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Principles of environmentally sustainable agriculture for building resilient and resource-efficient food systems
(Tubitak Scientific & Technological Research Council Turkey, 2025) Çakmakcı, Ramazan; Çakmakcı, Songül; Çakmakcı, Muhammet Fatih
As the demand for greater quantities of higher-quality food grows with population expansion, climate change, urbanization, and unsustainable agricultural practices accelerate the loss of arable land, ultimately threatening agricultural sustainability. Population growth necessitates a transition to nutritious, safe, and healthy food production systems that ensure higher yields, less reduced waste, improved social outcomes, and the integration of economic, social, and environmental sustainability principles. Urgent global challenges such as resource depletion, biodiversity loss, and climate change necessitate the protection of ecosystems and the sustainable use of natural resources. Agricultural systems must enhance food production and supply productivity, strengthen system resilience, and improve resource efficiency and sustainability. The sustainable development of agricultural systems based on resilience and productivity is important to ensure food security. The aim of this review is to compile, describe, and propose future strategies for promising food systems-including transformative innovations and alternative farming techniques-to facilitate the transition toward resilient, resource-efficient, and sustainable agriculture, and to mitigate long-term challenges. It also provides recommendations for future research, sustainability, resilience, and emerging food trends aimed at promoting sustainable food systems and green technologies, protecting ecosystems, resources, and biodiversity, and optimizing waste management and natural resource use. This article focuses on future sustainable food production and security, environmental protection, alternative protein sources, and innovative agricultural techniques; it highlights scientific and technological advancements, emerging research directions, and offers a comprehensive perspective on resilient, resource-efficient, and sustainable food production systems.
Evaluation of triply periodic minimal surface geometries in 3D-printed PLA scaffolds for chondrogenic differentiation
(Wiley, 2025) Kilic, Mahmut Alp; Akyuerek, Mustafa; Abidnejad, Roozbeh; Karakoc, Alp
Triply periodic minimal surface (TPMS) scaffolds are gaining attention in tissue engineering due to their continuous and interconnected porous architecture. In this study, three TPMS geometries-Gyroid, Diamond, and I-WP-were fabricated from polylactic acid (PLA) using fused deposition modeling (FDM), with all scaffolds designed to maintain the same overall porosity. Scaffold characterization included scanning electron microscopy (SEM), microcomputed tomography (micro-CT), compressive mechanical testing, and surface wettability analysis. Although porosity was constant, differences in Equivalent Circular Diameter (ECD) values were observed among the geometries, reflecting variations in pore morphology. Adipose-derived stem cells (ADSCs) were seeded onto the scaffolds and cultured under chondrogenic differentiation conditions for 21 days. Cell viability, gene expression (Col2, Col10, Sox9), and protein levels were assessed using RT-PCR and Western blot. All scaffold geometries supported cell attachment and chondrogenic differentiation to varying degrees. The Diamond geometry showed the highest chondrogenic marker expression at the mRNA level, while the Gyroid geometry promoted more stable protein expression with reduced hypertrophic signaling. These findings demonstrate that scaffold geometry, even under identical material and porosity conditions, can influence stem cell behavior. The results offer valuable insights for optimizing TPMS-based scaffold designs in cartilage tissue engineering applications.
3D-Printable, Self-Stiffening (4D) and Shape Morphing Hydrogel through Single-Step Orthogonal Crosslinking of Phenolic Biopolymers for Dynamic Tissue Engineering
(Wiley, 2025) Gungor, Nuriye Nazet; Kurt, Tugce; Sari, Buse; Isik, Melis; Okesola, Babatunde O.; Arslan, Yavuz Emre; Derkus, Burak
Particularly for dynamic, shape-changing, or fibrillar tissues such as muscles and blood vessels, the development of innovative biomaterials is crucial for advancing tissue engineering and regenerative medicine. This study introduces a novel multicomponent hydrogel created from silk fibroin (SF), tyramine-modified hyaluronic acid (HA_Tyr), and tyramine-modified gelatin (G_Tyr). Using an enzymatic orthogonal covalent bonding between phenolic groups, i.e., tyrosine and tyramine moieties of SF, HA_Tyr, and G_Tyr, a dynamically stiffening SF/HA_Tyr/G_Tyr (SHG) multicomponent hydrogel is achieved with enhanced mechanical properties. Utilizing an extrusion-based 3D printing approach, the precise fabrication of constructs with tailored geometries and functionalities is demonstrated. The emerging 3D-printed hydrogels undergo morphologic changes (4D) under 37 degrees C/phosphate buffer saline (PBS) conditions. The observed morphological change results from the conformational change and folding of SF leading to fibrillation. These multicomponent hydrogels also show significant promise in creating bio-instructive materials that meet the mechanical and functional requirements necessary for in situ tissue engineering. The study highlights the potential of these self-stiffening biomaterials to recover dynamic and fibrillar tissues, supported by both in vitro and pre-clinical chorioallantoic membrane (CAM) model evaluations that underscore their biocompatibility and pro-angiogenic properties.
In Vivo Wound Healing and Immune Response Studies of Chitosan Cryogels With Invertebrate Model Organism Galleria mellonella
(Wiley, 2025) Ekici, Sema; Kaya, Serhat; Durucu, Gurkan
In the present study, it was aimed to prepare single and double network chitosan (Ch) cryogels cross-linked with glutaraldehyde (G), which can be recommended for use as model wound dressings and hemostatic agents, and to reveal in vivo studies with Galleria mellonella. An in vivo study about Ch cryogels with these larvae was not declared in the literature, so our study is the first of its kind. G. mellonella was used to determine the effects of cryogels on immunity, oxidative stress, and wound healing. Cinnamic acid (CA) was loaded onto the cryogels, and the percent cumulative release data of CA were found to be in the range of 69%-80%. The results show that loading of CA onto [Ch-3]cry cryogels considerably improved immune responses; the [Ch-3]cry-CA group was the most successful in terms of immunological response, oxidative stress balance, and wound healing. In accordance with the 3R principles of ethical animal research, the use of G. mellonella in this study served as a scientifically relevant and ethically responsible alternative model to mammals for preliminary assessment of wound healing potential and innate immune activation. The porous structures, high mechanical strengths, and rapidly swelling-deswelling abilities of [Ch-2@Ch]cry and [Ch-3]cry cryogels indicated that these may be suitable for biomedical applications. Analysis of SEM micrographs indicated that the morphology of dual network cryogels prepared in the form of interpenetrating polymeric networks (IPNs) was more regular and homodispersed with respect to single network cryogels. The compressive elasticity modulus (E) values of IPNs cryogels (0.160 N/mm) is approximately 4.6 times that of Ch cryogels with a single network (0.035 N/mm).
A Quartz Tuning Fork-Based Immunosensor for Detection of Kidney Injury Molecule-1: A New Working Electrode for Electrochemical Applications
(Wiley, 2026) Ozkan, Seyma Senturk; Sezginturk, Mustafa Kemal
Kidney injury molecule-1 (KIM-1) is a Type I transmembrane glycoprotein and is a potential biomarker for detecting kidney damage, as its urinary levels fluctuate in cases of acute kidney injury. In this study, an electrochemical immunosensor was developed for the first time using a quartz tuning fork (QTF) working electrode to detect the KIM-1 biomarker. The gold-tipped QTF electrode surface was modified with 11-mercaptoundecanoic acid (11-MUA) to form a self-assembled monolayer (SAM). To construct the biosensor, extensive optimization studies were conducted on the fabrication parameters, followed by characterization and real urine sample testing to evaluate its applicability. Electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) methods were utilized in all electrochemical experiments. Morphological changes on the QTF electrode surface were examined using atomic force microscopy (AFM) and scanning electron microscopy (SEM). The developed electrochemical KIM-1 immunosensor demonstrated highly promising performance, exhibiting an exceptionally wide detection range (0.05-250 fg/mL). Furthermore, the dissociation constant (Kd) of the interaction between KIM-1 and its antibody was successfully calculated using the Hill equation, on the basis of the QTF-based system.
The Impact of Lipoprotein Apheresis on Inflammatory Factors: A Systematic Review and Meta-Analysis
(Wiley, 2025) Hatami, Alireza; Eslami, Masoud; Aslani, Saeed; Alizadeh, Shahab; Sukhorukov, Vasily N.; Karav, Sercan; Razi, Bahman
Lipoprotein apheresis is a well-established therapy for patients with dyslipidemia unresponsive to conventional lipid-lowering strategies. However, its impact on systemic inflammation remains uncertain. This systematic review and meta-analysis evaluated the effect of apheresis on circulating inflammatory markers, including C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). Following PRISMA guidelines, a systematic search of PubMed, Scopus, and ISI Web of Science was conducted up to June 2025. Studies reporting pre- and post-apheresis values for inflammatory markers were included. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Thirteen publications met inclusion criteria. Meta-analysis demonstrated that apheresis significantly reduced CRP levels (SMD = -0.31; 95% CI: -0.44 to -0.18; p < 0.001), particularly in long-term interventions. No significant changes were observed for IL-6, TNF-alpha, or hs-CRP. In conclusion, apheresis significantly reduces CRP levels, especially with long-term treatment, suggesting a modest anti-inflammatory benefit. However, its effects on other markers remain unclear. Larger and high-quality trials are warranted.
Age Structure, Growth, and Survival Rates of an Insular Population of Hemidactylus turcicus
(Wiley, 2025) Altunisik, Abdullah; Kurtul, Didem; Gul, Cigdem; Boran, Begum; Tosunoglu, Murat
The Mediterranean house gecko, Hemidactylus turcicus (Linnaeus, 1758), a widespread nocturnal lizard, exhibits diverse life-history traits, yet its insular populations in T & uuml;rkiye are underexplored. This study examines how Bozcaada's insular environment shapes the age structure, body size, growth rates, and sexual dimorphism of H. turcicus, providing a detailed demographic and morphometric baseline. We sampled 30 individuals (19 males, 11 females) from Bozcaada, & Ccedil;anakkale, T & uuml;rkiye, measuring snout-vent length (SVL), body mass, and additional traits (head length, width, height, forearm, and hind leg length). Age was determined via skeletochronology, counting phalangeal Lines of Arrested Growth (LAGs). Results show a maximum longevity of 7 years for males (mean: 4.26 +/- 0.33) and 6 years for females (mean: 3.91 +/- 0.41). SVL averaged 45.19 +/- 1.59 mm for males and 43.51 +/- 2.33 mm for females, with growth rates of 3.10 +/- 1.03 mm/year (males) and 3.58 +/- 1.24 mm/year (females), modeled using the von Bertalanffy equation. Sexual dimorphism was subtle (SDI = 0.04, male-biased), with no significant differences in morphometric traits between sexes. Survival rates were 0.78 for males and 0.76 for females, yielding adult life expectancies of 6.06 years (males) and 5.80 years (females), indicating a stable population. These findings suggest that Bozcaada's insular conditions, including limited resources and reduced predation, influence size, growth, and survival. This study establishes a novel profile of H. turcicus in an insular habitat, highlighting ecological adaptations and providing a foundation for future research and conservation strategies for this adaptable species.
A Novel Homozygous Frameshift Variant of SACS Gene in the Turkish Siblings With Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS)
(Wiley, 2025) Cokyaman, Turgay; Saltik, Zeynep Alara; Turan, Nihan Ecmel
Pathogenic variants of sacsin (SACS) gene cause autosomal recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS). It is a hereditary neurological disorder manifested with gait ataxia, intentional tremor, lower limb pyramidal signs and pes cavus. It was originally described in the late 1970s and has a high prevalence in northeastern Quebec, Canada. Here, we present for the first time a new SACS frameshift variant in two Turkish siblings. We detected a new homozygous frameshift variant of the SACS gene in the Turkish siblings diagnosed with ARSACS for the first time.
The Effect of Brief Group Psychoeducation on Cognitive Distortions, Automatic Thoughts and Functioning in Major Depressive Disorder: A Randomized Controlled Trial
(Wiley, 2025) Sagbas, Serap; Korkmaz, Sukru Alperen; Oyekcin, Demet gulec
Major depressive disorder (MDD) causes significant impairment and reduced functioning, yet it remains undertreated. This study examined the effectiveness of a structured, brief group psychoeducation programme for individuals diagnosed with MDD. The randomized controlled trial involved 52 adults diagnosed with MDD according to DSM-5 criteria. Participants were divided into two groups: an experimental group (n = 29) that received psychoeducation during a 12-week follow-up and a control group (n = 23) that received only standard pharmacotherapy. The intervention included two interactive psychoeducation sessions, each lasting 90-120 min, conducted in a group setting. Levels of depression, anxiety, cognitive distortions, automatic thoughts and functioning were assessed using the Hamilton Depression and Anxiety Rating Scales (HAM-D/HAM-A), the Cognitive Distortion Scale (CDS), the Automatic Thoughts Scale (ATQ) and the Functioning Assessment Short Test (FAST), respectively. The findings indicated that depression and anxiety scores significantly decreased in both groups after 12 weeks, with no difference between them in this regard. However, the group receiving psychoeducation experienced greater improvements in cognitive distortions and automatic thoughts compared to the control group, especially in areas such as helplessness, negative self-concept and giving up/helplessness. Although functioning levels improved in both groups, there was no significant difference between them. Structured brief group psychoeducation resulted in significant improvements, particularly in reducing cognitive distortions and automatic thoughts in patients with MDD. Psychoeducation is a practical approach that emphasizes cognitive processes along with pharmacotherapy. Including a broader range of psychotherapeutic modalities in treatment plans may further enhance functional outcomes.
Clinical Profiles and In-Hospital Outcomes of Pre-Existing Versus Newly Diagnosed Atrial Fibrillation in Coronary Care Units: Insights From the MORCOR-TURK National Registry
(Wiley, 2025) Aydin, Ertan; Ogutveren, Muhammed Mursel; Mert, Gurbet Ozge; Yeni, Mehtap; Gulasti, Sevil; Kucuk, Ugur; Candemir, Basar
Objective To compare demographic, clinical, and laboratory profiles and short-term outcomes between pre-existing (chronic) atrial fibrillation (AF) and newly diagnosed AF among patients admitted to coronary care units (CCUs) in Turkey, and to identify factors associated with in-hospital mortality within AF subtypes. Methods This multicenter, prospective national registry analysis included 540 consecutive AF patients from 50 CCU centers across seven geographic regions in Turkey (MORCOR-TURK National Registry; September 1-30, 2022). Patients were categorized as pre-existing AF (documented AF prior to or at admission) or newly diagnosed AF (first detected during hospitalization). Demographics, comorbidities, admission diagnoses, laboratory biomarkers (including NT-proBNP and hs-troponin I), management, and outcomes were recorded. Multivariable logistic regression identified independent predictors of in-hospital mortality. Results Pre-existing AF (n = 324) had higher prevalences of diabetes mellitus (42.3% vs. 31.5%; p = 0.012) and acute coronary syndromes (58.6% vs. 34.7%; p < 0.001). Newly diagnosed AF (n = 216) more frequently presented with heart failure (45.8% vs. 28.4%; p < 0.001) and dyspnea (67.1% vs. 48.5%; p < 0.001). Newly diagnosed AF exhibited higher inflammatory burden (CRP median 28.4 vs. 12.6 mg/L; p < 0.001) and lower hemoglobin (11.8 +/- 2.1 vs. 12.9 +/- 1.8 g/dL; p < 0.001). NT-proBNP was elevated in both groups and higher in newly diagnosed AF (median 4850 vs. 3240 pg/mL; p = 0.003). In-hospital mortality was greater with newly diagnosed AF (12.0% vs. 6.8%; p = 0.042). Independent mortality predictors included age, chronic kidney disease, cardiogenic shock, and log-transformed NT-proBNP, hs-troponin I, and CRP. Conclusion In Turkish CCUs, pre-existing and newly diagnosed AF constitute distinct clinical phenotypes with differing presentations, biomarker profiles, and short-term risk. Newly diagnosed AF is associated with greater inflammatory and hemodynamic stress and higher in-hospital mortality. Biomarker-enriched risk stratification may refine prognostication and guide targeted management within AF subtypes.
Development of Stable Microemulsions Containing Laurel Essential Oil Using Amylopectin and Gum Arabic as Natural Emulsifiers
(Wiley-V C H Verlag Gmbh, 2025) Berber, Mehmet Mert; Uzkuc, Nesrin Merve Celebi; Uzkuc, Hasan; Kuzu, Kubra Tarhan; Hosoglu, Muge Isleten; Togay, Sine Ozmen; Toklucu, Aysegul Kirca
This study aimed to develop food-grade microemulsions of laurel essential oil (L-EO) (MEs) stabilized with amylopectin (L-AP) and gum arabic (L-GA) and to determine characteristic properties of the MEs at different pH and temperatures during storage. L-EO was extracted using the microwave-assisted hydrodistillation technique. The prepared ME droplets ranged in size range from 328 to 347 nm in L-AP (pH 6.0) and from 327 to 432 nm in L-GA (pH 3.0). The total phenolic content and antioxidant capacity were 170.60 mg/L gallic acid equivalent (GAE) and 0.93 mM Trolox/mL in L-AP, respectively, while total phenolic content was 243.10 mg/L GAE and antioxidant capacity was 1.19 mM Trolox/mL in L-GA. Additionally, the MEs demonstrated relatively potent antimicrobial activity against Escherichia coli, Bacillus cereus, and Staphylococcus aureus strains. The main volatile compounds of L-EO were identified as 1,8-cineole (33.4%), sabinene (8.4%), and linalool L (6.6%).
Real-Time Prediction of Correct Yoga Asanas in Healthy Individuals With Artificial Intelligence Techniques: A Systematic Review for Nursing
(Wiley, 2025) Ozsezer, Gozde; Mermer, Gulengul
AimThis study aims to systematically review the real-time prediction of yoga asanas using artificial intelligence (AI) techniques to improve the quality of life in healthy individuals.DesignSystematic review.MethodsA comprehensive literature review was conducted in English using the keywords 'yoga', 'asana', 'pose', 'posture', 'machine learning', 'deep learning' and 'prediction' in the Web of Science, Google Scholar, PubMed and Scopus databases. The objective was to identify all relevant studies on the topic. Two independent researchers screened the titles and abstracts of the retrieved publications, applying the JBI Critical Appraisal Checklist for Diagnostic Test Accuracy Studies for quality assessment. The initial search yielded 3250 studies (Google Scholar: 3190, PubMed: 19, Scopus: 27, Web of Science: 14). After applying inclusion criteria, 15 studies were included in the final systematic review.ResultsAmong the included studies, nine employed deep learning (DL) models, three utilised machine learning (ML) and three applied a combination of both DL and ML techniques. The primary statistical evaluation method for real-time prediction was accuracy across all studies. The highest accuracy rates were observed in studies using DL models alone (min = 92.34%, max = 99.92%), followed by studies that combined DL and ML (min = 91.49%, max = 99.58%), and those using only ML (min = 90.9%, max = 98.51%). These findings indicate that integrating DL and ML models can enhance the accuracy of real-time yoga asana prediction.Patient or Public ContributionThe findings advocate for the implementation of DL and ML models in clinical and community settings to improve the real-time and precise prediction of yoga asanas, a well-established evidence-based nursing intervention for healthy individuals.
Antibacterial efficacy of pyrolysis-derived plant fractions against resistant pathogens: a comparative evaluation using nutrient and Müller-Hinton agar
(Wiley, 2026) Demirel, Maruf Hursit; Gul, Abdulkadir; Aydogmus, Ercan; Ozgen, Inanc; Arslanoglu, Hasan
BACKGROUND This study investigates the antibacterial potential of pyrolysis-derived extracts from rosehip fruit (RF), orange peel (OP), corn silk (CS), spurge root (ER) and mullein leaf (ML) against antibiotic-resistant pathogens using two different culture media. Bioactive compounds were obtained via a PID-controlled pyrolysis system, and antibacterial activity was evaluated to clarify both extract efficacy and medium-dependent effects on bacterial growth and diffusion.RESULTS Antibacterial activities were assessed using the agar well diffusion method, with ampicillin as a positive control, against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis. A key novelty of this work is the comparative evaluation of extract performance on nutrient agar (NA) and M & uuml;ller-Hinton agar (MHA). Among all samples, the ML extract exhibited the strongest antibacterial activity across all tested strains, producing inhibition zones of 18.85 mm against E. coli and 17.15 mm against E. faecalis on NA, compared with 13.05 mm and 13.60 mm on MHA, respectively. CS and ER extracts showed moderate antibacterial effects, with consistently higher inhibition zones on NA than on MHA. Ampicillin generated substantially larger inhibition zones on NA (33.35 mm for E. coli and 34.45 mm for P. aeruginosa) compared with MHA (13.80 and 27.70 mm, respectively), confirming the strong influence of culture medium composition on measurable antibacterial activity.CONCLUSION These results indicate that both plant extracts and ampicillin exhibit higher antibacterial activity on NA than on MHA. The pronounced efficacy of the ML extract highlights pyrolysis-derived plant fractions as promising natural antimicrobials and emphasizes the critical importance of culture medium selection. (c) 2026 Society of Chemical Industry.
Longitudinal trajectories of major depressive disorder provide further clinical perspectives for precision psychiatry
(Wiley, 2025) Atagun, Murat Ilhan
Major depressive disorder (MDD) is a common and debilitating disorder. MDD was considered to be a relatively benign disorder compared to other major psychiatric disorders. However, longitudinal research revealed heterogeneous and frequently chronic course. Episodic or chronic progress reframes MDD as a disorder with a variable and enduring course. The recognition of MDD's heterogeneity has prompted a methodological evolution in psychiatric research, moving away from group-level averages toward more sophisticated, person-centered analytical techniques. In addition to inherent heterogeneity, biological, psychosocial, and environmental factors are also influential on the clinical manifestations of MDD. The course of major depressive disorder is not only heterogeneous among individuals but also varies systematically across different populations. Multiple models have consistently identified several distinct trajectory classes across diverse populations and study designs, providing a more nuanced map of how MDD unfolds over a lifetime. The concept of MDD subtyping within precision psychiatry directly addresses its inherent heterogeneity. If different subtypes of MDD possess distinct neurobiological underpinnings, then identifying these specific subtypes through biomarkers may lead to highly targeted and significantly more effective treatments. Longitudinal perspectives are indispensable for an accurate understanding of prognosis, the development of preventive strategies, and the implementation of effective long-term management plans that can alter the illness's trajectory. It was aimed to review the MDD trajectories, treatments, and symptom clusters from population and life span-based perspectives in this paper.
Phytochemicals as Modulators of NETosis: A Comprehensive Review on Their Mechanisms and Therapeutic Potential
(Wiley, 2025) Askarizadeh, Fatemeh; Karav, Sercan; Sahebkar, Amirhossein
Medicinal plants have a longstanding history in the treatment of various diseases, including infectious and inflammatory disorders. These therapeutic effects are attributed to the presence of bioactive compounds. Among these, phytochemicals, particularly polyphenols such as curcumin, luteolin, resveratrol, alkaloids, and terpenoids, play a significant role as a secondary metabolites with potent NETosis-modulating properties. Phytochemicals include a wide range of bioactive substances with various therapeutic properties, including anti-inflammatory, antibacterial, anticancer, anti-metastatic, and antioxidant effects. These compounds specifically target NETosis in inflammatory and autoimmune disorders such as rheumatoid arthritis, lupus erythematosus, psoriasis, and cancer. In such conditions, unregulated inflammatory responses lead to complications and disease progression. Innate immunity and neutrophils are recognized as the primary constituents of the immune response. NETosis is a process associated with neutrophils in the inflammatory response, which is initiated to eliminate pathogens; however, as it is dysregulated, it results in tissue damage. This process is initiated in order to eliminate external factors and modulate inflammatory pathways. However, excessive activation of NETosis leads to tissue damage and exacerbates inflammation. The phytochemicals discussed herein modulate NETosis through distinct mechanisms, including inhibiting or reducing key mediators such as MPO, NE, and ROS. This study provides the first comprehensive review systematically evaluating the active phytochemicals effect in the treatment of various diseases, with a special focus on their NETosis-modulating effects. We highlight their specific mechanism of action against NETotic pathways and clinical potential as targeted therapies for NET-driven disease.
Pediatric earthquake-related amputations: associations with fasciotomy, crush syndrome, and entrapment duration
(Springer Heidelberg, 2025) Pazarci, Ozhan; Battal, Vahit Erdal; Gokmen, Mehmet Yigit; Sonmez, Emre; Cicek, Oguzhan; Uslu, Hakan
BackgroundPediatric earthquake victims face unique challenges due to their distinct physiology, vulnerability to crush and compartment syndromes, and long-term functional and psychosocial needs. While adult earthquake-related amputations have been described, comprehensive pediatric-focused analyses remain scarce.MethodsWe conducted a retrospective study of 54 pediatric patients who underwent earthquake-related amputations following the February 6, 2023, T & uuml;rkiye double earthquakes. Demographics, amputation characteristics, fasciotomy, crush syndrome, entrapment under debris, intensive care unit (ICU) admission, and early outcomes were systematically evaluated.ResultsLower extremity amputations predominated (79.6%), with bilateral limb loss in 18.5% of patients. Fasciotomy was performed in 40.7% and was associated with shorter entrapment duration (p = 0.023), longer hospitalization (p = 0.027), and absence of debris entrapment (p = 0.019). Crush syndrome (25.9%) was linked to longer hospital stay (p = 0.017) and higher ICU admission (p = 0.043). Debris entrapment (13.0%) significantly increased the risk of thoracic trauma (p = 0.046) and ICU requirement (p = 0.033). Notably, no fasciotomy was performed in entrapped children. Older age, crush syndrome, and debris entrapment were significantly associated with ICU admission.ConclusionsThis study provides an early description of pediatric earthquake-related amputations. Fasciotomy appeared most beneficial when performed shortly after rescue, whereas prolonged entrapment was linked to systemic compromise and critical care needs. Crush syndrome was associated with greater resource utilization. These early descriptive findings underscore the importance of pediatric-specific considerations in disaster preparedness and highlight priorities for future multicenter and comparative research.
Mechanistic insights into postbiotics as therapeutic agents in type 2 diabetes management
(Springer, 2025) Ebadpour, Negar; Faraji, Navid; Abavisani, Mohammad; Karav, Sercan; Sahebkar, Amirhossein
The rising prevalence of type 2 diabetes mellitus (T2DM) alongside its associated morbidity and complications underscores the need for adjunctive therapies beyond glycemic control and lifestyle modification. Emerging evidence implicates gut microbiota-derived metabolites in the modulation of host energy homeostasis. One of these metabolites, postbiotics-the bioactive substances created during the fermentation of probiotics-have now become a promising therapeutic. Postbiotics, which contain short-chain fatty acids (SCFAs), exopolysaccharides (EPS), peptidoglycans, bacteriocins, vitamins, and neurotransmitters, have numerous mechanisms that regulate glucometabolism, improve insulin sensitivity, and are able to attenuate systemic inflammation. These compounds are able to regulate insulin receptor signaling and hepatic glucose production by modulating such key metabolic pathways as glycolysis and gluconeogenesis. Based on the previous preclinical and clinical evidence, postbiotic compounds exhibit mechanistic plausibility as adjunct therapies for T2DM. However, due to heterogeneity in patient microbiomes and a lack of standardized formulations that limit current applicability, further investigations are required. Future investigations should focus on dose-finding, long-term safety, and stratification of responders based on microbial and metabolic phenotypes. This review explores the role of postbiotics in T2DM from a mechanistic point of view, highlights their clinical significance in T2DM management, and discusses the next avenue to improve the therapeutic approaches.
Cone beam computed tomography vs. microcomputed tomography for trabecular bone healing assessment
(Urban & Vogel, 2025) Deniz, Yesim; cetin Genc, Cigdem; Orhan, Kaan
PurposeThis study aimed to compare cone beam computed tomography (CBCT) and microcomputed tomography (mu CT) data to evaluate the micromorphological structure of healing bone in defects created on rabbit mandibles at different stages.MethodsResidual rabbit mandibular alveolar bone tissues from another animal study involving 18 rabbits were utilized. In the prior study, 10 x 4 mm bone cavities were created, left to heal naturally, and the animals were sacrificed after 21, 45, and 90 days. In this study, CBCT and mu CT imaging were performed on the excised defect regions. The micromorphometry parameters including bone-volume fraction (BV/TV), bone-surface density (BS/TV), fractal dimension, connectivity density (Conn. Dn.), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were examined by ImageJ (US National Institutes of Health, Bethesda, MD, USA). Paired two-sample t-tests, Wilcoxon test, and Bland-Altman plots were performed.ResultDifferences in the parameters Conn. Dn., fractal dimension, Tb.Th, and Tb.Sp were observed between CBCT and mu CT on day 21. By day 45, no significant differences were noted in BV/TV, BS/TS, Tb.Th, and Tb.Sp. On day 90, all measured parameters showed no statistically significant differences between CBCT and mu CT. Bland-Altman analysis showed an agreement for most parameters (BV/TV, BS/TV, fractal dimension, Tb.Th, and Tb.Sp) after 21, 45, and 90 days, with minimal biases emerging over time, while a more notable divergence in Conn. Dn. was observed.ConclusionCBCT can be used for micromorphological analyses on days 45 and 90 of bone healing as there were no differences between CBCT and mu CT during these periods. ZielIn dieser Studie sollten CBCT- (digitale Volumentomographie) und mu CT(Mikro-Computertomographie)-Daten verglichen werden, um die mikromorphologische Struktur der Knochenheilung in artifiziell erzeugten Defekten an Kaninchenunterkiefern in verschiedenen Stadien zu untersuchen.MethodeVerwendet wurde Restgewebe des Alveolarknochens von Kaninchen aus einer anderen Tierstudie mit 18 Kaninchen. In der vorangegangenen Studie wurden 10 x 4 mm gro ss e Knochendefekte geschaffen, die nat & uuml;rlich ausheilen sollten, und die Tiere wurden nach 21, 45 und 90 Tagen get & ouml;tet. In der vorliegenden Studie wurden CBCT- und mu CT-Aufnahmen der exzidierten Defektregionen durchgef & uuml;hrt. Die mikromorphometrischen Parameter einschlie ss lich Knochenvolumenanteil (BV/TV), Knochenoberfl & auml;chendichte (BS/TV), fraktale Dimension, Konnektivit & auml;tsdichte (Conn. Dn.), Trabekeldicke (Tb.Th) und Trabekelseparation (Tb.Sp) wurden mit ImageJ (US National Institutes of Health, Bethesda, MD, USA) untersucht. Durchgef & uuml;hrt wurden gepaarte Zwei-Stichproben-Tests, der Wilcoxon-Test und Bland-Altman-Diagramme.ErgebnisUnterschiede bei den Parametern Conn. Dn., fraktale Dimension, Tb.Th und Tb.Sp wurden zwischen CBCT und mu CT am 21. Tag festgestellt. Am 45. Tag wurden keine signifikanten Unterschiede bei BV/TV, BS/TS, Tb.Th und Tb.Sp festgestellt. Am 90. Tag zeigten alle gemessenen Parameter keine statistisch signifikanten Unterschiede zwischen CBCT und mu CT. Die Bland-Altman-Analyse zeigte eine & Uuml;bereinstimmung f & uuml;r die meisten Parameter (BV/TV, BS/TV, fraktale Dimension, Tb.Th und Tb.Sp) am 21., 45. und 90. Tag, wobei im Laufe der Zeit nur minimale Abweichungen auftraten, w & auml;hrend eine deutlichere Divergenz bei Conn. Dn. beobachtet wurde.SchlussfolgerungDie CBCT kann f & uuml;r mikromorphologische Analysen am 45. und am 90. Tag der Knochenheilung verwendet werden, da es in diesen Zeitr & auml;umen keine Unterschiede zwischen CBCT und mu CT gab.
In-vitro and In-silico evaluation of the inhibitory effects of Persea americana leaf extract against calcium oxalate stones
(Springer, 2025) Akyol, Emel; Danisman, Merve; Oner, Mualla
This study investigated the effects of Persea americana extract (PAE) as a potential inhibitor of calcium oxalate monohydrate growth using both in-vitro and in-silico methods with spontaneous crystallization to evaluate its effectiveness in preventing kidney stones. X-ray diffraction was used to characterize the morphology of calcium oxalate (CaOx) crystals, while scanning electron microscopy (SEM) was used to determine their particle size and crystal formation patterns. SwissADME (Absorption, Distribution, Metabolism, Excretion) computational analysis predicted the biological activity of the extract. The experimental results show that the inhibition of crystal growth increases with the amount of PAE in solution, and crystal growth was almost completely inhibited for 450 min at a concentration of 100 mL of PAE. The in vitro results also revealed that Persea americana leaf promoted the formation of calcium oxalate dihydrate (COD) crystals rather than monohydrate crystals. These findings on PAE's inhibitory effect on calcium oxalate crystallization suggest that natural additives could be valuable in treating kidney stone disease.
Avoiding radiation exposure during retrograde intrarenal surgery; a RIRSearch score for predicting longer fluoroscopy times
(Springer, 2025) Ozman, Oktay; Simsekoglu, Fatih; Sahin, Mehmet Fatih; Basatac, Cem; Akgul, Murat; Cakir, Hakan; Cinar, Onder
The aim of this study was to identify preoperative and perioperative predictors of radiation exposure during retrograde intrarenal surgery and to develop a scoring system to estimate intraoperative fluoroscopy time. Data from 753 patients who underwent retrograde intrarenal surgery for renal stones were obtained from a multicenter database. All procedures were performed under general anesthesia using fluoroscopy. Fluoroscopy time, recorded in seconds, was the primary outcome. Ordinal regression analysis was applied to evaluate the association between clinical variables and fluoroscopy duration. A predictive score was developed based on statistically significant factors. The performance of the score was tested using receiver operating characteristic curve analysis and a calibration plot.The mean fluoroscopy time was 58 seconds, while the median was 5 seconds. In 140 procedures, fluoroscopy time exceeded 120 seconds. Six parameters were independently associated with longer fluoroscopy use: absence of preoperative ureteral stenting, low stone density (<1000 Hounsfield units), small stone burden (<250 cubic millimeters), multiple stone localizations, failure of ureteral access sheath insertion, and use of large-caliber sheaths (>= 10-12 French). Each parameter was assigned a weighted value, generating a score ranging from 0 to 15. The scoring system demonstrated excellent discriminatory ability (area under the curve: 0.901). A score of 10 or more predicted fluoroscopy duration above 120 seconds with 87.5% sensitivity and 86.2% specificity.The RIRSearch Score is a practical tool for anticipating prolonged radiation exposure before retrograde intrarenal surgery. Surgeons may use this model to minimize unnecessary fluoroscopy and enhance occupational safety.

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