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The Prevalence Of Moral Injury Among Veterans Diagnosed With Post-Traumatic Stress Disorder (Ptsd): Analyses By Combat Exposure, Gender, Age Group, And Military Service, Carl B. Forkner

Doctoral Dissertations and Projects

The attacks on the United States on September 11, 2001, and the ensuing wars in Afghanistan and Iraq, heralded in a new concept affecting our combat and support military personnel. This concept is known today as moral injury. Military personnel were already familiar with post-traumatic stress disorder (PTSD), whether from personal experience or from reading and training on the subject, but no training addresses the prevalence or effects of moral injury. The term moral injury (MI) was first coined by psychiatrist Jonathan Shay and his colleagues based on feedback from military and veteran patients in 1998; however, it remains that …

Neutrophil Gelatinase-Associated Lipocalin (Ngal) And Urine Albumin-To-Creatinine Ratio (Uacr) In Patients With Chronic Kidney Disease: A Cross-Sectional Study, Nurul Annisa Yunus, Puspa Wardhani, Yessy Puspitasari, Satriyo Dwi Suryantoro, Zulfian Armah

Folia Medica Indonesiana

Chronic kidney disease (CKD) remains a major global health burden with an increasing prevalence and a substantial risk of progression to end-stage renal disease. Urine albumin-to-creatinine ratio (uACR) is widely used as a conventional biomarker reflecting glomerular injury in CKD, whereas neutrophil gelatinase-associated lipocalin (NGAL) has been proposed as a biomarker associated with tubular injury and inflammatory processes. This study aimed to determine the correlation between serum NGAL levels and uACR in patients with CKD. The authors conducted an analytical observational study with a cross-sectional design on 32 CKD patients at Universitas Airlangga Hospital. Serum NGAL levels were measured using …

Preoperative Low-Intensity Blood Flow Restriction Training Does Not Improve Quadriceps Strength Or Hypertrophy After Anterior Cruciate Ligament Reconstruction, Daniel Mcgurren, Kaycee Glattke, Molly Klanderman, Jedediah Lee, Anikar Chhabra, Arthur De Luigi

Journal for Sports Neuroscience

Objectives: To investigate the efficacy of a preoperative low-intensity blood flow restriction (LI-BFR) training intervention for patients undergoing anterior cruciate ligament reconstruction (ACLR).

Design: Pilot study

Methods: Twenty-eight patients undergoing primary ACLR participated in either a LI-BFR training or sham intervention at a rate of 2 sessions per week for 2 weeks before surgery. Quadriceps strength and cross-sectional area were measured via handheld dynamometry and leg press test before and after the intervention before surgery and at 5 different time points after surgery, through 24 weeks after surgery.

Results: Adjusting for sex, time, and strength/hypertrophy at baseline, there were no …

Anatomy And Function Of Vasopressin Receptor 1a-Expressing Neurons In The Limbic Thalamus, David Joseph Kahn

Theses and Dissertations

The vasopressin (Avp) system modulates social behavior through region-specific and sex-dependent mechanisms, yet the role of Avp receptor 1a (Avpr1a) signaling in the thalamus has remained largely unexplored. This dissertation examined the distribution and functional contributions of Avpr1a-expressing neurons across the mouse thalamus using a combination of genetic labeling, anatomical quantification, and chemogenetic manipulation. Mapping of Avpr1a-expressing neurons revealed a presence in most thalamic nuclei, with highest densities in the anterior thalamic nuclei and midline nuclei. Notably, Avpr1a-expressing neuron densities did not mirror previously described patterns of Avp innervation, and no sex differences in Avpr1a-expressing neuron density were observed. Chemogenetic …

The Role Of Mitochondrial And Lysosomal Damage In Neurotoxicity From Parkinson 'S-Related Environmental Exposures, Neda Ilieva

ETDs from 2020-2029

Parkinson's disease (PD) is a progressive motor neurodegenerative disorder with a predominantly idiopathic etiology. More recently, however, the contribution of exogenous risk factors such as environmental contaminants has become of interest. Some endogenous genetic risk factors have been well characterized, but the mechanisms by which exogenous insults, such as environmental contaminants, drive dopaminergic neurodegeneration remain incompletely understood. This dissertation will address how environmental contaminants converge on mitochondrial and lysosomal dysfunction to activate parallel neurotoxic signaling pathways, with a focus on the LRRK2 kinase and the cGAS-STING innate immune pathway. Chapter 2 demonstrates that pharmacological inhibition of LRRK2 kinase activity protects …

Effects Of Repetitive Peripheral Magnetic Stimulation On Poststroke Ankle Spasticity: A Double-Blind Randomized Controlled Trial, Hüseyi̇n Oğuzhan Aslantaş, Şehi̇m Kutlay, Haydar Gök, Semra Özkan, Seçi̇lay Güneş, Ati̇lla Hali̇l Elhan

Turkish Journal of Medical Sciences

Background/aim: Repetitive peripheral magnetic stimulation (rPMS) is a noninvasive, painless therapy aimed at improving spasticity, with a proposed mechanism that involves neuromodulation through somatosensory and proprioceptive afferent stimulation. The present study evaluates the effectiveness of rPMS on ankle plantar flexor spasticity in participants with stroke.

Materials and methods: Included in this prospective, double-blind, randomized, sham-controlled study were 50 participants with poststroke ankle plantar flexor spasticity graded 1–3 according to Modified Ashworth Scale (MAS). Participants were randomized into rPMS (n = 25) and sham (n = 25) groups. All participated in a conventional rehabilitation program, while the rPMS group received 10 …

Skin Cancer Surgery Under Local Anesthesia: Clinicopathologic Characteristics And Age-Stratified Outcomes In 533 Patients, Menekşe Kastamoni̇ Başkan, Süleyman Çeçen, Selçuk Akin, Şaduman Balaban Adim, Güzi̇n Yeşi̇m Özgenel

Turkish Journal of Medical Sciences

Background/aim: Skin cancer is the most common malignancy worldwide, particularly among elderly individuals. Many lesions are detected at an early stage because of their visibility and can be excised under local anesthesia, thereby avoiding the risks associated with general anesthesia or sedation. This study aimed to evaluate patient- and tumor-related characteristics in skin cancer surgery performed under local anesthesia, with particular emphasis on age-related outcomes.

Materials and methods: This retrospective study included 533 patients with 613 histopathologically confirmed skin cancers excised under local anesthesia between 2019 and 2024. Demographic, histopathological, and surgical variables were recorded, including age, sex, tumor location, …

Long-Term Outcomes Of Lamellar Crescentic Wedge Resection On Corneal Astigmatism And Optical Aberrations In Patients With Advanced Pellucid Marginal Degeneration, Ayşe Burcu, Hande Hüsni̇ye Telek, Hakan Mert, Yaprak Arzu Özdemi̇r, Züleyha Yalniz Akkaya, Evi̇n Şi̇ngar, Selma Özbek Uzman

Turkish Journal of Medical Sciences

Background/aim: The present study investigates the long-term changes in corneal astigmatism and aberrations following lamellar wedge resection in cases with advanced pellucid marginal degeneration (PMD).

Materials and methods: Patients with advanced PMD whose visual acuity did not improve with glasses or contact lenses underwent lamellar crescentic wedge resection. Pre- and postoperative assessments at 3, 6, 12, and 24 months using Pentacam HR were conducted to identify changes in corrected visual acuity, corneal astigmatism, and higher-order aberrations (HOAs) following the procedure, and compared with a control group.

Results: Statistically significant postoperative improvements in corrected visual acuity were observed at 6 and …

Impact Of Transforaminal Epidural Steroid Injection On Pain, Disability, And Kinesiophobia In Lumbar Disc Herniation With Radicular Pain, Hande Ece Öz, Rumeysa Çeti̇nkaya Bulutoğlu, Furkan Çeti̇n, Ezgi̇ Can, Alp Eren Çelenli̇oğlu, Ender Si̇r

Turkish Journal of Medical Sciences

Background/aim: The aim was to evaluate the effect of single-level transforaminal epidural steroid injection (TFESI) on kinesiophobia (KP) in patients with lumbar radicular pain (RP) caused by single-root, single-level lumbar disc herniation (LDH).

Materials and methods: A total of 63 patients diagnosed with unilateral single-level radicular pain due to LDH and treated with single-level TFESI were included. The Numeric Rating Scale (NRS), modified Oswestry Disability Index (MODI), Tampa Scale of Kinesiophobia (TSK), and Neuropathic pain (NP)-Douleur Neuropathique 4 Questionnaire (DN4) were used before the procedure and at 3 weeks and 3 months postoperatively.

Results: At baseline, 76.19% (n = 48) …

Clinical Outcomes Of Injectable And Conventional Pulmonary Valve Replacement In Severe Pulmonary Regurgitation, Sercan Tak, Murat Koç, Ali̇ Kutsal, Vehbi̇ Doğan

Turkish Journal of Medical Sciences

Background/aim: Pulmonary regurgitation following tetralogy of Fallot repair is a common long-term complication requiring pulmonary valve replacement. Injectable bioprosthetic valves offer a less invasive alternative to conventional surgical replacement, but comparative data in pediatric populations remain limited. This study aimed to evaluate short-term and long-term clinical outcomes of injectable pulmonary valve replacement and conventional pulmonary valve replacement in pediatric patients with severe pulmonary regurgitation following tetralogy of Fallot repair.

Materials and methods: This retrospective study included 22 pediatric patients who underwent pulmonary valve replacement. Patients were divided into injectable (n = 9) and conventional (n = 13) groups based on …

Common Femoral Vein Wall Thickness As A Supportive Imaging Marker In The Differential Diagnosis Of Behçet’S Uveitis, Seda Kutluğ Ağaçkiran, Esra Kardeş, Abdulbaki̇ Ağaçkiran, Haner Di̇reskeneli̇, Fatma Ali̇baz-Öner

Turkish Journal of Medical Sciences

Background/aim: Ocular involvement is a major cause of morbidity in Behçet’s disease (BD), and its diagnosis may be challenging, particularly for patients with isolated ocular manifestations or incomplete fulfillment of diagnostic criteria. Increased common femoral vein (CFV) wall thickness measured by Doppler ultrasonography (US) has previously been shown to be a sensitive and specific marker for systemic BD. This study aimed to evaluate whether CFV wall thickness measurement may serve as a supportive tool in distinguishing Behçet’s uveitis (BU) from other forms of inflammatory uveitis.

Materials and methods: This retrospective study included 45 patients with BU fulfilling the International Study …

Impact Of Race-Based And Race-Free Ckd-Epi Equations On Estimated Glomerular Filtration Rate In A Multicenter Retrospective Cohort Of Autosomal Dominant Polycystic Kidney Disease, Özgür Akin Oto, Abdulmeci̇t Yildiz, İsmai̇l Koçyi̇ği̇t, Hali̇l Yazici, Sai̇de Eli̇f Güllülü Boz, Yi̇ği̇t Kurtuluş, Alparslan Demi̇ray, Müge Doksan, Vafa Suleymanova, Ece Ük, Alper Akin, Bahar Bastani, John C. Edwards, Krista Leigh Lentine, Yaşar Kerem Çalişkan

Turkish Journal of Medical Sciences

Background/aim: The 2021 revision of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which eliminates race-based coefficients, may significantly influence disease staging and treatment in autosomal dominant polycystic kidney disease (ADPKD). This study was designed to evaluate the impact of the 2021 race-free CKD-EPI equation on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) staging in a multi-ethnic ADPKD population.

Materials and methods: In this multicenter, retrospective cohort study, 597 ADPKD patients were evaluated, including 515 self-identified as Caucasian and 82 as African-American. eGFR values at baseline and final follow-up were calculated using both the 2009 and 2021 …

A High Fib-4 Score May Be An Early Sign Of Severe Liver Damage In Patients With Primary Antibody Deficiencies, Haci Uğur Muşabak, Tuba Erdoğan, Emre Özbek, Dudu Merve Durak Anşi̇n, Zumrud Mehti̇

Turkish Journal of Medical Sciences

Background/aim: Liver damage is a significant complication that increases mortality and morbidity in primary immunodeficiencies (PIDs). Although biopsy is the gold standard, the fibrosis-4 (FIB-4) scoring system is a noninvasive method for diagnosing liver fibrosis. In this study, we investigated the value of the FIB-4 score as an early indicator of liver damage in patients with primary antibody deficiencies (PADs).

Materials and methods: Of 52 patients, 40 had common variable immunodeficiency (CVID), 12 had immunoglobulin G subclass deficiency (IgG-SGD), and they were enrolled in the study. Patients were divided into hematology, rheumatology + dermatology, gastroenterology/hepatology, and respiratory diseases groups based …

Optimistic And Ambivalent Attitudes Toward Clinical Artificial Intelligence, Sevi̇l Uygun İli̇khan, Si̇nem Ülke, Mahmut Özer, Matjaž Perc, Yavuz Ayhan

Turkish Journal of Medical Sciences

Background/aim: Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, healthcare professionals’ knowledge, attitudes, and perceptions regarding AI remain insufficiently understood. This study aimed to evaluate healthcare professionals’ perceptions of AI in clinical practice.

Materials and methods: This descriptive cross-sectional study included 260 healthcare professionals, including physicians, nurses, and healthcare technicians working at a tertiary public hospital in Türkiye. Participants completed the Healthcare Professionals and Artificial Intelligence Questionnaire, which assessed demographic characteristics, AI knowledge, workplace AI use, attitudes toward AI applications, ethical and legal concerns, perceived professional impact, and educational needs.

Results: Most participants reported limited AI knowledge; …

Pediatric Mr Cholangiopancreatography: Comparison Of 3d Fast Spin-Echo And Single-Shot Fast Spin-Echo Thick-Slab Techniques For Pancreaticobiliary Anatomy, Seda Kaynak Şahap, Suat Fi̇toz

Turkish Journal of Medical Sciences

Background/aim: This study compared thick-slab and three-dimensional (3D) T2-weighted magnetic resonance cholangiopancreatography (MRCP) sequences in pediatric patients with respect to image quality and visualization of the pancreaticobiliary anatomy.

Materials and methods: The MRCP examinations of 62 pediatric patients evaluated for suspected pancreaticobiliary pathology were retrospectively reviewed, comprising a total of 69 studies. Thick-slab single-shot fast spin-echo and 3D fast spin-echo MRCP sequences were compared. The visualization of pancreaticobiliary structures was assessed using a qualitative visual scoring system. Image quality was graded as good, moderate, poor, or nondiagnostic. Biliary anatomical variations were also evaluated. Statistical analysis was performed using appropriate nonparametric …

Omega-3–Rich Fish Oil Lipid Emulsions Significantly Prevent Sepsis-Driven Mesenteric Hypoperfusion And Multi-Organ Injury In Murine Models, Gökşen Öz, Esi̇n Özçelebi̇, Ayşe Yeşi̇m Göçmen, Cenk Sükmensüer, Selma Yildirim, Arzu Topeli̇, Alper Bektaş İski̇t

Turkish Journal of Medical Sciences

Background/aim: Parenteral feeding is used in critically ill patients when enteral nutrition is inadequate or intolerable, and the gastrointestinal tract is not functioning properly. Lipid emulsions play a major role in parenteral nutrition because they supply necessary fatty acids and a high-calorie density. We investigated the effects of parenteral lipid emulsions on mesenteric perfusion, inflammation-induced oxidation, and organ damage in lipopolysaccharide-induced mice endotoxemia model.

Materials and methods: In septic mice, organ damage induced by lipopolysaccharide was assessed by histopathology and biochemical examination. Additionally, an ultrasonic blood flowmeter was used to measure the impact of lipid emulsions on mesenteric blood flow. …

Bridging The Methodological Gap In Multitrauma Literature: A Competency-Based Educational Framework And Clinical Appraisal Filter, Şaki̇r Hakan Aksu, Burcu Doğan, Merve Yazla

Turkish Journal of Medical Sciences

Background/aim: The statistical complexity of contemporary multitrauma literature has increased considerably in recent years, which may pose challenges for clinicians seeking to interpret high-impact research and apply evidence-based practices. Characterizing this methodological landscape and exploring education-oriented approaches may help to improve the interpretability of the literature and support informed clinical decision-making.

Materials and methods: A cross-sectional analysis was conducted on the 100 most-cited multitrauma studies published in Science Citation Index Expanded journals indexed in the Web of Science database between January 2018 and November 2025. The statistical methods used in each article were categorized into the three competency levels of …

Vnotes High Uterosacral Ligament Suspension Versus Laparoscopic Lateral Suspension In The Management Of Vaginal Vault Prolapse: Initial Experience In A Single Tertiary Center, Ramazan Adan, Fati̇h Şahi̇n, Ulya Üskent, Mehmet Gökhan Çulha, Arzu Bi̇lge Teki̇n

Turkish Journal of Medical Sciences

Background/aim: The optimal technique for vaginal vault prolapse correction has yet to be identified. This study aimed to evaluate the anatomic and functional outcomes of women who underwent vaginal natural orifice transluminal endoscopic high uterosacral ligament suspension (vNOTES HUSLS) or laparoscopic lateral suspension (LLS).

Materials and methods: This retrospective study included symptomatic women with stage ≥2 vault prolapse who underwent vNOTES HUSLS or LLS between January 2019 and June 2022 at a tertiary center. The surgical efficacy, postoperative outcomes, complication rates, and recurrence frequencies of these procedures were compared. The primary outcomes of the study included anatomical success, patient-reported (subjective) …

A Caveat Regarding The Unfolding Argument: Implications Of Plasticity, Viknas N. O'Reilly-Shah, Alessandro Maria Selvitella, Aaron Schurger

Psychology Faculty Articles and Research

The unfolding argument in the neuroscience of consciousness posits that causal structure cannot account for consciousness because any recurrent neural network (RNN) can be “unfolded” into a functionally equivalent feedforward neural network (FNN) with identical input–output behavior. Subsequent debate has focused on dynamical properties and philosophy of science critiques. We examine a boundary condition on the unfolding argument for RNN systems with rapid plasticity in their connection weights. We demonstrate through rigorous mathematical proofs that rapid plasticity negates the functional equivalence between the RNN and the FNN. Our proofs address history-dependent plasticity, dynamical systems analysis, information-theoretic considerations, perturbational stability, complexity …

Forming Physicians For Others: The Identity Of The Jesuit Catholic Medical School, John Hardt, David G. De Marco Sj

Jesuit Higher Education: A Journal

Forming Physicians for Others: The Identity of the Jesuit Catholic Medical School

The Jesuit medical school accepts a widely-acknowledged telos: the preparation of the medical student to offer excellent patient care. It pursues this telos, however, through the distinctiveness of Ignatian formation, which finds expression in each domain of undergraduate medical education. This formative commitment, oriented toward and witnessing to an appreciation of the unconditional worth of the human being, may empower a subset of medical students—who are engaged by a life of faith and open to the transcendent invitation of their lives—to experience an even more fundamental transformation—one that …

Pa Dent J May 2018

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Jan 2018

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Nov 2017

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Sept 2017

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J May 2017

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Jan 2017

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Nov 2021

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Mar 2021

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J Nov 2020

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.

Pa Dent J March 2020

Pennsylvania Dental Journal

The Pennsylvania Dental Journal is produced by the Pennsylvania Dental Association six times a year, in January, March, May, July, September and November. Issues include regular columns with regional news impacting the Pennsylvania membership including editorial and government relations news, association activities, member updates, continuing education opportunities, and classifieds.