DSpace Arşivi :: Ana Sayfa

İstanbul Gelişim Üniversitesi Kurumsal Açık Erişim Arşivi

DSpace@Gelişim, İstanbul Gelişim Üniversitesi tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve yayınların etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.

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Preliminary efficacy of pharmacological treatments on sluggish cognitive tempo (cognitive disengagement syndrome): a systematic review and meta-analysis
(Frontiers Research Foundation, 2026) Kılınçel, Şenay; Bulut, Furkan; Göksel, Pelin; Usta, Miraç Barış; Kılınçel, Oğuzhan
Objective: Sluggish cognitive tempo (SCT), also referred to as cognitive disengagement syndrome (CDS), is characterized by symptoms such as mental fogginess, slowed behavior, daydreaming, and reduced alertness. It is increasingly recognized as a construct distinct from attention-deficit/hyperactivity disorder (ADHD). This systematic review and meta-analysis aimed to evaluate the effectiveness of pharmacological interventions on SCT/CDS-related outcomes. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science. Studies assessing pharmacological treatments with reported SCT/CDS outcomes were included. The primary quantitative synthesis focused on randomized controlled trials and crossover designs, while open-label studies were analyzed qualitatively. Standardized mean differences (Hedges’ g) were calculated using a small-k-robust random-effects model (Paule–Mandel t² estimator with Hartung–Knapp adjustment). A 95% prediction interval was additionally reported. Results: A total of seven studies were included in the qualitative synthesis, of which three (43%) provided sufficient data for meta-analysis. The total sample sizes of individual studies were generally small, contributing to limited statistical power. Using a small-k-robust random-effects model (Paule–Mandel t² with Hartung–Knapp adjustment), the pooled effect was g=0.39 (95% CI: 0.01–0.78). The 95% prediction interval was −0.06 to 0.85. Between-study heterogeneity ranged from moderate to high (I² > 50%), reflecting variability in study design, pharmacological agents, outcome measures, and population characteristics. Discussion: Preliminary evidence suggests that pharmacological treatments, particularly atomoxetine and methylphenidate, may be associated with moderate improvements in SCT/CDS symptoms. However, given the limited number of controlled trials and the heterogeneity in populations (e.g., ADHD with comorbid dyslexia), these findings should be considered exploratory. Further large-scale RCTs are necessary to confirm these results and establish personalized treatment protocols.
Immunophenotypes and prognosis in autoimmune cardiovascular disease: a narrative review from clonal hematopoiesis to myocarditis, microvascular angina, and HFpEF
(Surgical Associates Ltd., 2026) Khan, Suleman; Mahin, Fakhar E.; Rahman, Ibad Ur; Ahmad, Asifa Manzoor; Nawaz, Areesha; Siddiqui, Zainab Ali; Khalid, Aizaz Anwar; Iftikhar, Hammad; Fashafsheh, Nawras
Autoimmune cardiovascular disease (CVD) includes myocarditis, coronary microvascular dysfunction (CMD), and heart failure with preserved ejection fraction (HFpEF). Traditional risk scores often overlook these conditions despite their links to high morbidity. Recent research highlights the significance of immunophenotyping, such as clonal hematopoiesis of indeterminate potential (CHIP), type I interferon activity, Th17/Treg imbalance, and cardiac autoantibodies, to improve risk assessment and guide treatment. This review combines mechanistic and clinical data connecting these immune signatures to endothelial dysfunction, arrhythmias, and fibrotic remodeling. It underscores the atherogenic role of CHIP and its influence on HFpEF prognosis, the vasculopathy driven by type I interferon signaling in CMD, and autoimmunity in myocarditis mediated by Th17 dominance. Cardiac-specific autoantibodies, like anti-heart and v1- adrenergic receptor antibodies, serve as early prognostic markers. Moreover, integrating immune biomarkers with advanced imaging techniques, such as cardiac magnetic resonance and positron emission tomography, could enhance risk stratification and therapy monitoring. Current immunomodulating treatments, including TNF and IL-6 inhibitors, provide cardiovascular benefits, while glucocorticoids and JAK inhibitors carry dose-related risks. In the future, personalized algorithms that incorporate CHIP genotyping, interferon scoring, and continuous biomarker and imaging assessments may transform autoimmune CVD management. This review highlights these translational insights and research priorities to bridge the gap between immune dysregulation and cardiovascular outcomes.
Efficacy and Safety of Aripiprazole in Children and Adolescents With Autism Spectrum Disorder: A Meta-Analysis
(Baltimore, 2026) Kılınçel, Şenay; Bulut, Furkan; Kılınçel, Oğuzhan
Aim: Aripiprazole is one of the few pharmacological agents approved for managing irritability in children and adolescents with autism spectrum disorder (ASD). Methods: Randomized controlled trials comparing oral aripiprazole with placebo or active drugs in participants under 18 years were systematically searched in major databases through September 2025 (last search: September 15, 2025). The primary outcome was change in Aberrant Behavior Checklist–Irritability (ABC-I) scores; data were synthesized using random-effects models. Results: Eleven trials (N = 1,135) were included. Aripiprazole significantly reduced irritability (mean difference = −5.18; 95% CI = −6.72 to −3.64; I2 = 0%) and improved global ratings versus placebo. Common adverse effects were weight gain, sedation, and extrapyramidal symptoms, though discontinuation rates were comparable to placebo. Conclusions: Aripiprazole effectively and safely reduces irritability in pediatric ASD. Although adverse effects are frequent, they are generally manageable, supporting individualized dosing and long-term monitoring.
Global Disparities in Teletherapy Adoption: A Cross-Income Analysis of Mental Health Access
(MDPI, 2026) Alhassan, Gloria Nnadwa; Öztürkcan, Arda; Çalışkan Çavdar, Şeyma; Alhassan, Gloria Nnadwa
Mental health disorders affect nearly one billion people worldwide, yet treatment gaps exceed 75% in low- and middle-income countries. Teletherapy has emerged as a scalable solution, but its adoption differs sharply by economic context. This comparative ecological policy analysis used secondary aggregate data from WHO, World Bank, ITU, and national reports to examine teletherapy adoption in low-income (Nigeria, Kenya), middle-income (South Africa, India), and high-income countries (Norway, Canada). Descriptive statistics and simple linear regression were applied, with findings interpreted through the Consolidated Framework for Implementation Research (CFIR), Technology Acceptance Model (TAM), and Diffusion of Innovations theory. High-income countries achieved widespread adoption (>70%), enabled by universal broadband, comprehensive regulation, and strong reimbursement. Middle-income countries showed moderate uptake (15–30%), constrained by rural–urban digital divides and inconsistent policies. Low-income countries reported minimal integration (<5%), limited by unreliable internet, severe workforce shortages, high data costs, and sociocultural barriers. Digital infrastructure, regulatory maturity, and mental health workforce density explained 78% of the cross-country variance in adoption rates (R2 = 0.78). Equitable scale-up of teletherapy directly supports SDGs 3, 9, 10, and 17. Targeted investment and cross-income collaboration are essential to prevent digital mental health solutions from exacerbating existing inequities.
A multi -country citizen -science study on what makes us enjoy a cup of coffee
(Springer Nature, 2026) Juravle, Georgiana; Diaconașu, Delia Elena; Andrei, Ana -Maria; Reinoso Carvalho, Felipe; D’Alfonso, Simon; Goglio, Valentina; Motoki, Kosuke; Schmidt, Simone; Uçuk, Ceyhun; Van Doorn, George; Carvalho, Fabiana; Spence, Charles
Many coffee preferences are known, but studies that comprehensively integrate simultaneous contributions to coffee enjoyment are lacking. An online citizen -science questionnaire designed to identify those factors associated with momentary coffee liking, surveying demographics, extrinsic/intrinsic qualities, and coffee -related habits, is presented (N = 2,987; 5 continents; 7 languages; 11 countries; 77 nationalities). The results indicate a higher liking for coffee consumed black, during spring, in the morning, on Wednesdays, and from ceramic cups. Higher -priced coffee is appreciated significantly more, and liking -consumption quantity appears best -optimised at 4 –5 cups/day. Several key characteristics for coffee -dislike are evident: waking -up late, drinking from a cup with a lid on, at noon during autumn, with cream, and, potentially implying a possible coping mechanism for bitterness -disliking, adding sugar to coffee. These results constitute the first multi - country cross -context integration of momentary coffee liking and provide an empirical foundation for context -sensitive models linking sensory/behavioural/temporal factors in beverage preference research.