İstanbul Galata Üniversitesi Kurumsal Akademik Arşivi
DSpace@Galata, İstanbul Galata 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 telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Individualized respiratory exercise device originated in Türkiye: design, prototype, and first results
(Tubitak Scientific & Technological Research Council, 2026) Cilbir, Çiğdem Emirza; Harputlu, Özge Ertan; Uçgun, Hikmet; Ekşi, Büşra Ülker; Kara, Sarper; Kıyan, Esen
Background/aim: Respiratory muscle training (RMT) and breathing exercises are crucial components in cardiopulmonary rehabilitation. RMT includes inspiratory muscle training (IMT) and expiratory muscle training (EMT); however, existing RMT devices typically support only one of these. Incentive spirometers, which also provide visual feedback for breathing exercises, are frequently used. Achieving an RMT program requires multiple devices, which increases both the cost and complexity of the training regimen. This study aimed to design, calibrate, and test a novel individualized respiratory exercise device that integrates both IMT and EMT functions into a single unit, thereby offering a cost-effective, user-friendly alternative for comprehensive cardiopulmonary rehabilitation. Materials and methods: The design process involved a comparative analysis of existing RMT devices. A concept design was developed, followed by a three-dimensional-printed prototype. Calibration was performed using a pressure meter, with tests conducted on ten healthy volunteers across a range of inspiratory and expiratory pressures. Additionally, a pilot clinical study involving six healthy adults assessed the device’s impact on maximum inspiratory and expiratory pressures (MIP, MEP) and functional exercise capacity during an eight-week RMT period. Results: The internal consistency of the lowest (0.919) and the highest (0.841) levels of inspiration pressure, and of the lowest (0.901) and the highest (0.856) levels of expiration pressure, were highly reliable. Each healthy participant who completed the eight-week RMT program showed increases in MIP, MEP, and six-minute walking distance. Conclusion:The novel respiratory exercise device successfully combines IMT and EMT functions with an incentive spirometer, enabling comprehensive respiratory exercises and RMT within a single unit. Its ease of use and adaptability make it a promising option for both clinical and home-based rehabilitation, potentially improving accessibility and adherence to cardio
Analysis of caesarean section rates according to the Robson classification system and indications for caesarean delivery: experience from a tertiary health centre in Turkey
(BMC, 2026) Düzgüner, Soner; Sağır, Fulya Gökdağlı; Kale, İbrahim; Düzgüner, İpeknur Balin
Background Globally and in Turkey, caesarean section (CS) rates have risen steadily over recent decades, reflecting changes in clinical practice, maternal preference, medico-legal concerns, and healthcare system dynamics. The Robson Ten-Group Classification System, complemented by analysis of CS indications, provides a standardised and objective framework for identifying modifiable factors contributing to the increasing use of CS. This study aimed to evaluate CS rates in a tertiary healthcare centre in Turkey using the Robson classification in conjunction with specific clinical indications. Methods This retrospective observational study included all women who delivered at Umraniye Training and Research Hospital, Department of Obstetrics and Gynaecology, between 01 August 2018 and 11 September 2025. Data were obtained from the hospital’s electronic birth registry and categorised according to the Robson Ten-Group Classification System and indications for CS. Results During the study period, 25,767 births were recorded, of which 11,939 (46.4%) were delivered by CS. The most significant contribution to the overall CS rate originated from Robson Group 5 (23.8%), followed by Group 1 (5.2%). The most common indication for CS was previous uterine surgery, including prior CS and/or myomectomy (54.9%), followed by foetal distress (19.1%). Conclusion The overall CS rate in this study was 46.4%, with Robson Groups 5 and 1 accounting for the majority of procedures (29.0% combined). Previous uterine surgery and foetal distress were the predominant indications.
Dynamic ventilatory responses to submaximal exercise in obese adults
(2025) Yiğit, Şafak; Çılbır, Çiğdem Emirza; Üçgün, Hikmet; Harputlu, Özge Ertan; Ekşi, Büşra Ülker; Aslan, Göksen Kuran; Akıncı, Buket
Background: Obesity increases mechanical stress on the respiratory system, leading to changes in breathing mechanics during physical activity.
Aim: The aim of the study was to examine the dynamic ventilatory responses elicited by a submaximal exercise test in obese adults and to compare these responses with those of their non-obese peers.
Methods: Twenty-nine obese individuals (32±4/years) without chronic respiratory diseases and 30 non-obese peers (29±3/years) were included in the study. Exercise capacity and dynamic ventilatory responses were assessed using Spiropalm®-equipped six-minute walk test (6MWT). Inspiratory capacity (IC), minute ventilation (VE), and respiratory frequency (RF) were evaluated at rest and post-test. VEpeak and peak breathing reserve (BRpeak) were recorded.
Results: The six-minute walking distance of obese participants (479.21±47.16 m) was significantly lower than that of their healthy peers (584.61± 48.42 m) (p<0.001). While there was a significant difference between the groups in the change of VE at baseline and post-6MWT (p=0.017), changes in IC and RF were similar (p>0.05). BRpeak was lower in obese adults (p<0.001), whereas VEpeak was found to be higher in this group (p<0.001).
Conclusion: This study shows that obese adults exhibit altered ventilatory responses to submaximal exercise compared to their non-obese peers. Even in the absence of chronic respiratory diseases, these results indicate an increased ventilatory demand which may contribute to exercise intolerance and increased respiratory effort in obesity. These ventilatory adaptations could help inform targeted interventions aimed at improving exercise tolerance and respiratory capacity in this population.
The relationship between disease severity and mortality risk in critical care patients with respiratory muscle strength, muscle biomechanical properties and muscle architecture
(ERS Publications, 2025) Tanrıöğen, Beyza; Yurdalan, Saadet Ufuk; Kardeş, Kübra; Kabasakal, Elif; Parlak, Hakan; Elbaşı, Nurgül Dürüstkan; Yelvar, Gül Deniz Yılmaz
Aims: Long-term immobilization in critical care (CC) patients negatively affects the respiratory and musculoskeletal systems. Increased disease severity may worsen these systems, but the relationship with muscle strength, biomechanics, and architecture is unclear. Understanding these effects is essential for developing effective physiotherapy strategies.
Methods: CC patients who were not on mechanical ventilation were included. Disease severity and mortality risk of was evaluated with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. The respiratory muscle strength was recorded by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Ultrasonographic measurements were taken from quadriceps femoris (QF) for muscle thickness. Muscle tone was recorded from the rectus femoris (RF) and vastus lateralis (VL) with myotonometer.
Results: 31 CC patients with an age of 65.42±8.84 were included. Positive correlation between APACHE II score and right-left VL muscle tone (p=0.041, r=0.370, p=0.294, r=0.195, respectively) and right-left RF muscle tone (p=0.039, r=0.372, p=0.020, r=0.415); A negative correlation was detected between APACHE II score and right-left QF muscle thickness (p=0.001, r=-0.569, p=0.005, r=-0.493) and MIP and MEP (p=0.028, r=-0.394, p=0.045, r=-0.363).
Conclusion: An increase in disease severity negatively affects respiratory muscle strength, muscle biomechanics, and muscle architecture. Future studies investigating the impact of respiratory physiotherapy on these parameters may highlight the effect of physiotherapy approaches on clinical state in CC.
Transformational and transactional leadership in ambidexterous innovation: exploratory and exploitative outcomes
(Emerald Publishing, 2025) Hiziroğlu, Mahmut; Gümüş, Abdülkadir; Özer, Yağmur
Purpose - The research on the relationship between leadership styles and innovation behaviors, particularly exploratory and exploitative innovation, remains inconsistent and underdeveloped. To address this gap, this study aims to investigate the influence of transformational and transactional leadership styles on exploratory and exploitative innovation, while also examining the moderating effects of organizational factors, specifically firm size and organizational age. Design/methodology/approach - This study employs a quantitative research design, with the sample of firms that have at least ten employees. A total of 762 valid responses were collected through surveys. The data were analyzed using hierarchical regression analysis. Findings - The results reveal that transformational leadership positively influences exploratory innovation but negatively affects exploitative innovation, whereas transactional leadership positively influences both types. Notably, contrary to prior research, transactional leadership also enhances exploratory innovation. Firm size moderates these relationships in an inverted U-shape: transformational leadership fosters exploratory innovation in small and large firms and supports exploitative innovation in medium-sized firms. A similar pattern emerges for transactional leadership. Additionally, younger firms exhibit a stronger preference for exploratory innovation. Research limitations/implications - This study is limited to Turkish firms, which may restrict the generalizability of the findings. It relies on perceived innovation behavior rather than objective metrics and does not consider factors like sectoral or cultural differences. The cross-sectional design also limits causal inferences, indicating the need for longitudinal or experimental research to explore temporal dynamics. Practical implications - From a practical standpoint, this study highlights the critical role of leadership in shaping innovation behaviors, offering insights for organizations of different sizes and ages. It demonstrates how leadership styles can be leveraged to foster ambidextrous innovation, providing a tailored approach for leaders to enhance innovation while considering key contextual factors affecting leadership effectiveness. Originality/value - This study enhances understanding of how leadership styles influence the balance between exploratory and exploitative innovation in Turkish firms, emphasizing the moderating roles of firm size and age. It also challenges the conventional view that transformational and transactional leadership are exclusively linked to specific innovation types, offering a more nuanced perspective on the role of leadership in fostering ambidextrous innovation.
