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Öğe Virgin ureter vs. non-virgin ureter? A comparative analysis on complications and failure of retrograde intrarenal surgery: a multicentre case-control study from RIRSearch Group(Springer, 2025) Teke, Kerem; Çınar, Naci Burak; Çınar, Önder; Akgül, Murat; Başataç, Cem; Şimşekoğlu, Muhammet Fatih; Çakır, Hakan; Sıddıkoğlu, Duygu; Sancak, Eyüp BurakIt is unclear whether ureteral virginity has an effect on retrograde intrarenal surgery (RIRS). We aimed to evaluate the impact of ureteral virginity on RIRS outcomes in a multicenter study. Data from the RIRSearch study group database were retrospectively reviewed. Patients with a history of endoluminal interventions or extrinsic ureteral surgery were categorized as having a non-virgin ureter, while those without such histories were classified as virgin ureters. Case-control matching was performed based on age, gender, uretral access sheath size, and stone characteristics. Demographic, clinical, surgical and complication data were compared after-matching. A total of 894 procedures were included, with 119 (13.3%) involving non-virgin ureters. Pre-matching, the non-virgin ureter group had higher mean age (50.6 +/- 13.2 vs. 46.6 +/- 13.6 years) and Charlson comorbidity index >= 2 (51.3% vs. 40.4%). In addition, number of stones, total-stone volume and rate of multiple stone localization were significantly higher in non-virgin ureter group. Operation time, hospital stay, surgical failure, need for auxiliary treatment, and perioperative complications were significantly higher in non-virgin ureter group (p < 0.05). After case-matching, perioperative complications (18.7% vs. 5.3%), hospital stay (1.54 +/- 1.30 vs. 1.18 +/- 0.98 days), and auxiliary treatment requirements (20% vs. 8.4%) remained significantly higher in non-virgin ureter group (p < 0.05). There was no significant difference in postoperative complication rates (17.3% vs. 19.8%) or surgical failure rates (36% vs. 26%). Non-virgin ureters were associated with higher perioperative complication rate, longer hospital stays and increased need for auxiliary treatments during RIRS. Patients with non-virgin ureters may be informed about these potential risks before surgery.Öğe A Phosphodiesterase Type-5 (PDE-5) Inhibitor, Sildenafil, Ameliorates the NEC Induced Inflammation(Springer, 2025) Ovalı, Mehmet Akif; Öztopuz, Özlem; Karaboğa, İhsanThe connection between intestine microbiota and lung disease is described as the gut-lung axis, these organ systems are somehow interrelated in both homeostasis and disease development. In newborns, the most important gastrointestinal complications are necrotizing enterocolitis (NEC), and the pulmonary complication both cause significant systemic morbidity. In this study, sildenafil administered at varying doses in neonatal rat model of experimental necrotizing enterocolitis and focused on both mRNA expression and histopathological alterations. 15-day-old Wistar Albino rat pups were randomly divided into six groups; Control, NEC, DMSO, Sil_1mg, Sil_5mg, Sil_10mg (n = 5). NEC induction was performed using hypoxia/asphyxia and cold stress. At the end of the experiment, lung tissues were harvested, molecular and histopathological alterations were analysed. Histopathological examination was performed with hematoxylin&eosin and masson trichrome staining in lung samples of neonatal rats and the mRNA expression levels of TNF-alpha, IL-6 and HSPa5 genes were analyzed. The mRNA expression levels of TNF-alpha, IL-6 and HSPa5 were increased in the NEC group compared to the control group and sildenafil treatment could significantly reduced the levels of the genes and inflammation (*p < 0.05 and **p <= 0.0001). Alveolar edema and hemorrhage findings were observed in the lung tissue of the NEC group. Interstitial edema and hemorrhage findings were reduced in the groups treated with sildenafil compared to the NEC group. The data we obtained indicate that sildenafil administering at different doses has therapeutic effect on NEC induced lung tissue inflammation both at the mRNA expression and tissue levels.Öğe Investigation of Lycium barbarum Effects on Ovarium Damage Exposed to N-Methyl-N-Nitrourea(Springer, 2025) Eroğlu, Hüseyin Avni; Büyük, Başak; Aydeğer, Cemre; Demir, Ufuk; Makav, MustafaN-Methyl-N-nitrourea (MNU), is one of the N-nitroso compounds that people are commonly exposed to in various exogenous ways such as diet, tobacco smoke, cosmetics, household goods, indoor air, occupational exposure, etc. It is known that the compound damages organs and tissues in the body, and one of the affected structures is the ovarium. Lycium barbarum, used in medication in ancient China, has become more popular in recent years. Previous studies have mentioned that polysaccharide ingredients are the most bioactive parts of Lycium barbarum. Therefore, this study aims to investigate the effects of Lycium barbarum polysaccharides (LBP) on ovarian tissue damage exposed to MNU. In accordance with this purpose, a total of 12 21-day-old female Wistar Albino rats were divided into two groups: sham and treatment. The animals were administrated with 50 mg/kg MNU (i.p.) on days 21, 28, 35, and 42. The treatment group was treated with 800 mg/kg LBP via intragastric for 30 days. At the end of the study, animals were sacrificed under general anaesthesia, and the ovarian tissues were harvested. Shrinkage of follicles, lytic oocytes, and disintegrated stroma parameters were evaluated histopathologically. The genetic assessment of the Bcl-2, Bax, Bcl-2/Bax ratio, Caspase 3, p53, and p27 expression levels were determined. The histopathological parameters between the groups were statistically significant (for all parameters p < 0.001). Moreover, the Bcl-2, Bcl-2/Bax ratio, and p53 relative fold changes were significantly increased in the treatment group (p < 0.001, p = 0.045, and p = 0.011, respectively). The results revealed that LBP has ameliorative effects on MNU-induced ovarian tissue damage. Further studies are required to clarify the main underlying mechanisms.Öğe Humic acid attenuates cisplatin-induced nephrotoxicity in rats(Taylor & Francis Ltd, 2025) Tekeş, Ender; İçkin Gülen, Meltem; Sılan, Coşkun; Güven Bağla, AyselCisplatin-induced nephrotoxicity, a major limitation of this chemotherapeutic agent, involves oxidative stress, inflammation, and apoptosis. This study investigated the potential renoprotective effects of humic acid in a rat model of cisplatin-induced nephrotoxicity. Forty-two male Wistar rats were assigned to six groups: control, humic acid, cisplatin, cisplatin + humic acid 10 mg/kg, cisplatin + humic acid 20 mg/kg, and cisplatin + humic acid 40 mg/kg. On day 7, the rats were sacrificed, and cardiac blood and kidneys were collected for biochemical and histopathological examinations. Humic acid administration significantly attenuated the cisplatin-induced increases in renal TNF-alpha and NF-kappa B levels, indicating a reduction in inflammation. Humic acid also ameliorated histopathological damage, including Bowman's capsule dilatation, tubular cell degeneration, and hemorrhage. However, humic acid did not significantly alter oxidative stress parameters or caspase-3 levels. Humic acid demonstrates a protective effect against cisplatin-induced nephrotoxicity in rats, primarily by mitigating the inflammatory response. While HA's beneficial effects on oxidative stress and apoptosis were limited in this study, its ability to reduce inflammation highlights its potential as a therapeutic strategy to mitigate cisplatin-induced kidney injury.Öğe In silico molecular docking and in vitro analysis of atomoxetine(Taylor & Francis Ltd, 2025) Bolat, Nurullah; Hız-Çelikliyurt, Merve Meliha; Akıncı, Erhan; Akkuş, Gülsüm; Günay, Melih; Korkmaz, Şükrü AlperenAlthough atomoxetine, a selective norepinephrine reuptake inhibitor, is widely used in the treatment of attention-deficit/hyperactivity disorder (ADHD), there is limited data on its cytogenetic effects. This study aimed to investigate the cytotoxicity and genotoxicity of atomoxetine in vivo and silico. Chromosome aberration and micronucleus assays were used to analyze the genotoxic effect of atomoxetine in human peripheral blood lymphocytes under culture conditions. The mitotic index was assessed for cytotoxic potential. For the docking analysis, DNA receptor (1BNA) was prepared with ChimeraX, and the Atomoxetine molecule was optimized by Avogadro2.0 software. In silico molecular docking analysis was carried out utilizing SwissDock online platform. The results obtained were visualized using ChimeraX and Pymol software. Atomoxetine doses of 9.6 mu g/mL (equal to about 1.2 mg/kg as a maintenance dose), 14.4 mu g/mL (equal about to 1.8 mg/kg as the highest dose systematically tested), 48.0 mu g/mL (equal about to 6 mg/kg as five times the maintenance dose) and 96.0 mu g/mL (equal about to 12 mg/kg as ten times the maintenance dose) were analyzed. The findings clearly indicate that atomoxetine has no genotoxic effect at the therapeutic dose. However, we observed genotoxic effects at 48.0 and 96.0 mu g/mL doses. No strong binding affinity occurs in silico analyses. As one of the initial inquiries into the in silico and in vivo appraisal of atomoxetine's genotoxic impacts, the research has established that atomoxetine does not significantly affect the frequency of chromosomal damage or micronucleus formation. Genotoxic effects should be kept in mind at doses above clinical practice.Öğe Does the 5-Item Modified Frailty Index Predict Adverse Outcomes after Retrograde Intrarenal Surgery? A Case-Control Study by the RIRSearch Group(Mary Ann Liebert, Inc, 2025) Başataç, Cem; Şimşekoğlu, Muhammed Fatih; Teke, Kerem; Tuna, Mustafa Bilal; Çınar, Önder; Akgül, Hacı Murat; Özman, Oktay; Sıddıkoğlu, Duygu; Sancak, Eyüp BurakObjectives: We aim to assess whether severely frail patients have an increased risk of complications and worse surgical outcomes after retrograde intrarenal surgery. Methods: The data of 340 consecutive patients undergoing retrograde intrarenal surgery to treat upper tract urinary stones were analyzed retrospectively. The 5-item modified frailty index (mFI-5) was used to assess the frailty status. Using a cutoff value of score 2 in the mFI-5 score, patients were divided into two groups: patients with an mFI-5 score <2 were assigned to a non-frail (Group 1) group, and patients with an mFI-5 score >= 2 were assigned to a frail (Group 2) group. The patients' demographics, stone characteristics, operative outcomes, and complication rates were compared between the groups. The primary objective was to examine whether the surgical outcomes were much better in non-frail patients. Results: After matching confounding factors, Group 1 comprised 255 patients, and Group 2 comprised 85 patients. The baseline characteristics were similar between the groups. There were no statistically significant differences in terms of the median operation time and length of hospital stay among groups. There were no significant differences between groups for intraoperative complication rates (7.6% and 9.4%, respectively; P = .47) and postoperative complication rates (13.8% and 11.8%, respectively; P = .71), and stone-free rates (70.9% versus 72.9%, respectively; P = .73). Conclusions: Retrograde intrarenal surgery is an efficient and feasible treatment option for upper urinary tract stones in severely frail patients.Öğe Acute Measurement of Developmental Dysplasia of the Hip: Comparing Two Approaches for Measuring the Alpha Angle Using the Graf Technique(Sage Publications Inc, 2025) Dindar, Fırat; Aylanç, Nilüfer; Aylanç, Hakan; Ertem, Şenay Bengin; Sıddıkoğlu, Duygu; Reşorlu, MustafaObjective: The Graf method, in ultrasonography screening of developmental hip dysplasia, is based on angle measurements. Using different reference points may cause varied results. The aim of this study was to investigate to what extent the alpha angle obtained, varied at different reference points.Materials and Methods: There were 178 hips evaluated by two trained observers. Both measured the alpha angle with different reference points and these were labeled as methods A and B, for all the hips evaluated. The statistical analysis was performed with SPSS Version 21.Results: The average of observer 1, based on measurements with method A, were 65.63 (SD +/- 5.95) and based on method B were 73.39 (SD +/- 6.29). The average of the measurements of observer 2, utilizing method A were 64.39 (SD +/- 4.85) and based on method B were 69.92 (SD +/- 6.08). It was observed that method B showed higher mean and variability compared to method A. The agreement between observers was moderate in method A and poor in method B. The intraobserver correlation coefficient (ICC) was 0.69 for method A and 0.47 for method B. The ICC was considered good (e.g., 95%) for both observers in terms of using methods A and B.Conclusion: The use of ultrasonography still maintains its place in the diagnosis of developmental hip dysplasia. The Graf method is based on precise measurements, and the most decisive parameter is the alpha angle. Reference points in method A would be more useful in patient management and may increase the diagnostic accuracy.Öğe Is AI the future of evaluation in medical education?? AI vs. human evaluation in objective structured clinical examination(Bmc, 2025) Tekin, Murat; Yurdal, Mustafa Onur; Toraman, Çetin; Korkmaz, Güneş; Uysal, İbrahimBackgroundObjective Structured Clinical Examinations (OSCEs) are widely used in medical education to assess students' clinical and professional skills. Recent advancements in artificial intelligence (AI) offer opportunities to complement human evaluations. This study aims to explore the consistency between human and AI evaluators in assessing medical students' clinical skills during OSCE.MethodsThis cross-sectional study was conducted at a state university in Turkey, focusing on pre-clinical medical students (Years 1, 2, and 3). Four clinical skills-intramuscular injection, square knot tying, basic life support, and urinary catheterization-were evaluated during OSCE at the end of the 2023-2024 academic year. Video recordings of the students' performances were assessed by five evaluators: a real-time human assessor, two video-based expert human assessors, and two AI-based systems (ChatGPT-4o and Gemini Flash 1.5). The evaluations were based on standardized checklists validated by the university. Data were collected from 196 students, with sample sizes ranging from 43 to 58 for each skill. Consistency among evaluators was analyzed using statistical methods.ResultsAI models consistently assigned higher scores than human evaluators across all skills. For intramuscular injection, the mean total score given by AI was 28.23, while human evaluators averaged 25.25. For knot tying, AI scores averaged 16.07 versus 10.44 for humans. In basic life support, AI scores were 17.05 versus 16.48 for humans. For urinary catheterization, mean scores were similar (AI: 26.68; humans: 27.02), but showed considerable variance in individual criteria. Inter-rater consistency was higher for visually observable steps, while auditory tasks led to greater discrepancies between AI and human evaluators.ConclusionsAI shows promise as a supplemental tool for OSCE evaluation, especially for visually based clinical skills. However, its reliability varies depending on the perceptual demands of the skill being assessed. The higher and more uniform scores given by AI suggest potential for standardization, yet refinement is needed for accurate assessment of skills requiring verbal communication or auditory cues.Öğe Maculopapular Eruption in COVID-19 Patients: A Single-Center Comparative Study(Galenos Publ House, 2025) Kaya, Özge; Alkan, Sevil; Mermutlu, Selda Işık; Cinpolat, Havva Yasemin; Kılıç, Sevilay OğuzAim: Maculopapular eruption (MPE) due to the coronavirus disease 2019 (COVID-19) is increasingly reported. This study aimed to evaluate COVID-19 patients presenting with MPE and compare them with COVID-19 patients without MPE. Materials and Methods: COVID-19 patients with and without MPE followed up in a single tertiary center between March 2020 and December 2020 were assessed and compared in terms of demographic characteristics, clinical and laboratory findings. Results: A total of 114 COVID-19 patients (female: male ratio=0.4: 1, mean age: 51.44 +/- 16.62 years) confirmed by total polymerase chain reaction testing were evaluated. Patients with MPE during COVID-19 (n=44) and patients without MPE during COVID-19 (n= 70) were divided into two groups and compared. Among clinical findings, the incidence of fever, myalgia, anosmi and ageusia, rhinorrhea, and/or nasal congestion was significantly higher in COVID-19 patients with MPE. In terms of laboratory findings, creatinine, alkaline phosphatase (ALP), gamma-glutamyl transferase, lactate dehydrogenase, vitamin D, erythrocyte sedimentation rate, procalcitonin, ferritin, fibrinogen median levels were significantly higher in COVID-19 patients with MPE. In complete blood count, median hemoglobin, red blood cell, monocyte, eosinophil, and basophil counts were also significantly higher in the MPE group. In the multivariate logistic regression model, ALP was independently associated with MPE in COVID-19 patients (odds ratio: 1.099, 95% confidence interval: 1.056-1.144, p<0.00). Conclusion: The MPE in COVID-19 patients may be indicative of increased inflammation and organ damage. Early diagnosis and isolation of these patients and close follow-up are crucial in reducing the risk of organ damage and severe disease. In addition, ALP is an important laboratory parameter related to MPE in COVID-19 patients.Öğe Recent insights into depression from transcriptomic analysis(Termedia Publishing House Ltd, 2025) Günay, Melih; Çiçekliyurt, Meliha MervePurpose: Depression is a widespread mood disorder with a high rate of relapse and chronicity that can be affected by gender, and caused by traumatic or stressful events. Transcriptome analysis measures gene expression heterogeneity in cells, tissues, organs, and the whole body. The purpose of the study was to investigate both gender-specific and tissue-specific variations in gene expression regarding depression based on transcriptomic analysis using RNA-Seq data. Methods: The depression datasets GSE190518 and GSE214921 were downloaded from the Gene Expression Omnibus database provided by the NCBI. The GSE190518 datasets include peripheral blood samples (4 patients, 4 healthy controls), and the GSE214921 datasets contain human postmortem orbitofrontal cortex bulk tissue (20 patients, 19 healthy controls). All datasets were analyzed separately with the DESeq2 package in R. Later, GO and KEGG enrichment analyses of differentially expressed genes were performed using the clusterProfiler package in R. Results: Our results reveal that depression stimulates genes linked to the immune system, which is a common denominator in both brain tissue and blood samples. Overall, tissue-specific factors contribute to the association between depression and the immune system via distinct genes. Furthermore, gene ontology analyses revealed that HSPA6, HSPA7, HSPA1L, HSPA1A, and HSPA1B genes are co-represented in different pathways involved in molecular function, biological processes, and cellular components. Conclusions: Comparative transcriptomic evidence supports the immune hypothesis of depression in different tissue samples. Gender-specific depression may be triggered by protein misfolding.Öğe Bilişsel Esneklik Araştırmalarının Bibliyometrik Analizi ve Geleceğe Dair Görüler(Pamukkale Üniversitesi Eğitim Fakültesi, 2025) Toraman, Çetin; Çalışkan, Çiğdem; Korkmaz, GüneşBu çalışma, Web of Science (WoS) verilerine dayalı olarak Bilişsel Esneklik (BE) konusundaki araştırmaların güncel durumunu ortaya koymayı ve gelişimini incelemeyi amaçlamaktadır. Çalışmada, 1975-2023 yılları arasında WoS'tan elde edilen meta veriler kullanılarak, BE üzerine yazılmış araştırma literatürünün haritalandırılması için bibliyometrik analiz yaklaşımı benimsenmiştir. Analiz, yayın yılına göre makale dağılımı ve ortalama atıf durumu, BE üzerine en fazla yayın yapan dergiler ve BE ile ilgili atıf sayısı, en çok atıf alan BE makaleleri ve yazarları, BE hakkındaki makalelerin en çok atıf aldığı ülkeler, BE üzerine en fazla makale üreten yazarlar, yayınları, yazarların ülkeleri ve makalelerde BE ile ilişkili kelimelerin eğilimi gibi faktörleri içermektedir. Sonuçlar, yıllara göre makale yayınlama eğilimi son yıllarda artmasına rağmen, BE makalelerine atıfların en yüksek artışının 1990 ve 1994 yıllarında yaşandığını ortaya koymaktadır. En fazla yayın yapan dergiler ise Behavioural Brain Research, Psychiatry Research, Frontiers in Behavioral Neuroscience, Journal of Experimental Child Psychology, Journal of Neuroscience dergileridir. Bir diğer bulgu ise, BE makalelerinin en çok atıf aldığı ve en yüksek üretim oranlarına sahip ülkenin ABD olduğudur. Ayrıca, BE makalelerinde en sık kullanılan kelimelerin esneklik, prefrontal korteks, beyin, çalışma belleği, görev, bilişsel, bellek, karar verme, korteks, aktivasyon, yanıt-engelleme, yürütücü işlev, interferans, bilişsel kontrol ve şizofreni olduğu tespit edilmiştir. Bu çalışma, BE literatürü hakkında kapsamlı bir değerlendirme sunmakta ve gelecekteki araştırmalar için alanın gelişimi hakkında ilginç bilgiler sağlamaktadır.Öğe The effects of systemic ozone application and hyperbaric oxygen therapy on avascular necrosis of the femoral head: An experimental study in the vascular deprivation of the rat femoral head model(Turkish Joint Diseases Foundation, 2025) Yılmaz, Onur; Erken, Hüseyin Yener; İçkin Gülen, Meltem; Güven Bağla, Aysel; Adalı, Yasemen; Kuru, TolgahanObjectives: This study aims to assess the effects of systemic medical ozone (O3) application and to compare its effects with hyperbaric oxygen (HBO) therapy for preventing avascular necrosis of the femoral head in a rat model. Materials and methods: A total of 50 male Wistar albino rats were divided into six groups including five rats in each control and sham-operated control group and 10 rats in the remaining four groups: (i) control group, (ii) sham-operated control group, (iii) avascular necrosis group, (iv) intraperitoneal ozone given avascular necrosis group, (v) HBO therapy given avascular necrosis group, and (vi) intraperitoneal ozone and HBO given avascular necrosis group. We surgically induced osteonecrosis by cutting the ligamentum teres and placing a tight ligature around the femoral neck. At Week 11, we harvested femoral heads bilaterally from each animal and performed a macroscopic, histological evaluation and histomorphometric, immunohistochemical analysis. Results: The intertrabecular mesenchymal cell ratio was substantially higher in the O3 group than that of all other groups in the histological evaluation (p<0.05). Group O3 had also significantly more CD31-positive stained new vasculature than other groups, with the exception of the HBO therapy group, according to the immunohistochemical analysis (p<0.05). Conclusion: The results of this experimental study suggest that the application of medical ozone alone may have a positive effect on new vessel formation and the repair process and may be more beneficial than HBO therapy and HBO+O3 therapy in the vascular deprivation of the rat femoral head model. © 2025 All right reserved by the Turkish Joint Diseases FoundationÖğe Syphilis coinfection in individuals living with HIV: tertiary university hospital data(Pamukkale University, 2025) Alıravcı, Işıl Deniz; Yenice Aktaş, Sevinç; Kaya, SelçukPurpose: This study aimed to examine the coinfection of syphilis in HIV-positive individuals and the epidemiological and clinical characteristics of these patients. Material and methods: Our study was conducted in Çanakkale Onsekiz Mart University, between 13.02.2018 and 13.02.2024, in 26 patients with clinically and laboratory-confirmed syphilis co-infection among 142 HIV/AIDS patients who were followed up and confirmed in the infectious diseases and clinical microbiology outpatient clinic. Results: A total of 142 HIV positive and 26 (18.3%) syphilis coinfected patients between the ages of 17-77 were included in the study. The mean ages of the infected and syphilis coinfected patients were 39.1 and 41.07, respectively. Six (23%) of the coinfected patients were married, the remaining 14 (53.8%) were single or divorced, five had multiple partners; 20 (77%) were heterosexual, four (15%) were men who have sex with men (MSM), and two (8%) were bisexual. Simultaneous HIV/syphilis positivity was detected in 14 (54%) of the coinfected patients at the time of diagnosis, while 7 (27%) were detected during the HIV treatment follow-up period, and 5 (19%) were detected before HIV diagnosis. Of the patients with coinfection, five (19.2%) had primary syphilis, 10 (38.5%) had latent syphilis, and 11 (42.3%) had secondary syphilis at the time of diagnosis. Twenty-two (85%) of the patients had been diagnosed and treated for syphilis only once, while the remaining (15%) had received two or more treatments. Conclusions: The prevalence of syphilis coinfection and reinfection in patients was 18.3% and 15%, respectively. In cases of coinfection, male gender, alcohol and drug consumption, being MSM, irregular lifestyles, and sexual habits were found to be effective. It is important to conduct screening for syphilis and other sexually transmitted diseases (STDs) in HIV-infected patients. Providing psychiatric support to these patients in organizing their life plans is also very important for preventing HIV transmission and syphilis coinfection. © 2025, Pamukkale University. All rights reserved.Öğe The relationship between public health system resilience and psychological resilience: multilevel regression study(Turkish Society of Public Health Specialists, 2025) Çan, Gamze; Kartal, Hakan; Toraman, Çetin; Bakar, CoşkunObjective: This study aims to explore the effect of Public Health System Resilience (PHSR) on the psychological resilience of individuals. To demonstrate this interaction, the study investigated psychological resilience levels of individuals negatively affected by the recently experienced COVID-19 pandemic as a disaster period in the province of Çanakkale. Method: This study was conducted in two stages in April and September 2022. In the first stage, the PHSR Scorecard prepared by the United Nations Office for Disaster Risk Reduction was used to obtain the scores from the Merkez province of Çanakkale and the Bayramiç and Ayvacık districts. In the second stage, a questionnaire for demographic data and the Psychological Resistance Scale was administered to 510 people, including those over 65 years, small business owners, and students (high-school grades 2 and 3). The results were analyzed at two levels and with three different models using the Multilevel Regression analysis. Results: Based on the multilevel regression model formulated for the factors affecting Psychological Resilience, it was found that PHSR was an explanatory or predictor variable for psychological resilience, and a high public health system resilience was associated with a high psychological resilience (Model 1 ß:0,29, p<0,05), (Model 2 ß:0,26, p<0,01) (Model 3 ß:1,05, p<0,01). It was also found that in PHSR interactions, small business owner groups (β =-0,77, t=-2,35, p<0,05) and student groups (β =-1,56, t=4,72, p<0,01) were affected more negatively than the group aged over 65 years. Conclusion: Our study has demonstrated that PHSR effectively enhances individuals’ psychological resilience. © 2025 by the Association of Public Health Specialist.Öğe Relationship of Polymorphisms and Haplotype in Klotho Gene with Hypertension Risk(Pleiades Publishing, 2025) Çiçekliyurt, M.M.; Çolak, Y.; Balun, A.; Akgümüş, A.Abstract: Klotho gene is linked to promoting healthy aging and longevity. With age, serum Klotho levels decrease, resulting in age-related disorders. Polymorphisms contribute to a range of risk factors associated with disease onset, disease response, and therapeutic adverse effects. Klotho gene polymorphisms are linked to cardiovascular illness, although previous studies did not evaluate their relationship with hypertension. In this context, polymorphisms in the KL gene that disrupt gene expression or cause regulatory proteins to bind to the promoter region may trigger hypertension. So, the aim of our study investigated how two non-synonymous SNPs (rs9536314 and rs9527025) at the Klotho gene are connected to high blood pressure. The study was a case-control consisting of 226 hypertensive and 126 healthy individuals. All individuals were genotyped by real-time PCR. KL rs9536314 and rs9527025 polymorphisms were evaluated for hypertension risk using allele/genotype counting, OR-value, logistic regression, and haplotype analysis. As a results, hypertensive patients with recessive genotypes had twice the risk as the general population. KL rs9527025 was not a significant risk factor for dominant, recessive, and additive-modelled hypertension. In contrast, individuals with KL rs9536314 had a higher risk of hypertension in the recessive model. In conclusion: KL-rs9536314T → G would greatly increase the risk of hypertension in the recessive model. © Pleiades Publishing, Inc. 2025.Öğe Modified Dermal-Fat Flap Suspension Technique for Internal Nasal Valve Dysfunction: A Comparative Study With Conventional Cartilage Grafting(Lippincott Williams and Wilkins, 2025) Akyürek, Mustafa; Çakır, Bahadır; Hafız, Güneş; Tavas, OzanIatrogenic internal nasal valve (INV) dysfunction is a significant complication after nasal surgery, often necessitating revision surgeries involving cartilage grafting, which carries high risks of complications such as mucosal synechiae, septal perforations, and chronic inflammation. This study evaluates the efficacy of a modified dermal-fat flap suspension technique as an alternative to conventional cartilage grafting for INV reconstruction. A retrospective review was conducted of 30 patients treated between March 2019 and March 2023, including 8 patients who underwent the modified dermal suspension technique and 22 who received spreader grafts. Preoperative and postoperative nasal obstruction symptom evaluation scores were statistically analyzed using the Mann-Whitney U test. While both groups demonstrated significant postoperative improvements, no statistically significant differences were found between the groups. The modified technique, performed under local anesthesia, was associated with fewer complications and avoided extensive cartilage grafting or mucosal dissection, making it particularly suitable for patients with advanced age, high ASA scores, or complex surgical histories. Common complications included transient orbital edema and rare cases of skin discoloration, which resolved over time. Despite a small sample size and reliance on subjective nasal obstruction symptom evaluation scores, this study highlights the potential of the modified dermal-fat flap suspension technique as a less invasive, effective alternative for managing INV dysfunction, especially in high-risk patients. Further studies with larger cohorts and objective measures are needed to validate these findings. Copyright © 2025 by Mutaz B. Habal, MD.Öğe Corrigendum to “Spatial distribution and isotopic signatures of N and C in mosses across Europe” [Sci. Total Environ. 958 (2025) 178043](S0048969724082007)(10.1016/j.scitotenv.2024.178043)(Elsevier B.V., 2025) Izquieta-Rojano, Sheila; Morera-Gómez, Yasser; Elustondo, David; Lasheras, Esther; Santamaría, Carolina; Torrens-Baile, Julen; Alber, Renate; Coşkun, Mahmut; Coşkun, MünevverThe authors regret that the printed version of the above article contained two errors in the author list. The correct and final version of the author list and their corresponding affiliations follows. The added authors are Winfried Schröder and Harald G. Zechmeister. These individuals provided both samples and data from previously analyzed samples, and contributed to the initial manuscript draft. The authors would like to sincerely apologize for any inconvenience caused and greatly appreciate the understanding of the two authors mistakenly included and the two authors initially omitted. Sheila Izquieta-Rojanoa, Yasser Morera-Gómeza, David Elustondoa, Esther Lasherasa, Carolina Santamaríaa, Julen Torrens-Bailea, Renate Alberb, Lambe Barandovskic, Mahmut Coşkund, Munevver Coskune, Helena Danielssonf, Ludwig De Temmermang, Harry Harmensh, Zvonka Jerani, Sébastien Leblondj, Javier Martínez-Abaigark, Encarnación Núñez-Oliverak, Winfried Schröderl, Gunilla Pihl Karlssonf, Juha Piispanenm, Harald G. Zechmeistern, Zdravko Spirico, Trajče Stafilovc, Lotti Thönip, Jesús Miguel Santamaríaa aUniversidad de Navarra, Instituto de Biodiversidad y Medioambiente BIOMA, Irunlarrea 1, 31008 Pamplona, Spain bAgency for Environment and Climate Protection, Biological Laboratory, Unterbergstr. 2, 39055 Leifers, Italy cInstitute of Physics, Faculty of Natural Sciences and Mathematics, Ss Cyril and Methodius University in Skopje, POB 162, 1000 Skopje, Macedonia dCanakkale Onsekiz Mart University, Faculty of Medicine, Turkey eCanakkale Onsekiz Mart University, Vocational Health School, Turkey fIVL - Swedish Environmental Research Institute, Sweden gVeterinary and Agrochemical Research Centre CODA-CERVA, Tervuren, Belgium hUK Centre for Ecology & Hydrology, Environment Centre Wales, Deiniol Road, Bangor, Gwynedd LL57 2UW, UK iJožef Stefan Institute, Ljubljana, Slovenia jPatriNat (OFB, MNHN), 12 Rue Buffon, CP39, 75005 Paris, France kUniversidad de La Rioja, Facultad de Ciencia y Tecnología, Madre de Dios 53, 26006 Logroño, Spain lChair of Landscape Ecology, University of Vechta, P.O.B. 1553, 49364 Vechta, Germany mNatural Resources Institute Finland, Paavo Havaksen tie 3, FI-90570 Oulu, Finland nUniversity of Vienna, Department of Biodiversity and Conservation Biology, Rennweg 14, 1030 Vienna, Austria oGreen Infrastructure Ltd., Borongajska cesta 81c., HR-10000 Zagreb, Croatia pFUB - Research Group for Environmental Monitoring, Alte Jonastrasse 83, 8640 Rapperswil, Switzerland © 2025 The Author(s)Öğe The comparison of efficacy and safety of reusable and disposable-flexible ureteroscopes: case-control matching results of multicentric RIRSearch study group(Springer Science and Business Media B.V., 2025) Şahin, Mehmet Fatih; Dayısoylu, Hulusi Sıtkı; Yazıcı, Cenk Murat; Sıddıkoğlu, Duygu; Çınar, Önder; Akgül, Murat; Çakır, HakanPurpose: Today, disposable flexible ureteroscopes are increasingly used in retrograde intrarenal surgery (RIRS) as an alternative to reusable flexible ureteroscopes. The comparison of the safety and effectiveness of these two devices is still a matter of debate. This study evaluates the efficacy and safety of disposable-flexible ureteroscopes vs reusable flexible ureteroscopes in RIRS. Materials and methods: The study included 1165 RIRS cases, and the patients were divided into two groups. Group 1 consisted of cases with reusable RIRS, 838 in total, while Group 2 consisted of disposable RIRS cases, 327 in total. Due to significant differences, case–control matching was performed, and subsequently, there were 229 patients in both groups. The demographic and clinical data of patients, stone characteristics, surgical data, perioperative and postoperative complications, postoperative urinary tract infection rate, duration of hospitalization, and stone-free rates (SFR) were analyzed and compared. Results: No demographic differences were observed between the two groups after case–control matching. While operative time, SFR, and postoperative infection rates were similar between the groups (p > 0.05), fluoroscopy (p = 0.001) and hospitalization (p = 0.029) times were statistically significantly lower in the disposable ureteroscopy group. Perioperative and postoperative complications were also lower in this group (p = 0.018 and p = 0.001 respectively). Conclusion: Our research indicates that single-use ureteroscopes are a strong alternative to reusable ureteroscopes, demonstrating similar efficacy and reduced complication rates in the treatment of upper urinary tract stones. © The Author(s), under exclusive licence to Springer Nature B.V. 2025.Öğe Trends of COVID 19 Vaccines: International Collaboration and Visualized Analysis(The Turkish Society Of Clinical Microbiology and Infectious Diseases, 2021) Alkan, Sevil; Öntürk, Hatice; Alıravcı, Işıl Deniz; Sıddıkoğlu, DuyguObjective: We aimed to evaluate the research and publication trends on the coronavirus disease (COVID-19) vaccine, and so guide future studies. Materials and Methods: A bibliometric analysis was performed using a VOSviewer visualization methodology. Information about publications Web of Science database outputs, countries, institutions, journals, keywords, and citation counts was retrieved. Results: A total of 929 eligible publications from January 1, 2020, to February 28, 2021, were derived from the WOS database according to the search criteria. Publications were written in nine languages, mainly in English (96.7%). From these results, a total of 300 articles were reached by filtering. The average number of citations was found to be 7.73. The H-index of the articles, which were cited 2320 times in total, was 22. Most of the publications were articles (32.29%) and editorials (28.09%). There were 73 different research areas, mostly in general internal medicine (26.6%) and immunology (19.05%). The United States of America produced the majority of articles (31.32%). Conclusion: This bibliometric analysis presents that publications on the COVID-19 vaccine are rapidly changing at a time when exactly the effective vaccines of COVID-19 have not been discovered yet.Öğe CT angiography prior to DIEP flap breast reconstruction: a randomized controlled trial(Elsevier Ltd., 2022) Çolakoğlu, Salih; Tebockhorst, Seth; Freedman, Jonathan; Douglass, Sara; Sıddıkoğlu, Duygu; Chong, Tae W.; Mathes, David W.Background: CT angiogram (CTA) has become the preferred method for the planning of abdominal-based microsurgical breast reconstruction to gather information about location, number, caliber and trajectory of the abdominal perforators and to decrease overall flap dissection and operating room time. However, the high-level evidence to support its utility has been limited to nonrandomized retrospective and prospective studies. Methods: Patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction were prospectively randomized to preoperative CTA and no imaging groups. Patient demographics, operative times, selected row and number of perforators for flap harvest, agreement in perforator selection between radiologist and surgeon, and clinical outcomes data were collected. Two-way ANOVA, Fisher's exact and Student's t-tests were used for statistical analysis. Results: Overall, 37 patients with 63 flaps were included in this study. Seventeen patients had CT scan prior to surgery. Mean age was 50.5 ± 9.6 years. Flap dissection time was significantly shorter in the CT group (150.8 ± 17.8 vs 184.7 ± 25.1 min and p< 0.001). Although overall odds ratio (OR) time was also shorter in the CT group, this only reached a statistical significance in bilateral surgeries (575.9 ± 70.1 vs 641.9 ± 79.6 min and p = 0.038). Hemiabdomen side, selected DIEP row, and the number of dissected perforators did not affect the overall dissection time. Complication rates were similar between the two groups. Conclusion: This prospective, randomized study demonstrates that preoperative CTA analysis of perforators decreases flap harvest and overall OR time with equivalent postoperative outcomes.
