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Positive body image is a pathway between nature contact and life satisfaction across 58 nations
(Elsevier Ltd, 2026) Swami, Viren; Voracek, Martin; Stieger, Stefan; Stieger, Stefan; Ranjbar, Hamed Abdollahpour; Adebayo, Sulaiman Olanrewaju; Beydaǧ, Kerime Derya
Time spent in nature benefits human mental and physical well-being. However, much of the variance in outcomes of nature contact remains unexplained, suggesting that new mechanistic pathways need to be considered. Here, we tested a novel conceptual model linking nature contact with life satisfaction via pathways involving positive experiences of living in and experiencing the world through the physical self. Using data from the Body Image in Nature Survey (BINS; N = 50,363), representing respondents from 58 nations and speaking 36 different languages, we find that nature contact is associated with greater self-compassion and greater perceived restoration in nature, which in turn are associated with more positive body image. In addition, more positive body image is associated with greater life satisfaction. These associations were robust to sensitivity tests, generalised to all gender identities and age groups, and held individually in almost all national groups and languages. Although replications are needed, we propose that the materialities of natural environments help to link bodily experiences to the production and experience of well-being, a process that is largely stable across national groups.
Source-space EEG alpha activity reveals brain age gaps due to neurodegeneration and disparity
(Nature Research, 2026) Otero, Monica; Carriel-Rubilar, Felipe I.; Hernandez, Hernan; Cuadros, Jhosmary; Condado, Jorge G.; Sainz-Ballesteros, Agustin; Santamaria-Garcia, Hernando; Yıldırım, Ebru
Brain clocks are promising tools for evaluating brain health. However, most current methods rely on structural neuroimaging. Functionally based approaches remain scarce, especially for assessing age-related neurodegenerative diseases. This study examines whether the brain age gap (BAG), the difference between chronological and predicted brain age, reflects neurodegeneration when estimated from electroencephalographic resting-state (rsEEG) alpha-oscillations, a well-established marker of brain functional aging. It also explores whether alpha-based brain clocks reflect sociodemographic diversity and structural inequality. The BAG was computed using spectral descriptors of alpha-activity in the rsEEG source space of 1228 healthy participants, individuals with mild cognitive impairment (MCI), and patients with Alzheimer's disease or behavioral variant frontotemporal dementia, residing in 10 countries with varying levels of structural inequality. BAGs are increased in MCI and dementia groups, particularly in posterior cortical regions. Structural inequality emerges as the strongest predictor of BAG, surpassing cognition, education, and sex. The findings indicate that an alpha-oscillation-based brain clock provides a sensitive functional marker of brain aging, capable of capturing neurodegenerative processes as well as the impact of social disparities. This scalable, accessible approach to brain health shows promise for translational use and population-wide screening in underserved, resource-limited settings.
Correlation of the endoscopic esophagogastric junction integrity with symptomatic gerd in patients undergoing work-up for metabolic and bariatric surgery
(Springer, 2025) Şişik, Abdullah; Dalkılıç, Muhammed Said; Gençtürk, Mehmet; Yılmaz, Merih; Erdem, Hasan; Nguyen, Ninh T.
BackgroundGastroesophageal reflux disease (GERD) is a common adverse effect after metabolic and bariatric surgery (MBS). Identifying patients with preexisting GERD is critical for preoperative planning. The American Foregut Society (AFS) recently proposed a new endoscopic classification system for objective assessment of the esophagogastric junction (EGJ) integrity, building upon the Hill classification. Grade 1 represents an intact EGJ, while grades 2, 3, and 4 represent partial, moderate, and complete disruption of the ARB. Unlike Hill classification, the AFS classification includes objective measurement of hiatal axial length and aperture diameter. The study aimed to evaluate the ability of the AFS hiatus classification to predict GERD severity using symptom questionnaires.MethodsWe performed a prospective study of obese patients who underwent endoscopy as work-up for MBS. The endoscopy was evaluated for esophagitis, Barrett's esophagus, and AFS grade. All patients were also surveyed preoperatively with the GERD-HRQL, GerdQ, and RSI. The correlation between AFS grades and questionnaire scores was analyzed using Spearman's test.ResultsA total of 393 patients were included in the study. There were 81% female, with a mean age of 36 +/- 10.7 years and a mean BMI of 41.7 +/- 7.2 kg/m2. The AFS grades were distributed as follows: 11 (2.8%) patients had grade 1; 137 (34.9%) had grade 2; 162 (41.2%) had grade 3; and 83 (21.1%) had grade 4. There was a positive but weak correlation between AFS grades and all scoring systems, including GERD-HRQL (r = 0.201), heartburn (r = 0.203), regurgitation (r = 0.212), RSI (r = 0.110), and GerdQ scores (r = 0.202). However, the proportion of patients with esophagitis increased progressively with increasing grades (0% in grade 1, 2.2% in grade 2, 9.9% in grade 3, and 32.5% in grade 4, p = 0.01).ConclusionThe AFS hiatus classification can stratify the population with obesity based on rate of esophagitis and symptom scores. This study supports the practical utility of the AFS classification as an adjunct in the detection of patients who are at risk for GERD after MBS. Further validation studies with pH testing are needed.
In vitro investigation of the therapeutic effects of coriander powder extract in the detoxification of Pb and Cd exposure
(Istanbul Gelisim University, 2025) Nizamlioğlu, Fatma; Öncel, Hasan Uğur
Aim: This study was conducted to investigate the effect of coriander seed powder extract on the chelation rate of cadmium (Cd) and lead (Pb) in saliva, stomach and intestine using an in vitro digestion model. Method: The method recommended by the Dutch National Institute for Public Health and the Environment (RIVM) was used as an in vitro digestion model. 5 different concentrations (50, 100, 200, 300 and 500 mg) of coriander and garlic powder extracts, to which 100 ppm Cd and Pb were added, were digested in saliva, stomach and intestine. Cd and Pb ratios in each medium were measured by ICP- OES device. Results: As the amount of coriander (50, 100, 200, 300 and 500 mg) increased, the bioavailability of Cd similarly decreased in saliva to 73.09%, 69.72%, 68.86%, 69.71% and 64.70%, respectively, in the stomach environment to 35.93%, 38.40%, 38.46%, 37.06% and 34.44%, and in the intestinal environment to 16.45%, 15.09%, 11.89%, 4.69% and 3.70%. The bioavailability of Pb decreased in saliva to 72.72%, 67.16%, 69.46%, 68.31% and 64.06%, respectively, in the stomach it decreased to 37.50%, 35.97%, 37.07%, 34.93% and 33.81% respectively, and in the intestine it decreased to 16.83%, 14.94%, 9.86%, 4.26% and 3.10% respectively. Coriander was found to be effective in reducing the bioavailability of both Pb and Cd. In the medium-based comparison, the availability of Cd was highest in saliva and lowest in the intestine. In coriander extracts, Cd availability was significantly reduced compared to the control group (p < 0.01). A statistically significant decrease in availability was detected as the concentration increased (p < 0.01). In the medium-based comparison, the bioavailability of Pb was highest in saliva and lowest in the intestine. A significant decrease in the bioavailability of Pb was detected. Conclusion: This study has demonstrated that coriander possesses the capacity to bind cadmium and lead in an in vitro digestion model. Furthermore, this study has determined that coriander can be used as an alternative to chemical chelators (e.g. D-penicillamine) that may be harmful to the body in cases of chronic heavy metal exposure. Therefore, as an alternative, it is recommended to regularly provide coriander tablets or coriander consumption to prevent Cd and Pb exposure.
Muscle weakness, proprioceptive deficits, and postural stability in unilateral knee osteoarthritis: a comparative analysis of affected and unaffected limbs
(Hacettepe University, 2025) Bozgeyik Bağdatlı, Sibel; Yavuz, Duru Ceren; Çelebi, Ezgi; Yıldız, Adalet Elçin
Objective: This study aimed to investigate quadriceps and hamstring muscle strength, postural stability, proprioceptive sense, and weight-bearing asymmetry between the affected and unaffected lower limbs in patients with unilateral knee osteoarthritis (OA). Materials and Methods: A total of 79 patients (70 women, nine men; mean age 61.08 ± 6.28 years) diagnosed with unilateral knee OA according to the Kellgren-Lawrence classification were included. Demographic and clinical characteristics were recorded. Pain intensity was assessed using the Visual Analog Scale, and functional status was evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Muscle strength was measured with a manual muscle dynamometer, proprioception with joint position sense tests at different knee flexion angles, and postural stability using a force platform under both eyes-open and eyes-closed conditions. Weight-bearing distribution during bilateral stance was also evaluated. Results: Quadriceps and hamstring strength were significantly lower in the affected limb compared to the unaffected side (p  0.001). Weight-bearing on the affected limb was reduced under both eyes-open and eyes-closed conditions (p  0.001). However, no significant interlimb differences were observed in postural stability parameters or proprioceptive accuracy at any tested angles (p > 0.05). Additionally, patients demonstrated a significant asymmetry in load transfer during bilateral stance, favoring the non-affected limb. Conclusion: Patients with unilateral knee OA exhibit reduced muscle strength and weight-bearing capacity in the affected limb, along with asymmetrical load distribution during stance. These findings highlight the importance of addressing weight-bearing asymmetry and muscle weakness in early rehabilitation programs to prevent further functional deterioration and disease progression.
Hemşirelerin kronemik (zamansal iletişim) algıları ve etkileyen faktörlerin incelenmesi
(Gümüşhane Üniversitesi, 2025) Bakanoğlu Kalkavan, Emek; Şahin, Elif Nur; Dilek, Esranur
Amaç: Araştırma, hemşirelerin kronemik algıları ve etkileyen faktörlerin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırmanın örneklemini 01 Mart-31 Temmuz 2023 tarihleri arasında aktif olarak çalışan 411 hemşire oluşturmuştur. Veriler, bireysel özellikleri içeren kişisel bilgi formu, Kronemik Algısı Ölçeği ile online ve yüz yüze anket tekniği kullanılarak toplanmıştır. Veriler SPSS 22,0 paket programında analiz edilmiştir. Bulgular: Araştırmaya katılan hemşirelerin %92,7’si kadın, %51,8’i lisans mezunu, %42,8’si özel hastanede ve %45,0’i yatan hasta katında çalışmaktadır. Hemşirelerin Kronemik Algısı Ölçeği’nden aldıkları “Kronemik Algısı Genel” puan ortalaması orta seviyede bulunurken, ölçek alt boyutlarından “Statü ve Güç Mesafesi” ortalaması orta, “Kronemik Bilinci” ortalaması zayıf, “Kronemik Algısı, “Monokronik Polikronik Zaman” ve “Kültür Etkisi” ortalamaları yüksek olarak saptanmıştır. Hemşirelerde cinsiyet, öğrenim durumu, çalışılan kurum, çalışma arkadaşlarından memnuniyet, zaman yönetimi, zaman yönetiminin hemşire verimliliği ile ilişkisi, çalışırken zamanın iletişimi etkilediğini düşünme ve hasta özelliklerinin iletişimi etkilemesi görüşü ile ölçek alt boyutları arasında istatistiksel olarak anlamlı farklar saptanmıştır (p<0,05). Sonuç: Zaman, hemşirelik mesleğinde sağlık bakım kalitesini etkilemesi nedeniyle çok değerli bir kaynaktır. İletişim ise hemşirelik bakımını sunmada hemşirelik sürecinin ayrılmaz bir parçasıdır. Bu çalışma ile, hemşirelikte iletişim kurmada zamanın bir araç olarak kullanılmasının önemi vurgulanmıştır.
Correction: the effect of stretching exercises applied to caregivers of children with development disabilities on musculoskeletal muscle mobility and respiratory function (International Journal of Environmental Research and Public Health, (2024), 21, 10, (1361), 10.3390/ijerph21101361)
(Multidisciplinary Digital Publishing Institute (MDPI), 2026) Ataç, Amine; Atak, Ebrar
In the original first publication [1], the general information language in the second and third paragraphs of the Introduction section was revised and the expressions in the paragraphs were rearranged because of the coincidental similarity with the publication in the newly added Reference [17]. With this correction, the order of some references has been adjusted accordingly. The revised paragraphs and the newly added reference are shown below. Adequate hamstring extensibility plays a critical role in enabling functional movement patterns required in everyday life. However, reduced hamstring length is frequently observed in the general population, which may be explained by the muscle’s involvement in sustained postural control and its tendency to remain in a shortened state during prolonged static positions [9,10]. Shortening of the hamstring muscle can alter pelvic alignment by promoting posterior pelvic tilt, which subsequently affects spinal curvatures and pathologies, including a reduction in lumbar lordosis and an increase in thoracic kyphosis. These postural alterations may restrict thoracic mobility, influence diaphragmatic mechanics, and negatively impact respiratory efficiency. Furthermore, hamstring tightness may contribute to dysfunction not only locally but also across anatomically distant segments within the posterior kinetic chain [9,11–14]. The posterior kinetic chain comprises multiple muscle groups, including the spinal extensors, gluteus maximus, hamstring muscles, calf musculature such as the gastrocnemius and soleus, as well as intrinsic muscles of the foot [15]. Muscles forming the posterior chain function collectively to maintain upright posture against gravitational forces. Increased tension in any component of this chain, such as the hamstring muscle, may be transmitted to other interconnected structures. This phenomenon is consistent with the biological tensegrity model, which proposes that bodily tissues operate as an integrated system balancing tensile and compressive forces throughout the body [16–18]. Increased stiffness and reduced flexibility in the hamstring muscles are frequently accompanied by compensatory tension in proximal regions, particularly within the lumbar and shoulder musculature [14]. In the literature, there are studies explaining the relationship between hamstring muscles and respiratory parameters with the myofascial theory [9,16]. According to this theory, the human body is composed of fascia, a single tissue that functions as interconnected chains. Tension in one point of the fascia, which shows integrity, can result in tension or restriction in another part of the body [18]. Previous research has explored the association between hamstring muscle characteristics and respiratory parameters within the framework of myofascial continuity. According to this perspective, fascia functions as a unified connective network, allowing mechanical tension generated in one region to influence distant anatomical areas. In this context, alterations in diaphragmatic mobility or tension may contribute to functional limitations observed during the assessment of hamstring flexibility [15–17]. Bırık, B. Hamstring kas Kısalığında Miyofasyal Gevşetme Tekniğinin Posterior Zincir Kaslarının Mobilitesi, Solunum Fonksiyonları, Solunum kas Kuvveti ve Enduransı Üzerine Etkisi. Master’s Thesis, Bezmialem Vakıf University, İstanbul, Turkey, 2018. The authors state that the scientific conclusions are unaffected. This correction was approved by the Academic Editor. The original publication has also been updated.
Preoperative prediction of hiatal hernia based on the American Foregut Society (AFS) endoscopic classification in bariatric surgery
(SAGE Publications, Inc., 2026) Dalkılıç, Muhammed Said; Gençtürk, Mehmet; Yılmaz, Merih; Şişik, Abdullah
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STEM in early childhood: a phenomenological perspective on teachers' views, experiences, and professional development needs
(Necmettin Erbakan University, 2025) Özok Bulut, Nefise; Erdoğan, Serap
The implementation of STEM education in early childhood has become increasingly important for the development of children's 21st-century skills. However, the effective realization of this interdisciplinary approach is directly related to teachers' theoretical knowledge and practical competencies. In this study, the views, implementation experiences, and professional development needs of preschool teachers regarding STEM education were examined. The study, conducted using a phenomenological design, a qualitative research method, included 16 preschool teachers selected through criterion sampling. Data were collected through two online focus group interviews and analyzed using the content analysis method. The findings indicate that teachers define STEM as an interdisciplinary approach but have some misconceptions. While all teachers emphasized that STEM education is important and necessary for children, it was found that they do not implement it. The main factors hindering STEM education include a lack of professional support, insufficient knowledge, materials, and resources, time constraints, and inadequate administrative and family awareness. The research findings show that teachers need practical training, mentoring support, professional learning communities, and guiding resources and materials. The study also offers recommendations to improve the quality of STEM implementation in early childhood.
Relationship between childhood traumas, cognitive distortions and aggression in forensic psychiatry patients aggression in forensic psychiatry patients
(Routledge, 2026) Atay, Eda; Doğan, Ufuk; Işıl, Özlem; Hekim, Büke; Kılıç, Nilüfer
Aggression is a common problem in forensic psychiatric patients and an important problem for psychiatric nurses during the treatment, care and rehabilitation of patients. The aim of this study is to determine the relationship between childhood traumas, cognitive distortions and aggression in forensic psychiatry patients. This descriptive study was conducted with 103 forensic psychiatry patients treated in a high security forensic psychiatry hospital. The data of study were collected Introductory Information Form, Childhood Psychological Traumas Scale (CTQ), Cognitive Distortions Scale (CDS) and Buss-Perry Aggression Scale (BAQ). The data of the study were collected using the Introductory Information Form, the Childhood Trauma Questionnaire (CTQ), which assesses traumatic experiences in childhood; the Cognitive Distortions Scale (CDS), which measures dysfunctional thought patterns; and the Buss-Perry Aggression Questionnaire (BAQ), which evaluates levels of aggression. The study found a significant positive correlation among childhood traumas, cognitive distortions, and aggression, indicating that higher levels of childhood trauma and cognitive distortions are associated with increased aggression. This study highlights the importance of considering both early traumatic experiences and cognitive processes together in the management and prevention of aggression among forensic psychiatric patients. The findings emphasize the necessity of taking these factors into account for risk assessment and effective treatment planning.
Evaluating bariatric surgery in patients aged 60 years and older: a retrospective multicenter comparison of sleeve gastrectomy and roux-en-Y gastric bypass
(Mary Ann Liebert Inc., 2026) Dalkılıç, Muhammed Said; Yüce, Kenan; Zapater, Christophe Adil Fernandez; Özdemir, Neslihan; Kovancı, Hafize; Oumar, Mahamat Bechır Saleh; Şişik, Abdullah
Background: This study aimed to compare the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) in patients aged 60 and older, focusing on postoperative weight loss, improvement in obesity-related comorbidities, and perioperative outcomes. Methods: This was a retrospective analysis of data from three bariatric surgery centers with surgeries performed between January 2019 and September 2024. The study included patients aged >= 60 years who underwent either LSG or RYGB. The primary outcome was the comparison of weight loss metrics (excess weight loss [%EWL] and total weight loss [%TWL]) between LSG and RYGB. Secondary outcomes included the remission or improvement of type 2 diabetes mellitus (T2DM) and hypertension (HTN), 30-day postoperative complications, operative time, and length of hospital stay. Results: A total of 168 patients aged >= 60 who underwent LSG (n = 130) or RYGB (n = 38) were included. Both procedures resulted in similar weight loss outcomes, with a median %EWL of 58.6% for LSG and 61.2% for RYGB. The median %TWL was 23.1% for LSG and 26% for RYGB, with no significant differences between the groups (P = .275). The operative time was significantly shorter for LSG (60 minutes versus 110 minutes for RYGB, P < .001), and LSG patients had a shorter hospital stay (2 versus 3 days, P < .001). The 30-day complication rate was low for both groups, with no significant difference in complications between LSG and RYGB. Regarding comorbidity resolution, 90.7% of patients with T2DM and 93.6% with HTN experienced improvement or remission. Complete remission was achieved in 39% of all T2DM cases (37.5% in LSG, 42.9% in RYGB) and in 33% of all HTN cases (33.3% in LSG, 31.6% in RYGB), with no statistically significant differences between the groups. Conclusions: Bariatric surgery appears safe in older adults when guided by careful patient and procedure selection through multidisciplinary assessment. Both LSG and RYGB yielded comparable weight loss and remission outcomes for T2DM and HTN in this population.
Sleeve gastrectomy versus Roux-en-Y-gastric bypass in patients with body mass index over 50 kg/m2: international multicentre cohort
(Oxford University Press, 2026) Kollmann, Lars; Rosenblum, Ilan; Poljo, Adisa; Probst, Pascal; Muller, Markus K.; Kalinowski, Piotr; Dalkılıç, Muhammed S.; Şişik, Abdullah
Background Patients with initial body mass index > 50 kg/m(2) are vastly under-represented in randomized clinical trials demonstrating similar weight loss and diabetes remission rates after sleeve gastrectomy and Roux-en-Y gastric bypass. Methods Propensity score matching 1 : 1 was used to compare outcomes regarding weight loss and diabetes control after sleeve gastrectomy and Roux-en-Y gastric bypass in patients with body mass index > 50 kg/m(2) between 2012 and 2022 in a cohort from 13 centres in six European countries. The primary endpoint was percentage total bodyweight loss; secondary endpoints were diabetes remission rate and rate of persistent body mass index > 40 kg/m(2). Results In total, 3976 of 8160 patients were matched and included in the analysis (1988 in each group). Median age at baseline was 40.0 (range 16-76) years in the sleeve gastrectomy group and 39.5 (15-71) years in the Roux-en-Y gastric bypass group. Median body mass index at baseline was 56.2 (range 50.0-100.0) and 54.3 (50.0-83.9) kg/m(2), respectively (P < 0.001). The follow-up rate was 70.5% at 1 year and 24.4% at 5 years. Percentage total bodyweight loss at 1 and 5 years after sleeve gastrectomy was 30.2 (2.2-63.7) and 25.4 (-4.8 to 56.0)%, respectively, versus 31.2 (7.4-54.5) and 28.2 (-6.6 to 62.9)% in the Roux-en-Y gastric bypass group (P < 0.001 between groups in both time points). The prevalence of persistent body mass index > 40 kg/m(2) after 1 and 5 years was 42.7 and 57.6%, respectively, after sleeve gastrectomy versus 24.5 and 39.2% after Roux-en-Y gastric bypass (P < 0.001 between groups in both time points). A 5-year follow-up, the prevalence of a pathological haemoglobin A1c level (> 6.5%) was 12.9% after sleeve gastrectomy and 11.6% after Roux-en-Y gastric bypass (P = 0.323). Conclusion This study suggests that Roux-en-Y gastric bypass results in greater weight loss than sleeve gastrectomy in patients with body mass index > 50 kg/m(2), whereas improvements in diabetes appear comparable between procedures.
The mediating role of fertility anxiety in the relationship between fertility health knowledge and climate change anxiety
(John Wiley and Sons Inc, 2026) Tandoğan, Özden; Yakıt Ak, Eda; Sen, Mehmet Ali; Yaraşır Gillette, Ezgi
This study aimed to examine the mediating role of fertility health anxiety (M) in the association between fertility health knowledge (X) and climate change anxiety (Y) among women of reproductive age. The study involved 675 women of reproductive age. Data were collected using the Descriptive Information Form, the Fertility Health Knowledge Scale (FHKS), the Fertility Health Anxiety Scale, and the Climate Change Anxiety Scale (CCAS). The mediating role of fertility health anxiety was tested using the PROCESS macro Model 4, with age and marital status included as covariates. The mean age of the women was 27.39 +/- 9.81; 69.5% were single, and 75.3% had no children. Of the participants, 57.2% stated that climate change had an impact on fertility, and 51.4% stated that climate change would be associated with their decision to have children in the future. The analysis revealed a modest positive correlation between FHKS and CCAS scores (r = 0.162, p < 0.01). In the covariate-adjusted mediation model, the total effect of fertility health knowledge on climate change anxiety was significant (b = 0.101, SE = 0.024, beta = 0.162, p < 0.001). The direct effect remained significant (b = 0.110, SE = 0.023, beta = 0.176, p < 0.001). The indirect effect through fertility health anxiety, tested using the bootstrap method with 5000 resamples, was statistically significant but small in magnitude (b = -0.009, BootSE = 0.005, beta = 0.014, 95% CI: [-0.019, -0.001]), accounting for approximately 8% of the total effect, and should be interpreted with caution given its modest substantive size. Among the covariates, age was significantly and positively associated with climate change anxiety (beta = 0.157, p < 0.01), while marital status was not significant. The findings indicate that fertility health knowledge is positively associated with climate change anxiety; however, this association is partially offset through the anxiety-reducing association of fertility health knowledge with fertility health anxiety, highlighting the potential relevance of environmental concerns for reproductive well-being. These findings should be interpreted as preliminary: effect sizes were modest, explained variance was low (R-2 = 0.021-0.071), and the cross-sectional design precludes causal inference. Accordingly, the substantive significance of the indirect effect should not be overstated.
The safety profile of aspartame: a review of regulatory standards and emerging health concerns
(Wiley, 2026) Öncel, Hasan Uğur; Sökmen, Zehra
We reviewed the effects of aspartame, one of the artificial sweeteners widely used in the food industry, on human health. We evaluated the chemical structure, metabolic processes, and potential health effects of aspartame in light of scientific studies. Studies in various health areas, such as cancer risk assessment, effects on the nervous system and cardiovascular system, and its role in metabolic disorders, have led to various debates about the safety of aspartame for human health. While aspartame’s low-calorie structure provides an advantage for metabolic diseases such as obesity and diabetes, its potential effects on insulin sensitivity and gut microbiota have led to different conclusions. In light of the adverse effects of the phenylalanine amino acid in the structure of aspartame on brain development, we have tried to emphasize that consumption levels should be more closely monitored in special risk groups such as phenylketonuria (PKU) patients, children, pregnant women, and the elderly. The widespread use of aspartame in the food industry has led to the view that this structure is safe when consumed as a sweetener at acceptable daily intake levels. This review seeks to answer, “Is it a safe additive for human health when individual sensitivities and long-term effects are considered?”
Rethinking post-bariatric care: anorectal morbidity following sleeve gastrectomy and roux-en-Y gastric bypass
(Lippincott Williams and Wilkins, 2026) Erdem, Olgun; Acar, Aylin; Canbak, Tolga; Başak, Fatih; Kudaş, İlyas; Tosun, Hüsna; Tekesin, Kemal; Şişik, Abdullah
BACKGROUND: Bariatric surgery is a prevalent and effective treatment for morbid obesity, yet its potential long-term effects on anorectal health remain an under-investigated aspect of post-operative care. This study aimed to meticulously evaluate the incidence and the degree of severity of two common anorectal conditions, anal fissures and hemorrhoids, in a substantial cohort of patients following either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB), two frequently performed bariatric procedures. Understanding these potential post-surgical morbidities is crucial for a comprehensive approach to patient management. METHODS: A retrospective cohort study at a large tertiary referral center (2015-2023) included 280 patients (200 SG, 80 RYGB). Detailed pre- and post-operative data on anorectal conditions, bowel habits, and surgical outcomes were extracted from electronic records and statistically analyzed. RESULTS: The overall incidence of new-onset anorectal disorders (defined as the development of at least one of the conditions) was significantly higher in the RYGB group (47.5%) compared to the SG group (32.5%) ( P <0.001). Specifically, the incidence of new-onset hemorrhoids (36.5% vs. 23.5%, P =0.02) and anal fissures (29.0% vs. 16.0%, P =0.01) occurred more frequently in the RYGB group. The mean severity scores were also higher (Goligher score: 2.6±0.8 vs. 2.1±0.7, P = 0.01; fissure severity: 2.9±1.0 vs. 2.3±0.9, P = 0.02). Post-operative constipation and diarrhea were associated with higher risk, and RYGB was an independent predictor. Multivariate analysis, adjusting for age, sex, and baseline BMI, confirmed RYGB (OR 1.7, 95% CI 1.1-2.5, P =0.01) and post-operative constipation (OR 2.0, 95% CI 1.3-3.0, P =0.001) as independent predictors of new-onset anorectal disorders. CONCLUSIONS: Our findings highlight that not all bariatric procedures carry the same risk for anorectal complications, and RYGB specifically warrants closer attention. These findings underscore the clinical importance of incorporating proactive assessment and management of anorectal health, including bowel habit regulation and symptom monitoring, into the routine post-operative care of bariatric surgery patients to optimize their overall well-being.
From awareness to action: do the food safety attitudes affect sustainable food consumption behaviors in university students?
(Frontiers Media SA, 2026) Pınarlı Falakacılar, Çağla; Bilginer Diler, Gamzegül; Terzi, Merve
Background: Ensuring food safety and promoting sustainable food consumption are increasingly important public health priorities, especially among young adults who are forming long-term dietary habits. This study explored how university students' food safety attitudes relate to their sustainable food consumption behaviors. Methods: This cross-sectional study was conducted with 360 university students between May and September 2024. Validated scales were used to measure food safety attitudes (FSAS) and sustainable food consumption behaviors (SFCBS). Additional data collected included gender and body mass index (BMI). Statistical analyses evaluated differences between groups and correlations among key variables. Results: The findings showed that 83.3% of participants had adequate food safety attitudes. Female students scored significantly higher than males on both the food safety attitude and SFCBS scales, including subdimensions such as caring, assimilating, and shopping/cooking habits (p < 0.05). A moderate positive correlation was identified between FSAS and SFCBS, particularly for general nutritional behaviors (r = 0.446, p < 0.05). Additionally, positive correlations were found between SFCBS and FSAS subdimensions. Conclusion: Overall, the results indicate that female students exhibit stronger food safety attitudes and sustainable food consumption behaviors, and that fostering awareness of these practices during university years may contribute to healthier, more environmentally responsible lifestyles in line with global sustainability goals.
Segment-specific alterations in trapezius muscle viscoelasticity in chronic neck pain: a myotonometric case-control study
(Elsevier Ltd, 2026) Bozgeyik-Bağdatlı, Sibel; Yavuz, Duru Ceren; Özçelik, Berkant Anıl; Çetin, Hatice
Background: Chronic neck pain (CNP) is associated with altered muscle properties and pain sensitivity, especially in the trapezius muscle. However, evidence on how viscoelastic properties vary across different regions of the trapezius remains limited. Objective: This study aimed to compare the viscoelastic properties, pressure pain threshold, cervical range of motion, disability, depression, and perceived stress between individuals with CNP and asymptomatic controls. Methods: Twenty-six individuals with CNP (median age (IQR): 23 (22 – 24)) and 26 age- and sex-matched controls (median age (IQR): 23 (22 – 25)) were included. Muscle viscoelastic properties of the upper, middle, and lower trapezius were measured using the MyotonPRO. Pressure pain threshold was evaluated with a digital algometer, and cervical range of motion was assessed using a CROM device. Disability, depression, and perceived stress were measured using the Neck Disability Index, Beck Depression Inventory, and Perceived Stress Scale, respectively. Results: Individuals with CNP showed significantly increased muscle tone and stiffness in the upper trapezius bilaterally and altered viscoelastic properties in the middle trapezius (affected side). Pressure pain threshold values were significantly lower across all portions of trapezius. Despite these differences, no significant cervical range of motion limitations were found. Conclusion: Altered mechanical and sensory properties in the trapezius muscle — particularly in its upper and middle portions — may contribute to CNP, even in the absence of substantial cervical mobility limitations. This study provides the first comprehensive comparison of all three trapezius regions in individuals with CNP using handheld myotonometry, offering novel insights into the segment-specific mechanisms underlying chronic neck pain.
The mediating role of psychological well-being in the relationship between psychosocial health and psychological resilience in expectant women
(BMC, 2026) Özbaş Gençarslan, Derya; Açıkgöz Atay, Eda; Kaplan, Songül Nida; Özbaş, Ayşe Duygu; Yavaş Çelik, Melike; Işıl, Özlem
Background Although pregnancy is a part of the natural life cycle for every woman, the idea that pregnancy is a happy period and a state of emotional well-being has now been abandoned. This process causes intense changes to woman bodies, minds and society. The study aims to determine how psychological well-being mediates the relationship between psychological health and psychological resilience in expectant women. Methods The study was conducted descriptively with 130 expectant women who attended the obstetrics outpatient clinic at a university hospital between 15.07.2021 and 30.12.2021. Results A moderately significant association between psychosocial health and psychological well-being during pregnancy (p < 0.01), and a moderately strong association between psychological well-being and psychological resilience were found (p < 0.01). Psychosocial health and psychological resilience during pregnancy were also significantly associated at a low-level (p<0.1). The result of the Structural Equation Modeling Mediation analysis reveals that psychological well-being serves as a crucial mediating role in the relationship between psychosocial health and psychological resilience during pregnancy. (beta = 0.08, t = 0.61). The model fit indices were determined as X-2=237.12. Conclusions The study found that expectant women have an important role in strengthening the association between psychosocial health and psychological well-being through their mediating role of psychological well-being.
Cortisol hormone and stress levels: colorimetric assessment with artificial intelligence supported image processing method
(Konya Teknik University, 2026) Cingöz Çapan, Ebru; Çapan, Muhammed Ertuğrul; Öncel, Hasan Uğur; Arıcan, Ercan
This study presents a new method for determining cortisol hormone levels, a key biomarker of stress, using microfluidic pads to collect sweat samples. The pads facilitate the colorimetric detection of cortisol levels via the blue tetrazolium method. The resulting color change is analytically assessed using Convolutional Neural Networks (CNN), Decision Trees, and Vector Regression, alongside advanced image processing techniques. The developed algorithm is robust, providing reliable results despite hardware variations and color distortion, enhancing the system's applicability and generalizability across different environments. Validation studies conducted with ELISA and a colorimeter revealed that the system achieved an accuracy of 84.2% in determining users' cortisol levels. Additionally, psychosocial stress levels were assessed using the Copenhagen Psychosocial Risk Assessment and the Perceived Stress Scale tests during the collection of sweat samples from 20 participants. The results demonstrated a significant correlation between cortisol levels and stress, confirming the method's reliability and effectiveness in various applications.
Exploration of hope in pediatric oncology patients and their families: a systematic review and meta-synthesis of qualitative studies
(W.B. Saunders, 2026) Erkul, Münevver; Koyuncu, İlçim Ercan; Akça Sümengen, Aylin; Ay, Ayşe; Savaş, Eyşan Hanzade; Çakır, Gökçe Naz; Semerci Şahin, Remziye
Purpose Pediatric cancer, though less common than adult malignancies, poses significant emotional and psychological challenges for patients and their families. Despite advancements in medical treatments improving survival rates, hope remains a crucial psychological resource, influencing coping mechanisms and overall well-being throughout the cancer journey. This systematic review synthesizes qualitative studies exploring how pediatric oncology patients and their families perceive and experience hope. Method: Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Cochrane Library, Scopus, and Web of Science. Eligible qualitative studies were systematically screened and synthesized using thematic analysis to explore experiences of hope among pediatric oncology patients and their families. Results Four key themes emerged: (1) Holding on to Hope reflects aspirations for recovery and normalcy; (2) Coping with Psychosocial Challenges highlights emotional struggles and the role of support systems; (3) Faith and Spirituality underscores religious beliefs and resilience in sustaining hope; and (4) Communication and Information Needs emphasizes the importance of clear, honest, and developmentally appropriate communication with healthcare professionals. Conclusions Hope is a fundamental psychological resource for pediatric oncology patients and their families, shaping coping strategies and treatment adherence. Healthcare professionals should integrate hope-centered interventions to enhance emotional resilience. Future research should focus on developing and evaluating interventions that foster hope and improve psychosocial well-being in this vulnerable population. Implications to practice Nurses and healthcare professionals can strengthen emotional resilience and coping in children and their families by addressing uncertainty, supporting family involvement, and recognizing spiritual and cultural resources in clinical practice.

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