Inonu University

Objective This study aims to evaluate the effect of impacted third molars in different positions on stress distribution in the proximal and distal segments during sagittal split ramus osteotomy (SSRO) using finite element analysis. Materials and methods Finite element stress analysis was used to create models with impacted third molars in different positions. In SSRO-applied models, a 20 N force was applied in opposite directions to the proximal and distal segments along the sagittal osteotomy line. The von Mises, Pmax, and Pmin stress values induced by the applied force in the proximal and distal segments were analyzed to assess their potential impact on the risk of unfavorable fractures. Results Compared to the control model, the highest stress values were observed on the buccal side of the proximal segment in the distoangular model and on the lingual side of the distal segment in the horizontal model. Analyzing the von Mises, Pmax, and Pmin stress values in all models, it was found that the highest stress concentrations occurred predominantly on the buccal side of the proximal segment. Conclusion During SSRO, horizontally positioned impacted third molars may increase stress values in the distal segment, potentially elevating the risk of unfavorable fractures. In all models, higher stress concentrations were observed in the buccal region of the proximal segment. These findings highlight the clinical importance of patient-specific evaluation of third molars prior to SSRO.

Polypropylene is a versatile polymer with a wide range of applications, including food packaging. Especially, biaxially oriented polypropylene (BOPP) films are commonly used in the food industry due to their high mechanical strength, transparency, and barrier properties. However, thermal processing, such as sterilization, pasteurization, and packaging, can cause morphological deformation in BOPP films, leading to defects such as folding and shrinkage. In this study, the morphological deformation of BOPP films during heat treatment is investigated Thermal treatment is applied to the film structures at temperatures starting from 30°C to 130°C and increasing by 10°C. The chemical structures of the thermally aged BOPP films were examined by FTIR spectrophotometer. Surface morphology and microstructures of these films were examined by detailed AFM and SEM analysis. The results showed that thermal treatment caused significant morphological deformation in BOPP films. The mechanical and morphological deformation was more marked at temperatures above 90°C. FTIR analysis of the PP films showed that the chemical structures of the thermally aged films were not significantly affected by thermal treatment. FTIR analysis of films heat‐treated at 70°C revealed significant changes in C–C bonds within the polymer chain, indicating degradation. However, AFM analysis revealed that the surface morphology and microstructures of the heat‐treated films were significantly altered. Depending on the heat treatment, the surface roughness of the polymeric films increased. The results of this study provide new insights into the morphological deformation of BOPP films during heat treatment.

The objective of this study was to examine the protective effects of spiritual coping on post-traumatic stress, anxiety, and depression, and its contribution to well-being in individuals affected by the Kahramanmaraş earthquake on 6 February 2023. This study was based on the premise that spiritual coping acts as a protective factor against psychological distress. It aimed to identify the mechanisms through which spiritual coping alleviates the negative psychological effects of trauma and enhances mental health. The study sample comprised 382 individuals, the majority of whom (75.9%) were women, aged between 16 and 50, primarily young adults, who had experienced varying levels of impact from the earthquake. Structural equation modelling (SEM) was employed to analyse both the direct and indirect effects of spiritual coping on depression, stress, and anxiety. The findings indicated that spiritual coping was associated with a notable reduction in psychological distress, including stress, anxiety, and depression, and an increase in overall well-being. Furthermore, the model illustrated that spiritual coping contributes to enhanced psychological resilience by fostering adaptive mechanisms in the aftermath of trauma. These findings indicate that the incorporation of spiritual coping strategies into post-trauma interventions may prove an effective means of enhancing individuals’ mental health and resilience.

We aimed to show the outcomes of patients with ulnar impaction syndrome who had surgical treatment with the arthroscopic wafer procedure between 2013 and 2024. We analyzed data from 22 patients (22 wrists) treated with the arthroscopic wafer procedure. Visual analogue scale (VAS) score, Disabilities of Arm, Shoulder and Hand (DASH), and Mayo Wrist scoring systems were used for clinical evaluation, grip strength, and wrist range of motion (ROM) were compared with the nonoperative side, local tenderness examination at triangular fibrocartilage complex location between pisiform bone and ulnar head and ulnar grind test were evaluated. Patients were also asked to rate their satisfaction with the surgery. In radiological evaluations, preoperative and postoperative ulnar variance was measured. The mean follow-up period was 58.6 months. The mean VAS score was 2.86, the mean DASH score was 24.58, and the mean MAYO score was 72.64. There was no significant difference in wrist ROM between the operated side and the contralateral side (p > 0.05). The mean time to return to work after surgery was 6 weeks. A total of 77.3% of the patients had good or very good results. No complications were encountered in our study. According to our study findings, arthroscopic wafer procedure as a minimally invasive method provided satisfactory clinical and functional results with lower complication rates in patients with ulnar impaction syndrome.

Herein, the synthesis of silver(I)‐N‐heterocyclic carbene (Ag(I)NHC) complexes is presented. These complexes were synthesized from imidazolium salts and silver oxide via the deprotonation method. Ag(I)NHC complexes were characterized using various spectroscopic and analytical techniques, including FTIR, NMR, and elemental analysis. The single crystal structures of the complexes 1e and 1g were illuminated through x‐ray crystallography. The study demonstrates that the geometrical characteristics of both complexes closely match those of previously described complexes with a comparable ligand structure. Acetylcholinesterase (AChE) inhibitors prevent the excessive breakdown of acetylcholine by acting on acetylcholinesterase in its neurotransmission. In this way, they help to improve cognitive functions in patients with AD. On the other hand, human carbonic anhydrase inhibitors (CAIs) have been used clinically for many years as antiepileptic, antiglaucoma, antimetastatic, antitumor, and diuretic agents. In this study, the enzyme inhibition abilities of seven imidazol‐2‐ylidene‐silver(I) complexes bearing 4‐acetylphenyl side arm were examined against AChE and hCAs. These molecules exhibited a highly potent inhibition effect on AChE and hCAs (Ki values are in the range of 16.27 ± 1.81 to 130.79 ± 11.98 nM for AChE, 13.22 ± 1.88 to 182.14 ± 33.93 nM for hCA I, and 12.72 ± 1.99 to 62.36 ± 9.21 nM for hCA II). Novel imidazol‐2‐ylidene‐silver(I) complexes bearing 4‐acetylphenyl side arms 1a–g displayed efficient inhibitory profiles for the examined metabolic enzymes. Docking was additionally performed to investigate the interactions of the current complexes 1a–g with hCA I, hCA II, and AChE proteins. It has been determined that compound 1d has activity against all the tested proteins, with the most effective interaction observed with hCA I. The pharmacokinetic properties of the three top potent complexes for each target against the related proteins were also examined using the SwissADME and pkCSM web tools. In the meantime, the stabilities of the complexes with the highest binding potential according to the docking study were assessed through molecular dynamics simulation. The AChE–1a complex was found to be the one with relatively high stability. Also, further energy computations were made by using the MD simulation results. The compounds have been estimated to bind strongly with their targets.

Purpose This study aimed to evaluate the diagnostic potential of nystagmus direction observed during bow and lean tests (BLTs) in patients with posterior canal canalolithiasis BPPV (P-BPPV), lateral canal canalolithiasis BPPV (Lca-BPPV), and lateral canal cupulolithiasis BPPV (Lcu-BPPV). Methods A total of 62 patients (40 women, 22 men; aged 24–70 years) with clinically suspected BPPV were enrolled. Diagnoses included 39 cases of P-BPPV, 15 of Lca-BPPV, and 8 of Lcu-BPPV. Each participant underwent the Dix-Hallpike Test (DH), Head Roll Test (HRT), and bow and lean tests for diagnostic assessment. The primary outcome was the presence and direction of nystagmus during BLTs, in relation to BPPV subtype. Results Nystagmus was detected in 77.4% of subjects during the bow test and in 46.8% during the lean test. A statistically significant difference was found in nystagmus direction across BPPV subtypes (p < 0.05). Right-beating horizontal nystagmus during the bow test was significantly more frequent in right-sided Lca-BPPV. Right down-beating torsional nystagmus during the bow test occurred exclusively in left P-BPPV, while left down-beating torsional nystagmus was seen only in right P-BPPV. Right up-beating torsional nystagmus was significantly associated with right P-BPPV, and left up-beating torsional nystagmus with left P-BPPV (p < 0.05). Conclusions In P-BPPV, DH-induced nystagmus direction was opposite in the bow position but matched in the lean position. These findings underscore the diagnostic value of BLTs, particularly the bow test, in identifying the affected canal in posterior and lateral canal BPPV.

Current therapies for sporadic Alzheimer’s disease (sAD) provide only symptomatic relief, underscoring the need for treatments targeting its underlying pathophysiological mechanisms. Given the shared features between sAD and type 2 diabetes mellitus—particularly insulin resistance—repurposing antidiabetic agents like metformin has gained interest. Previous studies show that metformin rapidly reaches the brain following intranasal (i/n) administration and remains detectable for at least 2 h at a 3 mg/kg dose, supporting this delivery route for central nervous system targeting. I/n delivery of therapeutic agents bypasses the blood–brain barrier, enhances brain bioavailability, and minimizes peripheral side effects of such agents. In this preclinical study, we investigated whether low-dose i/n metformin (1 and 3 mg/kg) administered for 28 days could halt sAD-type changes. Our results demonstrate that i/n metformin improved cognitive function, including social behavior, in an intracerebroventricular streptozotocin (3 mg/kg)-induced rat model of sAD. Metformin administered i/n also reduced hippocampal microgliosis and apoptosis and enhanced phosphorylation of Akt and adenosine monophosphate-activated protein kinase. Moreover, it decreased hippocampal glycogen synthase kinase-3 beta levels, suggesting modulation of insulin signaling pathways. Notably, these neuroprotective effects were achieved at doses much lower than those used with systemic administration, underscoring the advantages of i/n delivery. Our findings suggest that low-dose i/n metformin is a promising, non-invasive, and disease-modifying therapeutic strategy for sAD, warranting further investigation.

This study was conducted in order to evaluate the effect of insulin administration training provided to patients with Type 2 diabetes mellitus who use insulin on their safe medication usage, pain levels, and treatment perception. A randomized controlled trial was designed. This study was conducted with a total of 84 patients (43 in the experimental group and 41 in the control group) diagnosed with Type 2 diabetes who were admitted to a public hospital in the Southeastern Anatolia Region of Turkey between October 2022 and March 2023. The patient information form, Insulin Administration Skill Observation Form, Visual Analog Scale, and Insulin Treatment Appraisal Scale were used. The experimental group was provided with individualized training and a booklet on the use of insulin. Both posttest and retention test measurements were taken after the insulin administration training. According to these measurements, insulin administration skill and insulin treatment perceptions of the experimental group were significantly higher than those of the control group, while their pain intensity score was significantly lower (p < 0.001). The results of this study revealed that the insulin administration training increased safe medication application and insulin treatment perceptions of the patients in the experimental group and lowered their pain levels. ClinicalTrials.gov = NCT05915338.

This study aimed to evaluate the effects of honokiol on 5-florourasil (5-FU) induced oral mucositis (OM) in rats. A total of 24 female Wistar Albino rats were injected with 5‑FU on day 1, 3 and 5. A superficial scratch was linearly created on the right buccal mucosa on days 3 and 5. The animals were randomly divided into control, vehicle, topical honokiol and systemic honokiol groups and sacrificed on the day 10 after the first 5-FU application. Blood and tissue sampling were analysed for total antioxidant status (TAS) levels, total oxidant status (TOS) levels plus histopathological evaluations. When the systemic and topical groups and vehicle group compared to control group, no statistically significant difference was found histopathological scores. (p = 1.000, p = 0.264, p = 1.000, respectively). There were no significance differences in histopathological scores between systemic and topical groups (p = 1.000), or between systemic and vehicle groups (p = 0.139). A statistically significant difference was observed in the histopathologic analysis between the topical and vehicle groups, (p = 0.006). There were no differences in TAS and TOS between the groups. The authors found no beneficial effect of systemic or topical honokiol on healing 5‑FU‑induced OM. To confirm its effects on OM, further studies are required with different study designs.

This study aimed to develop and validate the Artificial Intelligence - Digital Life Balance Scale (AI-DLBS), a psychometric tool designed to assess the multidimensional impact of digital technologies and artificial intelligence (AI) on individuals’ psychological, social, physical, and academic well-being. Utilizing ChatGPT-4, a novel AI-driven approach, the 40-item scale was constructed to measure five key dimensions: frequency and duration of digital device use, psychological and social effects, physical health impacts, academic performance, and technology access and dependency. Data were collected from three independent samples of university students in Turkey (N = 773, N = 325, N = 86) using convenience sampling. Exploratory and confirmatory factor analyses revealed a six-factor structure, explaining 60.83% of the variance, with acceptable model fit indices (e.g., RMSEA = 0.06, CFI = 0.90). The scale demonstrated strong internal consistency (Cronbach’s α = 0.68-0.87) and test-retest reliability. The AI-DLBS offers significant potential for psychiatric research and clinical practice, enabling mental health professionals to evaluate technology-related risks, such as anxiety, social isolation, and dependency, and design targeted interventions, including digital detox programs. The innovative use of AI in scale development highlights both its efficiency and ethical challenges, such as data bias risks. Findings suggest the AI-DLBS is a reliable and valid tool for assessing digital life balance, with implications for global mental health research and policy-making. Future studies should validate the scale across diverse populations and cultural contexts.

Objective Accurate segmentation of the mandibular and bifid canals is crucial in dental implant planning to ensure safe implant placement, third molar extractions and other surgical interventions. The objective of this study is to develop and validate an innovative artificial intelligence tool for the efficient, and accurate segmentation of the mandibular and bifid canals on CBCT. Materials and methods CBCT data were screened to identify patients with clearly visible bifid canal variations, and their DICOM files were extracted. These DICOM files were then imported into the 3D Slicer® open-source software, where bifid canals and mandibular canals were annotated. The annotated data, along with the raw DICOM files, were processed using the nnU-Netv2 training model by CranioCatch AI software team. Results 69 anonymized CBCT volumes in DICOM format were converted to NIfTI file format. The method, utilizing nnU-Net v2, accurately predicted the voxels associated with the mandibular canal, achieving an intersection of over 50% in nearly all samples. The accuracy, Dice score, precision, and recall scores for the mandibular canal/bifid canal were determined to be 0.99/0.99, 0.82/0.46, 0.85/0.70, and 0.80/0.42, respectively. Conclusions Despite the bifid canal segmentation not meeting the expected level of success, the findings indicate that the proposed method shows promising and has the potential to be utilized as a supplementary tool for mandibular canal segmentation. Due to the significance of accurately evaluating the mandibular canal before surgery, the use of artificial intelligence could assist in reducing the burden on practitioners by automating the complicated and time-consuming process of tracing and segmenting this structure. Clinical relevance Being able to distinguish bifid channels with artificial intelligence will help prevent neurovascular problems that may occur before or after surgery.

Objectives On February 6, 2023, seismic activity struck Kahramanmaraş, with earthquakes of magnitudes 7.7 and 7.6. The study aimed to determine the effect of the presence of PTSD and its scores on hygiene behaviors. Methods This cross-sectional study was conducted in Adıyaman, Türkiye, between September and October 2023. The study population comprised individuals aged 18 and above who had experienced the earthquake. The PTSD Checklist-Civilian (PCL-C) scale was used to evaluate PTSD, and the Hygiene Inventory was used to evaluate the participants’ hygiene behaviors. Results Females, those with lower levels of education, the unemployed, singles, those living in tents, individuals who lost a loved one in the earthquake, and those with PTSD had worse hygiene behaviors compared to other groups. In the multivariate model of linear regression analysis of hygiene total score, only the PTSD score retained its predictive significance for hygiene behavior. More than 50% of the participants had scores meeting PTSD. The total PTSD score and the prevalence of PTSD among women was notably greater. Conclusions Mental health plays a pivotal role in shaping individuals’ hygiene practices and behavior patterns post-disaster. Swift implementation of mental health interventions is crucial for the prevention of behavioral pathologies.

(1) Background: Research examining the combined influence of anthropometric characteristics, chronological age, and training age on motor performance in handball is limited. Given the sport’s demands and the participation of both adolescent and adult athletes, understanding these relationships is essential for talent identification, personalized training, and long-term athlete development. This study aimed to explore how these variables affect motor performance indicators such as speed, agility, and explosive power. (2) Methods: A cross-sectional study was conducted involving 29 male handball players. Anthropometric data (height and body weight), chronological age, and training age were collected. Motor performance was assessed using a 30 m sprint, a vertical jump test, and an agility test. (3) Results: Chronological age showed a strong positive correlation with training age (r = 0.819), and moderate correlations with height, body weight, vertical jump, agility, and sprint time. Training age was moderately correlated with vertical jump (r = 0.465) and agility (r = 0.439). Height and body weight were positively associated with sprint time. BMI exhibited low but consistent correlations with all motor tests. Regression analysis revealed that height significantly predicted sprint performance (β = 0.401, p = 0.033), while BMI was not a significant predictor. No significant regression models were found for agility or vertical jump performance. (4) Conclusions: The results suggest that both chronological and training age influence certain aspects of motor performance in handball players. Height may serve as a useful predictor of sprint ability, but anthropometric indicators such as BMI appear insufficient for explaining performance in agility or explosive power tasks. These findings support the use of multidimensional and individualized approaches in athletic assessment and training design.

Necrotizing enterocolitis (NEC) is a severe and often catastrophic gastrointestinal emergency that predominantly affects neonates, especially those born prematurely, and is associated with high rates of morbidity and mortality. Despite its significant clinical impact, the precise etiology and molecular pathogenesis of NEC remain incompletely understood. In this study, we conducted global transcriptomic profiling using high-throughput RNA sequencing in 11 premature neonates diagnosed with NEC, following rigorous inclusion and exclusion criteria. Compared to healthy controls, we identified 1,204 differentially expressed genes (DEGs), including 636 upregulated and 568 downregulated transcripts. Notably, genes involved in hypoxia-induced apoptosis (e.g., HIF1 AAS3, HIF1 AAS1), the caspase cascade (BCL2, BCL6, CASP5, CASP7), and inflammation (IL1RAP, IL6ST, TNFAIP3, TNFRSF10 A, TLR6, TLR10) were significantly upregulated. In contrast, IL18, a key modulator of inflammatory responses, was downregulated. Interestingly, several genes encoding selenoproteins (GPX1, GPX4, SELENON, SELENOM, SELENOF, SELENOW, SELENOT) were also downregulated, suggesting molecular evidence of selenium deficiency. Gene ontology and pathway enrichment analyses revealed widespread dysregulation in pathways related to hypoxia response, systemic inflammation, coagulation, antimicrobial defense, mitochondrial function, autophagy, selenium metabolism, and apoptosis. Collectively, our findings provide novel insights into the molecular underpinnings of NEC in premature infants and suggest that systemic hypoxia, oxidative stress, selenium deficiency, and programmed cell death contribute significantly to its pathogenesis. Supplementary Information The online version contains supplementary material available at 10.1007/s10142-025-01628-8.

Background This study aimed to develop a risk prediction model based on association rule mining to predict recurrent febrile seizures (RFS). Methods This is a retrospective observational study that examined the medical records of 105 children who were followed up with febrile seizure (FS) in a tertiary paediatric emergency department between October 2022 and December 2023. Children were divided into RFS and simple FS groups. RFS was defined as seizures occurring more than once within 24 hours of the first FS in the same febrile illness. Risk factors associated with RFS were determined by univariate and multivariate analyses. χ ² , Mann-Whitney U, receiver operating characteristics (ROC), multiple logistic regression and Classification Based on Association Rules Algorithm (CBA) analyses were applied to the dataset to obtain high-level outputs. Results RFS was detected in 32 out of 105 cases with FS (30.5%). Potential risk factors contributing to the development of RFS were seizure duration, number of recurrent seizures, family history, body temperature, time from fever onset to seizure, time from seizure onset to arrival at the emergency department, hyponatraemia, osmotic pressure and low haemoglobin level. The CBA algorithm obtained a total of 11 classification rules for the two patient groups. Additionally, the cut-off values obtained from CBA and ROC analysis showed satisfactory consistency. The CBA model achieved 97% overall accuracy classification performance. Conclusion The developed CBA model shows good predictive ability for RFS. The relevant model can be used as a risk estimation tool to identify children at risk of developing RFS.

Aim The aim of this study was to evaluate the permanent maxillary first molar rotation (PMMR) angles in cases of maxillary transverse skeletal deficiency (MTSD) and to compare them with a control group. Materials and methods In this study, which included a total of 88 patients (50 females, 38 males, with a mean age of 14.98 ± 2.14 years), consisting of 66 patients with MTSD and 22 patients in the control group, four groups were divided: Group 1 (MTSD without molar crossbite), Group 2 (MTSD with bilateral molar crossbite), Group 3 (MTSD with unilateral (right-sided) molar crossbite), and Group 4 (Control Group). Skeletal deficiencies were evaluated by measuring the interjugular, jugale right (JR), and jugale left (JL) distances on posteroanterior cephalograms (PACs), while occlusal relationships were assessed using 3-dimensional (3D) intraoral models. PMMR angles were measured using the 3D Slicer software on 3D intraoral models with the Ricketts Molar-Cusp Reference Line and the midsagittal reference plane. Statistical significance was set at p < 0.05. Results The PMMR angles and JR and JL distances of Group 2 were significantly higher, while the interjugular distance was found to be the lowest (p < 0.05). There was no significant difference in the PMMR angles between the Control group and Group 1 (p > 0.05), while the JR and JL distances were significantly smaller in the Control group (p < 0.05). In Group 3, on the crossbite side, both the PMMR and the JR and JL distances were significantly higher than on the non-crossbite side (p < 0.05). A significant positive correlation was found between PMMR angles and JR and JL distances (p < 0.05). Conclusion It was concluded that (i) mesiopalatal PMMRs are observed in the MTSDs with molar crossbite, (ii) molars with normal molar occlusal relationships have normal PMMR angles even in the presence of MTSDs, and (iii) early detection of MTSD enables timely interventions, preventing treatment delays and improving occlusal outcomes, particularly in developing patients, thereby optimizing long-term orthodontic results. Clinical relevance Considering the differences in PMMR angles between MTSD patients with and without molar crossbite, these findings should be taken into account when designing expansion appliances to achieve molar derotation in these patients.