Sürdürülebilir Kalkınma Amaçları
Yazarlar
- Uzun, Sevda(46)
- Kulakaç, Nurşen(21)
- Aydin, Aydanur(16)
- Demir, Selim(16)
- Tuncer, Metin(16)
- Topal, Fevzi(15)
- Turan, Ibrahim(15)
- Yilmaz, Coskun(14)
- Bayrakdaroglu, Serdar(12)
- Koçak, Tevfik(11)
- Aliyazicioglu, Yuksel(10)
- Gulcin, Ilhami(10)
- Ozturk, Samet(10)
- Topal, Meryem(10)
- Ceylan, Halil Ibrahim(9)
- Ceylan, Levent(9)
- Kilinc, Kagan(9)
- Mentese, Ahmet(9)
- Ozdes, Duygu(9)
- Tuncer, Gülsüm Zekiye(9)
- Duran, Celal(8)
- Emirza, Elif Güzide(8)
- Yaman, Serap Ozer(8)
- Yılmaz, Coşkun(8)
- Baltacı, Cemalettin(7)
- Demirağ, Hatice(7)
- Hintistan, Sevilay(7)
- Kaya, Feridun(7)
- Küçük, Murat(7)
- Ürkek, Bayram(7)
- Şengül, Mustafa(7)
- Bayrakdaroğlu, Serdar(6)
- Deger, Orhan(6)
- Genc, Berna(6)
- Gül, Abdulkadir(6)
- Gülçin, Ilhami(6)
- Günen, Mehmet Akif(6)
- Gürsoy, Ayla(6)
- Kurnaz, Muammer(6)
- Supuran, Claudiu T.(6)
Yayınlar
- MakaleYalnız künye2026The 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.
- MakaleAçık Erişim2026A novel cloud point extraction method using a benzimidazole-based ligand for the preconcentration of toxic heavy metals in water and food samples
Ozdemir, Olcay; Duran, Celal; Mentese, Emre; Ozdes, Duygu
In the present research, a novel cloud point extraction (CPE) method was developed for the separation and preconcentration of toxic Cu(ii), Ni(ii), Pb(ii), and Cd(ii) ions in environmental water and vegetable samples, prior to their determination by flame atomic absorption spectrometry (FAAS). The ligand 2-(2-(4-fluorobenzyl)-1H-benzo[d]imidazole-1-yl)acetohydrazide (FB-BIAH) was employed for the first time as an analytical complexing agent for the aforementioned metal ions, and Triton X-114 (TX-114) was preferred as the nonionic surfactant. Within the scope of optimizing CPE conditions, experimental parameters, such as pH, FB-BIAH and surfactant amounts, and incubation temperature and time, as well as centrifugation speed and duration, were systematically investigated. The optimal conditions for the simultaneous quantitative recovery of analyte ions were established as pH 7.0, an FB-BIAH amount of 2.5 mg, a TX-114 quantity of 25 mg, an incubation temperature of 60 °C, and an incubation time of 30 min. Under optimal conditions, the proposed method was successfully applied to river water and seawater, as well as different vegetable samples such as lettuce, parsley, and pepper. The results obtained demonstrated that the analyte ions could be reliably determined in complex matrices and that the method exhibited high analytical performance. Due to its simplicity, rapid applicability, environmentally friendly nature, and cost-effectiveness, the proposed CPE-FAAS method represents a promising approach for the routine analysis of toxic heavy metals in environmental water and food samples. This journal is
- MakaleAçık Erişim2026The 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.
- MakaleAçık Erişim2026Electric 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.
- 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.
- MakaleAçık Erişim2026Impact of sprouting pretreatment on physicochemical properties and in vitro digestibility of buckwheat milk
Tunç, Merve Tuğçe; Yılmaz, Fırat; Akdoğan, Arda; Atalar, İlyas; Odabaş, Halil İbrahim
BACKGROUND: Buckwheat is a strategic raw material for plant-based milk production due to its gluten-free nature and rich bioactive profile. However, antinutritional factors and starch structure limit the nutritional quality and technological properties of such beverages. This study aims to investigate the effects of sprouting pretreatment (0, 24, 48, and 72 h) on the physicochemical properties, rheological behavior, phytic acid content, and in vitro protein/phenolics digestibility of buckwheat milk. RESULTS: As the sprouting duration increased, the viscosity of buckwheat milk decreased from 31.42 to 15.42 mPa s (at 72 h) due to the enzymatic hydrolysis of starch and proteins. Rheological analysis revealed that all samples exhibited weak gel behavior. Color analysis showed a decrease in lightness (L*) while redness (a*) and yellowness (b*) values significantly increased with sprouting. The results showed that sprouting significantly reduced phytic acid content, reaching its minimum at 72 h. The highest in vitro protein digestibility was observed at 24 h of sprouting, after which a relative decline occurred due to the formation of protein–polyphenol complexes and metabolic amino acid utilization. Furthermore, total phenolic content, flavonoid content, and antioxidant capacities measured after in vitro digestion were substantially higher in sprouted samples, especially at 48 and 72 h, than in the control. CONCLUSION: The results indicate that a sprouting duration of 48 h represents an optimal balance for the physical stability and nutritional enhancement of buckwheat milk. At this stage, significant increases in bioaccessible phenolics were achieved while maintaining a stable colloidal structure.
- 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 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.
- 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.
- MakaleYalnız künye2026Identification of patulin-producing Penicillium isolates from decayed apples, their patulin production profiles, and the feasibility of high-purity patulin preparation
Dağ, Murat; Bozbeyoğlu, Pınar; Gül, Abdulkadir; Karpuz, Ömer; Baltacı, Cemalettin
This study presents a combined evaluation of patulin contamination by integrating fungal identification, assessment of toxin production, and the feasibility of obtaining high-purity patulin from biological sources. Fungal isolates recovered from naturally decayed apples collected from different agricultural environments in Türkiye were identified using MALDI-TOF MS and morphological characteristics, and were assigned to Penicillium expansum at a probable species level. The patulin production potential of the isolates was evaluated by inoculating them onto red, yellow, and green apple matrices under controlled laboratory conditions over an extended incubation period. Quantitative analysis using HPLC–UV, supported by LC–MS/MS confirmation, revealed substantial variability in patulin levels (7.58–49.80 mg/kg) depending on both isolate and apple matrix. Higher patulin levels were generally observed in yellow apple tissues, whereas lower levels were detected in red apples, suggesting a possible influence of matrix-related compositional factors. In addition, patulin was isolated and enriched using column chromatography with TLC-guided fractionation, yielding a high-purity compound (98.8%) with low moisture content (0.21%). Structural identity was confirmed by LC–MS/MS analysis. Overall, the findings indicate that patulin production is influenced by strain-level variability and matrix-related factors. Furthermore, the study demonstrates the feasibility of producing high-purity patulin suitable for in-house analytical applications. However, the produced material should not be considered a certified reference material, and further validation would be required for broader analytical use.
- 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 künye2026Multi-scale greening dynamics in Türkiye’s Ecoregions (2001–2024): the effects of elevation and land cover on NDVI change tendencies
Işık, Fatih; Eraslan, Selim
Understanding vegetation dynamics in terrestrial ecosystems is critical under the pressures of global climate change and anthropogenic activities. This study analyzes vegetation dynamics from 2001 to 2024 in Türkiye’s 13 biodiverse terrestrial ecoregions using a multi-scale approach, focusing not only on the main drivers, but also on the interactive and context-specific role of these factors. Using the Google Earth Engine (GEE) platform and MODIS Normalized Difference Vegetation Index (NDVI) data, integrated through a structured multi-scale framework, we applied statistical methods including the Mann–Kendall test, Kruskal–Wallis test, and LOESS curves optimized with leave-one-out cross-validation (LOOCV) to objectively model non-linear dynamics. The results revealed statistically significant positive NDVI change tendencies in all 13 terrestrial ecoregions (Mann–Kendall test, p < 0.05). Forest-dominated ecoregions exhibited the strongest greening, with Sen’s slope values reaching +0.0032 NDVI year⁻1 in the Euxine–Colchic Broadleaf Forests, whereas steppe ecosystems showed more moderate increases (e.g., Central Anatolian Steppe: + 0.0019 NDVI year⁻1). Across elevation gradients, the most consistent and strongest greening occurred at mid-elevations (500–1500 m; τ ≈ 0.40–0.65), while change tendencies weakened and became more heterogeneous at higher elevations. Land-cover-based analysis further showed that natural vegetation types exhibited the strongest nationwide tendencies (“Trees”: τ = 0.71; “Shrubland”: τ = 0.66), whereas anthropogenically influenced classes displayed weaker or regionally variable responses. Beyond documenting general greening patterns, the original contribution of this study lies in introducing a structured multi-scale framework that integrates long-term MODIS NDVI time series (2001–2024) with ecoregion, elevation, and land cover contexts. This approach enables the objective identification of ecosystem-specific and scale-dependent vegetation dynamics that cannot be captured by conventional single-scale or linear trend-based analyses commonly applied in previous studies in Türkiye.
- 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.
- 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.