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Article Citation - WoS: 1How Do Visual, Auditory and Motor Dual-Tasking Each Affect Swallowing and Chewing Function?(Wiley, 2024) Begen, Sena Nur; Arslan, Selen SerelBackground: It can be challenging to perform a second task at the same time as swallowing. Objective(s)The study aimed to investigate the effect of visual, auditory and motor dual-tasking on swallowing and chewing function in healthy young adults. Method: Right-handed healthy adults without any psychological and cognitive problems were included in the study. Swallowing was evaluated based on the dysphagia limit in different liquid textures such as water and nectar consistencies, and chewing was evaluated by the Test of Masticating and Swallowing Solids. For the second task, visual and auditory performance was assessed using reaction time, and the motor performance was assessed using a bilateral tapping task. Assessments were performed in two steps: baseline and dual-task. For baseline, all evaluation methods were applied individually. After completing the baseline assessment, dual-task assessment were carried out the following day. For dual-task assessment, the swallowing and chewing tasks were performed simultaneously with visual, auditory and motor tasks. Results: Results showed a significant decrease in dysphagia limit in the nectar consistency, and significant increase in chewing time, visual reaction time and tapping rate (right-left) when compared to baseline and dual-task conditions (chi(2)(3) = 9.61, p = .02; chi(2)(3) = 9.02, p = .02; chi(2)(3) = 28.09, p < .001; chi(2)(3) = 28.97, p < .001; chi(2)(3) = 21.56, p < .001, respectively). However, there were no differences in dysphagia limit in the water and auditory reaction time compared to baseline and dual-task conditions (chi(2)(3) = 3.18, p = .36; chi(2)(3) = 2.56, p = .50, respectively). Conclusion: Results shedding light on how simultaneous dual tasks can influence swallowing and chewing. Dual-tasking cause a decrease in both swallowing/chewing and the visual/motor performances. These results may provide valuable information for designing interventions or strategies aimed at improving or maintaining optimal swallowing and chewing during in various populations during daily life.Article Citation - WoS: 5Citation - Scopus: 5Development and Psychometric Analysis of a Pediatric Oncology Nurses' Educational Needs Scale(Wiley, 2023) Kudubes, Asli Akdeniz; Semerci, Remziye; Ozbay, Sevil Cinar; Ay, Ayse; Boztepe, HandanBackground/objectivesIt is important to determine the educational needs of pediatric oncology nurses in order to maximize and implement nursing care interventions. Therefore, this study aims to develop a valid and reliable measurement tool to determine pediatric oncology nurses' educational needs and examine its psychometric properties. Design/methodsThis methodological study was conducted with 215 pediatric oncology nurses in Turkey between December 2021 and July 2022. Data were collected with the "Nurse Information Form" and "Pediatric Oncology Nurses' Educational Needs Scale." IBM SPSS 21.0 and IBM AMOS 25.0 software programs were used for data analysis, and descriptive statistics were used to analyze numeric variables. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. ResultsThe factorial analysis was used to test the structural validity of the scale. A five-factor structure consisting of 42 items was developed. The Cronbach's alpha coefficient for "Illness" was .978, "Chemotherapy and Side Effect" was .978, "Another Therapy and Side Effect" was .974, "Palliative Care" was .967, "Supportive Care" was .985, and the total score was .990. Fit indices resulting from the study were chi(2)/SD: 3.961, root mean square error of approximation (RMSEA): 0.072, goodness-of-fit index (GFI): 0.95, comparative-of-fit index (CFI): 0.96, and normed fit index (NFI): 0.95. ConclusionThe Pediatric Oncology Nurses' Educational Needs Scale is a valid and reliable scale for pediatric oncology nurses to determine their educational needs.Article Citation - WoS: 3Evaluation of the Effects of Avatar on Learning Temporomandibular Joint in a Metaverse-Based Training(Wiley, 2024) Basmaci, Fulya; Bulut, Ali Can; Ozcelik, Erol; Ekici, Saliha Zerdali; Kilicarslan, Mehmet Ali; Cagiltay, Nergiz ErcilPurposeAvatars, representing users in the digital world, can influence users' behavior and attitudes. This study evaluates the impact of representing dental students receiving temporomandibular joint (TMJ) education in the metaverse via an anonymous or identified avatar.MethodsParticipants included 80 dental students in their fourth and fifth years of study. They were randomly assigned to either the avatar group (identified avatar) or the control group (anonymous avatar). Prior to training, participants completed a demographic questionnaire and a pretraining knowledge assessment. TMJ training was conducted in the metaverse for both groups. Pre- and post-training assessments included the Spielberger State-Trait Anxiety Inventory and a shyness scale to ensure group comparability. A post-test consisting of five questions was administered to both groups after 2 weeks of training.ResultsThere were no significant differences in pretraining scores for prior knowledge (p = 0.67), trait anxiety (p = 0.28), state anxiety (p = 0.92), or shyness (p = 0.42) between the avatar and control groups, indicating comparability at baseline. Post-training analysis revealed significantly higher post-test scores in the avatar group (median = 80) compared to the control group (median = 60) (p = 0.03).ConclusionsMetaverse environments offer various benefits for students, educators, and educational institutions in health education programs. Representing learners and their identities in training environments can enhance learning outcomes.Article Baby Steps of Parenting: Turkish Adaptation of Infancy Parenting Styles Questionnaire and Mother- and Infant-Related Characteristics Affecting Parenting in Infancy(Wiley, 2025) Bahtiyar-Saygan, BaharThe crucial importance of parenting for human development is well known, yet there has been little investigation, particularly regarding infancy parenting. This study investigates mother- and infant-related characteristics affecting parenting styles in the first year after birth. Additionally, adapting an Infancy Parenting Styles Questionnaire (IPSQ) to Turkish is aimed. In total, 110 mothers with babies in the first year of their lives (M age in months = 6.39, SDage in months = 3.72; 70 girls) participated in the study. Mothers filled out the IPSQ, Early Parenting Attitudes Questionnaire (EPAQ), Karitane Parental Self-Confidence Scale (KPSC), and Parental Stress Index-Short Form (PSI-SF). Four components emerged: involvement, discipline, anxiety, and routine. The IPSQ was found to be reliable (alpha = .81) and valid. The findings revealed that income, the number of children, and parental confidence were significant predictors for involvement; maternal education, parental confidence, parenting stress, and sleep wellness of the baby were significant predictors for discipline; and the number of caregivers and parental confidence were significant predictors for routine sub-components. Also, results indicated higher involvement and lower discipline in primiparous compared to multiparous mothers. The findings were discussed in light of the literature regarding the antecedents of parenting and its developmental outcomes.Article Citation - WoS: 3Citation - Scopus: 3Expectancy From, and Acceptance of Augmented Reality in Dental Education Programs: a Structural Equation Model(Wiley, 2024) Toker, Sacip; Akay, Canan; Basmaci, Fulya; Kilicarslan, Mehmet Ali; Mumcu, Emre; Cagiltay, Nergiz ErcilObjectiveDental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use.MethodsA correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's alpha, and composite reliability. Ten primary research hypotheses are tested with path analysis.ResultsA total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, beta = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, beta = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, beta = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, beta = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, beta = 0.046, L = 0.026, U = 0.086, p = 0.054).ConclusionInfrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.Article Citation - WoS: 2Citation - Scopus: 2Assessment of Anticancer Effects of Aloe Vera on 3D Liver Tumor Spheroids in a Microfluidic Platform(Wiley, 2025) Tevlek, Atakan; Kibar, Gunes; Cetin, BarbarosThe search for effective anticancer therapies has increasingly focused on natural compounds like Aloe vera, renowned for its therapeutic properties. This study investigates the anticancer properties of Aloe vera on 3D liver tumor spheroids via a PDMS-based microfluidic device, providing a more physiologically realistic model compared to traditional 2D cultures. HepG2 cells were cultivated to generate 3D spheroids on-chip, thereafter subjected to different concentrations of Aloe vera and the chemotherapeutic drug Doxorubicin to evaluate cytotoxic effects. The microfluidic system, validated by COMSOL simulations, facilitated continuous perfusion and real-time assessment of cell viability over a duration of 10 days. The results indicated that Aloe vera markedly diminished cell viability by triggering apoptosis at concentrations over 12.5 mg/mL. IC50 values were determined at 72 h: 25 +/- 0.10 mg/mL for Aloe vera and 5.47 +/- 0.03 mu g/mL for Doxorubicin in 2D cultures, but in 3D cultures, the IC50 values were 31.25 +/- 0.14 mg/mL for Aloe vera and 8.33 +/- 0.05 mu g/mL for Doxorubicin. This study underscores the promise of Aloe vera as a natural anticancer agent and illustrates the efficacy of microfluidic platforms for enhanced drug screening and customized medicine applications.Article Citation - WoS: 5Citation - Scopus: 9Deviations of Body Functions and Structure, Activity Limitations, and Participation Restrictions of the International Classification of Functioning, Disability, and Health Model in Children With Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis(Wiley, 2020) Ozipek, Melike; Arikan, Hulya; Calik-Kutukcu, Ebru; Kerem-Gunel, Mintaze; Saglam, Melda; Inal-Ince, Deniz; Ozcelik, UgurBackground To the best of our knowledge, there is no study in the literature investigating the extrapulmonary outcomes of children with non-cystic fibrosis (CF) bronchiectasis and CF under the framework of the International Classification of Functioning, Disability, and Health (ICF) model. The purpose of the present study is to evaluate the children with CF and non-CF bronchiectasis using the ICF model. Materials and Methods Children with CF, non-CF bronchiectasis, and healthy counterparts were evaluated (20 participants in each group) according to the ICF items in domain b (body functions), domain s (body structures), and domain d (activities and participation). The pulmonary functions, respiratory and peripheral muscle strength tests, and posture analysis were carried out for domain b. For domain d, however, the Glittre-activities of daily living test and Pediatric Outcome Data Collection were used. Results Muscle strength of shoulder abductors and hip extensors in children with CF was significantly lower than healthy children and adolescents (P < .05). The severity of lateral and posterior postural abnormalities in children with CF and non-CF bronchiectasis was higher than those of healthy children (P < .05). Among the patient groups, global function, sports/physical function, expectations, transfers/basic mobility, and pain/comfort were the most affected participation dimensions (P < .05). Conclusions This study highlights the need for comprehensive up-to-date evaluation methods according to the ICF model for understanding rehabilitation requirements in CF and non-CF bronchiectasis in different age groups.Article Citation - WoS: 6Citation - Scopus: 6Effect of Nutritional Support on Nutritional Status and Inflammation in Malnourished Patients Undergoing Maintenance Hemodialysis(Wiley, 2021) Demirci, Bahar Gurlek; Carrero, Juan Jesus; Tutal, Emre; Bal, Zeynep; Sezer, SirenIntroduction Protein energy wasting/malnutrition is a strong predictor of morbidity and mortality in patients on maintenance hemodialysis (MHD). We aimed to compare the effects of oral and/or intradialytic parenteral nutrition (IDPN) support on nutritional and inflammatory parameters in malnourished patients with MHD. Methods This is an observational study of 56 malnourished patients on MHD. We offered combined oral nutritional support (ONS) and IDPN for 12 months to all patients. Depending on patient choices for treatment, they were classified into four groups: group 1 (ONS only), group 2 (IDPN only), group 3 (both ONS and IDPN), and group 4 (patients who refused artificial nutrition support and only followed dietary advice). Normalized protein catabolic rate (nPCR), malnutrition inflammation score (MIS), and body composition (fat mass [FM], muscle mass [MM]) were assessed monthly. Findings The mean serum albumin levels of groups 2 and 3 significantly increased with the intervention, whereas that of group 4 significantly decreased. The mean nPCR levels of groups 2 and 3 significantly increased. Group 3 had the most significant positive change in serum albumin and nPCR levels. Mean serum C-reactive protein (CRP) levels of groups 1, 2, and 3 decreased, whereas those of group 4 increased. A increment in CRP was only identified in group 3. The MIS of groups 1, 2, and 3 significantly decreased whereas that of group 4 significantly increased. The increment % in FM was 1.1, 1.9, 9.1, and -2.9 for groups 1, 2, 3, and 4, respectively, and that in MM was -0.6, 4.4, 6.9, and -7.9 for groups 1, 2, 3, and 4, respectively. Discussion Compared to monotherapy or nutritional counseling, the choice of ONS plus IDPN is associated with improved nutritional status and decreased inflammation in malnourished patients on MHD. Nonetheless, interventional studies must be conducted to confirm these observations.Article The Role of Background Acoustic Stimuli in Dual Tasks: A Study on Postural Control Performance(Wiley, 2025) Saricamlik, Selin; Avci, Nizamettin Burak; Yigit, OznurIntroduction: Performing everyday tasks requires the use of multiple cognitive, sensory, and emotional systems. The interference of different variables in these multitasking systems affects our motor-balance system. This study was conducted to investigate how acoustic stimuli presented during a cognitive-motor dual task affect postural control in healthy young adults. Methods: Fifty-four healthy participants (39 females, 15 males; total age 21.87 +/- 1.18, range 19-24) were randomly assigned to control (silent), noise (multi-talker babble), or music (Mozart-Jupiter) groups based on testing environment. During the Stroop test, conducted with acoustic stimuli, postural sway velocity was measured on firm and foam surfaces with eyes open. The dual-task effect was assessed using the Wilcoxon test, and group comparisons employed one-way ANOVA or Kruskal-Wallis tests. Independent t tests and Mann-Whitney U tests were used for two-group comparisons. Statistical significance was set at p<0.05 (Bonferroni-adjusted p<0.017). Results: The silent cognitive-motor dual task increased postural sway on firm (median increased from 0.18 to 0.26 deg/s) and foam (median increased from 0.21 to 0.32 deg/s) surfaces. Music did not significantly affect cognitive performance or postural sway compared to the control group. However, noise reduced postural sway on firm and foam surfaces compared to the control group but did not affect cognitive performance. There was no significant difference in average Stroop response times between the groups or between the firm and foam surface comparisons. Conclusions: During inhibitory control tasks, cognitive effort prioritized in young people in easy-to-balance situations. Background noise affects motor-cognitive interaction, highlighting its potential for enhancing vestibular rehabilitation strategies in multitasking and guiding future research.Article Predicting Stroke Risk Using Machine Learning: A Data-Driven Approach to Early Detection and Prevention(Wiley, 2025) Sutcu, Muhammed; Jouda, Dana; Yildiz, Baris; Katrib, Juliano; Almustafa, Khaled MohamadStroke is a major global health concern and a leading cause of disability and mortality, emphasizing the need for early risk prediction and intervention. This study leverages statistical analysis, machine learning (ML) classification, clustering, and survival modeling to identify key stroke predictors using a dataset of 5110 records. Descriptive statistics reveal that age, glucose levels, BMI, hypertension, and heart disease are the most influential risk factors. Stroke prevalence is notably higher among hypertensive (13.25%) and heart disease patients (17.03%), as well as among former (7.91%) and current smokers (5.32%). Clustering analysis using PCA and t-SNE highlights high-risk groups with elevated glucose levels and advanced age. Among ML models, XGBoost offers the best trade-off between precision and recall, while na & iuml;ve Bayes achieves the highest recall (0.404), detecting more stroke cases despite higher false positives. Feature importance analysis ranks glucose, BMI, and age as dominant predictors, with XGBoost emphasizing cardiovascular conditions. Survival analysis confirms increasing stroke risk beyond age 60, with the Kaplan-Meier and Cox models showing a 31.9% risk increase linked to hypertension. These findings underscore the importance of early screening, lifestyle intervention, and targeted care. Future research should explore data-balancing methods like SMOTE and develop real-time tools to support clinical decision-making.
