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    861 research outputs found

    Investigation of the Susceptibility Rates to Ceftazidime-Avibactam and Colistin, Clonal Relationships, and Clinical Data of Patients with Carbapenem-Resistant Klebsiella Pneumoniae Isolates Detected in the ICUs of a Hospital in İstanbul

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    BACKGROUND: The increase in carbapenem-resistant K. pneumoniae (CR-Kp) in intensive care units (ICUs) causes treatment difficulties and increases risk in mortality. OBJECTIVES: The aim of this study was to investigate the susceptibility rates of CR-Kp isolates obtained from ICUs to ceftazidime-avibactam (CAZ-AVI) and colistin, carbapenem resistance genes, clonal relationships and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center, University of Health Sciences, & Uuml;mraniye Training and Research Hospital MATERIALS AND METHODS: This study was conducted between June 2023 and December 2024. Isolates were identified using VITEK MS v.3.2, and antibiotic susceptibility testing was performed using the VITEK 2 Compact system. CAZ-AVI susceptibility was determined using disk diffusion, and colistin susceptibility was determined using broth microdilution to determine minimum inhibitory concentration (MIC) values. Carbapenem resistance genes were determined using multiplex real-time polymerase chain reaction (RT-PCR) and clonal relationship arbitrarily primed-polymerase chain reaction (AP-PCR). MAIN OUTCOME MEASURES: Resistance genes of CR-Kp isolates, clonal relationships, CAZ-AVI and colistin resistance, and clinical characteristics of patients SAMPLE SIZE: Ninety-seven isolates from 76 patients RESULTS: Among patients with CR-Kp isolates, central venous catheter use was detected in 59 cases (78%), ventilator-associated pneumonia in 44 cases (58%), and bacteremia in 39 cases (51%), respectively. It was determined that 53 of the patients (70%) died. Using the AP-PCR method, 60 different genotypes were identified among 97 isolates, and clustering was determined in 42 of the isolates (46%). It was determined that 36 (37%) of the isolates were resistant to colistin and 42 (45%) were resistant to CAZ-AVI. NDM+OXA-48, OXA-48, KPC, KPC+NDM, and NDM genes were detected in 40 (43%), 32 (35%), 10 (11%), 2 (2%), and 3 (3%) isolates, respectively. It was determined that 30 (75%) of the isolates with NDM+OXA-48 and only 4 (12%) of the isolates with OXA-48 were resistant to CAZ-AVI. CONCLUSION: In addition to OXA-48, an increase in the frequency of CR-Kp isolates containing the NDM, NDM+OXA-48, KPC+NDM, and OXA-48+KPC genes were also detected. It was also determined that resistance to colistin and CAZ-AVI is increasing. The AP-PCR method can also be used to investigate infections. LIMITATIONS: Single center,Pulsed Field Gel Electrophoresis (PFGE) could not be performed together with AP-PC

    Assessment of the Nutritional Status of Syrian Refugee Women in the Lactation Period

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    Background: The Syrian civil war has caused large-scale displacement, with many Syrian refugee women migrating to T & uuml;rkiye. Lactation is a critical period requiring adequate nutrition for maternal and infant health. However, data on the nutritional status of lactating Syrian refugee women are limited. Aim: This study aimed to assess the nutritional status of lactating Syrian refugee women who migrated to T & uuml;rkiye due to the Syrian civil war. Methods: A cross-sectional study was conducted between October 5, 2017, and January 29, 2018, with 102 lactating Syrian refugee women with infants aged 0-6 months attending the Istanbul Al Farah Child and Family Support Center. Participants were selected using convenience sampling. Inclusion criteria were being a Syrian refugee woman in the lactation period, having an infant aged 0-6 months, and volunteering to participate in the study. Women with chronic illnesses or metabolic disorders were excluded. Data were collected through face-to-face interviews with the assistance of a translator, using a structured Turkish questionnaire covering demographic information, anthropometric measurements, and 3-day dietary records. Dietary intake was analyzed with the BEBIS9 program and compared to the T & uuml;rkiye Nutrition Guide recommendations. Although the dietary data were collected in 2017-2018, the analysis was conducted using the most up-to-date national guidelines to reflect current public health priorities. Results: Participants (n = 102) had an average age of 27.9 +/- 5.7 years, BMI of 27.3 +/- 4.6 kg/m(2), and monthly income of 1267 TL. Their daily energy intake was 1593.7 +/- 556.5 kcal/day. A large proportion of participants had inadequate intake of micronutrients, with the highest insufficiency observed for pyridoxine (88.2%), followed by vitamin A (81.4%), vitamin C (76.5%), thiamine (71.5%), riboflavin (63.7%), folic acid (81.4%), vitamin B12 (72.6%), iron (62.8%), and zinc (68.6%). Women with higher BMI in early lactation consumed more fat (p < 0.05). Significant associations were found between micronutrient intake and sociodemographic factors (p < 0.05). However, due to the small sample size and use of convenience sampling, the generalizability of the findings is limited. Future studies with larger and more representative samples are needed to confirm these results. Conclusion: Syrian refugee women in the lactation period showed inadequate intake of energy and essential micronutrients, likely due to poor socioeconomic and living conditions. Interventions such as culturally sensitive nutrition education, postpartum micronutrient supplementation, and improved access to migrant-friendly healthcare services are needed. Additionally, targeted policies and sustainable public health nutrition programs-such as food voucher schemes, fortified food distribution, and maternal support groups-should be developed in collaboration with health institutions and NGOs to improve maternal and infant health outcomes in this vulnerable population

    Fully Synthetic, Nature-Inspired Exosome-Mimetics for Melanoma Therapy

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    Fully synthetic exosome-mimetics (FSEMs) represent a nature-inspired drug delivery system designed to replicate the key physicochemical and biological properties of natural exosomes, while offering the potential to address limitations in scalability and reproducibility associated with natural exosomes. In this study, we prepared FSEMs at the laboratory scale. We loaded them with (–)-epigallocatechin-3-gallate (EGCG) and microRNA-23a (miR-23a), aiming to co-deliver therapeutic small molecules and nucleic acids for the treatment of melanoma. FSEMs were fabricated using three methods: thin-film hydration, ethanol injection, and microfluidics. They were surface-functionalized with either CD9, a tetraspanin involved in membrane fusion, or TSP-1, an adhesion protein promoting cellular interactions. Through physicochemical characterization via dynamic light scattering, we found that FSEMs were ∼ 100 nm in size, of low polydispersity (∼0.2) and showed a negative zeta potential (∼–55 mV). Both EGCG and miR-23a were efficiently encapsulated. SDS-PAGE analysis confirmed successful protein incorporation and correct positioning. In vitro release studies showed minimal premature leakage, supporting their suitability for cellular uptake-mediated delivery. When tested on melanoma cells (MDA-MB-435) and progenitor human dermal fibroblasts (FE002-SK2), FSEMs selectively killed melanoma cells while sparing fibroblasts. Importantly, EGCG within FSEMs was more effective than the free compound. Compared to conventional DOTAP-based liposomes, FSEMs were more selective and induced less off-target cytotoxicity. This study presents a proof-of-concept for fully synthetic, protein-functionalized FSEMs as dual carriers for both chemical and gene-based agents, offering a safer and potentially more effective alternative to traditional cationic liposomes. These results lay the groundwork for future in vivo validation and translational cancer research. © 2026 The Author(s

    Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial

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    Background Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period

    Comprehensive Proteomic and Metabolomic Analysis of Novel Substituted Fluoroquinolone Derivatives in Escherichia Coli Isolates

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    Antimicrobial resistance is one of the most important global problems, and new antibiotic requirements have been emerging as a key point in this issue. In the present work, we focused on the efficiency of two novel promising fluoroquinolone derivatives on resistant Escherichia coli isolates at the molecular level. Their mode of action and adaptation process were evaluated by using proteomics and metabolomics analysis. Proteomics analysis showed that two compounds have an effect mainly on the ribosomal process and energy metabolism. Moreover, we observed compounds that affect various important antimicrobial targets, such as ribosomal subunits, phosphotransacetylase, and chaperone proteins. In metabolomics analysis, we found that compounds altered bacterial metabolism directly. Pathway analysis showed that cofactor biosynthesis and energy metabolism were affected mainly by undertreated groups. Our experiments demonstrated that novel fluoroquinolone derivatives have promising results at the molecular level and results will contribute to further studies. © 2026 John Wiley & Sons Ltd

    Evaluation of Barriers to the Integration of Renewable Energy Technologies into Industries in Türkiye

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    The transition to renewable energy technologies is one of the most important ways to achieve the sustainable development goals (SDGs) of affordable and clean energy (SDG7); industry, innovation and infrastructure (SDG9); responsible production and consumption (SDG12); and climate action (SDG13). The widespread use of renewable energy technologies in developing countries will reduce dependence on imported fossil resources, increase industrial competitiveness, and support low-carbon development. Despite all their advantages, the integration of renewable energy technologies into industrial and domestic systems in developing countries remains slow due to a number of barriers. Financial constraints, technical and technological deficiencies, political restrictions and uncertainties, and organizational and managerial inadequacies are some of the barriers to the widespread adoption of renewable energy technologies. This study aims to identify, classify, and prioritize the barriers to the implementation of renewable energy technologies by applying multi-criteria decision-making methods in a fuzzy environment, with T & uuml;rkiye considered as a case study. The relative importance of the barriers identified using the Single-Valued Spherical Fuzzy SWARA method was assessed, and their interconnections and significance were systematically demonstrated. The findings will contribute to the development of policy and management strategies aligned with global sustainability goals, thereby facilitating a more effective and equitable transition to clean and resilient energy systems

    Telerehabilitation Transforms Recovery: Elevating Outcomes for Lower Limb Amputees

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    Background: Telerehabilitation provides a viable alternative for individuals facing barriers to in-person rehabilitation because of transportation issues and physical limitations. It enables remote monitoring and guidance, allowing patients to continue rehabilitation at home. Objective: This study aimed to assess the effectiveness of a telerehabilitation program in improving physical and psychological outcomes for lower limb amputees and to evaluate adherence to a home-based exercise program delivered via video. Study design: A randomized controlled trial. Methods: Sixty participants with lower limb amputations were randomized to an experimental group (telerehabilitation) or a control group (standard care). The intervention involved a 4-week supervised phase followed by a 4-week unsupervised phase. Primary outcomes were physical capacity, measured by the Six-Minute Walk Test (6MWT), and psychological status, assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes included adherence rates and patient satisfaction. Results: The experimental group showed significant improvements in 6MWT distance and Hospital Anxiety and Depression Scale scores compared to the control group. The mean 6MWT distance increased by 20% from baseline to the end of the supervised phase (P < 0.01) and was maintained during the unsupervised phase. Anxiety and depression scores significantly decreased (P < 0.05). Adherence was higher during the supervised phase (85%) but dropped during the unsupervised phase (60%). Conclusions: Telerehabilitation significantly improved physical and psychological outcomes for lower limb amputees. High adherence during the supervised phase emphasizes the importance of clinician support, whereas strategies are needed to sustain long-term engagement during the unsupervised phase

    New Diclofenac Hydrazones: Design, Synthesis, in Silico Studies and Anticancer Evaluation Against Breast Cancer

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    Breast cancer remains one of the most prevalent and lethal malignancies among women, highlighting the urgent need for novel therapeutic strategies that can overcome resistance mechanisms. The p38 alpha mitogen-activated protein kinase (MAPK14) plays a key role in inflammation-associated oncogenic signaling, making it an attractive molecular target for drug development. In this study, a novel series of diclofenac-based hydrazone derivatives (4a-4o) were designed, synthesized, and characterized using FT-IR, 1H- and 13C-NMR spectroscopy, thin-layer chromatography, and elemental analysis. Computational target profiling using SwissTargetPrediction identified MAPK14 as the primary predicted target. Molecular docking against the MAPK14 crystal structure (PDB ID: 1WBS) revealed high binding affinities (-11.41 to -8.34 kcal/mol), supported by MM/GBSA free energy calculations and molecular dynamics simulations, which confirmed stable ligand-protein interactions through hydrogen bonding with Asp168 and Glu71. In vitro cytotoxicity assays on MCF-7 (luminal A) and MDA-MB-231 (triple-negative) breast cancer cell lines demonstrated low-micromolar IC50 values, with compounds 4c, 4d, and 4e showing the strongest activity (2.1-4.5 mu M), surpassing the reference drug Tamoxifen. Overall, the results indicate that diclofenac hydrazones represent promising candidates anticancer properties through MAPK14 inhibition, providing a foundation for the development of next-generation therapeutics against breast cancer

    Past and Present of Nation-Building: Ideological Instrumentalization of Ministry of Youth and Sports of Turkey

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    Erturan-Ogut, E Esra/0000-0002-4320-1545When Erdogan declared in 2012, 'We will raise a pious generation', Turkey already had a national identity rooted in secularism and Turkism since the early Republic. His statement signalled an attempt to reshape identity along the AKP's anti-Kemalist lines. This study examines shifting nation-building agendas in state-run youth and sports institutions, comparing the early Republican era with the AKP period. Early programmes emphasized Turkism, secularism, and paramilitarism, reflecting the ideological imperatives of the time. Under the AKP, however, programmes increasingly promoted Islamism and neo-Ottomanism, opposing earlier values. The study argues that AKP-era youth policies deliberately sought to replace Kemalist principles, with the Ministry of Youth and Sports serving as a channel for ideological nation-building absent in formal education

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