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Öğe The investigation of fermented food consumption on gastrointestinal symptoms: a cross-sectional study in university students(Peerj Inc, 2025) Seven Avuk, Hande; Aydin, Oyku; Kocatepe, Neslihan; Sahin, Sude Melis; Akdogan, Irem; Cavus, EserBackground Fermented foods (FFs) are a valuable source of live microorganisms that can enhance human health, particularly gastrointestinal health, akin to probiotics. This study investigated the relationship between FFs consumption habits and gastrointestinal system findings in university students. Methods A cross-sectional anonymous survey included 546 university students, collecting data on sociodemographic characteristics, the Gastrointestinal Symptom Rating Scale (GSRS), and the Bristol Stool Form Scale (BSFS). FFs consumption habits were recorded using a food frequency questionnaire. Results Results showed that the average GSRS score was 33.66 +/- 16.89. According to the BSFS, 15% of students experienced constipation, 72.7% had moderate stool consistency, and 12.3% had diarrhea. Notably, kefir, vinegar, and sourdough bread were never consumed by 56.8%, 44.3%, and 41.9% of students, respectively. Significant differences were found between the frequency of yogurt, kefir, vinegar, cheese, pickle consumption, and gastrointestinal symptoms (p < 0.05). Students with normal stool consistency had fewer dyspepsia, abdominal pain, reflux symptoms, and overall gastrointestinal symptoms than those with constipation (p < 0.05). Conclusion The study concludes that FFs such as yogurt, cheese, pickles, and kefir may offer health benefits, reducing symptoms of reflux, dyspepsia, abdominal pain, and general gastrointestinal issues in young adults.Öğe Posttraumatic Stress Disorder-Related Mental Health Problems and Risk Factors After an Earthquake(Aves, 2025) Aker, Tamer; Onder, EceEarthquakes can have a substantial impact on communities, leading to severe economic losses, structural damage, casualties, and displacement, as well as adverse psychological effects on survivors. Previous studies have highlighted a broad spectrum of adverse psychological effects following disasters, such as sleep disturbances, emotional distress, depression, suicidal thoughts, anxiety, posttraumatic stress disorder (PTSD). Posttraumatic stress disorder is particularly common among disaster survivors. It is characterized by the emergence of specific symptoms following direct exposure (experiencing a traumatic event firsthand or witnessing it happen to others) or indirect exposure (learning about a traumatic event involving loved ones or repeatedly being exposed to distressing details of the event). Disasters, crises, and traumas are difficult life experiences that require individuals to seek support. It is crucial to identify key factors such as individuals' location, emotional state, and their specific needs during these times to provide effective assistance. Addressing these aspects is essential in preventing trauma from worsening or becoming more entrenched. Post-earthquake psychosocial support should include comprehensive, long-term, and sustainable interventions to improve the mental health of both individuals and society. The aim of this article is to evaluate PTSD and related mental health issues following earthquakes.Öğe Artificial Intelligence in Diagnostic Breast Ultrasound: A Comparative Analysis of Decision Support Among Radiologists With Various Levels of Expertise(Galenos Publ House, 2025) Celebi, Filiz; Tuncer, Onur; Oral, Muege; Duymaz, Tomris; Orhan, Tolga; Ertas, GokhanObjective: To investigate integrating an artificial intelligence (AI) system into diagnostic breast ultrasound (US) for improved performance. Materials and Methods: Seventy suspicious breast mass lesions (53 malignant and 17 benign) from seventy women who underwent diagnostic breast US complemented with shear wave elastography, US-guided core needle biopsy and verified histopathology were enrolled. Two radiologists, one with 15 years of experience and the other with one year of experience, evaluated the images for breast imaging-reporting and data system (BI-RADS) scoring. The less-experienced radiologist re-evaluated the images with the guidance of a commercial AI system and the maximum elasticity from shear wave elastography. The BI-RADS scorings were processed to determine diagnostic performance and malignancy detections. Results: The experienced reader demonstrated superior performance with an area under the curve (AUC) of 0.888 [95% confidence interval (CI): 0.793-0.983], indicating high diagnostic accuracy. In contrast, the Koios decision support (DS) system achieved an AUC of 0.693 (95% CI: 0.562-0.824). The less-experienced reader, guided by both Koios and elasticity, showed an AUC of 0.679 (95% CI: 0.534-0.823), while Koios alone resulted in an AUC of 0.655 (95% CI: 0.512-0.799). Without any guidance, the less-experienced reader exhibited the lowest performance, with an AUC of 0.512 (95% CI: 0.352-0.672). The experienced reader had a sensitivity of 98.1%, specificity of 58.8%, positive predictive value of 88.1%, negative predictive value of 90.9%, and overall accuracy of 88.6%. The Koios DS showed a sensitivity of 92.5%, specificity of 35.3%, and an accuracy of 78.6%. The less-experienced reader, when guided by both Koios and elasticity, achieved a sensitivity of 92.5%, specificity of 23.5%, and an accuracy of 75.7%. When guided by Koios alone, the less-experienced reader had a sensitivity of 90.6%, specificity of 17.6%, and an accuracy of 72.9%. Lastly, the less-experienced reader without any guidance showed a sensitivity of 84.9%, specificity of 17.6%, and an accuracy of 68.6%. Conclusion: Diagnostic evaluation of the suspicious masses on breast US images largely depends on experience, with experienced readers showing good performances. AI-based guidance can help improve lower performances, and using the elasticity metric may further improve the performances of less experienced readers. This type of guidance may reduce unnecessary biopsies by increasing the detection rate for malignant lesions and deliver significant benefits for routine clinical practice in underserved areas where experienced readers may not be available.Öğe JAK2 V617F Mutation in Endothelial Cells of Patients with Atherosclerotic Carotid Disease(Galenos Publ House, 2024) Diz-Kucukkaya, Reyhan; Iyigun, Taner; Albayrak, Ozgur; Eker, Candan; Gunel, TubaObjective: It has been shown that clonal mutations occur in hematopoietic stem cells with advancing age and increase the risk of death due to atherosclerotic vascular diseases, similarly to myeloproliferative neoplasms. Endothelial cells (ECs) and hematopoietic stem cells develop from common stem cells called hemangioblasts in the early embryonic period. However, the presence of hemangioblasts in the postnatal period is controversial. In this study, JAK2 gene variants were examined in patients with atherosclerotic carotid disease and without any hematological malignancies. Materials and Methods: Ten consecutive patients (8 men and 2 women) with symptomatic atherosclerotic carotid stenosis were included in this study. ECs (CD31+CD45-) + CD45- ) were separated from tissue samples taken by carotid endarterectomy.JAK2variants were JAK2 variants were examined in ECs, peripheral blood mononuclear cells, and oral epithelial cells of the patients with next-generation sequencing. Results: The median age of the patients was 74 (range: 58-80) years and the median body mass index value was 24.44 (range: 18.4230.85) kg/m2. 2 . Smoking history was present in 50%, hypertension in 80%, diabetes in 70%, and ischemic heart disease in 70% of the cases. The JAK2 V617F mutation was detected in the peripheral blood mononuclear cells of 3 of the 10 patients, and 2 patients also had the JAK2 V617F mutation in their ECs. The JAK2 V617F mutation was not found in the oral epithelial cells of any of the patients. Conclusion: In this study, for the first time in the literature, we showed that the JAK2 V617F mutation was found somatically in both peripheral blood cells and ECs in patients with atherosclerosis. This finding may support that ECs and hematopoietic cells originate from a common clone or that somatic mutations can be transmitted to ECs by other mechanisms. Examining the molecular and functional changes caused by the JAK2 V617F mutation in ECs may help open a new avenue for treating atherosclerosis.Öğe Evaluation of T. gondii , rubella, and cytomegalovirus seroprevalences among female Syrian refugees in Sanliurfa, Turkiye(J Infection Developing Countries, 2024) Gurses, Gulcan; Doni, Nebiye Yentur; Simsek, Zeynep; Aksoy, Mustafa; Hilali, Nese Gul; Ozek, BehireIntroduction: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii ( T. gondii ), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii , rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. Methodology: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii , CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). Results: The seropositivity rates of T. gondii , CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. Conclusions: A screening program should be implemented for T. gondii , CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.Öğe The Impact of Attenuation Correction on Positron Emission Tomography/Computed Tomography and Positron Emission Tomography/Magnetic Resonance Image Quality: A Phantom Study(Wolters Kluwer Medknow Publications, 2025) Ulusoy, Yagmur Idil; Yeyin, Nami; Demir, MustafaObjective:The quality of positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance (MR) images is a critical factor affecting the diagnostic reliability of clinical studies. An image quality (IQ) phantom is used to evaluate PET IQ. This study aims to acquire PET IQ phantom images on PET/CT and PET/MR systems and investigate the effects of attenuation correction on IQ.Materials and Methods:The PET IQ phantom was filled with F-18 fluorodeoxyglucose to achieve a lesion/background ratio of 4/1. The phantom was imaged separately on two different PET/CT scanners and one PET/MR scanner. Region of interest (ROIs) was drawn on both raw and attenuation-corrected images. Contrast and contrast-to-noise ratios (CNRs) were calculated from ROI counts.Results:For the smallest lesion with a diameter of 10 mm without attenuation correction, the contrast values in PET/CT and PET/MR images were found to be 1.32, 1.68, and 1.76, respectively. In attenuation-corrected images of the same lesion, the contrast values were 1.55, 1.89, and 2.22, respectively. The CNR values for the attenuation-corrected 10 cm lesion were 13.92, 12.05, and 13.36, respectively.Conclusion:Attenuation correction significantly improved IQ, with attenuation-corrected images demonstrating higher contrast and CNR values.Öğe Finite Element Analysis of Evolut Transcatheter Heart Valves: Effects of Aortic Geometries and Valve Sizes on Post-TAVI Wall Stresses and Deformations(Mdpi, 2025) Mutlu, Onur; Mazhar, Noaman; Saribay, Murat; Yavuz, Mehmet Metin; Ozturk, Deniz; Ghareeb, Abdel Naser; Yalcin, Huseyin CagatayBackground/Objectives: For transcatheter aortic valve implantation (TAVI) therapy, a catheter-guided crimped valve is deployed into the aortic root. Valve types such as Edwards balloon-expandable valves and Medtronic self-expandable valves come in different sizes and are chosen based on patient-specific aortic anatomy, including aortic root diameter measurement. Complications may arise due to variations in anatomical characteristics and the implantation procedure, making pre-implantation assessment important for predicting complications. Methods: Computational modeling, particularly finite element analysis (FEA), has become popular for assessing wall stresses and deformations in TAVI. In this study, a finite element model including the aorta, native leaflets, and TAVI device was used to simulate procedures and assess patient-specific wall stresses and deformations. Results: Using the Medtronic Evolut R valve, we simulated TAVI for 14 patients to analyze the effects of geometrical variations on structural stresses. Virtual TAVIs with different valve sizes were also simulated to study the influence of TAV size on stresses. Our results show that variations in aortic wall geometries and TAV sizes significantly influence wall stresses and deformations. Conclusions: Our study is one of the first comprehensive FEA investigations of aortic geometrical variations and valve sizes on post-TAVI stresses, demonstrating the non-linear relationship between aortic dimensions, TAV sizes, and wall stresses.Öğe Effects of Intermittent Fasting on Liver Steatosis and Fibrosis, Serum FGF-21 and Autophagy Markers in Metabolic Dysfunction-Associated Fatty Liver Disease: A Randomized Controlled Trial(Mdpi, 2025) Karahan, Tugce Ozlu; Akyuz, Elvan Yilmaz; Karadag, Demet Yilmaz; Yilmaz, Yusuf; Eren, FatihBackground: This randomized controlled study sought to determine the effect of intermittent fasting on anthropometric measurements, fibroblast growth factor (FGF)-21, and autophagy markers, as well as on hepatic steatosis and fibrosis levels in overweight or obese patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods: Patients were randomly assigned into two groups: received a dietary treatment involving 22-25 kcal/kg/day of energy for 8 weeks and followed the same dietary intervention and a 16:8 pattern. The extent of hepatic steatosis and fibrosis was determined using transient elastography on a FibroScan (R) device. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), determined by transient elastography, reflect hepatic steatosis and fibrosis, respectively. In duplicate, serum levels of FGF-21, Beclin-1, and ATG-5 were determined using enzyme-linked immunosorbent assay. Results: The study included 48 patients with a mean age of 48.2 +/- 1.4 years (27 female and 21 male). Improvements in anthropometric measurement and CAP and LSM levels and a decrease in serum FGF-21 levels were found in both groups (p < 0.05). Changes in the CAP and FGF-21 levels were higher in the energy + time-restricted diet group (p < 0.05). Autophagy-related protein (ATG)-5 levels increased only in the energy + time-restricted diet group [(0.74 (0.46-1.29) ng/mL vs. 0.95 (0.73-1.32) ng/mL, p = 0.03]. Conclusions: Intermittent fasting was potentially practical in the management of MAFLD. In particular, changes in FGF-21 and ATG-5 levels indicate the potential of intermittent fasting to regulate metabolic processes and autophagy. However, methodological limitations should be taken into consideration when interpreting the study results.Öğe Guideline Compliance of Artificial Intelligence-Generated Diet Plans After Bariatric Surgery: A Cross-Sectional Simulation Comparing ChatGPT-4o, DeepSeek and Grok-3(Mdpi, 2025) Yilmaz, Aylin Bolat; Kenger, Emre Batuhan; Karahan, Tugce Ozlu; Saglam, Duygu; Bas, MuratBackground/Objectives: Artificial intelligence (AI)-based tools are increasingly being used in tailored nutrition management, and evaluating their compliance with guidelines is significant in clinically sensitive areas, including bariatric surgery. This study aimed to investigate the extent to which diet plans recommended by AI models in the early period following sleeve gastrectomy (SG) align with current clinical nutrition guidelines (ASMBS, AACE/TOS). Methods: A total of 360 menu plans were generated using three AI platforms-ChatGPT-4o, DeepSeek V3, and Grok-3-for 40 simulated patients (20 females, 20 males; BMI 32-45 kg/m2) across three postoperative stages: liquid (day 5), puree (day 16), and solid (day 35). The energy and nutrient contents of the menus were analyzed using BeBiS 8.1; an experienced dietitian assessed compliance with the guidelines using a structured checklist. Nutrient intakes and guideline compliance scores were examined using within-patient Friedman tests followed by Bonferroni-adjusted pairwise comparisons. Results: ChatGPT-4o demonstrated the highest overall compliance scores, particularly in the liquid and pur & eacute;ed phases, while DeepSeek produced higher values for several micronutrients. All models showed substantial gaps in essential postoperative recommendations, most notably thiamine and multivitamin supplementation. Conclusions: Although LLMs can generate partially guideline-concordant postoperative diet plans, they consistently omit several critical elements of bariatric nutrition care. These findings indicate that LLM-generated menus may serve as supportive educational tools, and diet planning must be performed under the guidance of a specialist dietitian. This simulation does not assess clinical safety, efficacy, or patient outcomes and should not be used as a substitute for dietitian-led postoperative nutrition care.Öğe Development of an Ex Vivo Mitral Valve Evaluation Model Using a Pulsatile Flow Simulator(Journal of Visualized Experiments, 2025) Albrahimi, Ergida; Aka, Ibrahim Basar; Ali, Mhd Homam Alhaj; Korun, Oktay; Odemis, Ender; Ipek, GokhanSurgical mitral valve repair remains a challenging procedure. Although several repair techniques have been defined, data comparing their hemodynamic effects are lacking. The commercially available pulse duplicators are commonly used to simulate blood circulation through mechanical or 3D printed cardiac valves. However, due to the specific structure and working mechanism of the mitral valve, the experiments on surgical techniques require the use of biological tissues. Ex vivo lamb mitral valves are suitable for such experiments, but the methods for mounting these valves to the pulse duplicator system (PDS) are not well defined. To address this, we modified the system by 3D printing and silicone molding as a mitral valve holder. We excised the mitral valve from a lamb heart for each experiment, including its annulus and subvalvar apparatus. We implanted this into the atrioventricular (mitral) valve area of the test machine using the silicone holder. Papillary muscle tension was simulated by tying sutures around the chordae-papillary junctions and passing these sutures through the release hole at the bottom of the ventricular chamber. Initial testing of the valve competence was conducted at a heart rate of 120 beats per minute and a cardiac output of 2 L/min. Valve regurgitation and the pressure gradient between the atrial and ventricular chambers were measured using pulse duplicator electromagnetic flowmeters and validated with echocardiography. Baseline hemodynamic testing demonstrated consistent valve function across five experiments, with a mean regurgitation fraction of 21.1% and echo-derived transmitral gradients ranging from 5.15 to 8.13 mmHg. Stroke volumes and peak flow rates varied among specimens, reflecting physiological variability within the pediatric model.Öğe Exploring Ultrasound and Microwave-Assisted Accelerated Aging of Jerez Vinegar: Impacts on Phenolic, Volatile, Colorimetric, and Sensory Properties(Mdpi, 2025) Uysal, Reyhan Selin; Issa-Issa, Hanan; Carbonell-Barrachina, Angel A.; Sendra, EstherJerez vinegar is a high-quality wine vinegar produced in the Vinagre de Jerez denomination of origin (Spain) and is traditionally aged in wood barrels for over 10 years. Considering the long aging process, a practical technique to accelerate the aging process was simulated. This study aimed to evaluate ultrasound and microwave treatments as alternative aging methods for fresh Jerez vinegars with oak chips, and to investigate their effects on phenolic content, volatile compounds, and colorimetric and sensory properties. Fresh control samples with oak chips were treated using ultrasound (US) in an ultrasonic bath three times: 0.5 h (US1), 2 h (US2), and 10 h (US3). Microwave (MW) treatments were performed using a domestic microwave oven with three power/time combinations: 640 W for 10 min (MW1), 640 W for 20 min (MW2), and 800 W for 10 min (MW3). Compared with the fresh control (4230 mu g/kg), US- and MW-treated samples showed a significant reduction in total phenolic content, decreasing to 3943 mu g/kg in the US1 sample and to 3988 mu g/kg in the MW2 treatment. Moreover, volatile substances significantly decreased from 1019 mg/L in the fresh control to 623 mg/L in the US3 treatment and 716 mg/L in the MW1 sample. Regarding sensory properties, US3 and MW1 treatments exhibited marked distinctions in certain odor and flavor attributes when compared with the fresh control. As a result, both techniques modified the phenolic, volatile and sensory profiles. Further research is needed to fully mimic the aging process, but US has proven to be a promising technique.Öğe Breast Cancer Plasticity after Chemotherapy Highlights the Need for Re-Evaluation of Subtyping in Residual Cancer and Metastatic Tissues(Mdpi, 2024) Padzinska-Pruszynska, Irena Barbara; Akbar, Muhammad Waqas; Isbilen, Murat; Gorka, Emilia; Kucukkaraduman, Baris; Canli, Secil Demirkol; Taciak, BartlomiejThis research paper presents a novel approach to identifying biomarkers that can be used to prognosticate patients with triple-negative breast cancer (TNBC) eligible for neoadjuvant therapy. The study utilized survival and RNA sequencing data from a cohort of TNBC patients and identified 276 genes whose expression was related to survival in such patients. The gene expression data were then used to classify patients into two major groups based on the presence or absence of Wingless/Integrated-pathway (Wnt-pathway) and mesenchymal (Mes) markers (Wnt/Mes). Patients with a low expression of Wnt/Mes-related genes had a favorable outcome, with no deaths observed during follow-up, while patients with a high expression of Wnt/Mes genes had a higher mortality rate of 50% within 19 months. The identified gene list could be validated and potentially used to shape treatment options for TNBC patients eligible for neoadjuvant therapy providing valuable insights into the development of more effective treatments for TNBC. Our data also showed significant variation in gene expression profiles before and after chemotherapy, with most tumors switching to a more mesenchymal/stem cell-like profile. To verify this observation, we performed an in silico analysis to classify breast cancer tumors in Prediction Analysis of Microarray 50 (PAM50) molecular classes before treatment and after treatment using gene expression data. Our findings demonstrate that following drug intervention and metastasis, certain tumors undergo a transition to alternative subtypes, resulting in diminished therapeutic efficacy. This underscores the necessity for reevaluation of patients who have experienced relapse or metastasis post-chemotherapy, with a focus on molecular subtyping. Tailoring treatment strategies based on these refined subtypes is imperative to optimize therapeutic outcomes for affected individuals.Öğe Attachment Styles as Protective and Amplifying Factors in Caregiver Psychological Distress: A Multicenter Cross-Sectional Study in Oncology and Chronic Disease Caregiving(Mdpi, 2025) Ozonder Unal, Ipek; Pirincci Aytac, Miray; Ozgedik Turhan, Nur; Taylan, Yunus; Unal, Caglar; Topcu, Atakan; Berkol, Tonguc DemirBackground/Objectives: Caregiving for patients with advanced cancer or chronic illness imposes substantial psychological burden, yet the role of caregiver attachment style in moderating this distress is underexplored. This multicenter, cross-sectional study investigates how attachment styles influence the relationship between psychological distress and caregiver burden in two populations: family caregivers of palliative-stage cancer patients and those supporting patients with chronic diseases. Methods: Across Turkey, 819 caregivers (412 cancer, 407 chronic disease) completed the Zarit Caregiver Burden Scale, DASS-21, and Relationship Scale Questionnaire. Hayes' PROCESS macro was used to test the moderating role of attachment styles. Results: Cancer caregivers reported higher caregiver burden (Cohen's d = 0.35, 95% CI [0.21, 0.49]) and stress than chronic disease caregivers, but lower depression. Secure attachment was negatively associated with burden, while preoccupied attachment was positively associated. For cancer caregivers, secure attachment buffered the impact of depression on burden (interaction B = -0.611, 95% CI [-0.861, -0.361]), whereas preoccupied attachment amplified it in both groups (cancer caregivers: B = 0.292, 95% CI [0.064, 0.520]; chronic disease caregivers B = 0.505, 95% CI [0.174, 0.836]). The final regression models explained 43.1% of variance in burden for the cancer group and 10.9% for the chronic disease group. Conclusions: Attachment styles are significant moderators of the relationship between psychological distress and caregiver burden. Secure attachment is a protective factor, while preoccupied attachment is a vulnerability factor. These findings underscore the need for attachment-informed psychosocial interventions tailored to specific caregiver profiles to mitigate distress.Öğe Mindful Eating and Healthy Lifestyle Behaviors Among Women with and Without Regular Exercise Habits(Mdpi, 2025) Isiklar, Handan; Kucuk Yetgin, Meral; Saglam, Zuhal AydanBackground/Objectives: Eating mindfulness and healthy lifestyle behaviors play a key role in preventing unhealthy weight gain. Understanding how these behaviors differ according to exercise habits can guide interventions targeting women's health. This study aimed to compare healthy lifestyle behaviors and eating mindfulness between women with and without regular exercise habits. Methods: A cross-sectional, analytical, and descriptive study was conducted with 156 women: a Regular Exercise Group (REG, n = 68) and a Non-Exercise Group (NEG, n = 88). Data were collected through face-to-face interviews using the Mindful Eating Questionnaire (MEQ-30) and the Healthy Lifestyle Behavior Scale II (HLBS-II), along with dietary records and anthropometric measurements. Results: The REG scored significantly higher in eating discipline (p = 0.003) and in HLBS-II subscales of physical activity, nutrition, and stress management (p < 0.05). No significant differences were found in total MEQ scores, BMI-related nutrient intake, or other HLBS-II dimensions (p > 0.05). BMI values and smoking rates were lower in the REG (p < 0.05). Univariate logistic regression showed that BMI, eating discipline, physical activity, nutrition, stress management, and total HPLP-II scores were significantly associated with regular exercise (p < 0.05). In the multivariate model, BMI (OR = 1.114, 95% CI: 1.021-1.216) remained independently associated with regular exercise status. Conclusions: Although eating discipline was higher in the REG, overall mindful eating levels did not differ between groups. BMI were the strongest independent variables associated with regular exercise status, suggesting that while exercise supports positive lifestyle patterns, enhancing mindful eating may require additional targeted interventions.Öğe Enhancing work life through social cognition: the effect of SCIT in bipolar disorder(Frontiers Media Sa, 2025) Bikmaz, Zeynep Anaforoglu; Mackali, Zeynep; Cakir, SibelObjectives This study aimed to investigate the effectiveness of social cognition and interaction therapy (SCIT) in improving occupational functioning in individuals diagnosed with bipolar disorder I (BD-I). The effects of SCIT intervention with standard treatment methods were investigated on social cognition and functioning effects, which are often negatively affected in patients with BD-I.Methods The research involved 28 participants, allocated into two groups: An experimental group (n = 12) receiving SCIT for 8 weeks alongside standard treatments (pharmacotherapy and psychiatric interviews), and a control group (n = 16) undergoing standard treatment without additional interventions. Outcome measures were assessed using a suite of tools, including the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Eyes Test (ET), Metacognition Scale (MCI), Internalized Stigma of Mental Illnesses (ISMI), and Functioning Assessment Short Test (FAST). Given the small sample size, non-parametric tests were employed for data analysis. Analyses were conducted using the Mann-Whitney U test and Wilcoxon test for comparisons between the experimental and control groups and within groups. Also, the effects of the intervention on social cognition, occupational functioning and resistance to stigmatization were dealt.Results The findings revealed that participants in the experimental group showed significant improvements in social cognition and occupational functioning after SCIT compared to the control group. However, the levels of stigmatization experienced by individuals as a result of ISMI measurements were significantly lower in the SCIT group compared to the control group.Conclusion The study concludes that SCIT can be an effective intervention for enhancing certain psychosocial and cognitive functions in individuals with BD-I, thereby improving their occupational functioning. Nevertheless, the persistent levels of stigma indicate the need for additional strategies to address the broader challenges faced by individuals with BD-I in terms of societal perception and self-stigmatization.Öğe The effectiveness of online Eye Movement Desensitization and Reprocessing 2.0 Group Protocol on post-traumatic stress disorders symptoms, depression, anxiety, and stress in individuals who have experienced a traffic accident: a randomized-controlled study(Frontiers Media Sa, 2025) Yasar, Alisan Burak; Gundogmus, Ibrahim; Kubilay, Derin; Tunca, Gorkem Alban; Uygun, Ersin; Ciftci, Zeynep Zat; Kavakci, OnderIntroduction EMDR 2.0, an innovative approach rooted in the conventional Eye Movement Desensitization and Reprocessing (EMDR), has garnered attention due to its promising outcomes. The application of EMDR, whether it is EMDR or EMDR 2.0 protocol, in a group format, especially for conditions like Post-Traumatic Stress Disorder, will provide significant opportunities in terms of economic feasibility and accessibility, ultimately leading to widespread use. Building on the established effectiveness of EMDR 2.0 in individual applications, this study examines its impact in group settings. This protocol is designed to provide a structured framework for implementing EMDR 2.0 within group contexts, paving the way for a nuanced understanding of its potential benefits in collective therapeutic settings. This study aims to investigate the efficacy of the online EMDR 2.0 Group Protocol(EMDR 2.0 GP) versus Improving Mental Health Training for Primary Care Residents(mhGAP) on individuals with a history of traffic accidents in a controlled way.Methods In this randomized-controlled study sample includes volunteers who were involved in traffic accidents and were given the randomized online EMDR 2.0 GP and mhGAP Stress management module. The participants were given a sociodemographic data form, Depression Anxiety Stress 21 scale (DASS-21) and Impact of Event Scale-Revised (IES-R). Participants were evaluated with measurements before, after and one month after the application.Results The mean age of the participants was 34.80(8.10) years and 88.0% (n=22) were female. The change in DASS-21 Anxiety (h2=0.136), Stress (h2=0.140), IES-R Avoidance (h2=0.134), Hyperarousal (h2=0.0148), Total (h2=0.223) scores of online EMDR 2.0 GP was determined to be statistically significant compared to the mhGAP group. However, no statistically significant difference was observed in DASS-21 Depression (h2=0.017), IES-R Intrusion(h2=0.094), scores between the two groups.Discussion The RCT of online EMDR 2.0 GP indicated that this newly developed protocol, when applied to groups, may be effective in reducing anxiety, stress, and traumatic symptoms among a non-clinical sample.Clinical trial registration https://clinicaltrials.gov/study/, identifier NCT05596903.Öğe Are hedonic hunger and health-related quality of life associated with obesity in adolescents?(Frontiers Media Sa, 2025) Koc, Bilge Meral; Kenger, Emre Batuhan; Yuksel, Ezgi Arslan; Karahan, Tugce OzluThe purpose of the study is to find out the relationship between obesity, hedonic hunger and health-related quality of life (HRQoL). The questionnaire containing items on the sociodemographic characteristics, anthropometric measurements and nutritional habits of individuals (n = 902), the Children's Power of Food Scale and the KIDSCREEN-10 were used to determine the hedonic hunger and the HRQoL score. Hedonic hunger and HRQoL were evaluated according to the categories, frequency of consumption of sugary drinks and fast food. The females were found to have hedonic hunger more than the males (p < 0.05). Body mass index z-score categories of the adolescents showed that the obese eat more hedonically compared to the underweight and the normal-weight (p < 0.05), and this difference was not observed in the HRQoL scores (p > 0.05). There was a negative correlation between the hedonic hunger status and the HRQoL scores (R = -0.342, p = 0.000). The consumption of sugary drinks and fast food was associated with hedonic hunger and HRQoL scores in certain groups. Hedonic hunger is associated with obesity; hedonic hunger and quality of life are important factors associated with unhealthy food and drink intake.Öğe Molecular and In Silico Analysis of the CHEK2 Gene in Individuals with High Risk of Cancer Predisposition from Turkiye(Mdpi, 2024) Ozdemir, Ozkan; Bychkovsky, Brittany L.; Unal, Busra; Onder, Gizem; Amanvermez, Ufuk; Aydin, Eylul; Agaoglu, Nihat BugraBackground and Objectives: Checkpoint kinase 2 (CHEK2) is a tumor suppressor gene involved in DNA repair and cell cycle regulation. Pathogenic or likely pathogenic (P/LP) variants in CHEK2 are associated with increased cancer risk. Conversely, recent large cohort studies have identified certain variants that, despite being classified as P/LP by in silico analysis, are considered low risk. Thus, the genotype-phenotype correlations of CHEK2 require a better understanding. In this study, we aimed to characterize germline CHEK2 variants from a group of individuals who applied to cancer genetic clinics in the Marmara Region of T & uuml;rkiye. We also aimed to assess the phenotypic impacts of these variants by using a new score of statistically significant in silico predictors (SSIPs). Methods: We analyzed 1707 individuals with high risk cancer predisposition, focusing on germline CHEK2 variants, using SSIP scores and population-specific data. Results: CHEK2 variants appeared in approximately 8% of cases. The SSIP scores indicated that the missense mutation, p.Arg117Gly, significantly impairs DNA repair. Almost half of the variants had higher allele frequencies than the variants listed in the Genome Aggregation Database (gnomAD), and three variants had significantly higher frequencies compared to the variants listed on the Turkish Variome database (p.Thr476Met, p.Arg137Gln, c.592+3A>T), emphasizing the importance of population-specific data. Conclusions: This comprehensive analysis of CHEK2 variants in the Turkish population provides crucial insights for cancer geneticists and oncologists. Our findings will help to enhance the evaluation and management of cancer predisposition associated with CHEK2 in T & uuml;rkiye and other regions that have significant Turkish populations.Öğe Assessment of nutritional change processes and their relationship with macronutrient intake and anthropometric measurements in adults(Frontiers Media Sa, 2026) Seker, Beyza Nur; Kocatepe, Neslihan; Bayraktar, Damla Zeynep; Seven Avuk, HandeBackground This study assessed the relationship between adults' nutritional behavior change process and their diet implementation, energy, macronutrient intake, and anthropometric measurements. Methods This cross-sectional study was conducted with 400 adults (50% men, 50% women, median age 27 years). A face-to-face questionnaire including sociodemographic information, smoking status, diet experience, and the Nutritional Change Processes Scale (NCPS) was applied. Food consumption was recorded using a 24-hour recall method, and anthropometric measurements were taken. Results Among participants, 50.5% were classified as underweight-normal, 33.5% as overweight, and 16% as obese, while 37.8% had past dieting experience. Those with a dieting history had significantly higher NCPS scores [110 (52-192)] than those without [77 (48-176); p < 0.001]. The NCPS score of obese participants [113.50 (52-192)] was the highest compared to underweight-normal [79.50 (48-177)] and overweight [90.5 (48-176)] participants (p < 0.001). A positive correlation was found between total NCPS score and body weight, BMI, and body fat percentage (r = 0.200, p < 0.001; r = 0.355, p < 0.001; r = 0.161, p = 0.001, respectively). A negative correlation was observed with energy intake, carbohydrates, and carbohydrate percentage (r = -0.132, p = 0.008; r = -0.165, p = 0.001; r = -0.158, p = 0.002, respectively). However, in multivariable analyses, the association between BMI and NCPS was no longer significant after adjustment for age and gender, and was significantly influenced by energy intake (p < 0.05). Conclusion This study shows that obesity and past dieting experiences are associated with higher involvement in dietary behavior change processes, but this relationship is significantly influenced by age, gender, and energy intake. Furthermore, the finding that high awareness does not guarantee balanced macronutrient intake underscores the need for multidimensional weight management strategies that address both individual cognitive factors and environmental determinants.Öğe What's in your card? The impact of online food delivery apps on depression and eating behaviors(Frontiers Media Sa, 2025) Ozlu Karahan, Tugce; Cakmakci, Dila; Kurtoglu, Eylul; Kul, Zeynep; Kidan, Irem Sevim; Kenger, Emre BatuhanIntroduction Digitalization, through smartphones and online platforms, has become deeply embedded in daily life, beginning to exert significant effects on eating habits and psychological health. Online food delivery (OFD) applications (app) provide easy access to fast food and processed products, exposing individuals to a constant digital food environment. Examining the relationship of these applications with eating behaviors and conditions such as depression is particularly important in the context of increasing mental health problems among young adults. This study aims to examine the relationship between the frequency of use of OFD apps and user attitudes toward these apps, with depression level and eating behaviors in young adults.Methods Participants' demographic information, frequency of use of OFD apps, and attitudes toward these apps were determined by questionnaire questions; depression status was assessed using the Beck Depression Inventory; and eating behaviors were assessed using the Three-Factor Eating Scale (TFEQ-R21).Results A total of 383 young adults aged 18-35 years participated in our study. The group with the lowest frequency of OFD apps use (21.2 +/- 0.4) had significantly lower uncontrolled eating scores than the other groups (23.4 +/- 0.7 and 23.3 +/- 0.6; p = 0.005). In addition, a significant decrease in cognitive restraint levels was observed as the frequency of OFD apps use increased (p = 0.031). In addition, depression scores of individuals with more OFD apps (4-6) on their phones (14.1 +/- 1.3) were found to be higher than those of individuals who did not use any apps (8.8 +/- 1.4; p = 0.025).Discussion The findings of our study suggest that the digital food environment can be a determinant not only of individuals' physical health but also of their psychological health and behavioral eating habits.
