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Öğe Transformational and transactional leadership in ambidexterous innovation: exploratory and exploitative outcomes(Emerald Publishing, 2025) Hiziroğlu, Mahmut; Gümüş, Abdülkadir; Özer, YağmurPurpose - 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.Öğe Malocclusion as a Cause of Temporomandibular Joint Disorders(2025) İşçi, Kemal DevrimThe jaw and skull are joined at the temporal mandibular joint (TMJ), a synovial joint. You can find these two joints directly in front of your ears. Each joint comprises the mandibular condyle, the temporal bone’s articular tubercle, and an articulating disk. Allowed motions include lateral, vertical, and horizontal movement, protrusion, and retrusion. The complex motions of chewing, speaking, and generating facial emotions are made possible by this joint and the muscles that link to it. The joint pain and dysfunction that affect the jaw joint are known as temporomandibular disorders (TMDs) or TMJ syndrome. Myalgias, myofascial pain, arthralgia, disk displacement disorders, degenerative joint disease, subluxation, and 11 other pain-related and intra-articular TMJ diseases have been found by an international group. © 2025 Springer Nature Switzerland AG.Öğe Effect of solvent use on dentin crack in retreatment(2024) Zümrütel, Pelin; Haznedaroğlu, Faruk; Keleş, Ali; Basmacı, Gülsüm KutluAIM or PURPOSE: The aim of this study was to evaluate the effect of solvent use on dentinal crack formation in during root canal retreatment with micro-CT. MATERIALS and METHOD: Root canal treatments were performed on the mesial roots of 20 mandibular molars. The teeth were divided in two groups: Group A: solvent and Group B: Non-solvent. During primary treatment, canal preparation was performed using Revo-S files. The root canals were filled using the lateral compaction technique and AH Plus sealer. During retreatment procedure, Protaper Retreatment Files were used in both groups. Guttasolv was used as solvent during retreatment in group A. Before and after the initial treatment and retreatment, the teeth were imaged using microCT. Meanwhile, the remaining root canal filling materials in the teeth were also examined. RESULTS: Crack formation was not observed in either group. Residual filling material remained in the root canal after the procedure in both groups and there was no statistical significant difference found in terms of residual matter between the regions according to the results of the measurements made separately in three regions as coronal, middle, and apical regions. CONCLUSION(S): In conclusion, within the limitations of this in vitro study, it could be said that Ni-Ti systems do not cause dentin defects if used with or without a solvent. Even if the retreatment was performed close to ideal, it was determined that residual filling material remained on the canal walls during retreatment.Öğe Qraypen In Residual Caries Detection And Cavity Disinfection(2025) Bittar, Ahmad; Alkan, Elif; Tağtekin, DilekIntroduction: Residual bacterial activity after selective caries removal may compromise restoration longevity. QrayPen, a fluorescence-based device, enables real-time detection of red fluorescence (DR) and maximum red fluorescence (DRmax)— markers of bacterial activity. This case series explores QrayPen’s utility in identifying residual caries and evaluating the antibacterial effect of 2% chlorhexidine digluconate applied as a cavity disinfectant. Case description: Five adult patients with active dentinal caries underwent selective caries removal. QrayPen was used to measure DR and DRmax before and after chlorhexidine application. Measurements were standardized in a dark environment with consistent drying and probe positioning. Lesions were also evaluated using ICDAS II, Nyvad criteria, and ICCMS radiographic scores. All five cases showed detectable fluorescence post-caries removal; post-disinfection readings indicated reduced bacterial activity. Discussion: The findings suggest QrayPen can identify residual bacterial presence undetectable by conventional visualtactile methods. The observed decrease in DR and DRmax values after chlorhexidine application supports its effectiveness as an adjunctive diagnostic tool. This dual use may enhance decision-making in minimally invasive restorative protocols by confirming both cleanliness of the cavity and efficacy of disinfection. Conclusion/clinical significance: QrayPen may aid clinicians in verifying caries removal and evaluating cavity disinfection in real time. Its integration into routine practice could support more conservative and evidence-based restorative treatments, improving long-term outcomes.Öğe The Mediating Role of Climate Change Mitigation Behaviors in the Effect of Environmental Values on Green Purchasing Behavior within the Framework of Sustainable Development(Walter de Gruyter GmbH, 2025) Yilmaz, GoncaGlobal environmental challenges, including the depletion of natural resources, pollution, and population growth, have significantly impacted modern lifestyles. The environmental and socioeconomic dimensions of this reality are represented by climate change, one of the major threats facing the planet. People's environmental values and the green behaviors they exhibit based on these values are crucial in mitigating significant environmental problems, such as climate change. In this context, raising environmental awareness and motivating individuals to contribute to sustainable development and the circular economy particularly environmental protection can serve as an effective starting point. In line with this idea, data were collected from 236 participants in Istanbul in 2024 using the convenience sampling method. The data collected through the survey technique in the study were analyzed using the SPSS program and PROCESS, a macro developed for SPSS. In addition, confirmatory factor analysis and path analysis were performed with the Python programming language, and fit index was also presented. The research findings reveal a significant relationship between environmental values and green purchasing behavior. The mediating role of climate change mitigation behavior was also found.Öğe Deep Learning in neuroimaging for neurodegenerative diseases: State-of-the art, Challenges, and Opportunities(Elsevier B.V., 2025) Akan, Taymaz; Alp, Sait; Ledbetter, Christina Raye; Tafti, Ahmad P.; Arevalo, Octavio; Bhuiyan, Mohammad Alfrad NobelNeuroimaging is commonly used to diagnose neurodegenerative diseases (NDDs), providing crucial insights into brain changes before clinical symptoms manifest. Deep learning (DL) for neuroimaging can improve early diagnosis and disease monitoring. Clinical implementation of DL faces challenges in accurately representing realworld data. Recent models, particularly those focused on diagnostic categorization, have achieved high accuracy, but their applicability to patients is limited. Conflicting inferences have been reported, with findings from small cohorts generalizing conclusions without considering inter-scanner, intra- and inter-site variations. A theoretically feasible method involves gathering a comprehensive dataset that encompasses all patient demographics, but this presents practical challenges including harmonization, data incompleteness, class imbalance, and substantial costs. Existing research has also mostly focused on common NDDs like Alzheimer's Disease (AD) and Parkinson's Disease (PD). This contribution expands the literature by looking at a wider range of NDDs, exploring the latest advancements in applying deep learning algorithms to neuroimaging analysis for the diagnosis and monitoring of NDDs, including AD, Frontotemporal Dementia (FTD), Lewy Body Dementia, PD, Huntington's Disease, Amyotrophic Lateral Sclerosis, and Multiple Sclerosis. We emphasize how these approaches are handling spatial/temporal information available in brain volume imaging data. We conclude by discussing the challenges associated with the use of voxel-based, patch-based, ROI-based, and slice-based approaches in brain volume imaging. These challenges are further compounded by issues such as inter-site and inter-scanner variability, class imbalances in medical datasets, and the scarcity of accurately annotated data, all of which impact the performance and generalizability of deep learning models.Öğe Adapting the metaverse perception scale for Iranian nursing students: translation and psychometric assessment(Springer, 2025) Aghabarary, Maryam; Yıldırım, Tuğba Öztürk; Norouzinia, RoohangizThe integration of metaverse technologies into healthcare education is expand ing globally. However, there is a lack of culturally validated instruments to assess students’ perceptions within the Iranian context. This study aimed to evaluate the psychometric properties of the Persian version of the Metaverse Perception Scale among Iranian nursing students. A cross-sectional psychometric study was con ducted with 436 nursing students. The translated scale underwent Exploratory Fac tor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Internal consistency was assessed using Cronbach’s alpha. Convergent and discriminant validity were evaluated through Composite Reliability (CR), Average Variance Extracted (AVE), inter-construct correlations, √AVE, MSV and ASV. Factor analysis revealed a four factor structure—Education, Technology, Lifestyle, and Challenges—which ex plained 67.08% of the total variance. CFA results indicated that the refined 20-item version of the questionnaire had a good overall model fit (χ²/df=1.647; CFI=0.958; RMSEA=0.054). All CR values and AVE values were above 0.70 and 0.50, re spectively, supporting convergent validity. For all factors, √AVE values exceeded inter-construct correlations, and both MSV and ASV were lower than AVE, sup porting discriminant validity. The scale demonstrated strong internal consistency (Cronbach’s alpha=0.917−0.822). The Persian version of the Metaverse Perception Scale (P-MPS) is a valid and reliable scale for assessing nursing students’ percep tions of metaverse technologies in educational settings. This scale shows strong potential for application in both researcÖğe Smart Contracts, Blockchain, and Health Policies: Past, Present, and Future(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Kurt, Kenan Kaan; Timurtaş, Meral; Ozaydin, Fatih; Türkeli, SerkanThe integration of blockchain technology into healthcare systems has emerged as a technical solution for enhancing data security, protecting privacy, and improving interoperability. Blockchain-based smart contracts offer reliability, transparency, and efficiency in healthcare services, making them a focal point of many studies. However, challenges such as scalability, regulatory compliance, and interoperability continue to limit their widespread adoption. This study conducts a comprehensive literature review to assess blockchain-driven health data management, focusing on the classification of blockchain-based smart contracts in health policy and the health protocols and standards applicable to blockchain-based smart contracts. This review includes 80 core studies published between 2019 and 2025, identified through searches in PubMed, Scopus, and Web of Science using the PRISMA method. Risk of bias and methodological quality were assessed using the Joanna Briggs Institute tool. The findings highlight the potential of blockchain-enabled smart contracts in health policy management, emphasizing their advantages, limitations, and implementation challenges. Additionally, the research underscores their transformative impact on digital health policies in ensuring data integrity, enhancing patient autonomy, and fostering a more resilient healthcare ecosystem. Recent advancements in quantum technologies are also considered as they present both novel opportunities and emerging threats to the future security and design of healthcare blockchain systems.Öğe Machine learning–assisted classification of lung cancer: the role of sarcopenia, inflammatory biomarkers, and PET/CT anatomical-metabolic parameters(Springer Science and Business Media Deutschland GmbH, 2025) Tanyildizi-Kokkulunk, Handan; Alcin, Goksel; Cavdar, Iffet; Akyel, Resit; Ciftci-Kusbeci, Tuba; Caliskan, GonulAccurate differentiation between non-cancerous, benign, and malignant lung cancer remains a diagnostic challenge due to overlapping clinical and imaging characteristics. This study proposes a multimodal machine learning (ML) framework integrating positron emission tomography/computed tomography (PET/CT) anatomic-metabolic parameters, sarcopenia markers, and inflammatory biomarkers to enhance classification performance in lung cancer. A retrospective dataset of 222 patients was analyzed, including demographic variables, functional and morphometric sarcopenia indices, hematological inflammation markers, and PET/CT derived parameters such as maximum and mean standardized uptake value (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG). Five ML algorithms—Logistic Regression, Multi-Layer Perceptron, Support Vector Machine, Extreme Gradient Boosting, and Random Forest—were evaluated using standardized performance metrics. Synthetic Minority Oversampling Technique was applied to balance class distributions. Feature importance analysis was conducted using the optimal model, and classification was repeated using the top 15 features. Among the models, Random Forest demonstrated superior predictive performance with a test accuracy of 96%, precision, recall, and F1-score of 0.96, and an average AUC of 0.99. Feature importance analysis revealed SUVmax, SUVmean, total lesion glycolysis, and skeletal muscle index as leading predictors. A secondary classification using only the top 15 features yielded even higher test accuracy (97%). These findings underscore the potential of integrating metabolic imaging, physical function, and biochemical inflammation markers in a non-invasive ML-based diagnostic pipeline. The proposed framework demonstrates high accuracy and generalizability and may serve as an effective clinical decision support tool in early lung cancer diagnosis and risk stratification.Öğe Salvia argentea L. extract inhibits the production of NO, and pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), alleviates the inflammatory response of LPS-induced macrophages cells, and reduces the CRP level on carrageenan-induced paw edema(Springer Science and Business Media Deutschland GmbH, 2025) Alhamedi, Almonther; Demiroz Akbulut, Tugce; Baykan, Sura; Gümüştaş, Barış; Sanci, Ebru; Alsakini, Karrar Ali Mohammed Hasan; Nalbantsoy, Ayşe; Yavasoğlu, Altuğ; Karabay Yavasoğlu, N. ÜlküSalvia argentea L. (Lamiaceae) is a medicinal plant originating from the Mediterranean region and has been used since ancient times for the treatment of various diseases. This study aimed to determine the phytochemical composition of S. argentea L. ethanol extract and to evaluate its in vitro and in vivo anti-inflammatory activity and its acute oral toxicity. The chemical constituents of the ethanol extract prepared from the aerial parts of the plant were identified using HPLC. The in vitro anti-inflammatory activity of the extract was evaluated in LPS-stimulated murine macrophage RAW 264.7 cells and the human monocytic cell line THP-1 by measuring the levels of nitric oxide (NO), pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α). Acute toxicity of the extract was assessed in accordance with OECD guideline no 423. In vivo anti-inflammatory activity was evaluated based on the inhibition of 1% carrageenan-induced paw edema in rats. Serum CRP levels as an inflammatory marker, were measured via ELISA. Histological and immunohistochemical assessments were performed to identify tissue changes in the paw. HPLC profiling revealed that the extract contained rosmarinic acid (11.334 µg/mg dry extract), and salvigenin (2.74 µg/mg of dry extract) as major compounds. The extract significantly inhibited the production of NO, IL-1β, IL-6, and TNF-α without affecting cell viability. In vivo, the extract treatment exhibited a dose-dependent reduction in paw edema and serum CRP levels, along with notable histological improvements. Administration of the extract resulted in dose-dependent decreases of NF-κB expressions in the paw tissues. No signs of acute toxicity were observed (oral LD₅₀ > 2000 mg/kg). These findings suggest that S. argentea L. ethanol extract possesses significant anti-inflammatory potential supporting its possible development as a natural therapeutic agent for inflammatory disorders.Öğe From unmet childhood needs to parenting attitudes: breaking the cycle(Taylor and Francis, 2025)Objective: Rooted in Schema Therapy, this research posits that unmet physiological, social, and psychological needs during early life contribute to the development of enduring cognitive frameworks, termed early maladaptive schemas (EMS), which influence affect, behaviour, and cognition across the lifespan. Accordingly, the objective was to examine whether EMSs are systematically associated with specific parenting attitudes (PAs). Method: This correlational study employed a concurrent design. Participants included 246 volunteer parents of preschool-aged children residing in a cosmopolitan district of Istanbul. Data were collected online using validated measures of EMS and PA, along with additional items assessing potential confounding variables. Results: Correlational analyses revealed moderate positive associations between EMS and authoritarian parenting attitudes and moderate negative associations with democratic parenting attitudes. Hierarchical regression analyses showed that EMS accounted for over 20% of the variance in parenting attitudes, with socioeconomic status and education emerging as significant moderators. Discussion: EMSs significantly predict parenting attitudes, increasing authoritarian attitudes, and reducing democratic ones. Early identification of EMS, combined with schema-focused interventions and evidence-based parent education programs may help disrupt maladaptive parenting cycles and promote healthier parent–child dynamics.Öğe Representation of the City in Cinema: An Analysis of Kars Architecture as a Film Setting(Ataturk Universitesi, 2025) Öztürk, Sezer VolkanDue to cinema’s utilization of architecture as a filming location, the collaboration that has developed between these two disciplines has enabled the historical heritage of cities to be reflected on the silver screen. In this way, large audiences have become familiar with these cities through cinematic representation. As a border city that has experienced numerous occupations over time, Kars possesses a rich architectural, historical, and cultural background. These features have attracted the attention of many directors and screenwriters, and the city has taken on an almost leading role in several significant films. In this study, the ability of cinema to combine visuality and narrative has been examined through the spatial representation of the city of Kars in film. To analyze Kars’s cinematic representation from a multifaceted perspective and to obtain comparable data, a scene-content analysis was conducted on three films selected via a random sampling method. The spatial settings in these selected films were analyzed semiotically, focusing on their visual and symbolic meanings. Through this approach, the interaction between the city and its cinematic representation over time has been explored. Ultimately, the elements conveyed indirectly to the viewer constitute the foundation of semiotics, forming codes whose meanings are gradually interpreted by the audience. These codes, as presented through the films, contribute to the construction of a collective subconscious that reflects either an authentic or fictionalized image of the city and its society. As a result, the locations where films are shot are marketed either positively or negatively, intentionally or unintentionally. The findings of the analysis reveal that in the selected films, Kars is commonly represented through a rural narrative framework and is employed not as a realistic urban setting but rather as a fictionalized cinematic space. - Sinemanın mimarlığı bir çekim mekânı olarak kullanması nedeniyle bu iki disiplin arasında gelişen işbirliği; şehirlerin sahip olduğu tarihsel mirasın beyaz perdeye yansımasına, bu da çok sayıda insanın bu şehirleri sinema yoluyla kolayca tanımasına sebep olmuştur. Kars’ın sınır şehri olması ve yıllar içerisinde çok sayıda işgale uğraması sebebiyle şehrin mimarisi, tarihi ve kültürü zenginliklerle doludur. Bu zenginlikler günümüzde çok sayıda yönetmen ve senarist tarafından ilgi çekici bulunmuş ve şehir değerli birçok filmde adeta bir başrol oyuncusu gibi yer almıştır. Bu çalışmada, sinema sanatının sahip olduğu görseli ve anlatıyı bir araya getirme becerisi; Kars şehrinin sinemadaki temsili üzerinden okunmuştur. Kars'ın sinemadaki temsiliyetini çok yönlü inceleyebilmek ve karşılaştırabilir veri elde edebilmek adına; rastgele örnekleme yöntemiyle seçilen üç film üzerinden sahne-içerik analizi yapılmış ve film mekanları göstergebilimsel olarak incelenmiştir. Seçili filmlerdeki bu mekânların görsel ve sembolik anlamları, Kars'ın sinema sanatındaki temsili üzerinden okunarak yıllar içerisinde şehirle nasıl bir etkileşimde bulunduğu irdelenmiştir. Sonuçta dolaylı olarak seyirciye hissettirilen öğeler göstergebilimin temelini oluştururken seyircinin aslında ne anlama geldiğini zamanla kavradığı kodları meydana getirmektedir. Filmler ile verilen bu kodlar şehre ve topluma ait doğru veya kurgulanmış bir ortak bilinçaltı oluşturmaktadır. Neticede sinemanın çekildiği mekân olumlu veya olumsuz anlamda pazarlanmış olmaktadır. İncelenen filmlerde Kars şehri için kırsal bir anlatım dilinin ortak olarak tespit edildiği ve şehrin sinema mekânı olarak gerçek değil, kurgusal olarak kullanıldığı sonucuna varılmıştır.Öğe The Effect of Osteopathic Manipulative Treatment Adjunct on Stabilization Splint Treatment in Temporomandibular Joint Anterior Disc Displacement with Reduction Disorder: A Quantitative Analysis, Pilot Study(MDPI, 2025) Aklar, Ayca; Bal, Burcu; Tasdelen, Neslihan; Ertas, GokhanObjective: This study aimed to quantitatively assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunct to stabilization splint treatment for temporomandibular joint anterior disc displacement with reduction (ADDwR) disorder. Method: Thirty-eight joints were evaluated in this study. OMT, in addition to splint treatment, was administered to the study group, and the control group only received splint treatment. Before and after the treatments, the quality of life, the pain levels of distinct body regions, and the sleep quality were evaluated, while mandibular movements were assessed and condyle–disc position differences measured on magnetic resonance images. Results: In all the life qualities, except social functionality, increases after treatment were present for both control and study groups, but the increase was significant in bodily pain for the control group (p = 0.034) while increases were significant in physical functionality (p = 0.018), general health perception (p = 0.027), and reported health transition (p = 0.019) for the study group. Significant pain reduction in all body regions was seen in the study groups (p = 0.007–0.033), but the decrease was only significant for the temporomandibular joint for the control group (p = 0.011). The sleep quality significantly improved for the study group (p = 0.018). Limited after-treatment improvements in the condyle–disc positions were determined for both the normal joints and joints with ADDwR in the study group. Conclusions: The application of OMT adjunct to splint treatment increases quality of life and sleep, reduces bodily pain, and improves condyle–disc positions over the MRIs of TMJ.Öğe The Relationship Between Lip Augmentation and Teeth Visibility: A Cosmetic Perspective(Lippincott Williams and Wilkins, 2025) Altin, Fazilet; Muluk, Nuray Bayar; Cingi, CemalObjectives: This paper aims to describe the ideal relationship between lips and teeth as 2 critical facial features to guide young doctors keen on lip augmentation. Methods: The literature survey was performed in PubMed, EBSCO, UpToDate, Proquest Central databases of Kirikkale University, and Google and Google Scholar databases. Results: There is a relationship between the visibility of teeth and the amount of tooth show and its attractiveness, but only if the gingival exposure is within the standard setting and between the upper central incisor tips if the buccal corridor is not exceeding 1 mm. A smile's visual expression and aesthetics do not simply involve the lips alone. Facial esthetics result from harmony between several minor factors, the combination of which determines the patient's overall appearance. For instance, when laughing with an open mouth, a person's teeth become visible. The need for lip enhancement is based on the patient's aesthetic goals, infrastructural tooth position/visibility, and stage of facial aging. To help achieve lip augmentation goals, facial aesthetic subunits, soft-tissue patterns, and bony landmarks should be considered. Lip augmentation is typically performed by adding volume through various means and materials. Conclusions: The authors must offer essential new data on the relationship between lip augmentation and teeth visibility. A given upper lip enhancement will make the maxillary incisors visible to a greater or lesser extent. However, there is limited research on what constitutes a prioritized single most crucial factor in promoting maxillary incisor visibility.Öğe Skeletal muscle alterations in type 2 diabetes mellitus with and without dyslipidemia(BioMed Central Ltd, 2025) Satman, Ilhan; Dayican, Damla Korkmaz; Calikoglu, Fulya; Sahin, Humeyra Rekali; Perone, Francesco; Akinci, BuketBackground Diabetic dyslipidemia, a common comorbidity in people with type 2 diabetes, has been reported to be associated with adverse metabolic outcomes. Skeletal muscle is a key organ impacted by metabolic disorders; however, the specific effects of diabetic dyslipidemia on skeletal muscle mass, strength, and performance remain unclear. The aim of this study was to assess the skeletal muscle alterations of people with type 2 diabetes with and without dyslipidemia. Methods This retrospective study included 144 participants (mean age 51.3 +/- 7.1 years; 103 female, 41 male) aged 40-65 years. Body composition was assessed using bioelectrical impedance analysis (BIA), muscle strength via dynamometer, and functional capacity with the 6-minute walk test (6MWT). To minimize the confounding effect of longer diabetes duration in the diabetic dyslipidemia group, propensity score matching (PSM) was performed using a 1:1 nearest-neighbor method. All analyses were performed on matched groups. ROC analysis was conducted for variables showing significant differences. Results After PSM, people with diabetic dyslipidemia showed significantly lower skeletal muscle mass and skeletal muscle index (SMI), higher body fat percentage, and reduced 6MWD compared to those with diabetes alone (p < 0.05). In women with diabetic dyslipidemia, handgrip strength was significantly lower. ROC analysis revealed moderate predictive value for skeletal muscle mass (AUC = 0.682), SMI (AUC = 0.654), and 6MWD (AUC = 0.628). Conclusion This study demonstrated that people with diabetic dyslipidemia had lower skeletal muscle mass, SMI, and decreased physical performance compared to people with diabetes alone, even after matching for diabetes duration. These findings demonstrate early sarcopenic and dynapenic changes and highlight the need to consider skeletal muscle health and lipid abnormalities together in diabetes management.Öğe Exploring the Causal Links between ESG, R&D, and Firm Performance: Evidence from the US Technology and Food Companies(Institute of Geography of the Slovak Academy of Science, 2025) Boğa Şahin, Semra; Bozkurt, Gözde; Gillpatrick, TomThis study examines the causal relationships between ESG (Environmental, Social, and Governance) compliance, R&D expenditures, and financial performance in the technology and food sectors in the US. A panel dataset from 2012 – 2021 from the Thomson Reuters database was analysed for 12 food and 18 technology companies. The findings show that there are different causal relationships between sectors. While R&D investments in the technology sector positively affect firm performance by increasing ESG compliance, firm performance in the food sector directs ESG compliance, encouraging R&D investments. The study emphasizes that sectoral differences should be considered in sustainability and R&D strategies and guides policymakers and managers to develop approaches appropriate to the dynamics of the sector.Öğe Volumetric Three-Dimensional Evaluation of the Pharyngeal Airway After Orthognathic Surgery in Patients with Skeletal Class III Malocclusion(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Oz, Aslihan Zeynep; El, Hakan; Palomo, Juan MartinBackground: Orthognathic surgery significantly alters the dimensions of the pharyngeal airway. This study's objective was to assess alterations in the pharyngeal airway volume via cone-beam computed tomography (CBCT) after orthognathic surgery in patients with skeletal Class III malocclusion. Methods: This retrospective study analyzed CBCT images from 23 patients with skeletal Class III malocclusion (13 females, 10 males), who were categorized into two groups based on the surgical approach: double-jaw and single-jaw surgery. The double-jaw group included 13 patients who underwent bilateral sagittal split osteotomy (BSSO) and Le Fort I osteotomy, whereas the single-jaw group included of 10 patients who had underwent BSSO only. CBCT images were evaluated both before surgery and at a minimum of three months after surgery. The oropharyngeal volume (OP), nasopharyngeal volume (NP), total airway volume, posterior airway space (PAS), and the most constricted area at the base of the tongue (minAx) were measured. Statistical analyses were performed using either paired t-tests or Wilcoxon signed-rank tests depending on data normality, with a significance level set at p < 0.01. Results: In the double-jaw group, a significant volumetric increase was observed in the nasopharynx (5316 +/- 1948 mm(3) to 6064 +/- 1899 mm(3); p = 0.010) and oropharyngeal volume decreased from 17,097 +/- 5675 mm(3) to 14,290 +/- 5835 mm(3); however, this reduction was not statistically significant (p = 0.017). In contrast, the single-jaw group showed a significant reduction in oropharyngeal volume from 15,620 +/- 5040 mm(3) to 12,444 +/- 4701 mm(3) (p = 0.010), with no significant change in nasopharyngeal volume (p = 0.551). Total airway volume significantly decreased only in the single-jaw group (from 20,452 +/- 7754 mm(3) to 16,846 +/- 6529 mm(3), p = 0.010). Additionally, both groups exhibited marked decreases in PAS and minimum axial area values (all p < 0.01). Conclusions: Orthognathic surgery led to a significant volumetric increase in the nasopharynx in the double-jaw group, whereas the oropharynx volume significantly decreased only in the single-jaw group. Additionally, both surgical approaches resulted in a marked reduction in PAS and minimum axial area values, highlighting a notable impact on posterior airway dimensions.Öğe Anatomical Relationship of the Mylohyoid Ridge, Lingual Concavity, and Mandibular Canal: A Retrospective CBCT Study(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Girit, Melike Nur; Ansen, Gamze; Pence, Kadriye Betul; Yuzbasioglu, NeslihanBackground/Objective: This study aimed to determine the position of the mylohyoid ridge (MR) and lingual concavity (LC) in the mandible and their relationship with the mandibular canal (MC) and submandibular fossa, to provide anatomical guidance for surgical procedures in this region. Methods: A retrospective analysis was performed on cone beam computed tomography (CBCT) scans from 200 adult patients who had undergone imaging for dental treatment. On cross-sectional images at the level between the first and second molar roots, the following measurements were obtained: LC horizontal depth, LC height, LC depth, MR height, MR depth, and the distances from MR to MC (MR–MC) and LC to MC (LC–MC). Results: Mean values were: LC horizontal depth: 3.72 ± 0.90 mm, LC height: 11.74 ± 2.01 mm, LC depth: 12.54 ± 3.03 mm, MR height: 17.66 ± 2.60 mm, MR depth: 6.87 ± 2.38 mm, MR-MC: 8.30 ± 2.00 mm, and LC-MC: 3.72 ± 0.87 mm. All parameters were symmetrical between the right and left sides of the mandible, with no significant sex differences. The positions of the MR and LC were related to each other, and the position of the MC was related to the positions of the LC and MR. There was no correlation between the horizontal depth of the LC and the position of the MR, LC and MC. Conclusions: The vertical positions of the MR and LC are related to each other and MC. Therefore, it can be used as a landmark in implant surgery.Öğe Exploring the financial impact of digital transformation: A comprehensive analysis on firms(Elsevier B.V., 2025) Yavuz, Melih Sefa; Bozkurt, GözdeThis study aims for an in-depth exploration into the effects of digital transformation on firms’ financial performance and how this impact can be measured. The research employs a two-stage method to evaluate firms’ digitalization processes. In the first stage, keywords related to digitalization are extracted from annual reports through text mining, and digital transformation strategies in five different sectors are analyzed. Based on these analyses, the return of digitalization (ROD) ratio is developed to assess the effects of digital transformation. In the second stage, a panel data analysis is conducted to examine the impact of digitalization and the ROD ratio on a firm's performance. The research findings clearly indicate that digital transformation generates positive effects on firms’ financial performance. It also appears that digitalization provides a competitive advantage, particularly in areas such as operational efficiency and brand value. Firms with a high ROD ratio, which can be used as an indicator of digital transformation investments, demonstrate stronger financial performance. The ROD ratio has emerged as a critical indicator that effectively measures the financial outcomes of digital transformation.Öğe Organizational and Individual Antecedents of Resistance to Change: Organizational Climate and Technology Readiness(Sciendo, 2025) Eyitmiş, Ahmet Melih; Zümrüt, Muhammet ZekiBackground and purpose: There is interest in barriers to change in organizations. This research discusses factors affecting resistance to change based on employees’ technological competencies. This research aims to determine the mediating role of technology readiness in the effect of organizational climate in health institutions on resistance to change. Methodology: Research data were collected from 389 employees working in the healthcare sector. SPSS Process 2.13 macro was used to analyze the model. Results: According to the analysis results, organizational climate positively affected technology readiness. Additionally, organizational climate reduced resistance to change. In addition, employees’ readiness for technology reduced resistance to change. Finally, the mediating role of technology readiness (motivating and blocking factors) in the effect of organizational climate on resistance to change was significant. Further, a positive organizational climate in healthcare institutions increased employees’ readiness for new technologies and significantly reduced employees’ resistance to change. Conclusion: Creating a positive organizational climate can be vital in successfully implementing change processes in the healthcare sector. At the end of the research, theoretical and practical suggestions were presented. The research contributes to the literature by addressing the antecedents of resistance to change from organizational and individual perspectives.
