SDG 3 · Sağlık ve Kaliteli Yaşam · SDG

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MakaleAçık Erişim2026Scopus SJRQ2/r/munzur/1254
Water extracts of Fucus vesiculosus and Laminaria digitata enhance male reproductive parameters via antioxidant and NO/cGMP mechanisms in rats
Gencoglu, Hasan; Erten, Fusun; Er, Besir; Orhan, Cemal; Acisu, Tutku Can; Sahin, Kazim
Male sexual dysfunction is increasingly prevalent, driving interest in marine algal bioactives as potential natural modulators of reproductive physiology. Brown seaweeds such as Fucus vesiculosus and Laminaria digitata contain phlorotannins, fucoidans, and antioxidant compounds of applied relevance in phycology and biotechnology. This study assessed the effects of standardized water extracts of these two species on reproductive behavior, hormonal status, sperm quality, oxidative balance, and nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling in male Sprague–Dawley rats. Animals received the seaweed extracts orally by gavage (300 mg kg⁻1 day⁻1) for 52 days. Both extracts improved male reproductive behavior by reducing the time required to initiate mounting, intromission, and ejaculation (mount latency, intromission latency, and ejaculation latency), while increasing the number of these sexual behaviors during the test period (p < 0.05). Serum follicle-stimulating hormone and testosterone concentrations increased, alongside higher testicular superoxide dismutase, catalase, and glutathione peroxidase activities and lower malondialdehyde levels. Sperm count and motility improved, particularly with L. digitata extract. Western blot analyses revealed phosphorylated phosphodiesterase-5, endothelial NO synthase, and cGMP levels, with reduced endothelin-1 in testicular and epididymal tissues (p < 0.05–0.001). These findings indicate that extracts of F. vesiculosus and L. digitata, chosen for their well-documented antioxidant and phlorotannin-rich profiles, confer protective and prosexual effects associated with enhanced antioxidant defense and upregulation of NO/cGMP-related pathways, with the L. digitata extract exhibiting comparatively stronger activity.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/1234
Enhancing waiting time performance of clinical laboratories for pregnant patients with seasonal respiratory diseases: a simulation-based Lean Six Sigma approach
Ortíz-Barrios, Miguel; Celani de Souza, Helder Jose; Petrillo, Antonella; Gul, Muhammet; Yücesan, Melih; Navarro-Jiménez, Eduardo; Alfaro-Saíz, Juan-José; Ariza-Ortíz, Andrés
Purpose – Clinical laboratory performance is critical in managing seasonal respiratory diseases (SRDs); however, prolonged waiting times can lead to patient dissatisfaction and nonquality costs. This challenge is particularly acute for pregnant patients, who face increased health risks from diagnostic delays. This study aims to improve waiting times before sample collection in clinical laboratories serving pregnant patients with SRDs by integrating Lean Six Sigma (LSS) and Discrete-Event Simulation (DES). Design/methodology/approach – The proposed framework was validated in a public clinical laboratory using the DMAIC (Define–Measure–Analyze–Improve–Control) methodology. DES was embedded within the Analyze and Improve phases to model patient flow and assess improvement scenarios before implementation. Findings – The integrated LSS–DES approach resulted in a significant reduction in waiting times. During SRD peak periods, waiting time before sample collection for pregnant patients decreased from 1.01 to 0.10 h per patient. These results demonstrate the framework's effectiveness and practical usefulness for decision-makers seeking performance improvements in resource-constrained healthcare environments. Originality/value – This study enhances existing literature by integrating LSS and DES to address laboratory performance challenges associated with SRDs. The combined LSS-DES used for pregnant patients during outbreak periods is novel. The study offers contextual innovation for a vulnerable population, methodological advancement through embedding DES within the DMAIC cycle, and practical laboratory validation. The framework is particularly valuable for low- and middle-income countries (LMICs), where scalable solutions are essential.
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MakaleYayıncıda açık erişim2026Scopus SJRQ1/r/munzur/1220
tVNS Mitigates Neuroinflammation and Nociception in a Rodent LPS Endotoxemia Model
Atalar, Kerem; Alim, Ece; Calikusu, Aysen; Abbasoglu Topa, Elif Gulcicek; Gok Dagidir, Hale; Bahcelioglu, Meltem; Bukan, Neslihan; Erten, Fusun; Sahin, Kazım; Akarca Dizakar, Saadet Özen
The vagus nerve plays a modulatory role in the gut-brain axis. Intestinal barrier dysfunction and lipopolysaccharide (LPS) leakage into the systemic circulation are associated with several conditions, such as irritable bowel syndrome (IBS) and migraine headache. This study investigates the impact of non-invasive transauricular vagus nerve stimulation (tVNS) on the neuroinflammatory markers and pain behavior following an acute LPS challenge. Sprague–Dawley rats (n = 28) were given LPS or vehicle and subjected to tVNS or sham intervention in an acute LPS animal model that mimics the systemic consequences of barrier dysfunction. Behaviors were evaluated at the baseline and 6 h later, complemented by testing the levels of serum and brain neuroinflammatory markers. Behavioral analyses revealed that LPS exposure reduced the time spent in the open arm, grooming duration, and periorbital mechanical pain thresholds, and increased freezing duration. The tVNS intervention reversed these behavioral changes induced by LPS. LPS administration triggered elevated serum levels of IL-6, CGRP, haptoglobin, and VE-cadherin. LPS also increased IL-1β, PAR-2, haptoglobin, CGRP, and HMGB1 levels in the brain tissue. The tVNS intervention reversed the effects observed in the brain, but it did not change the elevated levels of inflammatory molecules in the systemic circulation. tVNS has the potential to modulate neuroimmune interactions, with an early impact on the brain during LPS surge. tVNS may have potential therapeutic benefits in managing pain-related disorders associated with LPS endotoxemia.
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MakaleAçık Erişim2026Scopus SJRQ2/r/munzur/1181
Change of micronucleus frequencies, antioxidant parameters and in silico in carp (Cyprinus carpio) fry exposed to ibuprofen
Kirici, Muammer; Tüzün, Burak; Yonar, Muhammet Enis; Poustforoosh, Alireza; Mişe Yonar, Serpil; Şeker, Engin; İspir, Ünal
Ibuprofen, a non-steroidal anti-inflammatory drug, has been detected in the aquatic environment, but little is known about its effects on fish and other aquatic organisms. This study aimed to investigate the effect of ibuprofen on micronucleus levels in erythrocytes and whole-body antioxidant parameters of carp (Cyprinus carpio) fry. Fish were exposed to immersion in two different doses of ibuprofen concentrations (50 and 250 μg/L) for 24, 48, 72 and 96 h and 14 days. No mortalities occurred in any group during the test. Abnormal behaviours such as irregular swimming, loss of balance and hanging vertically in the water were observed in some fish exposed to acute toxicity. In this study, a significant increase in the micronucleus number of red blood cells was observed throughout the study period (p < 0.05). Antioxidant parameters were measured spectrophotometrically. Results obtained showed that ibuprofen significantly increased (p < 0.05) malondialdehyde (MDA) levels, glutathione S-transferase (GST) and catalase (CAT) activities, but decreased (p < 0.05) the glutathione (GSH) levels of whole-body carp fry in a dose-dependent manner. Furthermore, ibuprofen significantly increased MDA, GST and CAT levels, but increased the GSH levels of whole-body carp fry in a time-dependent manner. These results indicate that carp fry is sensible to human pharmaceutical agents in aquatic environments. The manner and the constructed interactions between ibuprofen and two protein targets (immunoglobin and haemoglobin) were investigated using molecular docking and molecular dynamics simulation. The results indicated that ibuprofen could affect the haemoglobin activity. Finally, absorption, distribution, metabolism, excretion and toxicity analysis was performed to examine the drug potential of the studied molecules.
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MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1166
Predictive Value of Health Literacy on Health-Promoting and Protective Behaviours in Turkish Nurses and Allied Health Workers
Deniz Akan, Dilan; Yeşiltepe, Akgün
Aim: This study aims to investigate the extent to which Turkish nurses and allied health workers' levels of health literacy predict health-promoting and protective behaviours. Desing: A descriptive and cross-sectional study design was used. Methods: The study was conducted with 403 Turkish nurses and allied health workers working in different regions of Türkiye between January and May 2024. JASP 0.18.3.0, Jamovi 2.3.21, and SPSS 26 and AMOS26 programs were used for data analysis. Descriptive statistics and simple and multiple regression analysis were used in the analysis of the data. Results: A positive, moderately significant relationship was found between health literacy and health-promoting and protective behaviours (r = 0.460, p < 0.001). Regression analysis results showed that health literacy explained 21.1% (R2 = 21.1) of the change in health-promoting and protective behaviours and was a significant predictor of health-promoting and protective behaviours. Patient or Public Contribution: Understanding the predictive effect of health literacy and preventive health behaviours can guide practices and policies that will improve the level of health literacy and preventive health behaviours in healthcare workers. Improving their health literacy and preventive health behaviours can help patients and the general public increase their health literacy levels and gain positive health behaviours.
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Derleme MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1156
Nutraceuticals in Uro-Oncology: A Structured Expert Review and Precision-Oriented Framework
Erten, Fusun; Kalemoglu, Ecem; Kucuk, Omer; Sahin, Kazim
Urologic malignancies (UMs), including prostate cancer (PCa), bladder cancer (BCa), renal cell carcinoma (RCC), and testicular germ cell tumors (TGCT), are governed by interconnected molecular pathways that regulate proliferation, angiogenesis, metabolism, invasion, immune escape, and treatment resistance. Key pathways include PI3K/AKT/mTOR, VEGF/VEGFR, EGFR, FGFR, c-MET, androgen receptor signaling, DNA damage response, inflammatory transcriptional programs, and regulation of the tumor microenvironment. This structured expert review evaluates mechanistic, translational, epidemiological, and clinical evidence on food- and botanical-derived nutraceuticals that may influence cancer-related signaling, redox balance, inflammation, metabolic adaptation, and host–tumor interactions. Nutraceuticals are considered investigational adjunctive exposures rather than anticancer treatments or alternatives to standard care. Relevant literature was identified through a structured, non-systematic search of PubMed/MEDLINE, Scopus, Web of Science Core Collection, and Embase from database inception to 17 June 2026, supplemented by backward and forward citation searches. Eligible evidence comprised preclinical, observational, interventional, pharmacokinetic, formulation, safety, and drug–nutraceutical interaction studies. Evidence was evaluated by cancer type, compound class, molecular context, formulation, exposure, translational maturity, and safety, and was classified into five stages: prevention signal, mechanistic plausibility, bioavailability and exposure feasibility, exposure-linked biomarker activity, and clinical benefit. An exposure–species–compartment framework was used to assess whether parent compounds and relevant metabolites reached systemic, urinary, or target-tissue concentrations compatible with the proposed effects. Findings based solely on supraphysiological concentrations of unconjugated parent compounds were considered hypothesis-generating unless supported by human exposure or tissue-distribution data. Curcumin, green tea catechins, isoflavones, carotenoids, flavonols, stilbenes, and triterpenoids affect several cancer-related pathways, primarily in experimental models. Translation to clinical practice is constrained by inconsistent formulations, limited bioavailability, inadequate target-tissue exposure data, few biomarker-linked studies, and possible interactions with anticancer therapies. PCa and BCa provide the most suitable settings for exposure-verified mechanistic studies. In RCC, safety and treatment interactions should be prioritized, whereas in TGCTs, non-interference with curative cisplatin-based therapy must be demonstrated. Future studies should use chemically defined formulations, verify clinically relevant exposure, incorporate mechanism-matched biological-response endpoints, and confirm compatibility with established treatment. Current evidence does not support nutraceuticals as treatments for urologic malignancies.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/1155
Sleep quality in children with epilepsy and their mothers: A cross-sectional study
Veziroğlu, H.; Kemer, D.
Background The aim of this study is to evaluate the sleep quality of children with epilepsy and their mothers, and to identify the factors affecting sleep quality. Methods The sample comprised 103 mothers of children with epilepsy aged 318 years. Data were collected during face-to-face interviews using the Children's Sleep Habits Questionnaire (CSHQ) and the Pittsburgh Sleep Quality Index (PSQI). The data were analyzed using one-way analysis of variance (ANOVA), the Mann-Whitney U test, and correlation analysis. Results According to PSQI, 76.7% of mothers were found to have poor sleep quality. The mean total CSHQ score was 49.99 ± 7.60, indicating clinically significant sleep problems among the children. Mothers' PSQI total scores were significantly associated with income status, number of children, duration of epilepsy, and time spent in digital environments (p < 0.05). Children's CSHQ total scores were significantly associated with age at first seizure, seizure frequency, occurrence of seizures during the last three months, presence of nocturnal seizures, number of antiepileptic drugs used, and ownership of a phone/computer (p < 0.05). Conclusion It was found that children with epilepsy experienced sleep problems related to bedtime resistance and daytime sleepiness, and that their mothers had poor sleep quality. Therefore, the development of supportive intervention programs is recommended to prevent and manage sleep problems in children with epilepsy and their mothers. Implications to practice Multidisciplinary collaboration and nurse-led interventions should be implemented to promote sleep health and improve the quality of life of children with epilepsy and their families.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/1148
Hydrogeochemical controls on chromium speciation and potential human health risks in surface waters of an ultramafic mining watershed
Kutlu, Banu; Baydar, Tarık; Yıldırım, Vesile; Konurhan, Zekeriya
Accurate assessment of chromium contamination in mining-influenced watersheds requires distinguishing between the environmentally contrasting Cr(III) and Cr(VI) species, yet environmental monitoring and risk assessments still rely predominantly on total chromium concentrations. This study evaluated whether chromium speciation provides additional information beyond operational total chromium for assessing chromium occurrence and potential human health risks in an ultramafic, mining-influenced watershed. Surface-water samples were collected from 28 sampling stations across the Pülümür and Ovacık regions of the Eastern Anatolia Basin (Türkiye) between March 2025 and February 2026. Chromium speciation was determined using species-specific UV–Visible spectrophotometric methods and integrated with hydrochemical characterization, multivariate statistical analyses, mineralogical investigations (XRD, SEM–EDS, and FTIR), and deterministic and empirical-bootstrap human health risk assessments. Operational total chromium, defined as the sum of separately measured Cr(III) and Cr(VI), ranged from below the detection limit to 578.13 µg L−1. For contextual screening, this calculated value exceeded World Health Organization (WHO) drinking-water guideline for total chromium at 14 stations; however, it was not an independently measured total-Cr concentration. The highest Cr(VI) concentration occurred at a localized hotspot, whereas Cr(III) predominated throughout most of the watershed. Nevertheless, Cr(VI)-based screening thresholds were exceeded at multiple stations under the assumed untreated drinking-water ingestion scenario, indicating that operational total chromium alone did not consistently identify the spatial distribution of Cr(VI)-related potential risk. Screening-level hazard quotient (HQ) estimates were higher for children than for adults; however, direct untreated consumption of the sampled surface waters was not verified. Mining-influenced stations generally exhibited higher chromium concentrations, although the relative contributions of geogenic weathering and mining-related mobilization could not be quantitatively apportioned. Overall, chromium speciation provided additional environmentally and toxicologically relevant information beyond operational total chromium for evaluating chromium mobility and screening-level potential human health risks in this ultramafic watershed.
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MakaleAçık Erişim2026Scopus SJRQ2/r/munzur/1101
Exploring Health Literacy, Anxiety, and Perception Among Nursing and Allied Health Students in Turkey: A Cross-Sectional Study
Yeşiltepe, Akgün; Daşbilek, Ferhat; Ayhan, Mehmet Osman
Background: Health literacy, anxiety, and perception directly affect healthcare students' readiness for professional roles. Assessing these factors is crucial to enhance both their well-being and patient care quality. This study examined health literacy, health anxiety, and health perception among Health Sciences students and their links to socio-demographic factors. Methods: A cross-sectional and descriptive design was used in accordance with the STROBE guidelines. The sample, consisting of 258 students from Munzur University Faculty of Health Sciences, was selected using stratified and simple random sampling methods. Data were collected using a Descriptive Information Form, the Health Literacy Scale, the Health Anxiety Inventory, and the Health Perception Scale. Descriptive statistics, Mann−Whitney U, Kruskal−Wallis tests with Bonferroni correction, and Spearman's correlation analysis were conducted using SPSS 26 and JASP 0.19. Results: Students demonstrated inadequate health literacy (17.75 ± 11.37) and moderate health perception (43.43 ± 6.25); the mean health anxiety score was 18.78 ± 6.14. A weak but statistically significant positive correlation was found between health literacy and health anxiety (r = 0.225, p < 0.05) and between health perception and health anxiety (r = 0.215, p < 0.05); however, no significant correlation was observed between health literacy and health perception (r = 0.090, p > 0.05). Health perception revealed statistically significant differences according to maternal education level, place of residence, and frequency of reading health-related research. Health literacy significantly differed by academic department, year of study, perceived health status, and perceived usefulness of online health information. Health anxiety varied significantly by the presence of chronic illness, chronic illness status, perceived health status, medication use, and alcohol/tobacco consumption. Conclusion: The findings highlight the complex interplay between cognitive (health literacy), emotional (health anxiety), and perceptual (health perception) dimensions of student health. Promoting digital health literacy and providing counselling services may help reduce health anxiety and enhance self-awareness among health sciences students.
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MakaleAçık Erişim2026Scopus SJRQ3/r/munzur/1091
Neuro-linguistic programming for postoperative pain management: A randomized controlled trial
Dal, Nursel Alp; Beydağ, Kerime D.; Doğan, Aysel
Effective control of pain after cesarean delivery is essential, as poorly managed postoperative pain is a common complication that can impair maternal recovery and early infant care. This prospective, randomized, single-blind controlled trial, conducted in the postpartum unit of Kocaeli University Hospital, Kocaeli, Türkiye, between March 2021 and June 2022, compared the effect of a single neuro-linguistic programming (NLP) session added to standard postoperative care against standard care alone. Seventy-six consenting women were randomized in equal numbers to the intervention (standard care plus NLP) or control (standard care only) group. The primary outcome was pain intensity, measured with the Visual Analogue Scale (VAS) before and after the intervention period. Mean follow-up pain scores were significantly lower in the intervention group (2.37±1.792) than in the control group (6.68±2.068; p<0.001), while baseline pain scores and maternal demographic and obstetric characteristics did not differ significantly between groups. Adding a single NLP session to standard postoperative care effectively reduced pain after cesarean delivery, supporting its use as a non-pharmacological adjunct in postoperative nursing and midwifery practice. African Journal of Reproductive Health © 2026.; Une prise en charge efficace de la douleur après une césarienne est essentielle, car une douleur postopératoire mal gérée constitue une complication fréquente susceptible de nuire au rétablissement de la mère et aux premiers soins prodigués au nourrisson. Cet essai prospectif, randomisé, contrôlé en simple aveugle, mené dans l’unité post-partum de l’hôpital universitaire de Kocaeli, à Kocaeli, en Turquie, entre mars 2021 et juin 2022, a comparé l’effet d’une seule séance de programmation neurolinguistique (PNL) ajoutée aux soins postopératoires standard à celui des soins standard seuls. Soixante-seize femmes ayant donné leur consentement ont été randomisées en nombre égal dans le groupe d’intervention (soins standard plus PNL) ou dans le groupe témoin (soins standard uniquement). Le critère d’évaluation principal était l’intensité de la douleur, mesurée à l’aide de l’échelle visuelle analogique (EVA) avant et après la période d’intervention. Les scores moyens de douleur observés lors du suivi étaient significativement plus faibles dans le groupe d’intervention (2,37 ± 1,792) que dans le groupe témoin (6,68 ± 2,068 ; p < 0,001), tandis que les scores de douleur initiaux ainsi que les caractéristiques démographiques et obstétricales des mères ne présentaient pas de différence significative entre les groupes. L’ajout d’une seule séance de PNL aux soins postopératoires standard a permis de réduire efficacement la douleur après une césarienne, ce qui plaide en faveur de son utilisation comme complément non pharmacologique dans la pratique infirmière et obstétricale postopératoire.
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MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1086
Loneliness as a predictor of quality of life in older adults receiving primary health care in Türkiye: a cross-sectional study
Atila, Dinçer; Yeşiltepe, Akgün; Çal, Ayşe
Background: Loneliness and social isolation among older adults is a growing concern in many societies, as the aging population continues to increase. The aim of the study is to examine the relationship between loneliness and quality of life in individuals aged 65 and over who apply to primary health care institutions. Methods: This descriptive-correlational study was conducted face-to-face with 216 individuals aged 65 and over. The socio-demographic form and the Loneliness Scale for Elderly and Quality of Life Scale were used as data collection tools in the study. JASP 0.19, SPSS 26 analysis programs were used to perform t test, One Way ANOVA Bonferrroni test, Pearson correlation, and regression analysis. Results: According to Pearson correlation analysis, strong negative relationships were found between quality of life and loneliness in the elderly. As quality of life increased, levels of loneliness, social loneliness, and emotional loneliness decreased (r = −0.854, r = −0.737, r = −0.717; p <0.001). While there was a strong positive relationship between the loneliness scale for elderly and the social loneliness sub-dimension (r = 0.867, p < 0.001), there was also a positive relationship between the loneliness scale for elderly and the emotional loneliness sub-dimension (r = 0.835, p < 0.001). A statistically significant difference was found between chronic disease, educational status, income status, marital status, and both loneliness and quality of life. Conclusion: Loneliness is an important predictor of quality of life among older adults. Both social and emotional loneliness are negatively associated with quality of life, indicating that higher levels of loneliness are linked to lower quality of life in this population.
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MakaleYalnız künye2026Scopus SJRQ2/r/munzur/1058
The Turkish Version of the Self Evaluation of Breathing Questionnaire: Cross-cultural Adaptation, Validity and Reliability
Ataş, Kübra; Kızmaz, Erhan; Mutlu, Ebru Kaya
Investigating the validity and reliability of the Turkish version of the Breathing Self-Assessment Questionnaire (SEBQ), a tool for measuring dysfunctional breathing. Ninety-two healthy adults (mean (range) age 29.4 (19–56) years; 39 males) were analysed. The SEBQ was translated and adapted into Turkish. At baseline, data were collected using the SEBQ, Nijmegen Questionnaire (NQ), breath-holding time, and Short Form 36 (SF-36). The SEBQ was repeated within 7–14 days. SEBQ validity was assessed through content, structural, and convergent/divergent validity analyses, while reliability was evaluated for internal consistency, stability, and reproducibility. One item was removed based on exploratory factor analysis. The SEBQ has a two-factor structure and explains 50.1% of total variance, confirmed by confirmatory factor analysis. It has a positive correlation with the NQ and a negative correlation with SF-36 subscales, but not with breath-holding time and general health. The Cronbach’s alpha coefficient was 0.931, and the intraclass correlation coefficient was 0.814. The Standard Error of Measurement and Smallest Real Difference were 5.06 and 15.03, respectively. The SEBQ is well-structured, valid, internally consistent, stable, and reproducible for assessing subjective unexplained respiratory symptoms in the Turkish population.
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MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1040
Structural alignment and thematic complementarity between ISO 7101:2023 and Türkiye’s hospital quality standards: a qualitative document analysis
Karahüseyinoğlu, Furkan
Background: ISO 7101:2023, adopted in Türkiye as TS ISO 7101:2023, is an international management system standard for healthcare quality management published by the International Organization for Standardization (ISO) in October 2023 and structured according to ISO’s harmonised high-level architecture. SKS Hastane Sürüm 6.1 (Sağlıkta Kalite Standartları Hastane Sürüm 6.1) is Türkiye’s national hospital quality standards framework, comprising 5 dimensions, 46 sections, 523 standards, and 1,599 assessment criteria calibrated to hospital practice. Both documents coexisted within the Turkish health system at the time of this analysis: TS ISO 7101:2023 was adopted by the Turkish Standards Institution (TSE) in November 2023, while SKS Hastane Sürüm 6.1 has been in use since its publication in 2021. Despite the potential relevance of both frameworks to hospital quality governance, to the author’s knowledge, no published study has systematically compared the structural and thematic alignment of ISO 7101:2023 and SKS Hastane Sürüm 6.1. This study aimed to examine the degree and nature of correspondence between ISO 7101:2023 and SKS Hastane Sürüm 6.1 across a comprehensive set of hospital quality management domains. Methods: A qualitative document analysis with structured comparative mapping was conducted using the primary texts of ISO 7101:2023 (accessed as TS ISO 7101:2023) and SKS Hastane Sürüm 6.1. Fourteen analytical dimensions were specified a priori, covering organisational context, leadership and governance, quality planning, patient/person-centred care, patient safety and risk management, workforce competence, clinical and service delivery processes, information management, resource and infrastructure management, external provider management, performance measurement, incident reporting and learning, continuous improvement, and accessibility and equity. A seven-category coding scheme was applied to each dimension: Full Convergence (FC), Partial Convergence (PC), ISO-Dominant Management System Emphasis (ISO-D), SKS-Dominant Operational Specificity (SKS-D), Complementarity (COMP), Limited Explicit Correspondence (LEC), and No Direct Correspondence (NDC). Coding categories are analytical, not evaluative. Standard-level verification extending to confirmed standard codes and assessment-criteria-level content was conducted for five dimensions (D2, D3, D5, D8, D11). ISO 7101:2023 text is paraphrased with clause references; the document is copyrighted and is not extensively quoted. Results: Thirteen of the fourteen analytical dimensions were classified as Partial Convergence (PC). Dimension 7 (Clinical and Service Delivery Processes) was classified as Complementarity (COMP). No dimension was classified as Full Convergence or No Direct Correspondence. The Partial Convergence pattern reflects shared quality management intent across all domains, accompanied by systematic differences in documentary logic, prescriptive specificity, and regulatory mechanism. ISO 7101:2023 addresses quality domains through normative “shall” obligations within a harmonised management system architecture, leaving implementation methods to the organisation. SKS Hastane Sürüm 6.1 addresses the same domains through prescriptive, surveyable hospital standards and assessment criteria. Standard-level verification confirmed operationally specific requirements in SKS across governance committee structures (KKY06-10), risk management (KRY01-05), patient safety (KKY07), information system security and backup (DBY05, DBY10, DBY13), indicator management (GGİ01–07), and national performance reporting. Several ISO constructs — including formal change management planning (Cl. 6.3), risk awareness culture monitoring (Cl. 6.1.2), structured internal audit with independence criteria (Cl. 9.2), and eleven-input management review (Cl. 9.3) — were not confirmed as single equivalent standards in the verified SKS sections. Conclusions: ISO 7101:2023 and SKS Hastane Sürüm 6.1 show broad thematic overlap across hospital quality domains. SKS Hastane Sürüm 6.1 provides an operationally specific, nationally calibrated quality infrastructure for hospitals in Türkiye. ISO 7101:2023 provides a complementary management-system architecture that may supplement SKS’s operational standards with structural constructs for leadership accountability, quality objective documentation, change management planning, and cyclical system evaluation. The two frameworks are better characterised as potentially complementary than as competing. These findings are based on document-level analysis and cannot be interpreted as evidence of implementation effectiveness. Empirical research is needed to assess how the frameworks interact in hospital practice and to determine what benefits, if any, alignment may offer for hospital quality governance in Türkiye.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/1031
Analysis of the impact of the social justice index on the COVID-19 pandemic using artificial intelligence in EU and OECD countries
Utku, Anıl; Can, Ümit; BARUT, Abdulkadir; Pilatin, Abdulmuttalip; Sharabati, Abdel-Aziz Ahmad
The COVID-19 disease has evolved into a pandemic that affects the world in multiple dimensions. While COVID-19 spread rapidly to several nations, distinct patterns of spread emerged in each nation. This spreading behavior is related to various characteristics of countries, including social, political, and economic factors. In this study, an analysis of the COVID-19 pandemic in EU and OECD countries was conducted, taking into account the social justice index for the first time. The impact and significance of the social justice index on the COVID-19 analysis results were attempted to be revealed. As a result, it is understood that the countries with high Social Justice Index scores and sub-dimension scores are more successful in combating the COVID-19 pandemic. In addition, a new LSTM-based model was developed to predict the number of cases and deaths in these countries. The designed LSTM approach was compared with some well-known deep learning and machine learning algorithms. As a result of the experimental studies, the LSTM model obtained the best prediction results. Finally, the similarities between these countries in terms of the characteristics of the COVID-19 pandemic, including death and case spread, were analyzed, and exciting results were disclosed.
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MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1026
Health risk assessment of heavy metal accumulation in fruits exposed to geothermal waters: a case study and global implications
Arslan Topal, E Işıl; Topal, Murat; Çelik, Erdal; Öbek, Erdal
BACKGROUND: The present study investigated the potential health risks of heavy metals (HMs) in the fruits and leaves of mulberry and sour cherry trees exposed to water from Sivas geothermal basin (Turkey). RESULTS: The target HMs were ranked according to their hazard index as: Cd < Pb < Zn < Cu < Ni < Mn < Cr. The total hazard index for mulberry and sour cherry fruits was calculated as 7.87 and 4.57, respectively, and was determined to be well above the safe threshold value of 1.0. At the same time, the calculated cancer risk values exceeded the established maximum limit (1.0 × 10−4) for Ni (6.4 × 10−3) in mulberry fruit and for Cr (1.15 × 10−3) in sour cherry fruit. Ingestion has been identified as the primary route of exposure. The study results showed that Cr and Ni metals were ranked in the order of mulberry fruit > sour cherry fruit > mulberry leaf > sour cherry leaf, and that for mulberry and sour cherry fruit. CONCLUSION: The findings indicate that edible foods exposed to geothermal waters may have adverse effects on human health. Furthermore, the study highlights the necessity of reducing water discharges from geothermal fields and implementing phytoremediation strategies to ensure food safety in geothermally active agricultural basins.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/1022
Boron source–dependent regulation of bone mineralization and osteogenic molecular pathways in broilers with tibial dyschondroplasia
Orhan, Cemal; Sahin, Emre; Erten, Fusun; Er, Besir; Sahin, Nurhan; Ozercan, Ibrahim Hanifi; Kom, Mustafa; Akdemir, Fatih; Balci, Tansel Ansal; Denli, Muzaffer
Rapid genetic selection for growth rate and slaughter weight in broilers has been associated with a higher incidence of skeletal disorders, particularly tibial dyschondroplasia (TD), which causes considerable economic losses in poultry production. We investigated the effects of boric acid (BA) and sodium pentaborate pentahydrate (SPP) on growth performance, bone mineralization, tibial histopathology, and osteogenic protein expression in broilers with manganese (Mn) deficiency-induced TD. A total of 360 Ross 308 broiler chicks were used in a 2 × 2 × 3 factorial design with TD status (normal or Mn deficiency–induced TD), boron source (BA or SPP), and supplemental boron level (0, 4.37, and 8.74 mg elemental B/kg diet). Birds were randomly allocated to 12 groups with six replicates of five birds each. Clinical and histopathological findings confirmed TD induction. TD decreased body weight, feed intake, and carcass weight, while increasing feed conversion ratio (p < 0.05). Boron supplementation improved tibial mineral density and content in a dose-dependent manner (p < 0.05). In TD broilers, serum osteocalcin (OCN) concentrations were higher with high-level SPP supplementation than with BA supplementation (p = 0.012). Boron source and level significantly affected serum and bone boron concentrations, bone calcium concentrations (p < 0.05). In TD broilers, tibial osteoprotegerin levels were markedly elevated in the high-level SPP group (p < 0.001), whereas SRY-box transcription factor 9, hypoxia-inducible factor-1α, and tumor necrosis factor-α were reduced (p < 0.05). These findings indicate that SPP exerts regulatory effects on bone metabolism and osteogenic signaling pathways in TD-affected broilers.
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MakaleAçık Erişim2026Scopus SJRQ1/r/munzur/1020
Short-term effects of powerlifting-based training on hormonal, metabolic, and lipid profile markers in male basketball players: a randomized controlled trial
Tizar, Ercan; Erdoğan, Ramazan
Background: Powerlifting-based resistance training is increasingly incorporated into athletic conditioning programs; however, its short-term endocrine and metabolic responses remain insufficiently explored. Therefore, this study aimed to examine the short-term, exercise-induced changes associated with a powerlifting-based training program on selected hormonal, metabolic, and lipid profile parameters in male basketball players. Methods: This randomized controlled experimental study was conducted in accordance with CONSORT guidelines. Thirty male basketball players aged 18–24 years were randomly assigned to an exercise group (EG; n = 15) or a control group (CG; n = 15). Both groups continued their routine basketball training three days per week for six weeks, while the EG additionally performed a powerlifting-based training program. Serum concentrations of thyroid hormones (TSH, T3, and T4), insulin, glucose, growth hormone, testosterone, and lipid profile parameters were assessed before and after the intervention. Data were analyzed using two-way repeated-measures analysis of variance to evaluate group × time interactions. Results: Significant group × time interactions were observed for several biochemical parameters (p < 0.05). In the exercise group, insulin levels increased by 53.31%, while pre-exercise glucose levels under standardized conditions decreased by 14.46%. Thyroid hormones (TSH, T3, T4) increased by 45.26%, 18.85%, and 18.25%, respectively. Growth hormone and testosterone levels increased by 28.49% and 18.22%, respectively. In contrast, total cholesterol, LDL cholesterol, and triglyceride levels decreased by 2.49%, 4.28%, and 3.76%, respectively, while HDL cholesterol increased by 5.63%. No significant changes were observed in the control group. Effect size analyses indicated large interaction effects for key variables (e.g., insulin ηp² = 0.749; glucose ηp² = 0.757). The concurrent increase in insulin and decrease in glucose may reflect transient alterations in glucose–insulin dynamics rather than a direct improvement in insulin sensitivity. Conclusion: The inclusion of a powerlifting-based training program was associated with favorable short-term, exercise-induced changes in selected hormonal, metabolic, and lipid profile parameters in male basketball players. However, these findings should be interpreted with caution due to the limited sample size and intervention duration. Further studies employing larger cohorts and longer training periods are warranted to confirm these observations and to clarify their long-term physiological implications. Trial registration: ClinicalTrials.gov (NCT07398248), registered on 29/12/2025.
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MakaleYalnız künye2026Scopus SJRQ1/r/munzur/988
Determination of microplastic contamination and phthalate ester migration in canned and frozen packaged seafood: A probabilistic human health risk assessment via Monte Carlo simulation
Macit, Arife; Köktürk, Mine; Serdar, Osman; Alak, Gonca
This research was designed to identify the levels of microplastics (MP) and phthalate esters (PAE) in canned and frozen packaged fish and to assess the human health risks associated with these pollutants. Analyses were carried out on a total of 25 sample groups, including 10 different canned tuna samples, 9 different packaged seafood products, and 6 different packaging materials. Microplastics were characterized and polymer identification was performed using μ-Raman and ATR-FTIR spectroscopy, while PAEs were determined by GC–MS/MS. The obtained data were used to calculate estimated daily intake (EDI), hazard index (HI), hazard quotient (HQ), and cancer risk (CR), and uncertainty was assessed using Monte Carlo simulation. The findings revealed that both microplastic and phthalate exposure were higher in the frozen fish group than in canned products. The highest MP concentrations were recorded in packaged Whiting B (0.73 ± 0.25 items/g) and oil-added canned tuna (0.57 ± 0.15 items/g). Regarding PAEs, while DEHP and DBP were generally prominent, significant peak concentrations of BBP and DNOP were also identified, reaching 1.91 ± 0.01 ppm for BBP in canned tuna with sunflower oil and 1.84 ± 0.01 ppm in packaged whiting. Furthermore, higher exposure was observed in males for most PAEs. HQ and HI values were below 1 (maximum HI: 1.57 × 10−2 for males consuming frozen seafood), while CR values remained within an acceptable range (4.74 × 10−7 to 3.49 × 10−6). In conclusion, health risks related to processed fish consumption appear generally low; however, processing and packaging may contribute to contamination and warrant further investigation.
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MakaleYayıncıda açık erişim2026Scopus SJRQ1/r/munzur/931
Phenolic Profiling of Some Bryophyte Species: In Vitro and In Silico Assessment of Their Antimicrobial Potentials
Çambay, Zafer; Uslu, Harun; Coteli, Ebru; Göktaş, Bünyamin; Özdemir Bayçinar, Kevser; Emre, Mustafa Yunus; Güngören, Muhammed; Alataş, Mevlüt
This study explores the phytochemical composition and antimicrobial potential of Palustriella commutata, Philonotis calcarea, Cinclidotus riparius, Rhynchostegium riparioides, Plagiomnium ellipticum, and Porella platyphylla, with a focus on bryophyte species phenolic constituents and biological activities. HPLC analysis identified seven phenolic acids (4-hydroxybenzoic acid, 2,5-dihydroxybenzoic acid, 3,4-dihydroxybenzoic acid, caffeic acid, vanillic acid, syringic acid, and p-coumaric acid) across all species in varying concentrations. In in vitro antimicrobial tests, the bryophyte extracts used showed significant activity against Pseudomonas aeruginosa (ATCC 9027), while exhibiting relatively lower inhibition against Staphylococcus aureus (ATCC 25923). The study showed that all species extracts exhibited comparable activity to erythromycin against P. aeruginosa, while Cinclidotus riparius and Plagiomnium ellipticum extracts showed no activity against S. aureus, and the remaining species exhibited lower activity compared to erythromycin. Molecular docking studies demonstrated strong binding affinities of these phenolics to the active site of the target macromolecule (PDB ID: 3FRQ), suggesting meaningful interactions with residues such as ARG122 and ASN123, similar to erythromycin binding patterns. The findings indicate that bryophyte-derived phenolic compounds possess significant antimicrobial potential and may serve as promising candidates for the development of novel bioactive agents. This study provides a broad framework for the insufficiently researched antimicrobial potential of bryophytes by establishing direct links between species-specific phenolic fingerprints, experimentally observed antibacterial activities, and predicted receptor-level interactions. Further complementary biological studies are needed to confirm and expand upon these results.
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MakaleAçık Erişim2026Scopus SJRQ4/r/munzur/923
Prevalence of Depression and Associated Factors in Pregnant Women Attending the Emergency Obstetrics Clinic; [Acil Kadın Doğum Polikliniğine Başvuran Gebelerde Depresyon Sıklığı ve Etkileyen Faktörler]
Ak, Öznur; Beydağ, Kerime Derya; Dal, Nursel Alp
The goal of this descriptive study was to assess the prevalence of depression among pregnant women attending the emergency obstetrics clinic and to evaluate the relationship between sociodemographic, obstetric, and social-life characteristics and depression levels. The study was conducted at the University of Health Sciences Sarıyer Hamidiye Etfal Training and Research Hospital between June 6, 2025, and August 1, 2025. The study population comprised 720 pregnant women, and the sample consisted of 251 volunteer pregnant women selected at random. Data were collected using a researcher-developed questionnaire and the Beck Depression Inventory (BDI). The mean BDI score was 10.65 ± 7.02. The vast majority of pregnant women exhibited mild depressive symptoms. While no significant differences were found between depression and educational level, attendance at childbirth preparation courses, or number of pregnancies, significant associations were identified between depression and economic status, type of marriage, whether the pregnancy was planned, the belief that social life would be restricted, a perceived negative impact on sexual life, deterioration in relationships with the spouse, and exposure to verbal violence (p < 0.05). Depression during pregnancy is a major public health problem and is shaped by multifactorial influences. It is recommended that psychosocial assessments be integrated into antenatal follow-up, that at-risk groups be identified early, and that appropriate counseling services be provided. Depression screening should be conducted during routine obstetric follow-ups, and pregnant women in high-risk groups should receive psychosocial support and social service support.
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