Aims: This study aimed to evaluate preoperative HbA1c and serum 25-hydroxyvitamin D levels in patients with endometrial carcinoma and to investigate their associations with tumor grade and lymphovascular space invasion (LVSI).Methods: This retrospective study included 81 patients with histologically confirmed endometrial carcinoma and 30 control patients diagnosed with endometrial hyperplasia who underwent hysterectomy. Patients were categorized into four groups: grade 1-2 LVSI-negative, grade 1-2 LVSI-positive, grade 3 tumors, and controls. Preoperative glucose, HbA1c, and vitamin D levels were retrieved from medical records. Group comparisons were performed using Welch’s ANOVA with Games-Howell post hoc testing. Multivariate analysis of covariance (MANCOVA) was conducted adjusting for age and body-mass index.Results: Patients with endometrial carcinoma were significantly older and had higher BMI, glucose, and HbA1c levels, along with lower vitamin D concentrations compared with controls (all p
Aims: Acute appendicitis (AA) is a common surgical emergency with a heterogeneous clinical and pathological spectrum. Given their established roles in immune modulation, inflammation, and host-pathogen interactions, ABO blood group antigens have been investigated in various infectious and inflammatory diseases. In this study, we aimed to investigate the association between blood groups and the clinical course of acute appendicitis.Methods: This retrospective study data from patients who underwent appendectomy at our center were analyzed. Patients were classified into normal (n=42), uncomplicated (n=970), and complicated (n=213) appendicitis groups based on histopathological findings. Demographic data, ABO blood groups, histopathological findings, preoperative laboratory parameters, and length of hospital stay were evaluated and statistical analyses were performed.Results: No significant differences were observed in ABO blood group distribution among histopathological subgroups (p>0.05). In multivariate analysis, age and C-reactive protein remained independent predictors of complicated appendicitis (p
Aims: This study aimed to systematically evaluate the clinical accuracy and patient accessibility of ChatGPT-4-generated cardiovascular surgery patient education content across Turkish and English languages, examining language-dependent performance patterns and their implications for clinical practice.Methods: Twelve cardiovascular surgery specialists with minimum 5 years clinical experience conducted blinded evaluation of 52 ChatGPT-4 responses (26 Turkish, 26 English), generating 624 total expert assessments, across six cardiovascular surgery patient education domains using validated 7-point Likert scales. Simultaneously, computational accessibility analysis was performed using language-specific readability indices. Statistical analysis included effect size calculations and correlation analysis.Results: ChatGPT-4 demonstrated high clinical accuracy across both languages (mean satisfaction: 6.40/7.0, 91.4%), with 88.7% of responses receiving high expert ratings. However, profound language-dependent accessibility disparities emerged; Turkish responses achieved near-universal patient accessibility (mean score: 77.7±4.2), while English responses required university-level education (mean score: 30.2±6.1), creating a 47.5-point accessibility gap (Cohen’s d=9.07, p
Aims: To compare nutrition-related behaviors, gastrointestinal (GI) symptoms, food insecurity, and health-related quality of life between women with Hashimoto thyroiditis (HT) and healthy controls, and to explore factors associated with HT.Methods: In this case-control study conducted in Adana, Turkiye, 214 adult women (107 HT; 107 controls) completed a face-to-face questionnaire including a nutrition habits survey, the Mediterranean Diet Adherence Screener (MEDAS), the Food Insecurity Experience Scale (FIES), the Gastrointestinal Symptom Rating Scale (GSRS), and the Short Form-36 (SF-36). Group comparisons used chi-square and Mann-Whitney U tests, correlations were assessed with Spearman’s rho, logistic regression explored factors associated with HT, and path analysis examined interrelationships among food insecurity, MEDAS, GSRS, and SF-36.Results: Compared with controls, the HT group had lower Mediterranean diet adherence (median MEDAS 7 vs 8; p=0.023), higher constipation and reflux symptom scores (p=0.006 and p=0.023), and lower mental health scores (SF-36 mental health; p
Aims: This study aims to assess the level of radiation protection among 4th and 5th-year dentistry students and assistants and to relate this level to the increasing duration of their education. Additionally, it seeks to raise awareness regarding the ionizing radiation used in dental radiography and ensure that this awareness is applied within the framework of radiation safety in their professional careers. Methods: The study included 4th- and 5th-year dentistry students as well as assistant (specialization) students from various departments. Participants were administered a questionnaire consisting of two sections; the first section included sociodemographic information, and the second section contained questions assessing knowledge of radiation protection, with 2 multiple-choice questions and 16 true-false questions. Results: A total of 218 dentistry and specialization students answered the survey questions. When asked about devices that use ionizing radiation, 62.4% of participants identified computed tomography, 57.8% identified cone beam computed tomography, while 50.9% incorrectly identified magnetic resonance, and 18.8% incorrectly identified ultrasonography. Regarding radiation protection knowledge, 93.6% of participants acknowledged that ionizing radiation is harmful to living beings.Conclusion: Based on the evaluation of the responses, assistants generally demonstrated higher levels of radiation knowledge compared to dentistry students; however, this superiority was not consistent across all items, and in some specific questions students showed better performance.
Aims: To evaluate prenatal ultrasonographic findings, diagnostic distribution, and pregnancy outcomes in fetuses diagnosed with cloacal anomalies and to correlate imaging features with disease severity and prognosis.Methods: This retrospective study included 21 fetuses prenatally diagnosed with cloacal anomalies at a tertiary referral center. Maternal demographics, gestational age at diagnosis, prenatal ultrasonographic features, genetic testing results, associated anomalies, and pregnancy outcomes were reviewed. Cloacal anomalies were classified as persistent cloaca, cloacal dysgenesis, cloacal exstrophy, omphalocele-exstrophy-imperforate anus-spinal (OEIS) defects complex, or exstrophy-epispadias complex (EEC).Results: The mean gestational age at diagnosis was 24.7 (±5.17) weeks. Persistent cloaca was the most common diagnosis (42.8%), followed by cloacal exstrophy (28.6%), cloacal dysgenesis (14.3%), OEIS defects complex complex (9.5%), and EEC (4.8%). The most frequent prenatal ultrasonographic findings were pyelectasis/hydronephrosis, a lower abdominal cystic mass, and absence of the anal dimple. Cloacal dysgenesis was associated with severe urinary tract obstruction, characterized by oligohydramnios, megacystis, and bilateral hydronephrosis. Termination of pregnancy was performed in 57.1% of cases, while 23.9% survived postoperatively and 19.0% resulted in postnatal death.Conclusion: Prenatal ultrasonography plays a crucial role in identifying cloacal anomalies. Recognition of specific imaging patterns is essential for differentiating cloacal dysgenesis from other cloacal malformations, as severity strongly correlates with prognosis and pregnancy outcome.
Aims: Radiofrequency (RF) technologies are widely used in modern communication systems, particularly with the introduction of fifth-generation (5G) networks. Despite increasing exposure to RF fields, their potential biological effects remain controversial. This study aimed to evaluate the effects of repeated exposure to a 3200 MHz RF field on cardiac injury biomarkers in a rat model. We hypothesized that repeated RF exposure would induce measurable alterations in cardiac biomarkers.Methods: Thirty-four male Wistar albino rats (220-280 g) were randomly assigned to five groups: control, sham-15 min, sham-1 h, RF exposure-15 min, and RF exposure-1 h. Animals in exposure groups were subjected to a 3200 MHz RF field for 15 minutes or 1 hour daily for 15 consecutive days. Serum troponin I, creatine kinase (CK), and plasma brain natriuretic peptide (BNP) levels were measured using the Abbott Alinity I immunoassay autoanalyzer (Abbott Laboratories, Abbott Park, IL, USA). Statistical analyses were performed using GraphPad software. Results: No statistically significant differences were observed in troponin I or BNP levels among the groups (p
Aims: This study aimed to investigate whether adenoid hypertrophy-related obstructive sleep apnea syndrome (OSAS) affects hematological inflammatory parameters in children. Specifically, this study focused on evaluating the mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), which have been proposed as potential biomarkers of systemic inflammation in various pediatric and adult airway disorders.Methods: A retrospective case-control analysis was performed, including children diagnosed with OSAS secondary to adenoid hypertrophy and age-matched healthy controls without respiratory symptoms. Complete blood count parameters, including MPV, platelet, lymphocyte, neutrophil, and white blood cell counts, were obtained from the medical records. Inflammatory markers (NLR and PLR) were calculated and compared between groups. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of the significant hematological markers and to determine the optimal cutoff values.Results: A total of 129 pediatric patients were included in this study. The adenoidectomy group consisted of 61 children, while 68 children who underwent minor urological procedures served as controls. MPV, lymphocyte count, and PLR values did not differ significantly between the groups (p>0.05). However, hemoglobin levels were significantly lower in the OSAS group, whereas platelet count, white blood cell count, neutrophil count, and NLR were significantly higher (p
Aims: This study aimed to evaluate the effect of classical music exposure during clinical practice on perceived stress and coronavirus-related anxiety levels among dental students during the transition back to face-to-face education in the COVID-19 pandemic period.Methods: This prospective single-group clinical study with repeated measures included 46 systemically healthy dental students. Data were collected through face-to-face questionnaires at four different time points: baseline (T1), after patient care in the clinic (T2), before listening to music (T3), and after listening to music (T4). The questionnaire consisted of sociodemographic data, the Perceived Stress Scale-14 (PSS-14), and the Coronavirus Anxiety Scale (CAS). Data were analyzed using paired t-tests or Wilcoxon signed-rank tests, as appropriate.Results: Mean PSS-14 scores obtained before listening to music (T1, T2, and T3) were similar, whereas a significant decrease was observed after listening to music (T4). No statistically significant differences were found between T1 and T2 or T3 in terms of PSS-14 and CAS scores. However, PSS-14 and CAS scores at T4 were significantly lower compared with T1, T2, and T3 (p=0.004, p=0.001, p
Aims: To evaluate the impact of the COVID-19 pandemic on the epidemiology and clinical characteristics of viral lower respiratory tract infections (LRTIs) in young infants admitted to a neonatal intensive care unit (NICU).Methods: This single-center retrospective cohort study included 235 young infants hospitalized with viral LRTI between January 2018 and January 2024. Patients were categorized into pre-pandemic (n=54), during the pandemic (n=64), and post-pandemic (n=117) periods. Demographic characteristics, viral pathogen distribution, respiratory support requirements, length of stay, and clinical morbidities were compared. Multivariate logistic regression was performed to identify predictors of invasive mechanical ventilation (IMV).Results: RSV was the most frequently identified pathogen (49.8%), followed by SARS-CoV-2 (8.5%), influenza (6.4%), and rhinovirus (3.0%); no pathogen was detected in 24.7% of cases. Viral distribution differed significantly across pandemic periods (χ² test, p=0.017; Cramer’s V=0.35). RSV proportion increased from 40.7% (pre-pandemic) to 53.0% (post-pandemic), while SARS-CoV-2 emerged during the pandemic (20.3%). Respiratory support requirements differed significantly (p=0.002; Cramer’s V=0.22), with invasive ventilation decreasing from 50.0% (pre-pandemic) to 20.5% (post-pandemic). Length of NICU stay did not differ significantly among periods (p=0.354). Clinical morbidities were comparable across periods (all p>0.05). In multivariate analysis, RSV-related infection independently predicted IMV (OR 4.36, 95% CI 2.15-8.84, p
Aims: Aggression is influenced by both interpersonal threat sensitivity and internal emotional processing mechanisms. However, the relative contributions of rejection sensitivity, alexithymia, and emotional expressivity remain insufficiently clarified in adult populations. To examine the associations among aggression, rejection sensitivity, alexithymia, and emotional expressivity and to determine their predictive roles in aggressive behavior.Methods: Cross-sectional study conducted using an online survey. The sample consisted of 406 adults aged 18-58 years (53.9% female). Aggression (Buss-Durkee Aggression Scale), Rejection Sensitivity Questionnaire, Toronto Alexithymia Scale (TAS-20), and Berkeley Expressivity Questionnaire were administered.Results: Aggression showed positive correlations with rejection sensitivity (r=.41, p
Aims: This study aimed to (1) perform a comprehensive morphometric evaluation of the patellar tendon using magnetic resonance imaging (MRI) in a Turkish population, and (2) investigate the influence of demographic factors on tendon size.Methods: This retrospective study initially evaluated 135 knee MRI scans performed between January 2023 and May 2025. After excluding 17 patients (12 with prior knee surgery, 3 with significant degenerative changes, 2 with incomplete imaging), 118 patients were included in the final analysis. Participants were categorized by gender (61 females, 57 males), age group (18-29, 30-39, 40-49, 50-59, ≥60 years), and body weight. Patellar tendon thickness and width were measured at the proximal, middle, and distal levels, and tendon length was recorded. All measurements were performed using a standardized protocol on a 1.5-Tesla MRI scanner.Results: All thickness parameters were significantly higher in males than in females (proximal: 4.74±0.87 mm vs. 3.91±0.65 mm, p
Aims: To evaluate the one-year outcomes of conservatively treated isolated greater tuberosity fractures with minimal initial displacement, with particular emphasis on secondary surgical intervention, magnetic resonance imaging (MRI) findings, and the course of bone marrow edema (BME).Methods: This retrospective cohort study included 43 adult patients with isolated greater tuberosity fractures presenting between 2018 and 2023, all of whom had an initial displacement of ≤3 mm and were managed conservatively. Clinical and radiographic data were reviewed with a minimum follow-up of 12 months. The primary outcome was the need for secondary surgical intervention within one year. Secondary outcomes included MRI-detected concomitant soft-tissue pathology, time to BME regression on serial MRI, and final Constant-Murley score.Results: The mean patient age was 52.6±13.4 years, and 26 patients (60.5%) were female. During follow-up, 5 patients (11.6%) required secondary surgical intervention, all of which were arthroscopic procedures. No patient required secondary bony fixation or corrective surgery, and no cases of nonunion, malunion, or secondary displacement were observed. MRI was performed in 18 patients (41.9%) because of persistent symptoms or delayed recovery, and 12 of these patients (66.7%) demonstrated at least one concomitant soft-tissue pathology. All imaged patients who later required secondary surgery had at least one associated soft-tissue lesion. Serial MRI evaluation was available in 11 patients, with a median time to BME regression of 15 weeks (interquartile range, 12-20 weeks). The mean Constant-Murley score at 12 months was 81.4±9.6 and was lower in patients who required secondary surgery.Conclusion: Although minimally displaced greater tuberosity fractures are generally considered to have a benign clinical course, a subset of patients may develop persistent symptoms requiring secondary arthroscopic intervention. In these cases, associated soft-tissue pathology and prolonged bone marrow edema appear to be important determinants of outcome than fracture displacement.
Aims: Cameriere’s Third Molar Maturity Index (I3M) is well established for age-threshold determination, yet its application in regression-based age estimation has not been explored in the Turkish population. This study aimed to derive sex-specific linear regression models for estimating chronological age from I3M in Turkish adolescents and young adults.Methods: This retrospective cross-sectional study evaluated 200 digital panoramic radiographs of individuals aged 14-22 years. I3M was quantified on left mandibular third molars using standardized ImageJ-based measurements by a single blinded examiner (ICC=0.90). Linear regression models were constructed for the pooled sample and separately by sex.Results: I3M showed a statistically significant inverse association with chronological age in all models (p
Aims: This study aimed to develop and optimize biotinoyl tripeptide-1 (BTP)-loaded solid lipid nanoparticles (SLNs) and to evaluate their protective efficacy against heat-induced structural and thermal damage in hair fibers.Methods: A Box-Behnken experimental design was employed to optimize the formulation. The optimized BTP-SLNs were characterized for particle size, Polydispersity Index (PDI), zeta potential, and entrapment efficiency. Hair samples were exposed to repeated thermal cycles at 200°C over 15 days to simulate the thermal straightening damage. Morphological and thermal damage were also investigated using scanning electron microscopy (SEM) and differential scanning calorimetry (DSC).Results: The optimized BTP-SLN formulation demonstrated a particle size of 207.3 nm, PDI of 0.297, zeta potential of -10.6 mV, and an entrapment efficiency of 46.2%. Heat-treated control samples exhibited pronounced cuticle lifting, cortical disruption, and decreased α-keratin denaturation enthalpy. Empty-SLNs provided partial surface-level protection; the incorporation of BTP significantly enhanced thermal resistance. Additionally, BTP-SLN-treated hair showed improved cuticle integrity, reduced microfibrillary separation, increased denaturation peak intensity, and delayed onset of thermal degradation. Conclusion: BTP-loaded SLNs demonstrated protective effects against heat-induced hair damage, likely through a dual mechanism involving lipid barrier formation and stabilization of the keratin matrix. These findings suggest that BTP-SLNs represent a promising strategy for improving thermal protection in cosmetic hair care applications.
Aims: The aim of this study was to examine the relationship between emotional self-awareness and self-regulation among medical students and to evaluate the mediating role of cognitive flexibility in this relationship.Methods: This cross-sectional study included 151 medical students aged 18 years and older. Data were collected via an online survey using the Emotional Self-Awareness Scale (ESAS), the Cognitive Flexibility Inventory (CFI), and the Self-Regulation Scale (SRS). Relationships among variables were examined using correlation analyses, and the mediating role of cognitive flexibility was tested. Age and gender were controlled as covariates in the analyses.Results: Significant and positive relationships were found among emotional self-awareness, cognitive flexibility, and self-regulation. Mediation analysis revealed that cognitive flexibility played a partial mediating role in the effect of emotional self-awareness on self-regulation. The model explained approximately 50% of the variance in self-regulation, and the magnitude of the mediating effect of cognitive flexibility was large (K²=0.246). Subdimension analyses indicated that the control dimension of cognitive flexibility exhibited a stronger mediating effect compared to the alternatives dimension.Conclusion: The findings indicate that self-regulation among medical students is strengthened not only by emotional awareness itself but also by the cognitively flexible processing of this awareness. Cognitive flexibility, particularly through perceived control, can be considered a critical mechanism in transforming emotional self-awareness into functional self-regulatory behaviors.
Aims: This study aimed to investigate the effects of nature sound-based music listening on pain and physiological parameters in surgical intensive care unit (ICU) patients.Methods: This randomized controlled trial with a pretest-posttest design was conducted in the ICUs of a state hospital in İstanbul between March and May 2024 with 108 patients who met the inclusion criteria. Patients were randomly assigned to the intervention (n=54) and control (n=54) groups using a lottery-based randomization method with sealed opaque envelopes. The envelopes were prepared by an independent healthcare staff member not involved in the study and were opened after baseline assessments to ensure allocation concealment. The intervention group listened to nature sound-based music via disposable headphones for 30 minutes, while the control group received routine care. Outcome measurements were conducted 15 minutes after the intervention. Data were collected using the Patient Information Form, Numeric Pain Rating Scale, and Physiological Parameters Assessment Form.Results: According to the pre-test results, there was no statistically significant difference in pain scores between the intervention and control groups (p=0.639). However, systolic blood pressure was significantly higher in the intervention group (p
Aims: The aim of this study was to compare the accuracy of ChatGPT (GPT-5), Gemini (Gemini 2.5 Pro), and Grok (SuperGrok) on Dental Specialty Exam (DUS) endodontics questions and to examine differences by exam year and item format (text-based vs figure-based).Methods: Endodontics questions from Turkish Assessment, Selection and Placement Center (ÖSYM) DUS exams (2012-2021) were reviewed. Of 130 questions, three items officially canceled by ÖSYM were excluded, leaving 127 questions (122 text-based, 5 figure-based). Figure-based items included periapical radiographs, clinical photographs, or schematic diagrams. Questions were submitted to each model using default settings with one response per item; no tuning or repeat runs were performed. Responses were scored as correct/incorrect using the official answer key. Fisher’s exact test and, when required, Monte Carlo-corrected Fisher’s exact test were applied (p
Aims: This study aimed to evaluate the attitudes and perceptions of dental students in Turkiye toward Artificial Intelligence (AI) and to explore their views regarding the integration of AI into dental education and clinical practice.Methods: This study employed a descriptive, observational cross-sectional design and included undergraduate dental students from multiple dental faculties throughout Turkiye. Data were obtained using a structured online questionnaire adapted from an instrument with established validity. The survey collected information on the participants’ sociodemographic features, their level of familiarity with AI, and their attitudes toward its use in dental practice. The data analysis consisted of descriptive statistics and between-group comparisons, with statistical significance defined as p
Aims: The aim of this study was to investigate the level of knowledge, perceived self-confidence, and clinical exposure of dental students to emergency situations.Methods: The study population consisted of 156 fourth- and fifth-year dental students enrolled at Bolu Abant İzzet Baysal University. Data were obtained through a structured online questionnaire comprising 28 items. The survey addressed demographic characteristics, previous emergency training, clinical encounters with emergencies, and preparedness attitudes. Knowledge levels were assessed for commonly encountered emergencies in dental practice. Statistical comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests, with significance set at p
