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- Uzun, Sevda(79)
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Yayınlar
- MakaleYalnız künye2026Paranormal Health Beliefs in Travel Motivation and Experiences: The Case of Gırnavaz Jinn
Şimşek Evren, Emine
This study was conducted to determine the travel motivations and experiences of paranormal health tourists. In the study, the Gırnavaz Mound in Mardin/Türkiye, where the tomb of the leader of the first Muslim jinn is located, was analyzed. The data were collected with semi-structured interviews conducted with 15 visitors and 2 religious officials. Four main themes and six subthemes were identified during the manual content analysis process. The main themes were named “Paranormal Story: Healing Jinn,” “Motivation for Paranormal Health Tourism,” “Paranormal Health Tourism Experiences,” and “Sense of Healing: Placebo.” Findings reveal that paranormal health tourists are motivated by feelings of helplessness and belief. Their experiences are shaped by ritual participation and shared emotional exchanges with others. The peak experience—encountering a jinn leader in a dream—can be disrupted by environmental factors. Those who reach the peak experience feel a sense of healing that can be attributed to the placebo.
- MakaleAçık Erişim2026Immersive Virtual Reality as a Tool to Reduce Anxiety and Distress in Patients With Breast Cancer During Radiotherapy
Aydin, Aydanur; Uslu, Gonca Hanedan; Gursoy, Ayla
Background: – Virtual reality (VR) can be an innovative method to reduce patients’ anxiety and support their psychological health. Objective: – To evaluate the anxiety and distress-reducing effects of using immersive VR (IVR) intervention in breast cancer patients undergoing radiotherapy (RT). Methods: – Sixty breast cancer patients undergoing RT were recruited for the quasi-experimental study. The participants were divided into the intervention group and the control group. Anxiety and distress, the primary outcome measures, were assessed before the first and after the last radiation session using reliable scales. Patients in the intervention group watched a tranquil forest view with birdsong and meditation music during each RT session using IVR goggles. Results: – Both group patients had similar levels of anxiety and distress before the start of RT. After the intervention, the anxiety and distress of the patients in the intervention group decreased significantly compared with the control group. In addition, treatment-related comfort was higher in the intervention group. Overall, the majority of patients in the intervention group expressed a high level of satisfaction with this IVR experience. Conclusion: – Patients who experienced an IVR intervention showed less anxiety and distress, greater comfort, and higher satisfaction. This innovative technique can be used as a practical solution to alleviate anxiety and distress in various healthcare settings. Implications for Practice: – Immersive VR can be used in treatment and care interventions that cause anxiety and distress in oncology patients.
- MakaleYalnız künye2026Determinants of sleep quality and fatigue in patients undergoing hemodialysis
Kazak Salti, Aysun; Topali, Hasret; Türkmen, Osman Oğulcan
Aim: This research aimed to evaluate sleep quality and fatigue among individuals undergoing hemodialysis and to explore the determinants affecting these variables. Methods: This observational investigation was carried out among 78 who were regularly receiving hemodialysis therapy. The research was carried out between May and October 2025 in three different public hospitals among individuals undergoing hemodialysis treatment. Data were gathered using the Patient Information Form (PIF), the Fatigue Severity Scale (FSS), and the Pittsburgh Sleep Quality Index (PSQI). Results: The mean score of the hemodialysis patients on the FSS is 4.97 ± 1.11, and the mean PSQI value is 7.76 ± 3.64. A moderately positive and statistically noteworthy relation was observed between the PSQI and FSS scores. Additionally, a low negative meaningful correlation was seen between ferritin levels and the FSS scores, as well as between calcium levels and the PSQI scores. The use of medications related to chronic disease and the PSQI scores were identified as significant predictors of the FSS scores. Conclusion: Fatigue and sleep quality in individuals receiving hemodialysis treatment are related to each other, as well as to biochemical balance and treatment adherence.
- MakaleAçık Erişim2026Spinal Manipulation, Dynamic Neuromuscular Stabilization, and Their Combination in Chronic Non-Specific Low Back Pain: A Four-Group Randomized Clinical Trial
Alak, İsmail; Hatik, Sefa Haktan; Büyükkirli, İlker Can; Aydin, Emine Busra
Spinal manipulation (SM) and stabilization-focused exercise are commonly used in chronic low back pain, yet evidence on their combined effects is limited. This randomized controlled trial compared SM and dynamic neuromuscular stabilization (DNS), alone or combined, in chronic non-specific low back pain. Forty-eight participants were randomized (1:1:1:1; n=12/group) using a computer-generated sequence with opaque sealed-envelope concealment to Control, SM, DNS, or SM+DNS (SMDNS). Interventions (except Control) were delivered twice weekly for 4 weeks. Outcomes (VAS, ODI, RMDQ, DNS-HS, PostureScreen) were assessed at baseline and follow-up. Assessor blinding was not feasible (treating physiotherapist also assessed outcomes); analyses used coded group labels.Within-group analyses showed significant improvements in most outcomes (p<0.05), except for postural deviation in the SM group and frontal postural deviation in the DNS and SMDNS groups. Between-group comparisons indicated greater early pain reduction with SMDNS at the second assessment (p<0.05). By week 4, pain decreased most in DNS and SMDNS (VAS Δ=−3), while SM showed Δ=−2 and Control showed no change. Disability improved most in DNS/SMDNS (ODI Δ=−13.39/−15.38; RMDQ Δ=−5.24/−5.77). Week-4 effect sizes favored SMDNS over Control and SM for key outcomes (VAS D2 g=2.07 vs Control, 1.24 vs SM; ODI PC2 g=1.73 vs Control, 1.05 vs SM; RMDQ PC2 g=1.34 vs Control, 0.23 vs SM). Overall, adding SM to DNS may enhance early pain relief; the magnitude of between-group differences (effect sizes with 95% CIs) supports interpretation, while clinical relevance should be considered alongside established MCIDs and confirmed in larger trials with longer follow-up.
- MakaleAçık Erişim2026A Qualitative Research on The Applicability of Value-Based Payment Method in The Health System of Türkiye; [Değer Bazlı Geri Ödeme Yönteminin Türkiye Sağlık Sisteminde Uygulanabilirliği Üzerine Nitel Bir Araştırma]
Tekinarslan, Merve; Kaya, Sıdıka
This study explores value-based payment reforms in healthcare, aiming to enhance productivity, efficiency, and quality of care by shifting the focus from quantity to value. Using a grounded theory approach and the Delphi technique, 28 healthcare stakeholders were selected through purposive sampling. Data were analysed with MAXQDA 2020, and value parameters were ranked by importance. Findings define value in healthcare as "a quality service," with participants supporting value-based repayment despite some limitations. Fifteen key value measurement parameters were identified. The study recommends addressing resistance to change and implementing necessary revisions for Türkiye to adopt this model successfully.
- MakaleAçık Erişim2026Investigation of the Antioxidant, Antibacterial, and Food Safety Potential of Silver and Copper Nanoparticles Green Synthesized Using Pointed Cherry Laurel (Prunus laurocerasus L.) Extract
Kobya, Havva Nur; Gül, Abdulkadir; Karpuz, Ömer; Baltacı, Cemalettin
This study reports the green synthesis of silver (PFAgNPs) and copper (PFCuNPs) nanoparticles using an aqueous extract of pointed cherry laurel (Prunus laurocerasus L.) fruit (PF-E) and explores their applicability in food safety. The NPs were characterized via UV–Vis spectroscopy, FT-IR, XRD, SEM, EDX, and TEM confirming their successful formation and morphology. Total phenolic content (TPC), flavonoid content (TFC), and antioxidant capacity (TAC) were measured for both PF-E and the synthesized NPs. While PFCuNPs exhibited higher TPC, PFAgNPs showed superior TFC and TAC. Notably, antioxidant assays (DPPH, ABTS, FRAP) indicated stronger radical scavenging activity for PFCuNPs. Antibacterial tests against Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, and Pseudomonas aeruginosa revealed broad-spectrum activity of PFAgNPs, with the highest inhibition against E. coli (19.4 ± 0.3 mm), whereas PFCuNPs showed dose-dependent efficacy, strongest against E. faecalis (9.6 ± 0.2 mm). LC–MS/MS analysis of the PF-E extract revealed quinic acid (63.42 mg/g), chlorogenic acid (2.38 mg/g), protocatechuic acid (0.07 mg/g), protocatechuic aldehyde (0.04 mg/g), hesperidin (0.03 mg/g), and naringenin (0.02 mg/g) as major components. The adsorption efficiencies of the synthesized PFAgNPs and PFCuNPs were evaluated against the toxic food contaminants patulin and HMF using both standard aqueous solutions and real food systems (apple juice). In standard aqueous solutions, PFAgNPs achieved removal efficiencies of 70.96% for patulin and 52.22% for HMF, while PFCuNPs showed 61.08% and 36.38%, respectively, at 5 g/L after 240 min. In real food systems, the adsorption efficiencies decreased, with PFAgNPs and PFCuNPs removing 34.24% and 32.90% of patulin, and 39.09% and 31.87% of HMF, respectively. The adsorption kinetics of HMF and patulin onto PFCuNP and PFAgNP were found to conform to both the pseudo-first-order and pseudo-second-order kinetic models for aqueous solutions as well as real samples. These findings confirm that the biosynthesized NPs offer dual functionality as antibacterial agents and toxin adsorbents, presenting a green, sustainable approach to food safety enhancement.
- MakaleAçık Erişim2026Psychological dynamics shaping performance perception in athletes: the influence of coaching behaviours, psychological safety, self-efficacy, and resilience
Sakallı, Derya; Şenel, Ender; Menteş, Görkem; Salman, Kaan
This study aimed to examine how athletes’ perceptions of supportive and controlling coaching behaviours influence their perceived performance through the mediating effects of psychological safety, self-efficacy, and psychological resilience. Unlike previous work, this study integrates these three psychological factors into a single structural model, offering a comprehensive understanding of the mechanisms linking coaching behaviours to performance perceptions. Data were collected from 369 Turkish athletes representing different sports and competitive levels using validated self-report questionnaires. Structural equation modelling (SEM) was employed to analyse the direct and indirect relationships among variables. The results revealed that supportive coaching behaviours positively predicted perceived performance through increased psychological safety, self-efficacy, and resilience, whereas controlling coaching behaviours had the opposite effect. Among the mediators, self-efficacy emerged as the strongest predictor of performance perception. These findings provide novel evidence that psychological safety and resilience strengthen this relationship by fostering adaptive and confident athlete functioning. The study contributes to the literature by demonstrating the integrative role of psychological resources within the frameworks of self-determination and social cognitive theories. Practically, it underscores the importance of supportive coaching practices that enhance psychological resources essential for sustained motivation, well-being, and optimal performance.
- MakaleYalnız künye2026Effects of a puppet-assisted house-tree-person test on fear and anxiety in children receiving chemotherapy and associated influencing factors: A projective, quasi-experimental study
KAHRIMAN, Ilknur; AKSOY, Bahar; KANDAZ, Ufuk; BORAN, Serpil; GÖGER, Berrin; KIRBAŞ, Zila Özlem
Objectives This study investigated the effect of the puppet-assisted House-Tree-Person Test (HTP-T) on fear and anxiety levels in children undergoing chemotherapy treatment and the factors influencing these outcomes. Methods The study employed a one-group pretest–posttest quasi-experimental design combined with HTP-T analysis. The study was conducted with 29 children aged 5–12 years receiving chemotherapy at the pediatric hematology-oncology outpatient clinics of a university hospital in the Eastern Black Sea Region of Türkiye during the 2022–2024 years. Data were collected using “the Demographic Information Form for Children and Parents, the Children's State Anxiety Scale (CSA), the Children's Fear Scale (CFS), and HTP-T". Data analysis was performed using descriptive statistics, repeated measures ANOVA, and HTP-T analysis. Results Statistically significant differences were observed in children's mean CSA (F = 3.898, p = 0.026, η2 = 0.122) and CFS (F = 5.313, p = 0.008, η2 = 0.159) scores across the pre-treatment, during-treatment, and post-treatment measurements. The HTP-T analysis revealed that children had difficulty regulating anxiety and fear, expressed concerns about family and environmental events, reported feelings of loneliness, and exhibited strong emotional attachment to their families. Conclusion The study demonstrated that incorporating puppet-assisted HTP-T during chemotherapy contributed to reducing children's fear and anxiety and offered a useful approach for identifying influencing factors. Implications for nursing practice HTP-T, a therapeutic play technique incorporating puppetry and projective methods, may be effective in reducing fear and anxiety among children undergoing chemotherapy.
- Derleme MakaleAçık Erişim2026The effect of non-pharmacologic treatments in individuals with problematic pornography use: a meta-analysis of randomized controlled trials
Yıldız Karaahmet, Aysu; Bilgiç, Fatma Şule; Karakaş, Sevda
This study aimed to systematically review and meta-analyze the effects of non-pharmacological treatments on problematic pornography use (PPU), pornography use frequency, sexual dysfunction, psychological symptoms, and quality of life in individuals with PPU. A comprehensive literature search was conducted in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science between June and July 2024. MeSH-based keywords were used to identify relevant Randomized Controlled Trials (RCTs) published in the last ten years. Five RCTs with a total of 826 participants were included. Non-pharmacological interventions significantly reduced PPU (SMD: −1.16; 95% CI: −2.10 to −0.22; p = 0.02) and pornography use frequency (SMD: −0.74; 95% CI: −1.43 to −0.05; p = 0.04) compared to control groups. No statistically significant effects were found for sexual dysfunction (SMD: −0.47; p = 0.05) or psychological symptoms (SMD: −0.42; p = 0.06), though moderate effects were observed. Risk of bias was high or unclear in terms of participant and outcome blinding. Non-pharmacological interventions appear effective in reducing PPU and use frequency. Although effects on sexual function and psychological symptoms were not significant, the findings suggest potential improvements in overall quality of life.
- MakaleAçık Erişim2026Impacts of Phenolic Compounds Alone and in Combination with Natural Substances or Drugs on Cancer Cells
Budak, Burhan; Sarikaya, Sevim Beyza Ozturk
Phenolic compounds (PCs) are secondary metabolites found in the root and flower parts of plants that help protect the plant from pathogens. The amount and content of the plant species and the environment in which they live vary. Because PCs have antioxidant properties, they have a preventive effect against oxidising substances. Therefore, PCs in the human diet contribute to the prevention of cancer, osteoporosis, diabetes, and many other diseases. Cancer is the most dangerous and deadly disease among these diseases today. Although many chemotherapeutic drugs are used against cancer, the tendency to use other drugs or other applications has increased because the effectiveness of chemotherapeutic drugs is low and healthy cells are damaged in the process. PCs boost the effectiveness of chemotherapeutic drugs against cancer cells while, preserving the health of other cells. In this review, in vivo and in vitro studies conducted in cancer lines, applications of PCs alone, combined applications of PCs with natural substances, and the effects of PCs with drugs were investigated and discussed. In conclusion, gallic acid, ellagic acid, caffeic acid, and ferulic acid are frequently used in cancer treatment. These findings highlight the potential of PCs as versatile adjuvants in cancer treatment, which can increase drug efficacy, protect healthy cells, and minimise toxicity. Consequently, they highlight the therapeutic potential of PCs as complementary agents in cancer treatment strategies.
- MakaleYalnız künye2026Aged people with chronic diseases dying: An investigation of metaphorical perceptions and cognitive structure; [Sterbende ältere Menschen mit chronischen Erkrankungen: Eine Untersuchung metaphorischer Wahrnehmungen und kognitiver Strukturen]
Demir Çam, Sevgi; Uzun, Sevda; Aydin, Esra; Altindaş, Sueda
Purpose: This study was designed to examine the metaphorical perceptions and cognitive structures of aged individuals with chronic diseases towards death. Methods: The research was conducted as a qualitative study based on metaphor analysis. Data were collected using a semi-structured interview form that investigated the metaphorical perceptions of 15 individuals with chronic diseases towards death and a form that was asked to be explained with drawing technique. In the semi-structured interview form “Death is like … because …”, metaphor expression was included, and in the other part “Describe your thoughts about death with drawings”, the form containing the expression was used. The data were analyzed using the content analysis technique. The study was conducted and reported according to the COREQ checklist. Results: It was determined that the old individuals with chronic diseases who participated in the study produced 4 metaphors with the writing technique and 4 metaphors with the drawing technique. As metaphors, the themes of end of life and a new beginning, extinction and feeling of emptiness, journey of life, salvation and reunion were determined. Conclusion: As a result of the study, it was determined that old individuals with chronic diseases had anxiety about death. In addition, it was determined that old individuals had negative and positive cognitive schemas about death. In this context, old individuals with chronic diseases may need psychosocial support systems.
- Derleme MakaleYalnız künye2026Marine microsporidia: Hidden diversity, aquatic emergence and zoonotic risks
Bekircan, Çağrı; Kurnaz, Muammer
Marine Microsporidia represent an increasingly important but historically underestimated group of aquatic intracellular parasites. Although traditionally associated with invertebrates and fishes, recent molecular and environmental studies have revealed extensive hidden diversity across marine ecosystems together with unexpected phylogenetic links between aquatic and human-associated lineages. This review synthesizes five decades of research (1975–2025) concerning the biology, evolution, taxonomy, host–pathogen interactions, ecological diversity, and zoonotic significance of marine Microsporidia. Particular emphasis is placed on members of the Enterocytozoonidae, including Enterocytozoon hepatopenaei, Nucleospora spp., and Desmozoon lepeophtherii, which represent major threats to aquaculture sustainability and may contribute to cross-environmental transmission pathways. Environmental DNA studies further indicate that marine microsporidian diversity is substantially underestimated by morphology-based approaches. However, current evidence for zoonotic transmission remains largely indirect, resting chiefly on phylogenetic relatedness, shared genotypes across hosts and environmental (eDNA) detection; direct, seafood-borne human infection has not yet been demonstrated. Current evidence suggests that aquaculture intensification, climate-driven environmental change, and expanding seafood trade may facilitate the emergence and dissemination of zoonotic microsporidian lineages. Integrating marine Microsporidia into One Health surveillance frameworks is therefore increasingly important for both ecosystem and public health management.
- MakaleAçık Erişim2026Validation of the Turkish Fear of War Scale (FOWARS): Psychometric Evidence and Associations with Tolerance of Uncontrollability, Psychological Symptoms, and Personality Traits
Kaya, Feridun; Türkkan, Tuğba
Growing geopolitical instability has led to increasing concerns about the psychological impact of war beyond directly affected populations, highlighting the need for culturally appropriate instruments to assess fear of war. In this study, we evaluate the psychometric properties of the Turkish version of the Fear of War Scale (FOWARS) and examine its associations with sociodemographic characteristics and personality traits. A total of 643 adults across two independent samples (sample 1 = 360; sample 2 = 283) completed the FOWARS, the Tolerance of Uncontrollability Questionnaire, the Next Big Five Inventory (BFI-2), the Depression Anxiety Stress Scale-21 (DASS-21), and a sociodemographic information form. Confirmatory factor analysis supported the original two-factor structure of the FOWARS, with the Turkish version demonstrating satisfactory structural validity, convergent validity, discriminant validity, criterion-related validity, strong internal consistency, and measurement invariance across gender. Fear of war was negatively associated with tolerance of uncontrollability and positively associated with depression, anxiety, and stress. In addition, fear of war was significantly associated with gender, socioeconomic status, agreeableness, neuroticism, and conscientiousness. These findings expand the understanding of the individual determinants of fear of war, underscoring the importance of developing targeted interventions for vulnerable populations.
- MakaleYalnız künye2026Exposure to Violence and Therapeutic Communication in Nursing Students
Erol, Ahmet; Tuncer, Metin
Background: – Workplace violence negatively affects the professional development of nursing students. Objectives: – To investigate nursing students’ exposure to violence, violence-management competence, and therapeutic communication during clinical practice. Methods: – A descriptive, cross-sectional, correlational study involves 530 nursing students. Data were collected between September 2024 and February 2025 using a Sociodemographic Form, the Workplace Violence Competence Scale, and the Therapeutic Communication Skills Scale. Results: – Violence was reported by 32.8% of students, mainly verbal (60.9%) and psychological (47.1%), often by patients or relatives. Communication skills correlated positively with violence management competence, explaining 18.1% of the variance. Higher self-confidence, problem-solving, voluntary choice of profession, and prior education were associated with better outcomes. Conclusions: – Nursing students are at substantial risk of violence during clinical practice, and their ability to manage it is enhanced by therapeutic communication and supportive factors, underscoring the need to strengthen curricula and faculty preparation.
- MakaleAçık Erişim2026Rethinking sexual response: are erogenous zones—including nipple stimulation—more than secondary stimuli? A meta-analysis
Yildiz Karaahmet, Aysu; Karakas, Sevda; Bilgic, Fatma Sule
Objectives: The nipple, a key erogenous zone in female sexual response, is often insufficiently considered in clinical practice, and scientific studies on nipple stimulation are limited. The aim of this study was to conduct a systematic review and meta-analysis of studies examining the effect of nipple stimulation on sexual response and sexual satisfaction in young women. Methods: For this systematic review and meta-analysis, studies were identified through a search of the PubMed, Cochrane Library, EBSCOhost, Embase, Web of Science, PsycINFO, and Scopus databases without any year restrictions. Results: A total of nine studies (~1276 participants) were included in the systematic review. Of these, six studies (390 intervention, 441 control; n = 831) contributed to the meta-analysis of sexual response/orgasm outcomes, and six studies (655 intervention, 621 control; n = 1276) contributed to the meta-analysis of sexual satisfaction. Nipple stimulation significantly improved sexual response [standardized mean difference (SMD) = 0.51, P < .00001] and sexual satisfaction (SMD = 0.59, P = .005). Discussion: Nipple stimulation may be used as a supportive method to enhance sexual function and sexual satisfaction in young women. It may be considered as a complementary approach to sexual counseling and therapy, particularly for women experiencing sexual aversion, difficulty with arousal, and orgasm problems. This meta-analysis suggests that nipple stimulation may have a moderate positive effect on sexual response and sexual satisfaction in young women; however, the findings should be interpreted with caution due to the limited age range of the included population and the heterogeneity across studies.
- MakaleAçık Erişim2026Eccentric Hamstring Strength and Interlimb Asymmetry in Professional Football Players: A NordBord-Based Longitudinal Analysis of Two Professional Teams
Altuğ, Tolga; Söyler, Mehmet; Yılmaz, Coşkun; Eraslan, Meriç; Aydın, Ahmet Serhat; Kadı, Mustafa Nurullah; Akyol, Pelin; Küçük, Hamza
The aim of this study was to examine temporal changes in eccentric hamstring strength, impulse-based mechanical outputs, and interlimb asymmetry in professional football players performing a football-specific eccentric hamstring training program. Forty male football players (18–25 years) from two teams competing in the Turkish Second Professional Football League participated in this longitudinal cohort study. Eccentric hamstring performance was assessed at three time points (pre-, mid-, and post-season) using the NordBord Hamstring Testing System. Mixed-design repeated-measures ANOVA revealed significant main effects of time and significant time × Team interactions for left and right maximal impulse values (p < 0.05). In contrast, maximal eccentric force variables showed no significant time effects, although significant time × Team interactions were observed for both limbs (p < 0.05). Interlimb maximal force asymmetry and mean asymmetry demonstrated significant time effects, while Team effects and interaction terms were not significant. Overall, these findings indicate that temporal changes in eccentric hamstring performance in professional football players may be more clearly reflected in force–time–dependent metrics, particularly impulse, rather than peak force outputs. Accordingly, impulse-based measures may provide additional insight into eccentric hamstring performance changes in professional football players.
- Derleme MakaleAçık Erişim2026Intersection of Precision Nutrition and Bladder Cancer: A Narrative State-of-the-Art Review of Potential Applications and Challenges
Koçak, Tevfik; Özbek, Yağmur Demirel; Bodur, Mahmut; Yeşil, Süleyman; Ağagündüz, Duygu
Bladder cancer (BC) is a biologically heterogeneous tumor affected by genetic, metabolic, environmental, and lifestyle factors. Recent research indicates that nutrition can change the way urothelial cancer forms by affecting inflammation, oxidative stress, cellular energy, and the epigenome. It can also change the risk of BC and how well treatment works. Simultaneous progress in precision nutrition (PN) and nutriomic profiling—encompassing nutrigenomics, nutrigenetics, nutriepigenetics, metabolomics, and microbiome science—presents novel options to tailor dietary regimens beyond universal guidelines. In this review, we consolidate existing knowledge regarding the nutritional factors influencing BC, outline pertinent principles of PN for BC prevention and survival, and explore how urine proteomics and molecular subtyping facilitate the integration of PN into precision oncology. Our review examines the methodological, bioinformatic, biomarker, and clinical translation challenges that impede the implementation of PN in BC management; these challenges include the need for validated nutritional biomarkers with mechanistic endpoints, interoperable data platforms, and rigorously designed clinical trials. Finally, we emphasize future prospects for PN-guided medical nutrition therapy and dietary models during and after systemic treatment recovery. We propose research priorities that will facilitate the integration of PN-informed individualized dietary plans with medical and surgical approaches in BC treatment, aiming to decrease the costs associated with expensive or excessively aggressive treatment methods, thereby supporting long-term survival care. This review seeks to establish a conceptual framework for the integration of PN into BC management by delineating the opportunities and challenges, hence promoting hypothesis-driven research in a promising yet underexplored domain.
- MakaleAçık Erişim2026Neuromuscular and Kinetic Adaptations to Symmetric and Asymmetric Load Carriage During Walking in Individuals with Chronic Low Back Pain
Tajik, Raheleh; Dhahbi, Wissem; Mimar, Raghad; Khaleghi Tazji, Mehdi; Ceylan, Halil İbrahim; Bayrakdaroğlu, Serdar; Stefanica, Valentina; Hammami, Nadhir
Aim: This study examined how load size and symmetry affect trunk muscle activation patterns, vertical ground reaction forces, and estimated lumbar spine compression during overground walking in individuals with chronic low back pain (CLBP) and those without symptoms. Methods: Thirty male participants (15 with CLBP, 15 controls; ages 23–28 years) performed walking tests under four load conditions: symmetric and asymmetric carriage at 10% and 20% of body weight. Bilateral surface electromyography measured activation from seven trunk muscles (rectus abdominis, external oblique, internal oblique, latissimus dorsi, lumbar erector spinae, multifidus) and the thoracolumbar fascia region, normalized to maximum voluntary isometric contractions (%MVIC). Force plates recorded vertical ground reaction forces synchronized with heel-strike events. A repeated-measures ANOVA with Bonferroni corrections was used to analyze the effects of load configuration and magnitude. Results: Asymmetric loading at 20% body weight caused significantly higher peak vertical ground reaction forces compared to symmetric loading (mean difference = 47.3 N, p < 0.001), with a significant interaction between load magnitude and configuration (p = 0.004, ηp2 = 0.26). Participants with CLBP showed consistently higher trunk muscle activation throughout the gait cycle (peak: 37% MVIC vs. 30% MVIC in controls; p < 0.001, d = 1.68), with maximum recruitment at shorter muscle lengths and 24% less activation at optimal length (95% CI: 18.2–29.8%). The lumbar erector spinae and multifidus muscles exhibited the highest activation during asymmetric 20% loading in CLBP participants (0.282 and 0.263%MVIC, respectively), indicating compensatory neuromuscular strategies. Conclusion: Asymmetric load carriage creates disproportionately high mechanical and neuromuscular demands, effects that are greatly amplified in individuals with CLBP. These findings support rehabilitation strategies that improve load distribution and restore motor control, thereby reducing compensatory strain and enhancing trunk stability.
- MakaleYalnız künye2026Determining the effect of blockchain technology on the medical waste management process in the circular economy framework using integrated FUCOM-ARAS methods
Batar, Bilge; Peker, İskender
Background: The circular economy concept aims to reduce environmental impact by promoting resource reuse, minimizing waste through input reduction, and lowering costs. Rising costs are leading healthcare facilities and other organizations to prioritize medical waste management. Blockchain technology, introduced in 2008, functions as a database of auditable and traceable transactions built on a network of trust-based blocks. Key features such as transparency, reliability, accessibility, flexibility, and automation can significantly enhance the efficiency of medical waste management processes, thereby contributing to the circular economy. Objective: This study aims to evaluate the effectiveness of medical waste management—critical for healthcare institutions and sustainable development—within the framework of the circular economy. Multi-criteria decision-making (MCDM) techniques are used to assess the contributions of blockchain technology to this process. Methods: A literature review was conducted to identify relevant criteria and alternatives. The Full Consistency Method (FUCOM), an MCDM technique, was used to calculate the weight of each criterion. The Additive Ratio Assessment (ARAS) method was applied to rank the alternatives. Conclusion: According to the analysis's findings, transparency, traceability, and dependability are the three most important criteria, respectively. The stages of medical waste storage, disposal, and transportation have the highest priority ratings among the available options. According to these results, incorporating blockchain technology into medical waste management can significantly improve system traceability and reliability, enhancing its role in the circular economy. Notably, the storage phase is the most appropriate for implementing blockchain. However, the other phases’ comparatively high appropriateness scores attest to the technology's capacity to be used efficiently across the waste management cycle. This integration promotes traceable and transparent procedures, guaranteeing dependable waste management procedures in healthcare facilities and supporting the objectives of the circular economy and sustainability. Additionally, the sensitivity analysis shows that when the weighting of criterion is altered, the ranking of alternatives changes as well. This dynamic interaction emphasizes how blockchain technology may be successfully integrated into all phases rather than being restricted to just one because waste management is cyclical and holistic.
- MakaleAçık Erişim2026The effect of hawthorn vinegar, black mulberry syrup, and green tea on oral mucositis and oral health-related quality of life in individuals with diabetes: a single-blind, randomized controlled trial
Demiraǧ, Hatice; Akeren, Zahide
Objective – This study was designed as a single-blind randomized controlled trial to investigate the effects of hawthorn vinegar, black mulberry syrup, and green tea on oral mucositis and quality of life related to oral health in individuals with diabetes. Methods – Total of 120 participants were divided into four groups (hawthorn vinegar, black mulberry syrup, green tea, control; n = 30 each) and the study was completed. All participants completed the “Patient Information Form, ” “Oral Assessment Guide (OAG/ADR), ” and “Oral Health-Related Quality of Life Scale (OHQoL-UK)” before the study, on the 7th day, and after the study. In the experimental groups (hawthorn vinegar group, black mulberry syrup group, green tea group). In addition to routine oral mucositis treatment, patients with DM gargled for 1 min with diluted hawthorn vinegar [1 tablespoon (10 cc) mixed with 40 cc of water], pure black mulberry syrup, or green tea solution three times a day for 14 days, 15–20 min before meals. Results – Patients in the hawthorn vinegar group showed a decrease in oral mucositis and an increase in oral health-related quality of life at the interim measurement (day 7) and final test (day 14) measurements (p < 0.05). A negative correlation was found between the severity of oral mucositis and quality of life (p < 0.05). Conclusion – Although there was no difference between hawthorn vinegar and black mulberry syrup, they were found to be more effective than green tea in reducing oral mucositis and improving oral health-related quality of life, and all three complementary treatments were found to be effective. Clinical Trial Registration – identifier [NCT06481254]. https://register.clinicaltrials.gov/prs/beta/studies/S000E5O000000043/recordSummary.
