Zeynal Yasaci

Objective: To examine the independent associations of average daily smartphone usage and smartphone addiction severity with cervical proprioception and sleep-related outcomes in university students. Pearson correlations and hierarchical multiple regression were used, with Benjamini–Hochberg FDR correction for multiple comparisons. Methods: This cross-sectional study included 159 students aged 18-24 years. Smartphone addiction was assessed with the Smartphone Addiction Scale–Short Version, and average daily smartphone usage was obtained from built-in screen-time records. Cervical proprioception was evaluated using laser-measured joint position error (JPE). Sleep quality, insomnia severity, bedtime procrastination, anxiety, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Bedtime Procrastination Scale, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), respectively. Pearson correlations and hierarchical multiple regression were used, with Benjamini–Hochberg FDR correction for multiple comparisons. Results: Mean smartphone usage was 342.21 ± 133.70 min/day. In hierarchical regression models, average daily smartphone usage was independently associated with insomnia severity (β =. 0.39, P < .001), poor sleep quality (β = 0.36, P < .001), and bedtime procrastination (β = 0.28, P = .004). These associations remained significant after additional adjustment for PHQ-9 and GAD-7 scores. Patient Health Questionnaire-9 was independently associated with insomnia severity and sleep quality, whereas GAD-7 was not significant. Smartphone addiction severity was independently associated with flexion JPE (β = 0.31, P = .001). Its association with bedtime procrastination was not significant after adjustment for depressive and anxiety symptoms. Conclusion: Smartphone usage duration was consistently associated with sleep-related disturbances, whereas smartphone addiction severity was independently associated with flexion JPE. Causal or temporal relationships cannot be inferred. Cite this article as: Yasaci Z, Arslan HN, Çapadan G, Tari N, Uzun N. Beyond screen time: associations of smartphone use and addiction severity with cervical proprioception and sleep-related outcomes. Arch Health Sci Res. 2026, 13, 0138, doi: 10.5152/ArcHealthSciRes.2026.26138.

Aim: Communication during developmental disability diagnosis disclosure may influence parents’ emotional responses, understanding, and engagement with care. This study investigated parents’ experiences and preferences regarding disclosure and their evaluations of the communication behaviors of the person who initially communicated the diagnosis. Methods: This descriptive cross-sectional web-based survey was conducted between July and November 2020 with 95 parents of children diagnosed with developmental disabilities. A semi-structured questionnaire assessed demographic characteristics, disclosure experiences and preferences, and perceived communication behaviors. Findings were summarized using descriptive statistics. Results: The most common diagnoses were Down syndrome (22.1%), cerebral palsy (17.9%), and intellectual disability/developmental delay (16.9%). Most parents reported physician-led disclosure (73.7%), whereas 93.7% preferred disclosure by a physician. More than half received the diagnosis in a crowded or shared room (52.6%), while 93.7% preferred a private room. In addition, 31.6% reported receiving inadequate information about their child’s medical condition and treatment, and 35.8% stated that the person who initially communicated the diagnosis did not adequately recognize their emotional distress.Conclusion: Group-level distributions of reported experiences and stated preferences differed descriptively across several aspects of disclosure. The findings indicate areas requiring attention, particularly privacy, information provision, and emotional sensitivity. Because individual-level concordance was not analyzed, these results should not be interpreted as demonstrating within-parent mismatch. Improving privacy, empathy, clarity of information, and post-diagnostic guidance may enhance parental satisfaction and support engagement with care.

Total knee arthroplasty (TKA) has become increasingly common in younger and more active patients. However, conventional patient-reported outcome measures f

Background and Objectives: Functional capacity assessment is essential in bariatric surgery candidates, but the Six-Minute Walk Test (6MWT) may be limited by fatigue, joint pain, and spatial constraints in individuals with severe obesity. Shorter tests such as the Two-Minute Walk Test (2MWT), Three-Minute Walk Test (3MWT), and One-Minute Sit-to-Stand Test (1MSTS) have been proposed as alternatives, yet comparative data in this population remain scarce. We aimed to evaluate the validity, reliability, and clinical utility of the 2MWT, 3MWT, and 1MSTS as substitutes for the 6MWT in patients preparing for bariatric surgery. Materials and Methods: In this cross-sectional study, 142 obese adults (BMI ≥ 30 kg/m²) underwent standardized 2MWT, 3MWT, 6MWT, and 1MSTS protocols. Correlation, linear regression, test–retest reliability (ICC), and ROC analyses were used to determine each test’s correlation and discriminative accuracy for impaired exercise tolerance (6MWT < 450 m). Results: The 3MWT showed the strongest correlation with the 6MWT (r = 0.930) and the highest explained variance (R² = 0.865), especially in individuals with BMI > 50. It also exhibited excellent reliability (ICC > 0.9) and a strong ROC profile (AUC = 0.931; 212 m cut-off). The 2MWT demonstrated acceptable concurrent validity but slightly lower agreement. The 1MSTS showed weak and inconsistent associations with 6MWT performance, suggesting limited value in assessing aerobic capacity in this population. Conclusions: The 3MWT appears to be a valid, reliable, and clinically practical alternative to the 6MWT in individuals with severe obesity. The 2MWT may be used when time or patient tolerance is limited. The 1MSTS, while safe and simple, may reflect strength and coordination more than aerobic capacity, limiting its utility in this context.

Background: The COVID-19 pandemic has disrupted healthcare systems and potentially delayed the diagnosis of progressive diseases such as lung cancer. This study aimed to evaluate the impact of the pandemic on access to healthcare among lung cancer patients and to analyze the types and stages of lung cancer diagnosed during this period compared to the pre-pandemic era. Materials and Methods: This retrospective comparative study included 209 patients diagnosed with lung cancer at Harran University Chest Diseases and Oncology Clinics: 52 before the pandemic and 157 during the pandemic. Demographic and clinical data, including age, gender, smoking status, cancer type, diagnostic method, and stage, were collected from hospital records. Statistical analyses were performed using SPSS v.26, with significance set at p < 0.05. Results: There were no significant differences between groups in age, gender, or smoking status (p > 0.05). The rate of advanced-stage diagnoses (Stage 4A–4B) significantly increased during the pandemic (63.7% vs. 44.2%; p = 0.031), with Stage 4B cases nearly doubling. Additionally, the number of pa-tients without definitive staging increased. Adenocarcinoma (31.8%) and squamous cell carcinoma (25.5%) were the most common types. Bronchoscopy (29.9%) and FOB+EBUS (29.3%) were the most frequently used diagnostic methods. During the pandemic, a relative increase was observed in the use of less invasive procedures such as transthoracic biopsy and thoracentesis. Conclusions: The findings indicate that the COVID-19 pandemic contributed to delays in lung cancer diagnosis, as evidenced by a higher rate of late-stage presentations. These results underscore the need for resilient diagnostic systems and proactive strategies to ensure timely cancer diagnosis dur-ing healthcare crises. Keywords: Lung cancer, COVID-19 pandemic, Diagnosis delay, Cancer staging Öz Amaç: COVID-19 salgını sağlık sistemlerini bozmuş ve akciğer kanseri gibi ilerleyici hastalıkların teşhisini geciktirmiştir. Bu çalışmanın amacı, salgının akciğer kanseri hastaları arasında sağlık hiz-metlerine erişim üzerindeki etkisini değerlendirmek ve bu dönemde teşhis edilen akciğer kanserinin türlerini ve evrelerini pandemi öncesi döneme göre analiz etmektir. Materyal ve Metod: Bu retrospektif karşılaştırmalı çalışmaya Harran Üniversitesi Göğüs Hastalıkları ve Onkoloji Kliniklerinde akciğer kanseri teşhisi konan 209 hasta dahil edildi: 52'si pandemiden önce ve 157'si pandemi sırasında. Yaş, cinsiyet, sigara içme durumu, kanser türü, tanı yöntemi ve evre dahil olmak üzere demografik ve klinik veriler hastane kayıtlarından toplandı. İstatistiksel analizler SPSS v.26 kullanılarak yapıldı ve anlamlılık p < 0,05 olarak belirlendi. Bulgular: Yaş, cinsiyet ve sigara kullanımı açısından gruplar arasında anlamlı fark bulunmadı (p > 0,05). Pandemi döneminde ileri evre (Evre 4A–4B) tanı oranı anlamlı şekilde artmış (%63,7 vs. %44,2; p = 0,031) ve Evre 4B oranı yaklaşık iki katına çıkmıştır. Ayrıca evrelemesi yapılamayan vaka sayısı artmış-tır. Adenokarsinom (%31,8) ve skuamöz hücreli karsinom (%25,5) en sık görülen tiplerdi. Bronkoskopi (%29,9) ve FOB+EBUS (%29,3) en yaygın tanı yöntemleri olup; pandemi döneminde transtorasik bi-yopsi ve torasentez gibi daha az invaziv girişimlerde göreceli artış izlenmiştir. Sonuç: Bulgular, COVID-19 pandemisinin akciğer kanseri tanısında gecikmelere katkıda bulunduğunu, bunun da geç evre başvurularının daha yüksek oranda görülmesiyle kanıtlandığını göstermektedir. Bu sonuçlar, sağlık krizleri sırasında zamanında kanser teşhisini sağlamak için dayanıklı tanı sistemlerine ve proaktif stratejilere olan ihtiyacı vurgulamaktadır. Anahtar Kelimeler: Akciğer kanseri, COVID-19 pandemisi, Tanı gecikmesi, Kanser evreleme

Aim: The study aimed to investigate the potential role of soluble urokinase plasminogen activator receptor (SUPAR) levels in the blood and bronchoalveolar lavage (BAL) fluid for the early diagnosis of lung cancer and tuberculosis (TB). Methods: Bronchoscopy and BAL were performed on 66 patients with a prediagnosis of lung malignancy or tuberculosis. SUPAR levels were measured using the ELISA method and compared with those from 30 healthy individuals as the control group. Results: Blood SUPAR, values were 199.40 ng/L in malignancy patients, 246.09 ng/L in TB patients, and 234.60 ng/L in others. In BAL fluid, values were 56.78 ng/L in lung cancer patients, 39.24 ng/L in TB patients, and 44.00ng/L in other diseases. Significant differences were found in blood SUPAR between patients and controls (p

Background Post-COVID-19 syndrome (PCS) causes persistent symptoms that impair quality of life, and telerehabilitation (TR) provides an effective remote alternative for addressing these challenges. Aim This study aimed to evaluate the effects of a TR-based exercise program on dyspnea, pain intensity, and functional capacity in individuals with PCS. Design Sixty PCS patients were randomized into a telerehabilitation group (TG, n = 32) or a control group (CG, n = 28). The TG received supervised TR sessions twice a week for 6 weeks, while the CG performed unsupervised home exercises. Assessments were conducted at the baseline and the end of 6 weeks. Results TG showed significantly greater improvements compared to CG. mMRC decreased by 1.16 (95% CI, 0.93–1.38) vs. 0.36 (95% CI, 0.17–0.55), NPRS by 1.44 (95% CI, 0.95–1.92) vs. 0.6 (95% CI, 0.28–0.93), and 5-TST improved by 6.8 s (95% CI, 5.59–8.01) vs. 2.12 s (95% CI, 1.08–3.17). Significant differences were also observed for PSQI (p = 0.018) and HADS-anxiety (p = 0.001). Conclusions A TR-based exercise program significantly reduced dyspnea and pain intensity while improving functional capacity in PCS patients, making it an effective alternative to unsupervised exercise regimens. Trial registration This study is prospectively registered at NCT05381675 (clinicaltrials.gov).