Beykent University

OBJECTIVES: Fibromyalgia (FM) syndrome is a chronic musculoskeletal disorder that profoundly impacts not only patients but also their informal caregivers, affecting their quality of life and work productivity. This study aims to investigate the impact of FM on the work productivity and quality of life of informal caregivers. METHODS: This cross-sectional study included FM patients who applied to our Physical Medicine and Rehabilitation clinic and their informal caregivers. FM was diagnosed using the revised 2016 American College of Rheumatology (ACR) criteria. A healthy control group and their cohabiting relatives were also included. FM patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), while caregivers and control group relatives completed the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH) and the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF). RESULTS: The study included 68 FM caregivers and 68 control group relatives. WPAI scores revealed significant differences in presenteeism, overall work productivity loss, and activity impairment between FM caregivers and controls (p<0.05), though no difference in absenteeism was observed. WHOQoL-BREF scores showed significant reductions across all quality-of-life domains for FM caregivers compared to controls, with a notable correlation between the FIQR scores of FM patients and the social relationships domain of their caregivers (p=0.026, r=-0.269). CONCLUSIONS: FM poses substantial burdens on both patients and their informal caregivers, reducing caregivers’ work productivity and quality of life. Given the chronic nature of FM and the resulting long-term caregiving responsibilities, interventions that support both patients and caregivers, such as integrated healthcare and psychotherapy, may be beneficial. Further longitudinal studies are needed to examine these effects over time and support the development of comprehensive caregiver support strategies.

Background This study investigated the risks of eating disorders in sports where weight control is critical, focusing on apprentice jockeys and wrestlers. Method A total of 31 apprentice jockeys and 22 wrestlers, aged 15 to 19, participated in the study. To evaluate eating behaviors, participants completed the Eating Attitudes Test-26 (EAT-26) and the ORTO-15 test. The EAT-26 assessed the risk of disordered eating, with scores of 20 or above indicating high risk, while ORTO-15 scores below 40 suggested a risk of unhealthy eating obsession. Data were analyzed using SPSS 25.0, with a significance level set at p < 0.05. Results The results showed a significant difference in the EAT-26 mean scores between apprentice jockeys and wrestlers (p = 0.034). Apprentice jockeys had higher mean scores (15.97 ± 9.72) than wrestlers (11.05 ± 9.19), with 25.8% of apprentice jockeys and 13.6% of wrestlers classified as having high risk for eating disorders. Subdomain analysis revealed that bulimic and oral control behaviors were similar between groups (p > 0.05), but dieting scores were significantly higher among apprentice jockeys (p = 0.004). According to the ORTO-15 results, 67.7% of apprentice jockeys and 81.8% of wrestlers scored below 40, indicating a high prevalence of healthy eating behaviors, with no significant difference between the groups (p = 0.562). Conclusion These findings highlight the heightened risk of eating disorders in weight-control sports, particularly among apprentice jockeys who compete more frequently than wrestlers. Increased dieting among jockeys may raise their vulnerability to disordered eating. Classifying wrestling and horse racing as weight-class sports may encourage athletes to adopt healthier food choices.

Ablative polymeric composites were fabricated using vacuum impregnation and hot press molding techniques. The composites consisted of needled carbon fiber felt as the reinforcing material and resorcinol‐formaldehyde (RR) or boron‐modified resorcinol‐formaldehyde resin (RRB) as the matrix. Different weight percentages of titanium diboride (TiB 2 ) were incorporated as a filler. The ablation mechanisms of the composites were derived from SEM‐EDS, XPS, and XRD analysis of char layers formed after exposure to an oxyacetylene flame. The composites displayed excellent thermal insulation properties during the oxyacetylene test. The back surface temperatures ranged from 24.8 to 26.8 °C, indicating minimal heat penetration through the composites. This composite demonstrated a linear ablation rate (LAR) of 0.0053 mm/sec, a mass ablation rate (MAR) of 0.0195 g/sec, and a charring rate (CR) of 0.0543 mm/sec. During ablation, the low LAR, MAR, and CR values of C‐RRB‐T composites confirm that these composites are promising for thermal protection system applications in aerospace. Highlights Resorcinol formaldehyde matrix was modified with boron and filler TiB 2 . Composites were fabricated using vacuum impregnation and hot press molding. The thermal stability and char yields of the composites increased with TiB 2 . The addition of TiB 2 to the C‐RRB composite improved the ablation properties.

The chemical reactivity, electronic properties, and nonlinear optical characteristics of Si-doped single-wall carbon nanotubes (Si-SWCNTs) have been investigated within the framework of density functional theory (DFT) in the presence of drug molecules. Additionally, the toxic and antioxidant activities of Si-SWCNTs for drug interactions were examined for the first time using conceptual DFT. This analysis involved calculating charge transfer and the electrophilicity index, as well as constructing an electron donor–acceptor map (DAM) based on the nanotube segment length, in comparison with silicon carbide nanotubes (SiC-NTs). The DAMs illustrate the electron-donating and -accepting capacities of nanotubes and drug molecules. The adsorption energy calculations indicate that SiC-NT exhibits a stronger affinity for Aldara (ALD) drugs than Si-SWCNTs. DAM analysis suggests that SiC-NT is a superior electron acceptor, generating higher oxidative stress and toxicity than Si-SWCNTs. Si-SWCNTs have also been evaluated as potential amperometric drug sensors, demonstrating an acceptable recovery time of 17.6 s and significant variations in work function and conductivity for shorter Si-SWCNTs. Others have potential applications in detecting, recognizing, and transporting ALD in medical drug delivery systems. The best acceptor in the complexes has a slightly positive ΔG value and negative entropy change, indicating increased structural order and potential advantages in drug delivery and carriers. The highest first hyperpolarizability value was observed in the shorter Si-SWCNT/ALD complexes, underscoring their potential for nonlinear optical (NLO) applications in aqueous environments. This study provides a comprehensive understanding of the advantages of Si-SWCNTs over SiC-NTs, highlighting their potential as promising nanomaterials for advanced NLO applications.

Background Subacute low back pain (LBP) is a critical phase that can determine long-term patient outcomes. Exercise therapy, including Pilates, is widely used to manage LBP, but its effectiveness in the subacute phase remains underexplored. This randomized controlled trial aims to compare the effects of an 8-week Pilates-based intervention versus a home exercise program on pain intensity, functional disability, and quality of life in patients with subacute LBP. Methods Sixty-six participants with subacute LBP were randomized into two groups: a supervised Pilates group and a home exercise group. Pain intensity (Visual Analog Scale), functional disability (Roland-Morris Disability Questionnaire), and quality of life (Short Form-36) were assessed at baseline, post-intervention, and 3-month follow-up. Results Both groups exhibited significant improvements in all outcome measures ( p < 0.001). However, the Pilates group showed superior reductions in pain intensity ( p = 0.010 post-treatment, p = 0.002 at follow-up) and functional disability ( p = 0.009 and p = 0.002). Additionally, quality of life scores improved more significantly in the Pilates group, particularly in physical function ( p = 0.031 and p = 0.025) and general health ( p = 0.005 and p = 0.012). Conclusions Pilates-based rehabilitation was more effective than a home exercise program in improving pain, disability, and quality of life in patients with subacute LBP. These findings support the inclusion of Pilates in early-stage rehabilitation to prevent chronicity. Trial registration Clinical Trials Number: NCT06699511.

Cancer remains a critical global health challenge, necessitating advanced drug delivery systems through innovations in materials science and nanotechnology. This study evaluates gadolinium metal‐organic frameworks (Gd‐MOFs) as potential drug delivery systems for anticancer therapy, particularly when combined with radiotherapy. Gd‐MOFs were synthesized using terephthalic acid and gadolinium (III) chloride hexahydrate and then loaded with methotrexate (MTX). Characterization via fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), magnetic resonance imaging (MRI), and X‐ray diffraction (XRD) confirmed their correct structure and stability. Effective MTX loading and controlled release were demonstrated. Anticancer effects were assessed on human healthy bronchial epithelial cells (BEAS‐2B) and human lung cancer cells (A549) using the 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay under in vitro radiation therapy. MTX/Gd‐MOF combined with radiotherapy showed a greater reduction in cancer cell viability (41.89% ± 2.75 for A549) compared to healthy cells (56.80% ± 1.97 for BEAS‐2B), indicating selective cytotoxicity. These findings highlight the potential of Gd‐MOFs not only as drug delivery vehicles but also as radiosensitizers, enhancing radiotherapy efficacy and offering promising evidence for their use in combinatory cancer therapies to improve treatment outcomes.

This study investigates the multifunctional properties of three‐dimensional (3D)‐printed Polylactic acid (PLA) and Poly‐ε‐caprolactone (PCL) scaffolds reinforced with graphene oxide (GO) for advanced biomedical applications utilizing the fused filament fabrication method. PLA/PCL (80:20) was selected for its balance of stiffness and flexibility, while GO was incorporated at varying concentrations (0.5 weight percent (wt%), 1, 2, and 3 wt%). Composite filaments were produced through melt blending and extrusion, with subsequent 3D printing to create scaffolds. Fourier transform infrared spectroscopy analysis at 1 wt% GO revealed optimal functional group interactions. Differential scanning calorimetry and thermogravimetric analysis showed significantly enhanced thermal stability and crystallinity, while mechanical tests demonstrated 41.9% and 15% improvements in tensile and compressive strengths, respectively. Scanning electron microscopy analysis indicated morphological differences in the PLA/PCL matrix with increasing GO content. Rheological analysis indicated that lower GO concentrations led to an optimal viscosity, enhancing processability and maintaining structural integrity, with 1 wt% providing the best balance between ease of flow and mechanical stability. These findings highlight the potential of GO‐reinforced PLA/PCL scaffolds for biomedical applications, identifying 1 wt% GO as the optimal concentration for achieving superior thermal, mechanical, and rheological properties. Highlights GO‐reinforced PLA/PCL filaments were successfully produced for scaffolds. GO enhances PLA/PCL scaffold strength, stability, and processability. 1 wt% GO improves thermal, mechanical, and rheological properties. GO boosts thermal stability, crystallinity, and structural integrity. SEM reveals PLA/PCL matrix changes with increasing GO content.

Background Genetic disorders significantly impact public health and quality of life, necessitating precise and timely diagnosis for effective risk management and treatment. Genetic diagnostic centers (GDCs) play a critical role in this process but face numerous occupational health and safety (OHS) challenges. The classification of GDCs based solely on biosafety levels is insufficient for assessing their overall OHS conditions. This study aims to systematically evaluate OHS practices in GDCs and propose a new classification approach based on hazard dimensions. Methods This cross‐sectional study was conducted in 15 GDCs in Istanbul, including two public and 13 private facilities with 75 employees. Data were collected through a structured survey with 49 statements covering seven hazard dimensions. Regression and correlation analyses were used to assess the impacts and interrelationships of these dimensions on risk management. Principal Component Analysis (PCA) was applied for dimensionality reduction, and the k‐Nearest Neighbours (k‐NN) algorithm classified laboratories into safety levels. Results Personal protective equipment had the highest impact on risk management (56.3%), while physical security had the lowest (34.8%). Among the 21 identified hazard relationships, 18 were very strong and three were strong. PCA reduced the data into three primary components, explaining 81.9% of the variance. The k‐NN algorithm achieved a classification accuracy of 93.33%, consolidating six hazard dimensions into three and categorizing centers into three safety levels. Conclusion The findings emphasize the need for an updated OHS classification for GDCs beyond biosafety levels. Integrating hazard dimensions into safety assessments can improve risk management and enhance laboratory safety standards.

Background Neck pain (NP) and temporomandibular disorder (TMD) pain often coexist, particularly among office workers, but their interaction and impact on neck disability remain insufficiently explored. Objectives To investigate the prevalence of self-reported TMD pain in office workers with NP and assess its impact on neck disability. Methods This cross-sectional survey collected data through an online questionnaire from 662 office workers (66.3% female; mean age: 35.4 ± 8.9 years) with NP. Participants were categorized into two groups: isolated NP (NP group) and coexisting NP and temporomandibular disorder pain (NP + TMD pain group). TMD diagnosis was based on the Pain Screener. Neck pain and disability were assessed using the Bournemouth Neck Questionnaire (BNQ) and Neck Disability Index (NDI). Parafunctional behaviors were evaluated using the Oral Behaviors Checklist (OBC). Statistical significance was set at p < 0.05. Results The NP + TMD pain group had significantly higher BNQ and NDI scores than the NP group (p < 0.001), indicating more severe pain and disability. Additionally, 69.1% of the NP + TMD pain group reported awake bruxism compared to 37.7% in the NP group (p < 0.001). Joint noises (80.5% vs. 6.9%) and jaw locking (30.1% vs. 1.9%) were also more frequent in the NP + TMD pain group (p < 0.001). Logistic regression showed that high OBC scores, joint noises, and closed jaw locking were strong predictors of NP + TMD pain. Conclusion The findings reveal significant correlations between NP and TMD pain, but the cross-sectional design limits conclusions about causation. Further longitudinal or interventional studies are needed to explore whether TMD pain contributes to NP, vice versa, or if both share common underlying mechanisms. Clinical Trials Number: NCT04900870.

The landing gear systems of aircraft are fundamental for the safety of flight operations, which include takeoffs, landings, and inflight operations. Nonetheless, conventional automation and control systems have difficulties with these tasks due to internal non-linear dynamics, external factors, and the complexity of coordinating all gear positions. This paper solves these problems by developing an optimized sequence control fuzzy logic controller (FLC) for the landing gears. With the use of a Mamdani-type fuzzy inference system (FIS), the work presented in this paper introduces novel control states of "Transit" and "Locked" that provide additional resilience and accommodation for the system. Optimization methods were used to improve the form of membership functions and refine rule bases to increase responsive decision-making. This research highlights the lack of fuzzy logic application in aviation subsystems by attempting to fill the gap of highly adaptive real-time operational and emergencies inadequately addressed in previous research. All the conducted simulations for different flight conditions, including hostile conditions and system failures, demonstrated a 25% improvement in the accuracy of transitions compared to the conventional systems and a 15% faster response time. Moreover, the system maintained functionality during mechanical malfunctions, suggesting that these new approaches may be leading toward true robustness and redundancy within the system. This micromachining strategy can be easily integrated with advanced optimization techniques and adaptive control schemes, significantly contributing to safety as well as efficiency in aerospace engineering. By focusing on the practical application of these advancements, this work leads to reliability and operational safety improvement in airline automation intelligence.

Gray Wolf Optimization (GWO), inspired by the social hierarchy and cooperative hunting behavior of gray wolves, is a widely used metaheuristic algorithm for solving complex optimization problems in various domains, including engineering design, image processing, and machine learning. However, standard GWO can suffer from premature convergence and sensitivity to parameter settings. To address these limitations, this paper introduces the Hierarchical Multi-Step Gray Wolf Optimization (HMS-GWO) algorithm. HMS-GWO incorporates a novel hierarchical decision-making framework that more closely mimics the observed hierarchical behavior of wolf packs, enabling each wolf type (Alpha, Beta, Delta, and Omega) to execute a structured multi-step search process. This hierarchical approach enhances exploration and exploitation, improves solution diversity, and prevents stagnation. The performance of HMS-GWO is evaluated on a benchmark suite of 23 functions, showing a 99% accuracy, with a computational time of 3 s and a stability score of 0.9. Compared to other advanced optimization techniques such as standard GA, PSO, MMSCC-GWO, WCA, and CCS-GWO, HMS-GWO demonstrates significantly better performance, including faster convergence and improved solution accuracy. While standard GWO suffers from premature convergence, HMS-GWO mitigates this issue by employing a multi-step search process and better solution diversity. These results confirm that HMS-GWO outperforms other techniques in terms of both convergence speed and solution quality, making it a promising approach for solving complex optimization problems across various domains with enhanced robustness and efficiency.

Today, healthcare services in gynaecology and obstetrics aim for women to be independent in care and to provide self‐management. At this point, the nurse's role as an educator in gynaecology and obstetrics has gained importance, and the patient education process should be carried out in line with the needs and characteristics of women. Therefore, using new technologies in the planning and implementation of patient education will increase the quality of education by providing practical education in a systematic, fast, and easy way. The use of Spotify, one of the new technologies, in patient education in gynaecology and obstetrics will enable women to access education easily at any time, place, and even position. Preferring Spotify in patient education in gynaecology and obstetrics will enable women to gain independence and healthy behaviour by respecting themselves. The preference for Spotify as an innovative approach to patient education in gynaecology and obstetrics is of great importance in digital health applications. This commentary draws attention to the use of digital learning platforms (Spotify, podcasts, YouTube) in obstetrics and gynaecology.

Background and Objectives: Despite the development of treatment methods and the emergence of alternative new approaches in recent years, the visual prognosis of retinoblastoma contains deficiencies and this situation increases the need for the development of new treatment approaches. The cytotoxic and apoptosis-inducing effects of the combination of boswellic acid (BA), which has been determined to have significant potential in preclinical and clinical studies of various diseases, and Cisplatin (Cis), a potent chemotherapy agent, were investigated on the human retinoblastoma cell line (Y79). Materials and Methods: The cytotoxic effect of BA and Cis on Y79 cells was determined by the water soluble tetrazolium-1 (WST-1) test, the apoptotic rate of the cells was determined by annexin V staining, and the gene expressions of Protein53 (p53), Caspase-3 and Nuclear factor kappa B (NF-κB), which play an important role in apoptosis, were determined by RT-qPCR analysis. Interleukin 1-beta (IL1-β), tumor necrosis factor-α (TNF-α) and interferon γ (IFN-γ) levels were analyzed in cell lysates obtained from the experimental groups. Results: The combination of BA and Cis selectively inhibited the growth of Y79 cells and modulated NF-κB signaling, potentially through post-translational regulatory mechanisms. Moreover, it induced apoptosis by increasing p53 and Caspase-3 expressions, confirming its pro-apoptotic effects. Additionally, the combination treatment was associated with a reduction in inflammatory cytokine levels (TNF-α, IL1-β), suggesting a potential regulatory effect on inflammation-related pathways rather than direct inhibition of NF-κB activation. Conclusions: These findings suggest that BA combined with Cis inhibits Y79 retinoblastoma cell growth by inducing apoptosis and modulating NF-κB signaling. While NF-κB mRNA levels increased, reduced inflammatory cytokines and enhanced apoptosis suggest potential post-translational regulation. Further studies are needed to confirm NF-κB protein-level effects and in vivo efficacy.

Secondary electron emission is the primary signal formation and/or amplification technique utilized in accelerator beam monitors and photomultiplier tubes where incident energetic particles cause ejection of additional electrons from a secondary emission surface. The materials employed as surfaces for secondary electron emission have demonstrated exceptional resistance to radiation, making them suitable for serving as the active media in radiation-hard calorimeters. With this motivation, we developed dedicated secondary electron emission sensor modules, tested them with particle beams and developed Monte Carlo simulations to predict the performance of large-scale calorimeters. Here, the details of the sensor modules and the results of the beam tests and simulations will be discussed. Recently, we have applied high secondary emission yield materials, Al2O3 and TiO2, as surface coatings on the anode plates of one-glass resistive plate chambers developing the so-called hybrid resistive plate chambers. The beam test results manifestly show the contribution of the secondary emission layer on the overall electron multiplication in the gas gap. The measurements also enable preliminary assessment of the secondary emission principle in thin Al2O3 and TiO2 layers in a particle shower/avalanche environment and the development of Monte Carlo simulations. Here we describe the details of the direct utilization of the secondary electron emission surfaces and the impact of the findings on future implementations.

Future collider experiments and the upgrade of the existing large-scale experiments impose unprece-dented radiation conditions for the calorimeter systems, particularly in the forward region. The calorimeters envisaged for these operating conditions must be sufficiently radiation-hard and robust in order to perform as expected for the entire lifetime of the experiments. In this context, a novel calorimeter design utilizing quartz-Cherenkov calorimetry, termed Q-Wall has been developed. The Q-Wall concept is a sampling calorimeter that alternates between plates of absorber (Fe, Pb, W, etc.) and active planes. The active planes comprise compact arrays of PMTs with either very thick quartz windows or fused silica pads optically coupled to traditional PMT windows. In these active elements, charged particles with β > 0.685 produce Cherenkov radiation which im-pinges directly onto the photocathode of the PMT. The Q-Wall concept holds the promise of a very fast and highly granular tracking calorimeter suitable for high radiation environments. A prototype module of Q-Wall was constructed and tested at CERN test beam. The prototype consisted of three photodetector setups: multianode PMTs directly coupled to ultraviolet-transmitting (UVT) plexiglass in a 2 x 2 and 3 x 3 configuration, an 8 x 8 array of SiPMs coupled to a 5 x 5 array of borosilicate glass cubes, and a 3 x 3 array of SiPMs connected to a 3 x 3 array of borosilicate glass cubes. Here we report on the results of these tests and compare them with electromagnetic shower development simulations with Geant4.

Spinal fusion cages play a crucial role in stabilizing the spine and promoting bone growth in degenerative spine disorders. Recent advancements in biodegradable polymer‐based cages have introduced materials with shape memory properties, enabling minimally invasive implantation and improved adaptability. This study focuses on the development of 4D‐printed PLA/PCL blend spinal cages, investigating their thermal, mechanical, biodegradation, and shape memory properties, alongside surface wettability through contact angle measurements. The novelty of this study lies in identifying the optimal PLA/PCL ratio, balancing mechanical strength, biodegradability, and shape memory behavior for spinal fusion applications. The findings highlight PLA/PCL (80:20) as the most suitable composition, offering a well‐balanced combination of properties. Differential scanning calorimetry (DSC) analysis revealed that 20 wt% PCL enhances toughness, flexibility, and crystallinity while slightly reducing the glass transition temperature. Mechanical testing showed improved fracture behavior and elongation at this ratio, with tensile stress peaking before decreasing at higher PCL concentrations due to increased ductility. Biodegradation studies confirmed an increasing degradation rate with higher PCL content, while contact angle measurements indicated greater hydrophilicity, though this trend reversed at higher concentrations. Shape memory analysis demonstrated that as PCL content increased from 10 to 60 wt%, shape recovery decreased from 76.07% to 61.28%, while high shape fixity (96.42%–99.80%) was maintained. The PLA/PCL20 blend exhibited a 74.5% shape memory effect and a 68.75% recovery rate in the spinal cage design, making it a promising material for minimally invasive spinal fusion applications.

This paper aims to effectively tackle decision-making problems on interval-valued Fermatean fuzzy sets; the current research suggested an integrated approach based on the WASPAS method. The criteria weights were determined by combining the objective weights obtained by the similarity measure approach with the subjective weights provided by decision-makers. This combination made achieving more realistic weights possible. Interval-valued Fermatean fuzzy sets were subjected to improved scoring functions and novel similarity measures concerning objective and subjective weights. The application of green supply chain management is discussed to show that the created approach fully applies to multi-criteria decision-making issues in the actual world. Green supply chain management was examined using critical success factors to control and audit enterprises’ processes as a numerical example of the developed method. In the examinations, it was seen that the companies implementing the selected GSC applications achieved close results and thus acted appropriately to the situation. To validate the stability of the developed technique, this study also includes a sensitivity analysis utilizing different weights of criterion and different values of the method’s parameters. According to the investigation, merging subjective and objective weights enhanced the method’s stability created with different criteria weights. The outcomes of the approach developed here were compared with those of other approaches previously put forth in the literature to assess its performance accurately.