spinopelvic balance assessments as well as shoulder balance parameters on X-ray. Functional measures: clinical evaluations were performed using the SF-36 and SRS-22(r) scores. Methods: Patients with Lenke type 5C scoliosis who underwent selective (group 1) or nonselective (group 2) instrumentation were retrospectively analyzed. Group 1 included 47 patients (42 females and five males) with a mean age of 16.1 +/- 2.4 year (range, 12-22), and group 2 included 58 patients (53 females and five males) with a mean age of 16.3 +/- 3.4 yr (range, 12-24; P > .05). Radiological evaluations included coronal, sagittal, and spinopelvic balance assessments, as well as shoulder balance parameters. Clinical evaluations were performed using SF-36 and SRS-22(r) scores; results were compared between the two groups. Results: Both groups exhibited similar results in terms of coronal, sagittal, and spinopelvic balance as well as shoulder balance in many data after surgery (P > .05). Clinical outcomes, assessed via SF-36 mental health and SRS-22(r) scores, did not show statistically significant differences between groups (P > .05), except fort the physical role difficulty domain of the SF-36, where the selective fusion group (77.1 +/- 31.6) showed significantly better scores than nonselective group (58.2 +/- 36.1). However, the mean surgical time and transfusion requirement were significantly lower in the selective fusion group. Conclusion: When appropriately applied, selective fusion achieves comparable radiologic and clinical outcomes to nonselective fusion, with the added advantages of shorter surgical time and lower transfusion requirements.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    Corynebacterium in Granulomatous Mastitis: Clinical Features and Treatment Outcomes

    Tepe, Dilsat; Ulusahin, Mehmet; Kula, Sibel; Yilmaz, Gurdal

    Objective: Granulomatous mastitis (GM) is a chronic inflammatory breast disease with a heterogeneous clinical presentation and uncertain optimal management. Increasing evidence suggests a role for Corynebacterium species, particularly Corynebacterium kroppenstedtii, in its pathogenesis. This study aimed to evaluate the clinical characteristics, treatment strategies, and outcomes of granulomatous mastitis, with particular emphasis on cases associated with Corynebacterium species and the impact of antibiotic therapy. Materials and Methods: This retrospective cohort study included female patients with GM treated at a university hospital between January 2018 and January 2023. Patients were grouped according to Corynebacterium isolation. Clinical characteristics, microbiological findings, and treatment modalities-oral steroids, combined antibiotic-steroid therapy, antibiotics with intralesional steroids, and segmental mastectomy-were evaluated. The impact of lipophilic antibiotics (tetracyclines, linezolid, rifampin) combined with steroids was assessed. Recurrence rates and associated factors, including symptom duration, were analyzed. Results: A total of 165 patients were included in the study, of whom 25 tested positive and 140 negative. Corynebacterium spp. were detected in 15.15% of cases, with C. kroppenstedtii identified in 8.48%. Patients with Corynebacterium-associated GM had more extensive abscess formation and required more interventional procedures. Multimodal treatment strategies combining steroids, antibiotics, and surgery resulted in favorable outcomes. Lipophilic antibiotics combined with steroids showed a positive but statistically non-significant effect. Recurrence occurred in 16.4% of patients and was associated with longer symptom duration. Conclusion: Accurate microbiological identification is essential in GM, particularly in C. kroppenstedtii infections, to guide targeted antibiotic therapy and reduce recurrence. Tailored management strategies, including lipophilic antibiotics, may improve outcomes. Further studies are needed to define optimal treatment duration and the role of surgery in refrac-GM.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    An ergogenic approach to enhancing performance in archery: the acute effects of caffeine

    Türker, Ustun; Ates, Zeynep Hazal; Görgülü, Mumine; Kiyici, Fatih; Bayrakdaroglu, Serdar

    Background and Study Aim Ergogenic aids are widely used to enhance exercise performance and training adaptations. Among these, caffeine is recognized for its stimulatory effects on the central nervous system and neuromuscular function. Despite their widespread use, the relative effectiveness of such aids in improving performance in precision-based target sports such as archery remains a matter of practical interest. This study aimed to examine the effects of acute caffeine supplementation on shooting performance in university-level archers. Material and Methods A total of 12 licensed university archers (mean age: 22.92 +/- 2.11 years) participated in this study. A single-group pretest-posttest experimental design was employed. Participants completed two laboratory sessions separated by 72 hours under standardized conditions. In each session, anthropometric and hearing assessments were conducted. This was followed by the ingestion of 200 mg of caffeine. After a 60-minute absorption period, archers performed shooting tests at 18 meters. The protocol included practice trials and 10 sets of scoring shots. Data were analyzed using paired-samples t-tests and repeated-measures ANOVA. These methods accounted for within-subject variability across sets. Statistical significance was set at p < .05. Results Posttest scores were consistently higher than pretest scores across most sets. Statistically significant improvements were observed in Sets 2, 3, 4, 6, 8, 9, and 10 (p < .05). Sets 1, 5, and 7 showed nonsignificant differences. Overall performance increased significantly from 6.61 +/- 1.20 to 8.33 +/- 0.39 (p < .001), with a large effect size (Cohen's d = 1.90; eta 2 = .50). Repeated-measures ANOVA revealed a significant main effect of condition (p < .001). No significant set or interaction effects were found. This indicates that performance improvements were consistent across shooting sets. Conclusions Acute caffeine supplementation was associated with improved shooting performance in university-level archers. The findings suggest that caffeine may have potential as an ergogenic aid in precision-oriented sports requiring sustained attention and performance consistency. However, the results should be interpreted with caution due to methodological limitations. These include the absence of a control condition and the small sample size. Further randomized placebo-controlled studies are needed to confirm and extend these findings.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Shared burdens: An Interpretative Phenomenological Analysis of couples facing infertility

    Muslu, Ozge Nur; Uluç, Sait

    This study explores the psychological and emotional impacts of infertility treatments on couples. Utilizing Interpretative Phenomenological Analysis, this qualitative research delves into the shared experiences of five couples undergoing fertility treatments, uncovering the deep-seated personal and relational dynamics of their journeys. Three key themes were identified: From Hope to Exhaustion: Navigating the Emotional Rollercoaster of Treatment, Redefining Togetherness: Making Sense of Infertility as a Couple, and Networks of Care: Negotiating Support Within and Beyond the Couple. Study explores how couples undergoing in vitro fertilization construct shared meaning around their experiences and how the process shapes their relational and psychological dynamics. This study adopts a couple-based interpretative phenomenological approach to reveal how partners co-construct meaning, manage shared distress, and experience relational growth during infertility treatment. It offers new insights into the dyadic processes that foster resilience amid infertility.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Temporofacial (TemFa) Lift

    Kaderi, Sina; Ekinci, Can; Köse, Aydan Ayse

    Background Today, people increasingly embrace the natural process of aging while seeking to age gracefully and elegantly. As a result, there has been growing interest in facelift and facial rejuvenation techniques. Patients tend to prefer methods that refresh the facial expression, offer natural-looking results, and leave minimal scarring. Objectives The authors describe a new technique and its tips that include short-scar facelift in addition to forehead and midface lift, especially for patients between the ages 35 and 50 with moderate skin sagging and excess. This procedure also includes intervention on the platysma muscle and all major retaining ligaments. Methods Seventy-four patients, all female, who were operated on with the TemFa lift technique described by the author, were evaluated with midface area measurements and Brow Positioning Grading Scale (BPGS), and the preoperative and postoperative results are presented. Results Compared with the preoperative results, the ratio of the upper midface area (P1) to the lower midface area (P2) increased significantly in the postoperative period (p < 0.05), while the BPGS results decreased significantly (p < 0.05), resulting in a younger eyebrow height and position. After the operation, the square face appearance is replaced by a more youthful V-shaped face. Conclusion TemFa lift technique can be considered as a suitable surgical technique for patients between the ages 35 and 50 who have moderate excess skin and sagging but also want some improvement in the neck and jawline area.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    Unipolar mania as a distinct clinical presentation: Differences in illness course and psychosocial functioning compared with bipolar I disorder

    Soygenc, Elcin Izmir; Onur, Ozge Sahmelikoglu

    Objective: Growing evidence suggests that unipolar mania (UM) may represent a distinct clinical condition rather than a subtype of bipolar disorder (BD). The present study aimed to compare the sociodemographic characteristics, clinical features, and psychosocial functioning of euthymic patients with UM or bipolar I disorder (BD-I) and healthy control subjects. Method: This cross-sectional study included euthymic patients with UM (n=58), BD-I (n=58), and healthy control subjects (n=58). Diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, and euthymia was confirmed using the Young Mania Rating Scale, Beck Depression Inventory, and Positive and Negative Syndrome Scale. Psychosocial functioning was assessed using the Functioning Assessment Short Test (FAST) in all groups and the Bipolar Disorder Functioning Scale (BDFS) in the UM and BD-I groups. Sociodemographic and clinical data were collected using a structured form. Group comparisons were conducted using appropriate parametric and nonparametric statistical analyses. Results: Both patient groups demonstrated significantly impaired psychosocial functioning compared with healthy controls across all FAST subdomains (p<0.05). On the BDFS, patients with UM showed better emotional functioning and less social withdrawal than patients with BD-I (p<0.05); however, total functioning scores did not differ significantly between groups (p>0.05). Clinically, UM was characterized by manic-predominant onset, higher rates of mood-congruent psychotic symptoms, longer episode duration, and more frequent hospitalizations. Suicidal behavior and total number of mood episodes were higher among patients with BD-I (p<0.05). In the final logistic regression model, mood-congruent psychotic symptoms during the first episode were independently associated with UM relative to BD-I, whereas a history of suicide attempts was associated with lower odds of UM (p<0.05). Conclusion: Although both groups exhibited functional impairment, patients with UM demonstrated relatively better emotional and social functioning than those with BD-I. These findings suggest that UM may be associated with a distinct functional profile, with potential implications for prognosis and treatment planning. Incorporating functional outcomes into the clinical assessment of UM may help optimize therapeutic strategies and improve long-term psychosocial outcomes.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    Association of Serial Intra-Abdominal Pressure Measurements with Renal Outcomes and Mortality in Critically Ill Adults

    Öztürk, Ayse Sari; Konur, Kamil; Kara, Ekrem

    Background/Objectives: Intra-abdominal hypertension (IAH) is a common but under-recognized condition in critically ill patients and is associated with adverse outcomes, particularly acute kidney injury (AKI) and mortality. However, the prognostic value of intra-abdominal pressure (IAP) remains incompletely defined. This study aimed to evaluate the association between IAP levels and clinical outcomes, and to determine its prognostic significance in intensive care unit (ICU) patients. Methods: This prospective cohort study included adult patients admitted to the ICU between 2024 and 2025. Serial IAP measurements were performed using the transvesical method on days 0, 1, 3, 5, and 7. Demographic, clinical, and laboratory data, along with severity scores (SOFA and APACHE II), were recorded. Patients were followed for 90 days. Primary outcomes were AKI and 90-day mortality. Statistical analyses included regression models, survival analysis, and ROC curve analysis. Results: The prevalence of IAH was 54%. IAH was significantly associated with advanced age, male sex, higher body mass index, increased comorbidity burden, sepsis, positive fluid balance, and higher disease severity scores. Patients with IAH had a significantly higher frequency of AKI occurrence and increased mortality. IAP levels positively correlated with serum urea and creatinine levels. Serial IAP measurements, particularly on days 5 and 7, showed progressively improved predictive performance for mortality. Survival analysis revealed significantly reduced survival in patients with IAH. Conclusions: IAH is highly prevalent in critically ill patients and is strongly associated with renal dysfunction and mortality. Serial IAP measurements may provide useful prognostic information in critically ill patients; however, these findings require validation in larger studies.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    The Stranger at Home: Lived Experiences of Online Gambling Within the Family in Siirt, Türkiye

    Bektaş, Ahmet; Toprak, Adnan; Solmaz, Mustafa; Solmaz, Fatih; Erbaş, Sefa; İliter, Seyfettin; Parlar, Yasin

    Online gambling is a growing public health concern whose harms extend to the family, yet its familial consequences remain underexplored in contexts where gambling is illegal and extended-family ties are strong. This study examined how men who gamble online perceive gambling to affect their families in Siirt, Türkiye. Using a qualitative exploratory design, in-person semi-structured interviews with nine married or previously married men who currently or formerly gambled online (recruited via purposive and snowball sampling) were analyzed with a hybrid deductive-inductive, codebook thematic analysis (Fereday & Muir-Cochrane, 2006), informed by the six phases of Braun and Clarke (2006). Four themes were identified: entry into online gambling and the experience of addiction; the internal disintegration of the nuclear family; the household’s economic collapse and drift into crime; and the extended family, stigmatization, and the cultural framing of harm. Participants perceived gambling to erode communication and trust, dispossess the household, and displace men from the provider role, while family responses followed conventional gendered lines-disrupting the material division of roles while reactivating a traditional gender order. Distinctive contextual mechanisms emerged, including the extended family’s collective debt-clearing in exchange for religious oaths and the operation of stigma through kinship networks that threatened collective family honor. Because all participants were gamblers, the findings reflect their perceptions of family impact rather than the direct experiences of affected others. The results extend a predominantly Western evidence base and underscore the need for culturally sensitive, family-inclusive support that works with existing kinship structures while protecting those most burdened.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    • SDG 16 · Barış, Adalet ve Güçlü Kurumlar
    İncele
  • MakaleAçık Erişim2026
    An Approach to the Evaluation of Spent Coffee Grounds: Use in Functional Apricot Bar Formulation

    Berktaş, Serap; İncegül, Yasemin; Çam, Mustafa

    Fruit bars are snack products obtained by mushing fruit, adding sugar, pectin, and other ingredients, and drying the resulting mixture. The aim of this study was to investigate the effects of spent coffee grounds (SCGs), a valuable waste product of the coffee industry, on the physicochemical and bioactive properties of a snack fruit bar enriched with bioactive properties after mushing apricot fruit. Results showed that apricot bars containing 2.5%, 5%, and 7.5% SCGs had higher phenolic, flavonoid, antioxidant activity (ABTS and DPPH), ascorbic acid, and total carotenoid contents compared to the control group. Especially, the fruit bar containing 7.5% SCG stood out in terms of tested bioactive properties. Therefore, it has been determined that the antioxidant and phenolic compounds found in SCGs are also reflected in fruit bars. Furthermore, α-amylase and lipase inhibition values were increased in the enriched fruit bars, and the potential of the developed fruit bars to exhibit antidiabetic and antiobesity properties was improved. Furthermore, the intestinal phase phenolic compound bioaccessibility values of the enriched fruit bars (87.40%–133.3%) were higher than the SCG-free control fruit bar (91.7%). The potential for creating an alternative product with improved nutritional and economic benefits by adding a waste product rich in bioactive compounds such as SCGs to the fruit bar formulation was evaluated. Such products could be considered a new alternative to a functional snack product group rich in bioactive substances that could be incorporated into today's diet.

    • SDG 2 · Açlığa Son
    • SDG 3 · Sağlık ve Kaliteli Yaşam
    • SDG 12 · Sorumlu Üretim ve Tüketim
    İncele
  • MakaleAçık Erişim2026
    Measuring Perceived Social Support After Disaster: Development and Validation of the Perceived Social Support in Disasters Scale (PSSDS-28)

    Oruç, Abdurrahman; Cengiz, Ekrem

    Background/Objectives: Measuring perceived social support after disaster remains an unresolved psychometric problem. Most instruments do not jointly capture the source of support (from whom it comes) and its function (how it operates). None has been validated in a disaster-survivor sample with retrospectively framed items. We developed and validated the Perceived Social Support in Disasters Scale (PSSDS-28), a 28-item measure integrating both dimensions. Methods: In Phase 1, a PRISMA 2020-guided systematic review; a two-round Delphi with eight experts, cognitive interviews (n = 12); and a pilot study (N = 150) produced a 31-item form. In Phase 2, face-to-face data were collected from 607 adults affected by the 6 February 2023 Kahramanmaraş earthquakes (Türkiye). Multiple analytic frameworks converged on a five-factor, 28-item structure comprising family–relative, social environment, institutional, emotional, and instrumental–informational support. Results: The correlated five-factor model fit the independent validation sample well (CFI = 0.954, RMSEA = 0.076, and SRMR = 0.072) and outperformed a one-factor alternative (ΔCFI = 0.222). Blocks showed strong internal consistency (ordinal α = 0.852–0.949), composite reliability (0.865–0.950), and adequate test–retest stability (ICC = 0.542–0.909). Scalar measurement invariance held across six groupings, with no meaningful differential item functioning. Convergent and discriminant evidence supported construct validity, and common-method variance was negligible. Institutional (M = 3.29) and instrumental–informational support (M = 2.99) scored lowest—a profile a global score would conceal. Conclusions: The PSSDS-28 provides promising initial psychometric evidence for a multidimensional post-disaster assessment instrument situated at the perceived–received interface, a target that general-purpose scales are not designed to capture. Criterion-related validity, cross-cultural validity, and cross-disaster replicability remain to be demonstrated.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    Drivers’ Perceptions of Vertical Traffic Signs and Their Implications for Road Safety: Evidence from a Field Survey

    Durmus, Tahsin; Coruh, Emine

    Accurate perception and interpretation of the road environment are essential for safe driving. Vertical traffic signs play a key role in communicating warnings, regulations, and guidance to road users, thereby supporting safe and efficient traffic flow. However, their effectiveness depends not only on proper design and placement but also on how accurately and promptly they are perceived by drivers, which may be influenced by factors such as attention, cognitive workload, physical and mental condition, and fatigue. This study evaluates the contribution of selected vertical traffic signs to driving safety along a designated roadway section in Şanlıurfa, Türkiye. Face-to-face surveys were conducted with 480 active road users. Drivers’ knowledge, compliance behavior, safe route preferences, perceived visibility, and the effects of missing or inadequate signage were analyzed. The results indicate that driving exposure, education level, and experience significantly influence knowledge and perception of traffic signs, while compliance shows limited variation. These findings suggest that knowledge alone does not necessarily translate into behavioral compliance and underscore the importance of considering both driver-related factors and infrastructure characteristics in traffic safety strategies. The study provides practical insights for improving the visibility, placement, and overall effectiveness of vertical traffic signs in rapidly developing urban environments.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    • SDG 11 · Sürdürülebilir Şehirler ve Topluluklar
    İncele
  • MakaleAçık Erişim2026
    Weekly Fluctuations in Internal Load and Neuromuscular Performance Across a 10-Week Training Period in Elite Female Boxers

    Aydın, Ahmet Serhat; Altuğ, Tolga; Yılmaz, Coşkun; Badau, Adela; Söyler, Mehmet

    This study examined weekly internal load and neuromuscular performance in elite junior female boxers over 10 weeks. Internal load was quantified using session rating of perceived exertion (sRPE), from which weekly monotony and strain were derived. Neuromuscular performance was assessed weekly using wall-sit endurance and a repetitive jump test. Twenty elite junior female boxers (Mean ± SD: 18.9 ± 1.2) were monitored during regular training without experimental manipulation. Weekly sRPE-derived training load, monotony, and strain showed statistically significant week-to-week fluctuations (p < 0.001). Neuromuscular performance improved in week 2, declined during weeks 3–5, and partially recovered in week 6. The findings demonstrated consistent temporal alignment between internal-load indices and week-to-week neuromuscular performance changes within an observational monitoring framework. Inter-individual variability was observed across athletes. Overall, sRPE-derived indices reflected training stress patterns and were aligned with neuromuscular performance changes in elite female boxers, supporting their use for contextual monitoring of weekly training responses. These findings support the practical integration of internal-load and performance monitoring in elite female combat-sport settings. Future research incorporating boxing-specific external-load metrics, physiological markers, and longer monitoring periods may further refine individualized load-management strategies.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Optic disc segmentation: Improved U-Net model and hyperparameter optimization with harmony search algorithm

    İncir, Ramazan; Bozkurt, Ferhat

    Vision loss negatively impacts individuals quality of life, creating a societal issue. As stated by the World Health Organization, vision loss is significant concern among health problems. Glaucoma and Diabetic Retinopathy are among the primary causes of vision impairment and loss. Early diagnosis of these diseases is crucial for guiding appropriate treatment. Optical disc segmentation plays a key role in diagnosing these diseases and helps in effectively detecting them through the analysis of retinal images. This study proposes method based on the automatic processing of fundus images to contribute to the early diagnosis of eye diseases. Improved U-Net architecture developed for optical disc segmentation is used. To enhance the models performance, the improved U-Net architecture has been strengthened with residual and custom convolution blocks. Genetic Algorithm, Particle Swarm Optimization Algorithm, Ant Colony Optimization and Harmony Search Algorithm were used for hyperparameter optimization. Comparisons showed that the Harmony Search Algorithm achieved better results, improving overall model performance and providing more accurate segmentation outcomes. The models performance has been tested on the IDRiD and DRISHTI-GS datasets. The improved architecture outperformed existing methods in the literature. Significant improvements were observed in key segmentation metrics such as IoU and Dice coefficient. In experimental studies using the IDRiD and DRISHTI-GS datasets, the proposed model achieved IoU scores of 93.65% and 95.20% and Dice scores of 96.72% and 97.54% respectively. The model was able to accurately define optical disc boundaries even in low contrast and complex images. The obtained success demonstrates the models potential as valuable tool for the early diagnosis of vision loss causing diseases.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    The Mediating and Moderating Roles of Innovation Climate in the Relationship Between Nurses’ Attitudes Toward Artificial Intelligence, Creative Self-Efficacy, and Clinical Competence

    Karakaya Suzan, Ozge; Gül, Uğur; Koyuncu, Oğuz; Akdeniz, Canberk

    Background: Artificial intelligence (AI) is increasingly integrated into health care; however, how nurses’ attitudes toward AI and creative self-efficacy are associated with perceived clinical competence within different organizational contexts remains unclear. Aim: To examine whether perceived climate for innovation statistically mediates the association between nurses’ attitudes toward AI and perceived clinical competence and moderates the association between creative self-efficacy and perceived clinical competence. Methods: This cross-sectional study included 233 nurses recruited online by convenience sampling from hospitals in Türkiye between January and March 2026. Self-report measures assessed attitudes toward AI, creative self-efficacy, perceived climate for innovation, and perceived clinical competence. Pearson correlations and PROCESS Models 4 and 1 with 5000 bootstrap samples tested statistical mediation and moderation. Adjusted analyses included age, gender, previous AI-related training and AI use, educational level, professional experience, and institution type. Results: Attitudes toward AI were indirectly associated with perceived clinical competence through perceived climate for innovation; the adjusted indirect association remained significant (B = 0.0700, SE = 0.0333, 95% CI [0.0173, 0.1453]), consistent with partial statistical mediation. Perceived climate for innovation also moderated the association between creative self-efficacy and perceived clinical competence after adjustment (interaction B = −0.1672, SE = 0.0447, 95% CI [−0.2552, −0.0792]). This positive association became weaker as perceived climate for innovation increased. Conclusion: Attitudes toward AI, creative self-efficacy, perceived climate for innovation, and perceived clinical competence were significantly associated, and the statistical mediation and moderation patterns remained after adjustment. The cross-sectional, self-report data do not establish temporal or causal mechanisms or effects on objectively measured clinical performance or patient outcomes. Implications for Nursing Management: Nurse managers may consider supporting AI literacy, safe AI use, team-based learning, and innovation-supportive work environments. These strategies should be evaluated prospectively using objective clinical and patient outcomes before their effectiveness is inferred.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Impact of stress ball intervention on satisfaction, comfort and anxiety in hemodialysis patients: a randomized controlled trial

    Salti, Aysun Kazak; Topali, Hasret; Turkmen, Osman Oğulcan

    Hemodialysis (HD) patients commonly experience psychological distress and anxiety, which may affect their comfort and satisfaction during treatment. This study examined the overall impact of stress ball use on satisfaction, comfort, and anxiety among individuals receiving HD. A total of 46 patients were randomized between January and July 2025. Three participants in the intervention group withdrew before completing the study; therefore, the final analysis included 43 patients (20 in the stress ball group and 23 in the control group). Data were collected using the Patient Information Form (PIF), Visual Analog Patient Satisfaction Scale (VAPSS), Hemodialysis Comfort Scale (HCS), Distress Thermometer (DT), and Visual Analog Scale for Anxiety (VAS-A). Patients in the intervention group used a stress ball for at least 15 minutes during each of twelve HD sessions. Measurements were obtained at baseline, midpoint, and post-test, while the control group received standard care and was assessed concurrently. The study findings demonstrated that anxiety levels decreased over time in the stress ball group, whereas they increased in the control group. Similarly, distress levels decreased in the stress ball group, while no significant change was observed in the control group. HD comfort scores decreased in the stress ball group but increased in the control group. In contrast, no statistically significant difference was found between the groups in terms of the VAPSS scores. These results highlight the potential value of simple distraction techniques in clinical settings for further improving psychological outcomes.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Classification and detection of Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes using Fourier-transform near infrared spectroscopy coupled with machine learning

    Ozturk, Samet; Huang, Lihan; Hwang, Cheng-An; Sheen, Shiowshuh

    This study was conducted to investigate the potential use of Fourier-transform near-infrared (FT-NIR) spectroscopy combined with machine learning (ML) algorithms to accurately identify three foodborne pathogens, including Salmonella spp., Listeria monocytogenes, and Escherichia coli O157:H7. Each bacterial strain (two per pathogen) was individually cultured and purified through sequential washing using ethanol–deionized (DI) water solutions. Each purified culture was transferred into each well of a 96-well cell plate covered with custom-cut filter paper and then vacuum dried at 50 °C under 20 kPa for 1 h. The absorbance spectra of dehydrated bacterial cells were then acquired across the range of 1000–2400 nm using a diffuse reflectance probe connected to a FT-NIR process analyzer. To identify the optimal classification pipeline, the acquired spectra were analyzed using ten different pre-processing methods, three feature selection methods, and supervised algorithms including partial least squares discriminant analysis (PLS-DA), support vector machine (SVM), random forest (RF), artificial neural network (ANN), and convolutional neural network (CNN). Furthermore, the accuracy of the developed ML pipelines was further enhanced through under-sampling and boosting steps. The results demonstrated that SVM, RF, ANN and CNN outperformed PLS-DA, where the classification accuracies were above 90%. The findings demonstrate that using Savitzky-Golay first derivative (SG1) filtering to pre-process the full spectra followed by SVM classification yielded the highest accuracy, achieving 95.3% overall accuracy in ML pipeline. This study highlights the powerful capability of FT-NIR spectroscopy coupled with ML algorithms to detect and identify foodborne pathogens on dehydrated surfaces in process environments.

    • SDG 2 · Açlığa Son
    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    The effect of acupressure on symptom management in children: A meta-analysis of randomized controlled trials

    Akay, Gamze; Yıldız, Muhammed; Oğuzhan, Hatice; Uzun, Sevda

    Purpose Pediatric patients often experience distress, pain, and nausea during medical procedures. This meta-analysis aimed to synthesize current evidence on the potential efficacy of acupressure on symptom management among pediatric patients aged 0–19 years. Design and methods This study was designed as a meta-analysis of randomized controlled trials . The literature search was conducted in PubMed, Web of Science, Scopus, EBSCOhost, Google Scholar, and the YÖK Thesis Center in January 2025 and updated in August 2026, with no restriction on publication year. After the reviews, 17 studies were included in the study. The data were synthesized by meta-analysis and narrative methods. Results The pooled analysis indicated that acupressure was associated with statistically significant reductions in reported anxiety (SMD = −1.021, p < 0.001), pain (SMD = −1.397, p < 0.001), and nausea (SMD = −0.388, p = 0.006). However, substantial statistical heterogeneity was observed for anxiety (I2 = 78.8%) and pain (I2 = 94.4%), and the number of studies available for each outcome was limited (anxiety: n = 6; pain: n = 9; nausea: n = 4). Conclusions and practice implications Current evidence suggests that acupressure may be a promising complementary approach for managing anxiety, pain, and nausea in pediatric patients. However, given the small number of studies per outcome, small sample sizes, and high statistical heterogeneity, these findings should be interpreted with caution. Further rigorous, well-designed RCTs are required to confirm these observations before routine clinical implementation can be recommended.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    The effect of eHealth-based guided self help interventions for binge eating disorder : a meta-analysis of randomized controlled trials

    Tuncer, Gülsüm Zekiye; Tuncer, Metin

    With rapid technological advancements, eHealth-based guided self-help interventions have become accessible, flexible, cost-effective, and stigma-reducing treatment options for binge eating disorder (BED). This meta-analysis evaluated the effectiveness of these interventions in individuals diagnosed with BED or showing BED symptoms, based on eight randomized controlled trials with 1,575 participants. Intervention length varied between a single session to four months. Six studies focused solely on web-based guided self-help interventions, one study implemented a hybrid approach combining face-to-face and online components, and another study employed two distinct online guided self-help methods. The interventions included psychoeducational modules, therapist feedback, online behavior monitoring, and self-assessments. eHealth-based guided self-help significantly reduced binge eating psychopathology (SMD: 0.53; 95% CI: 0.20–0.86) and objective binge eating (OBE) days (SMD: 0.49; 95% CI: 0.12–0.85) compared to controls. These interventions offer effective solutions for individuals facing barriers to traditional treatment access.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleYalnız künye2026
    Efficient ensemble learning with multi-scale fusion based deep neural network for skin lesion classification

    Reis, Hatice Catal; Turk, Veysel

    Melanoma, a type of skin cancer, is a severe skin cancer that is critical for early diagnosis but difficult to detect. Deep learning is promising in melanoma diagnosis because it can automatically analyze visual features and perform end-to-end learning. However, achieving the optimum balance between performance and computational efficiency for the effective use of these models in clinical applications is an important research topic. In this study, three innovative methods are proposed for skin cancer detection: PADSCNet, P-DEFF, and M–DEFF. The PADSCNet is an effective neural network developed with CNN and multi-head attention techniques, designed with fusion methods, and stands out with its minimum number of parameters despite being quite deep. The P-DEFF and M–DEFF are based on ensemble learning techniques; P-DEFF was developed with a single deep learning model, and M–DEFF was developed with multiple pre-trained deep learning models. The proposed approaches were tested on the Skin Cancer: Malignant vs. Benign dataset, which was pre-processed using image enhancement techniques. According to the experimental results, PADSCNet achieved accuracy rates of 88.12 %, P-DEFF 93.75 %, and M–DEFF 95.00 %. In additional experiments conducted with the PADSCNet model, 93.12 % accuracy rates were achieved in the CNN for Melanoma Detection Dataset, and 95.00 % accuracy rates were achieved in the PH2 dataset. These findings show that the proposed methods are effective in skin cancer detection and can achieve successful results in clinical applications.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele
  • MakaleAçık Erişim2026
    Electric field–induced inflammatory and angiogenic responses in rat female reproductive tissues: evidence for early extracellular matrix remodeling

    Ozmen, Ozlem; Asci, Halil; Kolay, Oznur; Selcuk, Elif Nur; Yuksel, Duygu; Comlekci, Selcuk; Karabacak, Pinar

    High-intensity electric fields (EFs) are increasingly encountered in occupational and environmental settings, raising concerns regarding their potential biological effects on hormonally responsive organs. However, the cellular and molecular responses of female reproductive tissues to short-term exposure to high-voltage EFs remain insufficiently characterized. This study aims to investigate EF-associated histopathological and immunohistochemical alterations in major female reproductive organs. Forty adult female Wistar albino rats were randomly assigned to five experimental groups (n = 8 per group): a control group (0 min) and four EF-exposed groups subjected to a nominal electric field intensity of 10 kV/m EF for 1, 5, 15, or 30 min using a custom-designed parallel-plate exposure system. The field intensity was verified at predefined measurement points within the exposure setup. Ovaries, uterus, and uterine tubes were examined using hematoxylin–eosin staining and semi-quantitative histopathological scoring. Immunohistochemical analyses were performed to evaluate the expression of tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and osteonectin as markers of inflammation, angiogenesis, and extracellular matrix remodeling. Exposure to the electric field was associated with time-dependent histopathological alterations, including tissue edema, hemorrhage, epithelial degeneration, and leukocyte infiltration. The most pronounced ovarian and uterine changes were observed in the 30-min exposure group, whereas the uterine tubes exhibited comparatively milder structural alterations. Immunohistochemical analysis demonstrated increased TNF-α and VEGF expression in higher-exposure groups, suggesting activation of inflammatory and angiogenic pathways. Osteonectin expression was elevated in all examined reproductive tissues and was also detected in regions without overt morphological damage, indicating its potential sensitivity to early tissue stress responses associated with EF exposure. Significant correlations were observed between histopathological injury scores and immunohistochemical marker expression levels. Overall, short-term exposure to high-intensity electric field was associated with inflammatory signaling, angiogenic responses, and extracellular matrix remodeling in female reproductive tissues in this experimental model. These findings provide histological and immunohistochemical evidence of tissue responses to EF exposure and underscore the need for further studies incorporating comprehensive exposure characterization and additional molecular endpoints to better define potential reproductive health implications to high-voltage electric fields.

    • SDG 3 · Sağlık ve Kaliteli Yaşam
    İncele