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Diagnosis of approximal caries in children with convolutional neural networks based detection algorithms on radiographs: A pilot study
No full textObjectives: Approximal caries diagnosis in children is difficult, and artificial intelligence-based research in pediatric dentistry is scarce. To create a convolutional neural network (CNN)-based diagnostic system for the prompt and efficient identification of approximal caries in pediatric patients aged 5-12 years. Materials and methods: Pediatric patients'digital periapical radiographic images were collected to create a unique dataset. Various augmentation methods were used, and approximal caries in the augmented images were labeled by a pediatric dentist to minimize labeling errors. The dataset consisted of 830 data labeled for approximal caries on 415 images, which were divided into 80% training and 20% testing sets. After comparing 13 detection algorithms, including the latest YOLOv8, the most appropriate one was selected for the proposed system, which was then evaluated based on various performance metrics. Results: The proposed detection system achieved a precision of 91.2%, an accuracy of 90.8%, a recall of 89.3%, and an F1 value of 90.24% after 300 iterations, utilizing a learning rate of 0.01. Conclusion: Approximal caries has been successfully detected with the developed system. Future efforts will focus on augmenting the dataset and expanding the sample size to enhance the efficacy of the system
Investigating the Relationship between Sport Engagement and Intention to Quit Smoking
No full textSports are a positive phenomenon for people of all ages in terms of mental, physical, and spiritual health. Smoking can have a negative impact on the aforementioned health issues. Based on these considerations, the study's goal was to investigate the relationship between commitment to sports and intention to quit smoking, and the relational screening model was employed to this end. The research group consisted of 248 individuals determined by convenience sampling method. The “Sport Engagement Scale (SES)” and the "Intention to Quit Smoking Scale (IQSS)" were used in the study. To examine demographic characteristics, the T-test and ANOVA tests were used in the data analysis. The relationship between the scales was also assessed using the Pearson correlation test. The study's findings revealed that participants' average scores on both sport engagement and its factors, as well as their intention to quit smoking, were close to high. The t-test and ANOVA test results revealed significant differences in the variables of gender, health effects of smoking, weekly sports day, the years of smoking, and the years of doing sports. It was determined that there were positive and significant relationships between the scores of intention to quit smoking and te overall score of sport engagement scale and its "vigor and absorption" factors
Determinants of health expenditures in E7 countries: Empirical findings from panel data analysis
No full textEkonomilerin gelişmişlik düzeyi açısından, sağlık harcamaları oldukça önemli bir unsurdur. Beşeri sermaye düzeyine doğrudan etki eden sağlık harcamalarına yönelik yapılan yatırımlar, ülkelerin kalkınma süreçlerini olumlu etkilemektedir. Bu çalışmada E7 (Endonezya, Meksika, Türkiye, Brezilya, Hindistan, Çin ve Rusya) ekonomileri için sağlık harcamalarının belirleyicileri analiz edilmiştir. 2000-2020 döneminin incelendiği çalışmada, panel veri analizi yöntemi kullanılmıştır. Bu kapsamda açıklayıcı değişkenler; makroekonomik ve demografik unsurlar ile çevresel bozulma unsurlarını içerecek şekilde geniş kapsamda ele alınmıştır. Değişkenler arasında yatay kesit bağımlılığı ve heterojenlik sorunlarının tespit edildiği çalışmada, Ortalama Grup Tahmincisi (AMG) kullanılmıştır. Bulgular makroekonomik değişkenler ve çevresel bozulmanın sağlık harcamaları üzerindeki niceliksel etkisinin demografik unsurlara göre daha fazla olduğunu göstermektedir. Ayrıca sağlık harcamaları gelir esnekliğinin ise bire yakın olduğu, diğer bir ifadeyle sağlık harcamalarının zorunlu mal niteliğinde olduğu sonucuna ulaşılmıştır.Health expenditures represent a crucial factor in terms of economic development. Investments in health expenditures, which directly influence the level of human capital, positively contribute to countries' development processes. This study analyses the determinants of health expenditures for the E7 economies (Indonesia, Mexico, Turkey, Brazil, India, China, and Russia). Employing the panel data analysis method, the study examines the 2000-2020 period. The explanatory variables comprehensively address macroeconomic, demographic, and environmental degradation factors. Given the detection of cross-sectional dependency and heterogeneity issues among the variables, the study utilizes the Augmented Mean Group (AMG) estimator. The findings reveal that macroeconomic variables and environmental degradation exert a greater quantitative impact on health expenditures than demographic factors. Additionally, the income elasticity of health expenditures is close to one, indicating that health expenditures can be characterized as a necessity
Macroeconomic determinants of health quality: The case of Türkiye
No full textSon yıllarda küresel çapta salgın hastalıklarda görülen artışlarla birlikte sağlık sektöründe meydana gelen gelişmeler, insanların sağlık kalitesi üzerinde çeşitli etkiler meydana getirmiştir. Dolayısıyla sağlık kalitesinin belirleyicilerinin neler olduğunun araştırılması, hem politika yapıcılar hem de bilim insanları için ilgi çekici bir çalışma alanı olmaktadır. Bu bağlamda bu tez çalışmasının temel amacı, sağlık kalitesinin makroekonomik belirleyicilerinin neler olduğunun araştırılmasıdır. Çalışmada sağlık kalitesinin belirleyicileri, 1975-2022 dönemi verileriyle Türkiye ekonomisi için zaman serisi analiz teknikleri kullanılarak araştırılmaktadır. Sağlık kalitesinin sağlık harcamaları değişkeniyle ölçüldüğü çalışma; ekonomik büyüme, çevre kirliliği, ticari dışa açıklık, enerji tüketimi, finansal gelişme, enflasyon oranı, yenilenebilir enerji, kentleşme, nüfus artış hızı ve tarımsal katma değer değişkenlerinin ele alındığı yedi farklı tahmin modelini içermektedir. Çalışmada değişkenler arasındaki uzun dönemli asimetrik ilişkiler, yapısal kırılmalar dahil edilerek NARDL modeli yardımıyla araştırılmaktadır. Analiz bulguları; Türkiye'de ekonomik büyümenin pozitif ve negatif şoklarının sağlık harcamalarını negatif etkilediğini ancak negatif şokların etkisinin daha fazla olduğunu, çevre kirliliğine yönelik pozitif şokların sağlık harcamalarını artırdığını, nüfus artış hızında meydana gelen pozitif bir şokun sağlık harcamalarını azaltırken negatif bir şokun artırdığını, enflasyon oranındaki pozitif ve negatif şokların sağlık harcamalarını artırdığını, ticari dışa açıklık ve yenilenebilir enerjideki negatif bir şokun sağlık harcamalarını artırdığını, enerji tüketiminin pozitif ve negatif şoklarının sağlık harcamaları üzerinde doğrudan etkisinin bulunmadığını, finansal gelişmenin negatif şoklarının sağlık harcamalarını artırmada daha etkili olduğunu, kentleşmenin pozitif şoklarının sağlık harcamalarını azalttığını ve tarımsal katma değerin negatif şoklarının sağlık harcamalarını azalttığını ortaya koymaktadır. Tez çalışmasından elde edilen sonuçlar, Türkiye'de sağlık kalitesinin iyileştirilmesine yönelik kapsamlı bir inceleme sunmaktadır. Dolayısıyla bulgular, sağlık harcamalarının etkinliğini sağlayarak sağlık kalitesini iyileştirmeye yönelik atılacak adımlarda politika yapıcılar ve karar alıcılar için yol gösterici çıkarımlar sunmaktadır.In recent years, the developments in the health sector together with the increase in global epidemic diseases have had various effects on people's health quality. Therefore, investigating the determinants of health quality is an interesting field of study for both policy makers and scientists. In this context, the main purpose of this thesis is to investigate the macroeconomic determinants of health quality. In this study, the determinants of health quality are investigated using time series analysis techniques for the Turkish economy with data for the period 1975-2022. The study, in which health quality is measured with the health expenditure variable, includes seven different estimation models that include economic growth, environmental pollution, trade openness, energy consumption, financial development, inflation rate, renewable energy, urbanization, population growth rate and agricultural value added variables. In the study, long-run asymmetric relationships between variables are investigated with the help of the NARDL model by including structural breaks. The analysis findings reveal that positive and negative shocks of economic growth in Türkiye negatively affect health expenditures, but the effect of negative shocks is greater, positive shocks to environmental pollution increase health expenditures, a positive shock in the population growth rate decreases health expenditures while a negative shock increases them, positive and negative shocks in the inflation rate increase health expenditures, a negative shock in trade openness and renewable energy increases health expenditures, positive and negative shocks of energy consumption do not have a direct effect on health expenditures, negative shocks of financial development are more effective in increasing health expenditures, positive shocks of urbanization decrease health expenditures, and negative shocks of agricultural value added decrease health expenditures. The results of this thesis provide a comprehensive review on improving health quality in Türkiye. Therefore, the findings provide guiding implications for policymakers and decision-makers in the steps to be taken to improve health quality by ensuring the efficiency of health expenditures
Analysis of medical tourism users' repurchase intentions within the framework of medical tourism destination image and planned behavior theory
Full text linkÖZET Sağlık hizmetlerindeki gelişmeler ve küreselleşme, medikal turizm kavramını ortaya çıkarmakla kalmamış, aynı zamanda sektörün hızla büyümesini sağlamıştır. Uluslararası ulaşımın kolaylaşması, sosyal medyanın pazarlama aracı olarak kullanılması ve maliyetlerin düşmesi gibi faktörler medikal turizmin yayılmasına katkıda bulunmuştur. Bu araştırma, Türkiye'nin medikal turizmde güçlü bir destinasyon imajına sahip olup olmadığını ve bu imajın, sağlık hizmeti kullanıcılarının yeniden hizmet alma niyetlerine etkisini planlı davranış teorisi ile ilişkilendirerek incelemeyi hedeflemiştir. Sosyo-demografik özellikler, medikal turizm niyetlerini ölçmek için Planlı Davranış Teorisi çerçevesinde gerçekleştirilen MEDTOUR ölçeği ile Medikal Turizm Destinasyon İmajı ve Yeniden Hizmet Alma Niyeti ölçekleri kullanılarak anket formu oluşturulmuştur. İstanbul'daki bir estetik merkezine başvuran 502 sağlık turizmi kullanıcısından 406'sının katılımıyla toplanan veriler SPSS 26 paket programı kullanılarak analiz edilmiştir. Güvenirlik analizleri (Cronbach's Alpha), bağımsız gruplar t-testi, tek yönlü varyans analizi (One way ANOVA), faktör analizi, basit ve çoklu regresyon analizi uygulanmıştır. Araştırma sonuçlarına göre, öznel normların sağlık hizmeti tercihlerini etkileyen önemli bir faktör olduğu belirlenmiştir. Medikal turizm destinasyon imajının, yeniden hizmet alma niyetini %74,9 oranında açıkladığı görülmüştür Türkiye'nin medikal turizm destinasyon imajının, yeniden hizmet alma niyeti üzerinde önemli bir etkiye sahip olduğu tespit edilmiştir. Demografik faktörler açısından ise, 50-59 yaş grubundaki bireyler ve evli katılımcıların daha yüksek yeniden hizmet alma niyeti gösterdiği saptanmıştır. Ayrıca, analiz sonuçlarında saptanan davranışa yönelik tutumun negatif etkisi, planlı davranış teorisi çerçevesinde maliyet, ulaşım kolaylığı ve hizmet kalitesi gibi dışsal faktörlerle etkileşim içinde farklılık gösterebileceği şeklinde yorumlanmıştır. S-O-R Modeli'nin entegre edildiği araştırmada, uyarıcı (stimulus) olarak değerlendirilen medikal turizm destinasyon imajı ile organizma (organism) boyutunda yer alan öznel norm arasında pozitif ve anlamlı bir ilişki olduğu belirlenmiştir. Araştırma sonucunda, bu sürecin bireyde bir tepki (response) olarak yeniden hizmet alma niyeti geliştirdiği tespit edilmiştir Bu bulgular, Türkiye'nin medikal turizmdeki güçlü imajını pekiştirmektedir.ABSTRACT Advancements in healthcare services and globalization have not only introduced the concept of medical tourism but have also facilitated the rapid growth of the sector. Factors such as easier international travel, the use of social media as a marketing tool, and reduced costs have contributed to the spread of medical tourism. This study aimed to examine whether Turkey has a strong destination image in medical tourism and how this image impacts the intentions of healthcare service users to reuse services, using the framework of the Theory of Planned Behavior. Socio-demographic characteristics, medical tourism intentions, and scales including the MEDTOUR scale within the framework of the Theory of Planned Behavior, the Medical Tourism Destination Image scale, and the Intention to Reuse Services scale were used to create a survey form. Data were collected from 406 out of 502 medical tourism users who applied to an aesthetic center in Istanbul, and the data were analyzed using SPSS 26 software. Reliability analyses (Cronbach's Alpha), independent samples t-test, one-way analysis of variance (One-way ANOVA), factor analysis, and simple and multiple regression analyses were conducted. According to the study results, subjective norms were found to be a significant factor influencing healthcare service preferences. It was observed that the medical tourism destination image explained 74.9% of the variance in the intention to reuse services. Turkey's medical tourism destination image was found to have a significant impact on the intention to reuse services. In terms of demographic factors, individuals in the 50-59 age group and married participants exhibited a higher intention to reuse services. Additionally, the negative effect of attitudes toward behavior identified in the analysis was interpreted as potentially varying due to interactions with external factors such as cost, accessibility, and service quality within the framework of the Theory of Planned Behavior. The study, which integrated the Stimulus-Organism-Response (S-O-R) Model, identified a positive and significant relationship between the medical tourism destination image, considered as a stimulus, and subjective norms, classified under the organism dimension. The findings revealed that this process results in the development of an intention to reuse services as a response. These results further reinforce Turkey's strong image in medical tourism
Ecotoxicological Effects of MPs as Emerging Micropollutants: Examination of Biomarkers, Current State, and Future Perspectives
No full textKnown ubiquitously, including in terrestrial and aquatic ecosystems, microplastics (MPs) are pollutants of concern and their harmful effects pose a growing threat. MPs, especially when considered together with increasing pollution and destructions in the ecosystem, cause deterioration of ecosystem functions and structure, raising concerns about possible negative effects on the environment. The environmental effects of microplastics, which increase especially rapidly in different environmental conditions, have been still discussed by many researchers today. While studies generally focus on the increase and effects of MPS in the oceans and seas, there is still a knowledge gap regarding its status and effects in freshwater and soil. Therefore, it is very important to evaluate the effects of MPs on both terrestrial and aquatic ecosystems. The toxic compounds used as additives in the formation of microplastics absorb the pollutants in the environment during their stay in the land and aquatic environment and then may cause the development of microorganisms in these areas or threaten the environmental media by being directly assimilated by organisms. Therefore, this situation creates an ever-increasing danger and risk potential for ecosystems, and especially their sustainable presence on land and water creates negative effects on human health and the ecosystem. So, in this context, this book section aims to define MPs pollution in terrestrial and aquatic ecosystems and to determine the ecotoxicological effects observed in ecosystems. In addition to the presence and potential effects of microplastics in soil and clean waters, their effects on human-food security, animal, ecosystem, and human health will be focused on. At the same time, biomarkers of microplastics that cause oxidative stress and damage to microalgae will be investigated. In addition, it is also aimed to present the current challenges and perspectives for future research in the context of microplastics and their effects, which are also known as worrisome. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2025
An Analysis of Quality Parameters Changes in Agricultural Water Systems with Wavelet Transform Model
No full textClimate change, population growth, industrialization, overconsumption, and pollution strain water and resources, posing risks to ecosystem sustainability. Urgent action plans based on decision support systems are essential to protect environmental health and secure global food resources. This study employs the Wavelet model to analyze the impacts of agricultural and environmental factors on water resources in a selected irrigation basin by assessing water quality parameters, including chemical, physical, and biological properties, through seasonal sampling and wavelet transformations to detect temporal and spatial trends. Results showed increased salinity, nitrate, boron, total suspended solids (TSS), and chemical oxygen demand (COD) in groundwater and irrigation canals, particularly during dry periods. High nitrate (average 0.36 mg/L) and TSS levels (average 1152 mg/L) were linked to agricultural activities, while industrial influences contributed to the variability of boron ranging from 0.01 to 0.40 mg/L and COD ranging from 20 to 235 mg/L. The study highlights the temporal persistence of water quality challenges and spatial differences driven by external and environmental factors. Predictive wavelet analyses suggest that without intervention, water quality could worsen. These findings highlight the need for wavelet-based techniques to develop accurate management strategies for mitigating environmental impacts and ensuring long-term resource sustainability in irrigation-dependent regions. © 2025 by the authors
The impact of internal marketing and healthcare workers satisfaction on patient focus
Full text linkBu çalışmanın amacı, uyarıcı-organizma-tepki modeli (S-O-R) temelinde içsel pazarlamanın sağlık çalışanlarının memnuniyetine etkisini değerlendirerek, bu memnuniyetin müşteri (hasta) odaklılık üzerindeki rolünü ortaya koymaktır. Araştırmada, bağımsız değişken olarak içsel pazarlamanın, bağımlı değişkenler olan iç müşteri (çalışan) memnuniyeti ve müşteri (hasta) odaklılık üzerindeki etkisi incelenmiştir. Bu amaca yönelik olarak bir model oluşturulmuş ve veriler demografik bilgi formu, içsel pazarlama ölçeği, iç müşteri (çalışan) memnuniyet ölçeği ve müşteri (hasta) odaklılık ölçeği üzerinden toplanmıştır. Anket verilerinin toplanmasında kolayda örnekleme yöntemi kullanılarak, Ankara ilindeki sağlık kurumlarında görev yapan 316 kişi araştırmanın örneklemini oluşturmuştur. Araştırma verilerinin analizinde IBM SPSS ve AMOS programları kullanılmıştır. Kurulan hipotezler Yapısal Eşitlik Modeli ile test edilmiştir. Yapılan analizler, sağlık hizmetlerinde içsel pazarlama uygulamalarının hem iç müşteri memnuniyeti hem de müşteri odaklılık üzerinde anlamlı ve olumlu etkiler yarattığını göstermektedir. Çalışanların memnuniyet düzeyleri, işletmelerin içsel pazarlama stratejileriyle doğrudan ilişkilendirilmiş ve çalışanların ihtiyaçlarına duyarlılık gösteren, motivasyonlarını artıran uygulamaların iş tatmini ve hasta odaklılıkları düzeylerini güçlendirdiği tespit edilmiştir. Özellikle motivasyon, ödül ve işgören odaklı alt boyutların, çalışan memnuniyeti üzerinde kritik bir rol oynadığı belirlenmiştir.The aim of this study is to evaluate the effect of internal marketing on the satisfaction of healthcare professionals based on the stimulus-organism-response model (S-O-R) and to reveal the role of this satisfaction on customer (patient) orientation. In the study, the effect of internal marketing as an independent variable on the dependent variables of internal customer (employee) satisfaction and customer (patient) orientation was examined. A model was created for this purpose and data were collected via demographic information form, internal marketing scale, internal customer (employee) satisfaction scale and customer (patient) orientation scale. Convenience sampling method was used in the collection of survey data and 316 people working in healthcare institutions in Ankara constituted the sample of the study. IBM SPSS and AMOS programs were used in the analysis of research data. The established hypotheses were tested with Structural Equation Model. The analyses conducted show that internal marketing practices in healthcare services create significant and positive effects on both internal customer satisfaction and customer orientation. Employee satisfaction levels are directly related to the internal marketing strategies of the businesses and it has been determined that practices that are sensitive to the needs of employees and increase their motivation strengthen job satisfaction and patient focus. It has been determined that motivation, reward and employee-oriented sub-dimensions in particular play a critical role in employee satisfaction
New Insights into the application of Copper-Based polymer composites as Catalysts: An Indepth experimental and computational study
No full textA series of polyaniline-copper oxide (PANI-CuO) composites were synthesized using in-situ chemical oxidation polymerization (PCI) and mechano-chemical preparation (PCS) methods. The influence of the synthesis methods on the morphological, structural, surface, thermal, and optical properties of the composites was systematically investigated. Characterization techniques including Fourier transformer infrared (FTIR), Raman spectroscopy, Xray diffraction (XRD), scanning electron microscopy (SEM), thermal gravimetric (TG), and differential thermal analysis (DTA), and photoluminescence (PL) were employed to confirm the formation of the composites and analyze their structural features. The morphology of the PANI-CuO composites was found to be dependent on the PANI/CuO ratio and the synthesis method. XRD revealed the semi-crystalline nature of PANI and the monoclinic structure of CuO. Photocatalytic performance was evaluated by the degradation of anionic Reactive Orange-122 (RO-122) dye with the PCS-81 composite achieving 91 % degradation of RO-122 in 120 min. Recyclability tests demonstrated high stability of the composites, suggesting their potential as efficient photocatalysts for dye removal from aqueous solutions. FTIR, Raman, and SEM analyses were used to monitor morphological and structural changes during RO-122 photodegradation. Conceptual Density Functional Theory (CDFT) calculations were also performed to identify reactive sites for hydroxyl radical attack, and reactivity descriptors were calculated using the DFT/B3LYP/6-31G(d) method. A photocatalytic degradation mechanism for RO-122 was proposed by integrating computational and experimental data.Research Fund of Tubitak [221Z258]; Tekirdag Namik Kemal University BAP unit [NKUBAP. 01.GA.22.437]The financial support provided by Research Fund of Tubitak through Project No. 221Z258 and Tekirdag Namik Kemal University BAP unit through Project No. NKUBAP. 01.GA.22.437 is gratefully acknowledged
A moment resistant beam end connection using energy dissipative couplers for precast concrete structures
No full textThere is an increasing demand for precast reinforced concrete (RC) structures due to their undeniable advantages, such as rapid assembly, material standardization, and labor quality. The structural performance of precast RC structures depends not only on the quality of the precast members but also on joints and connections. In recent years, significant attention has been given to replaceable energy-dissipative devices for beam-to-column connections in precast RC structures. This paper proposes a novel moment-resisting energy-dissipative beam end connection in precast RC systems. The proposal is based on the results of intensive experimental and numerical studies conducted in the research project. The beam longitudinal reinforcements are connected to the joint using the developed fuse-type mechanical couplers (FTMCs) that have energy dissipation capability. While the bending moment in the connection is transformed into an axial force couple and transferred by FTMCs, the shear force is transmitted through the steel hinge at the center of the beam. The cyclic behavior of the proposed connection was experimentally investigated, resulting in a robust numerical model for the connection. The experiments demonstrated that the proper configuration of FTMCs in the connection enables reaching a 4% drift ratio without causing major damage to the RC beams. Macro models adopting pivot and kinematic hysteresis approaches for FTMCs were built in the numerical part. The pivot model reasonably and consistently predicted the experimental force-displacement relations of the proposed connections. The ability of the pivot model to estimate the energy dissipation capacities varies almost 6 similar to 16%.Scientific and Technological Research Council of Turkey (TUBITAK) [TEYDEP 5190016]This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) (Grant Number: TEYDEP 5190016)