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  Acute Effects of Transcutaneous Auricular Vagus Nerve Stimulation on Autonomic Nervous System Regulation and Spasticity in Children with Spastic Cerebral Palsy: A Preliminary Study

  (MDPI AG, 2026) Yalçın, Gülay; Açar, Görkem; Kavak, Muhammet Fatih; Külekçioğlu, Sevinç; Özden, Ali Veysel

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  Objective: This study aims to investigate the acute effects of transcutaneous auricular vagus nerve stimulation (taVNS) on autonomic nervous system (ANS) regulation and spasticity in children with spastic cerebral palsy (SCP). Methods: This preliminary study includes 20 children aged 2–15 years diagnosed with SCP. Participants undergo a single session of taVNS. Spasticity is assessed using the Modified Ashworth Scale, and autonomic regulation is evaluated through heart rate variability (HRV) parameters measured before and immediately after stimulation. Results: Following taVNS, spasticity scores decrease significantly (Modified Ashworth Scale: pre 2.00 ± 0.64 vs. post 1.60 ± 0.52; p = 0.004). Significant reductions are also observed in mean heart rate (pre 98.60 ± 16.32 bpm vs. post 91.25 ± 20.22 bpm; p = 0.022), LF/HF ratio (pre 2.22 ± 2.22 vs. post 1.12 ± 0.84; p = 0.006), and LF power (p = 0.009). No significant changes are detected in RMSSD, pNN50, or HF power (all p > 0.05). No adverse events are reported. Conclusions: This preliminary study suggests that a single session of taVNS may be associated with acute changes in autonomic regulation and reductions in spasticity in children with SCP. The observed shifts in HRV parameters indicate a modulation of sympathovagal balance. These findings support the feasibility of taVNS as a non-invasive neuromodulatory approach and warrant further large-scale, controlled studies with longer follow-up. Because of the small sample size, the absence of a control or sham group, and the short (1-min) HRV recording window, these results should be regarded as preliminary and hypothesis-generating, and they require confirmation in larger, randomised, sham-controlled studies. Clinical Trial Registration: This study was registered at ClinicalTrials.gov (Identifier: NCT06880887) on 10 March 2025. The study was conducted between January 2025 and March 2025; registration on 10 March 2025 therefore occurred during the enrolment and data-collection period rather than prior to it. This retrospective registration is acknowledged as a limitation.

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  The mediating role of academic perfectionism in explaining the relationship between selfesteem and life satisfaction in sport sciences students

  (BioMed Central Ltd, 2026) Çuhadar, Abdullah; Karakullukcu, Ömer Fatih; Koç, Mustafa Can; Özbey, Ömer; Şahinler, Yunus; Gümüş, Hüseyin; Mola, Dessalegn Wase

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  Background The purpose of this research is to determine the relationship between sport sciences students’ selfesteem and life satisfaction levels and to test the mediating role of academic perfectionism in this relationship. The study aims to understand how academic perfectionism affects the connection between self-respect and general life satisfaction among students facing academic and personal challenges in sport sciences education. Method The study employed a quantitative research design using questionnaires collected from 578 students studying at the sport sciences faculties of Karamanoğlu Mehmetbey University and Alanya Alaaddin Keykubat University in Turkey. Three standardized instruments were used as data collection tools: the “Rosenberg Self-Esteem Scale,” “Life Satisfaction Scale,” and “Academic Perfectionism Scale.” Structural equation modeling was utilized to test the research hypotheses and analyze the relationships between variables. Results Self-esteem positively predicted academic perfectionism among sport sciences students. Contrary to expectations, self-esteem negatively affected life satisfaction directly. Academic perfectionism was found to negatively and significantly predict life satisfaction. The mediating effect analysis showed that while self-esteem directly and negatively affected life satisfaction, it demonstrated an indirect weak negative effect through the mediating variable of academic perfectionism. Conclusion The findings suggest that the relationship between self-esteem and life satisfaction in sport sciences students is complex and mediated by academic perfectionism. While self-esteem generally contributes positively to life satisfaction, its influence becomes problematic when channeled through academic perfectionism, which may contribute to a negative impact on overall life satisfaction. This suggests that high self-esteem may lead to perfectionist tendencies in academic settings, which may paradoxically reduce students’ satisfaction with life. The findings suggest the potential importance of addressing perfectionist behaviors in sport sciences education to enhance student well-being.

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  Capital Structures of Small Family Firms in Developing Countries

  (Now Publishers Inc, 2022) Baş, Tuğba; Muradoğlu, Yaz Gülnür; Phylaktis, Kate

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  This study uses firm level survey data to assess whether the capital structure theory is portable to small firms in developing countries and whether family ownership and management play a role in their financing decisions. Using a sample of firms from 24 developing countries from all over the world, our main results show (i) the size of the firm is an important factor in the level of leverage; (ii) small family firms do not follow the pecking order; (iii) the country of incorporation is an important determinant for the debt financing decisions of small family firms; they are sensitive to institutional characteristics, and the macroeconomic environment variables of the country; and (iv) the difference in capital structure choices is related to management styles of small family firms. © 2022 T. Bas, Y. G. Muradoglu and K. Phylaktis.

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  A novel upper-extremity-based performance test for sarcopenia: reliability and clinical utility of the elbow performance test

  (Royal Academy of Medicine of Ireland, 2026) Yıldırım, Taha Yasin; Kalaoğlu, Eser; Aydın, Tuğba; Türker, Kemal Sıtkı; Karacan, İlhan

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  Background Given the limitations of gait speed tests for sarcopenia assessment, this study evaluated the Elbow Performance Test (EPT), a simple upper-extremity alternative. Aims This study aimed to evaluate the test-retest reliability of the EPT and its ability to distinguish between older adults with sarcopenia and healthy young controls. Methods This cross-sectional study included 96 male participants: 43 older adults with sarcopenia (≥60 years) and 53 healthy young controls (≤40 years). Assessments covered muscle strength, mass, and physical performance, including 4-meter gait speed, the Short Physical Performance Battery (SPPB), and Timed Up and Go (TUG). The EPT required 30 self-paced elbow flexion-extension repetitions with a 1-kg weight. Test-retest reliability was assessed after 7–10 days using intraclass correlation coefficients (ICCs). Results All performance test scores differed significantly between the sarcopenia and control groups (p < 0.01). The EPT showed excellent test–retest reliability in both the control (ICC = 0.932; 95% CI:0.885–0.960) and sarcopenia (ICC = 0.905; 95% CI:0.831–0.947) groups. In terms of reliability, the EPT outperformed gait speed and SPPB in both groups and was comparable to the TUG test in the sarcopenic group. Conclusions The EPT demonstrated excellent reliability and effectively distinguished between older adults with sarcopenia and healthy controls. Given its simplicity, high repeatability, and minimal equipment needs, the EPT may serve as a practical tool for assessing upper-extremity muscle performance, particularly in settings where traditional lower-extremity-based tests are less feasible. Further studies are warranted to confirm its broader clinical utility across diverse populations. Clinical trial registration This trial was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07065448) on July 03, 2025.

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  Microleakage of Class II composite restorations bonded with universal adhesives containing different functional monomers: an in vitro study

  (BioMed Central Ltd, 2026) Doğan, Ecem; Cevval Özkoçak, Begüm Büşra; Aytaç Bal, Fatma

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  Background: This in vitro study aimed to evaluate and compare the microleakage of Class II composite restorations bonded with universal adhesives containing different functional monomers, with particular emphasis on a chemically cured universal adhesive applied using different etching strategies. Methods: Standardized Class II cavities were prepared in 120 extracted human molars and randomly allocated into 12 groups (n = 10) according to the adhesive system and etching strategy. The adhesives evaluated included a three-step etch-and-rinse system, a two-step self-etch system, and three universal adhesives applied in total-etch, selective-etch, and self-etch modes, including a chemically cured universal adhesive. All cavities were restored with a nanohybrid resin composite and subjected to 5000 thermocycles between 5 °C and 55 °C. Microleakage at occlusal and gingival margins was assessed using 0.5% basic fuchsin dye penetration under stereomicroscopy. Data were analyzed using nonparametric statistical tests (α = 0.05). Results: Significant differences in microleakage were observed among the groups (p < 0.001). The three-step etch-and-rinse adhesive demonstrated the lowest microleakage values at both occlusal and gingival margins. Universal adhesives applied in self-etch mode exhibited significantly higher microleakage, particularly at the gingival margin. The chemically cured universal adhesive showed comparable marginal sealing only when combined with phosphoric acid etching. Conclusions: Within the limitations of this in vitro study, multi-step adhesive systems and universal adhesives used with total-etch or selective-etch strategies provided superior marginal sealing compared with single-step self-etch applications. These findings highlight the clinical importance of etching strategy selection in Class II composite restorations, particularly at gingival margins where light attenuation may compromise polymerization in deep proximal boxes.

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