WoS

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14411/18

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Unpacking Women’s Worries about Leadership: The Interplay of Perceived Sexism and Organizational Support
(SAGE Publications Inc, 2026) Metin Camgoz, Selin; Yilmaz, Berru Ayse; Metin-Orta, Irem
Background Despite significant advancements in workplace equality, gender-based discrimination continues to hinder women's leadership aspirations and potential. In many non-Western societies, cultural and institutional structures intensify the influence of sexism on women's professional experiences.Objective This study explores how benevolent and hostile sexism, together with perceived organizational support, affect female employees' worries about leadership roles. It also examines whether organizational support moderates the relationship between sexism and leadership-related anxieties.Methods Data were collected from 201 full-time female employees working in various occupations in Türkiye. An online survey included the Worries about Leadership scale, the Perceived Organizational Support Scale, and the Perceived/Experienced Sexism Scale. Hypotheses were tested using moderation analysis via the PROCESS macro.Results Benevolent sexism and perceived organizational support were both negatively associated with worries about leadership. Perceived organizational support moderated the effect of benevolent sexism on leadership worries, such that higher support reduced its impact, demonstrating a crossover effect. Specifically, benevolent sexism was linked to fewer leadership worries when organizational support was low but associated with more worries when support was high. However, hostile sexism showed no main or interaction effect with POS on WAL.Conclusion This study highlights the complex role of benevolent sexism in shaping women's leadership concerns, showing both its potentially protective and harmful effects. It also emphasizes the need for culturally sensitive approaches that go beyond generic organizational support to actively challenge subtle sexism and promote gender-inclusive leadership readiness in non-Western contexts.
The Prognostic Impact of 18F-FDG PET SUVmax in Patients with Non-Small Cell Lung Cancer
(Bayrakol Medical Publisher, 2026) Gulcek, Ilham; Agar, Mehmet; Kalkan, Muhammed; Celik, Muhammet Reha; Ulutas, Hakki
Aim: The maximum standardized uptake value (SUVmax) of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) enhances clinical prediction in non-small cell lung cancers (NSCLC). This study aimed to investigate whether SUVmax could serve as a prognostic factor and improve clinical prognostication. Methods: This retrospective study included 86 patients with NSCLC who underwent surgical resection. Using receiver operating characteristic (ROC) analysis, the SUVmax cut-off value was 12.3. Patients with SUVmax values below 12.3 were classified as Group A, while those with values above 12.3 were designated as Group B. Survival analyses were performed using the Kaplan-Meier method. Overall survival was defined as the time from diagnosis to death. Confidence intervals were reported at 95%, and a p-value of <0.05 was considered statistically significant. The variables analyzed for survival included gender, age, surgical approach, histopathological subtype of lung cancer, cancer stage, T score, and N score. Results: Survival analyses revealed statistically significant associations between SUVmax and age (p=0.043), gender (p=0.060), surgical approach (p=0.037), and histopathological subtype (p=0.026). Due to insufficient sample size within subgroups, separate p-values were calculated for each stage, T score, and N score. Based on the obtained p-values, no statistically significant correlation was found between SUVmax and overall survival across different stages, T scores, or N scores, except for stage 1A and T1b. Conclusion: SUVmax contributes to determining appropriate diagnostic and treatment protocols and aids in predicting the prognosis of the disease.
The Objects and Effects of the Restrictions by Object Under Art. 101(1) TFEU: Has the ECJ Solved the Riddle
(Springer Heidelberg, 2026) Korkmaz Goka, Ekin
The concept of by object infringements under Art. 101(1) of the TFEU has been a subject of ongoing controversy. Central to this debate are two primary issues: the interpretation of the term object and whether the effects or non-agreement elements in general should be considered when determining it. Should the latter question be answered affirmatively, further complications arise, particularly regarding the scope of the analysis in relation to the effects analysis and the allocation of the evidentiary burden between the parties. EU case law has significantly contributed to this debate, both in support and contradiction. The ECJ has, albeit implicitly, developed a system which seeks to strike a balance between competing interests while considering economic realities. However, the use of ambiguous terminology, inconsistencies in judicial rulings, and a lack of sufficiently clear explanations in certain cases have hindered the literature and national authorities from fully understanding the underlying system. This study aims to address this gap in the literature by providing a comprehensive legal analysis of the concept of by object infringements under Art. 101(1), in light of the framework established by the ECJ. The objective is to contribute to greater legal certainty in this area.
The Evaluation of System Reliability Under Dependent Shock Magnitudes
(Springer, 2026) Eryilmaz, Serkan
This paper studies shock models by assuming a certain kind of dependence among shock magnitudes. In particular, discrete time extreme and run shock models are investigated when the shock magnitudes follow discrete autoregressive process of order 1. Exact expressions are obtained for the reliability functions and mean time to failure values under both models. The method for deriving the reliability characteristics is based on the use of probability generating functions. Numerical results are presented when the shocks arrive according to a Binomial process.
The Evaluation of System Reliability Under Dependent Shock Magnitudes (Vol 28, 22, 2026)
(Springer, 2026) Eryilmaz, Serkan
Software Code Smell Prediction Model Using Shannon, Renyi and Tsallis Entropies
(MDPI, 2018) Blazauskas, Tomas; Gupta, Aakanshi; Misra, Sanjay; Suri, Bharti; Kumar, Vijay; Damasevicius, Robertas
The current era demands high quality software in a limited time period to achieve new goals and heights. To meet user requirements, the source codes undergo frequent modifications which can generate the bad smells in software that deteriorate the quality and reliability of software. Source code of the open source software is easily accessible by any developer, thus frequently modifiable. In this paper, we have proposed a mathematical model to predict the bad smells using the concept of entropy as defined by the Information Theory. Open-source software Apache Abdera is taken into consideration for calculating the bad smells. Bad smells are collected using a detection tool from sub components of the Apache Abdera project, and different measures of entropy (Shannon, Renyi and Tsallis entropy). By applying non-linear regression techniques, the bad smells that can arise in the future versions of software are predicted based on the observed bad smells and entropy measures. The proposed model has been validated using goodness of fit parameters (prediction error, bias, variation, and Root Mean Squared Prediction Error (RMSPE)). The values of model performance statistics (R-2, adjusted R-2, Mean Square Error (MSE) and standard error) also justify the proposed model. We have compared the results of the prediction model with the observed results on real data. The results of the model might be helpful for software development industries and future researchers.
Simulation-Based Optimization of HVAC Systems in Aging Educational Facilities: Addressing IAQ Challenges Through Retrofitting
(MDPI, 2026) Saleh, Yousif Abed Saleh; Turhan, Cihan; Turhan, Burcu
Indoor air quality (IAQ) in educational buildings plays a critical role in the health, cognitive performance, and well-being of occupants. Aging university facilities often rely on outdated ventilation systems that are not designed to meet current demands or respond to dynamic occupancy levels. This study investigates the performance and feasibility of various advanced ventilation strategies in comparison to an existing balanced mechanical ventilation (BMV) system in a university classroom accommodating 100 students. Using a Dynamic Building Energy Simulation Program, simulations were conducted to evaluate IAQ (using CO2 levels), energy consumption, and thermal comfort under three retrofitting scenarios: BMV, demand-controlled ventilation (DCV), and hybrid ventilation combining natural and mechanical airflow. The simulations indicate that DCV cuts annual HVAC energy use by 33% relative to the baseline, while the hybrid strategy achieves the greatest reduction of 42% and maintains CO2 levels and thermal comfort within recommended limits. Although hybrid systems provide seasonal advantages, their complexity may limit applicability. In addition to technical analysis, this study also explores the financial and tax-related challenges associated with retrofitting ventilation systems in university buildings. Investment payback periods, operational costs, and potential tax incentives are discussed to evaluate economic viability. Overall, the endorse hybrid ventilation as the most cost-effective strategy where mixed-mode control is feasible, and DCV as a practical alternative for buildings unable to employ natural ventilation.
Self-Efficacy as the Saviour: Defending Psychological Well-Being against the Destructive Power of Social Undermining
(Inderscience Enterprises Ltd, 2026) Tosun, Burcu; Basim, Hamdullah Nejat; Kibaroglu, Gamze Guner
Employee psychological well-being is crucial for fostering a positive work environment and ensuring organisational success. Social undermining, which disrupts workplace relationships, often leads to stress, anxiety, and burnout. However, self-efficacy - the belief in one's ability to successfully perform tasks - can help mitigate these adverse effects. This study investigates the detrimental impact of social undermining on employees' psychological well-being and examines the protective role of self-efficacy. Data were collected from 582 employees in the fast-moving consumer goods sector. The findings underscore the importance of prioritising psychological well-being in the workplace and reveal how self-efficacy can act as a buffer against the harmful effects of social undermining. By exploring the interplay between social undermining, self-efficacy, and psychological well-being, this study provides valuable insights into their influence on employee outcomes. Furthermore, the research highlights strategies for minimising the negative impact of undermining behaviours by co-workers and supervisors, thereby fostering a healthier work environment.
Prognostic Value of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index for 1-Year Mortality After Transcatheter Aortic Valve Implantation
(MDPI, 2026) Guney, Murat Can; Suygun, Hakan; Turinay Ertop, Zeynep Seyma; Polat, Melike; Bozkurt, Engin; Ayhan, Huseyin; Keles, Telat
Objectives: Systemic inflammation, malnutrition, and immune dysregulation have emerged as important determinants of long-term outcomes after transcatheter aortic valve implantation (TAVI). The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immunonutritional biomarker that integrates these pathophysiological domains; however, its prognostic value in TAVI patients has not yet been investigated. This study aimed to evaluate the association between the CALLY index and 1-year mortality after TAVI. Methods: This retrospective observational study included 532 consecutive patients who underwent TAVI at a tertiary-care center between 2014 and 2023. Baseline laboratory parameters were obtained before the procedure, and the CALLY index was calculated as (albumin & times; lymphocyte count)/(C-reactive protein & times; 10). The primary endpoint was 1-year mortality. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminative ability of the CALLY index and conventional surgical risk scores. Multivariable regression analyses were used to identify independent predictors of mortality. Results: During the 1-year follow-up period, 85 patients (15.9%) died. Patients who died had significantly lower baseline CALLY index values compared to survivors (p < 0.001). The CALLY index demonstrated good discriminative performance for 1-year mortality (AUC: 0.797), outperforming EuroSCORE II (AUC: 0.705) and the Society of Thoracic Surgeons (STS) score (AUC: 0.619). A CALLY cut-off value of 0.45, derived using Youden's index, was associated with a more than threefold increased risk of mortality. In multivariable analysis, the CALLY index remained independently associated with 1-year mortality, along with EuroSCORE II and more than mild mitral regurgitation. Conclusions: The CALLY index is a strong and independent predictor of 1-year mortality after TAVI and provides incremental prognostic value beyond conventional surgical risk scores. Given its simplicity and reliance on routinely available laboratory parameters, the CALLY index may serve as a practical tool for long-term risk stratification in patients undergoing TAVI.
Quantitative Quality Evaluation of Software Products by Considering Summary and Comments Entropy of a Reported Bug
(MDPI, 2019) Misra, Sanjay; Kumari, Madhu; Misra, Ananya; Damasevicius, Robertas; Fernandez Sanz, Luis; Sanz, Luis Fernandez; Singh, V. B.
A software bug is characterized by its attributes. Various prediction models have been developed using these attributes to enhance the quality of software products. The reporting of bugs leads to high irregular patterns. The repository size is also increasing with enormous rate, resulting in uncertainty and irregularities. These uncertainty and irregularities are termed as veracity in the context of big data. In order to quantify these irregular and uncertain patterns, the authors have appliedentropy-based measures of the terms reported in the summary and the comments submitted by the users. Both uncertainties and irregular patterns have been taken care of byentropy-based measures. In this paper, the authors considered that the bug fixing process does not only depend upon the calendar time, testing effort and testing coverage, but it also depends on the bug summary description and comments. The paper proposed bug dependency-based mathematical models by considering the summary description of bugs and comments submitted by users in terms of the entropy-based measures. The models were validated on different Eclipse project products. The models proposed in the literature have different types of growth curves. The models mainly follow exponential, S-shaped or mixtures of both types of curves. In this paper, the proposed models were compared with the modelsfollowingexponential, S-shaped and mixtures of both types of curves.
Post-Hoc Mixture Models to eBLUPs from Linear Mixed-Effects Models: A Tractable Approach for Clustering Irregular Longitudinal Data
(Taylor & Francis Ltd, 2026) Balakrishnan, N.; Hossain, Md Jobayer
Clustering longitudinal data with irregular and sparse measurement schedules has become important in analyzing many medical data and associated decision-making. These datasets often involve observation times that vary across individuals, making trajectory-based analysis essential for uncovering meaningful patterns. Mixture-based linear mixed-effects models, such as heterogeneous linear mixed-effects models and growth mixture modeling, are commonly used for this purpose. While theoretically powerful, these methods often suffer from convergence issues and computational inefficiency in large-scale applications. This study introduces a computationally efficient two-step approach that applies a post-hoc mixture model to empirical Best Linear Unbiased Predictors (eBLUPs), derived from a fitted (piecewise) linear mixed-effects model under homogeneity assumptions. The method is then demonstrated with real clinical data, in which it effectively identified distinct growth trajectories in early childhood data involving 3,365 children across 51,711 clinic visits. The optimal number of clusters is then selected using the BIC, likelihood ratio tests, and model-based validation, achieving the best balance of model fit, classification stability, and interpretability. Simulation studies have shown that eBLUPs preserve individual-level heterogeneity and that post-hoc mixture modeling outperforms HLME across varying separability. Overall, this approach offers a robust, interpretable, and scalable alternative to traditional clustering methods for irregular longitudinal data.
On Nonlocal Boundary Caputo Tempered Fractional Coupled Systems in Banach Spaces (Vol 33, 13, 2026)
(Springer Nature, 2026) Benchohra, Mouffak; Kadari, Halima; Karapinar, Erdal; Salim, Abdelkrim
Novel Enterococcus Phages Identified through Comprehensive Screening to Control Contamination in Chicken Meat
(Wiley, 2026) Unal, Gultekin; Cengiz, Gorkem; Cufaoglu, Gizem; Acar, Bahar Onaran; Ayaz, Naim Deniz; Yildiz, Tansu; Erdinc, Ayse Nur
BACKGROUND Antibiotic-resistant Enterococcus faecalis and E. faecium are persistent contaminants in food and environmental settings, including poultry-related matrices, contributing to food safety risks and antimicrobial resistance (AMR) dissemination. This study aimed to identify Enterococcus phages through environmental screening and evaluate their biocontrol potential using a chicken wing food model. RESULTS From 1719 environmental samples, 45 Enterococcus-targeting phages were isolated, and two (Efs.1 1-1 and Efm 3-10) with the broadest lytic profiles were selected for characterization. Transmission electron microscopy revealed that both phages belong to Caudoviricetes with siphovirus-like morphology, latent periods (6-8 min), and high burst sizes (90-110 PFU per cell). Whole-genome sequencing revealed complete circular genomes with estimated completeness values between 0.97 and 1.00, and no detectable virulence, lysogeny, or AMR genes. The phages were stable at pH 4 for 60 min and tolerated 40-60 degrees C for 1 h. Phage titers decreased from 10.0 to no less than 6.0 log PFU mL(-1) across all storage conditions over 12 months. In vitro assays in tryptic soy broth showed that while the control groups reached 8.56-9.12 log CFU mL(-1) at 24 h at 37 degrees C, no bacteria were detected in any of the phage-treated samples (limit of detection: 1 CFU mL(-1)). In the chicken wing food model, phage treatment maintained bacterial counts below the detection limit (<1 log CFU g(-1)) throughout refrigerated storage. Mean log reductions reached 1.78-2.78 and 3.71-4.71 log CFU g(-1), respectively. CONCLUSION These novel lytic phages exhibit strong stability and rapid antibacterial activity, offering promising biocontrol agents to reduce Enterococcus contamination in chicken meat.
New Criteria on Oscillatory and Asymptotic Behavior of Third-Order Nonlinear Dynamic Equations with Nonlinear Neutral Terms
(MDPI, 2021) Ozbekler, Abdullah; Grace, Said R.; Alzabut, Jehad
In the paper, we provide sufficient conditions for the oscillatory and asymptotic behavior of a new type of third-order nonlinear dynamic equations with mixed nonlinear neutral terms. Our theorems not only improve and extend existing theorems in the literature but also provide a new approach as far as the nonlinear neutral terms are concerned. The main results are illustrated by some particular examples.
Nonlinearity and Structural Breaks in Oil Prices: Policy Implications and Macroeconomic Interactions
(Walter de Gruyter GmbH, 2026) Omay, Tolga; Sungur, Nazli Ceylan
This study examines Brent crude oil price dynamics using an integrated framework of bootstrap sequential break detection and Asymmetric Exponential Smooth Transition Autoregressive (AESTAR) modeling. We demonstrate that oil prices follow an AESTAR process where structural breaks emerge endogenously through dual transition functions, reconciling previously competing explanations in the literature. Analysis of monthly data (1985-2023) identifies major structural shifts coinciding with critical economic events, while revealing these breaks emerge automatically through regime-dependent means. Enhanced testing confirms embedded LSTAR-dominant dynamics with ESTAR components, while skeleton analysis validates the dual equilibrium framework with balanced regime distribution. Generalized Impulse Response Function analysis reveals distinct shock transmission patterns: Tier 1 extreme events (delta max > 1.8) exhibit persistent deviations requiring sustained policy intervention, while Tier 2 events demonstrate mean reversion properties suitable for conventional responses. The framework provides observable threshold levels ($53.62, $37.39) enabling real-time policy intervention, supporting regime-contingent monetary policy and strategic petroleum reserve management protocols. This approach offers policymakers actionable tools for managing oil price volatility through empirically validated intervention strategies.
Multi-State Linear Three-Dimensional Consecutive k-Type Systems
(Cambridge Univ Press, 2026) Yi, He; Balakrishnan, Narayanaswamy; Li, Xiang
Consecutive $k$-type systems have become important in both reliability theory and applications; in spite of a large literature existing on them, three-dimensional consecutive $k$-type systems have not yet been studied for multi-state case. In this paper, we introduce several different types of multi-state linear three-dimensional consecutive $k$-type systems for the first time, with due consideration to possible overlapping of failure blocks. The finite Markov chain imbedding approach is then used for the derivation of their reliability functions with state spaces and transition matrices provided in a novel way, and the involved computational process is illustrated through several numerical examples. Finally, some possible applications of the work and potential extensions are pointed out.
Malnutrition, Diet Quality, and Psychological Well-Being in Older Adults: A Hospital Outpatient Study
(BMC, 2026) Cihan, Berna Betul; Naharci, Mehmet Ilkin; Konyaligil, Dilara Bersan; Topkaya, Merve Sena; Tel Adiguzel, Kubra; Koc, Nevra
Background The ageing process can lead to malnutrition due to a variety of physiological and psychological issues. Investigating nutrition, lifestyle and psychological status is important for improving the health of the geriatric. The aim of this study was therefore to evaluate the relationship between malnutrition, dietary quality and psychological well-being in older adults. Methods One hundred three older adults treated at the Gülhane Training and Research Hospital Geriatrics polyclinic participated in this cross-sectional study. The researchers recorded sociodemographic characteristics, health information, anthropometric measurements, the Short Nutritional Assessment Questionnaire for 65 + (SNAQ(65+)) screening test, the Mediterranean Diet Adherence Scale (MEDAS) and the Psychological Well-Being Scale for the Older People (YPIOA) using a questionnaire during face-to-face interviews. Generalised Anxiety Disorder-7 (GAD-7) test was administered to older adults who applied to the geriatrics outpatient clinic at the time of application; individuals who did not meet the criteria were excluded from the study. Results The results of the study showed that the psychological well-being scale scores of individuals who strictly adhered to the Mediterranean diet (mean = 68.1) were significantly higher than those of individuals who did not adhere to the Mediterranean diet (mean = 59.5)(p < 0.05). Linear regression was used to evaluate older adults according to their MEDAS and YPIOA values. The test results revealed a significant positive correlation between the MEDAS score and the YPIOA (p < 0.05). However, no significant difference was found between the groups when the relationship between the MEDAS and SNAQ(65+) scores of older adults was evaluated (p > 0.05). Conclusion According to the results of the study, geriatric people who scored higher on the MEDAS also scored higher on the YPIOA. However, no significant relationship was found between SNAQ(65+) and MEDAS scores. These findings suggest that the quality of an individual's diet may affect not only their physical health, but also their psychological well-being. Therefore, treatment plans for the nutritional needs of older adults should take into consideration not only energy and nutrient intake, but also the individual's lifestyle, habits and psychological status.
Memory, Narrative, and Collective Gendering of Identity: Revolutionary Women in Turkey
(Cambridge Univ Press, 2026) Bektas, Eda; Sensonmez, Gokhan
This article examines the construction of gendered collective identity among leftist women in Turkey through their post-1980 coup prison memory. By analyzing 124 autobiographical narratives, we uncover a process of identity formation grounded in a continuous negotiation between past struggles and present concerns, constituting a counternarrative that challenges the master narrative of defeat and submission prevalent after the coup. The article's tripartite framework of distance, substance, and persistence underscores women's journey from marginalization to collective empowerment, producing shifting subject positions across time. By placing temporality at the center of collective identity formation, this study contributes to feminist memory literature and identity studies while addressing a significant historiographical gap by bringing the neglected struggles of leftist women in Turkey to light.
Machine Learning and Scenario-Based Forecasting of Türkiye’s Renewable Energy Transition toward Net-Zero 2053
(Elsevier, 2026) Sutcu, Muhammed; Yildiz, Baris; Sahin, Nurettin; Almomany, Abedalmuhdi; Gulbahar, Ibrahim Tumay
The issue of global warming has been identified as one of the most critical challenges of the 21st century, with the consumption of fossil fuels being identified as a major contributor to greenhouse gas emissions. In response to these challenges, countries worldwide are expediting their transition towards renewable energy sources to meet international climate commitments, such as the Paris Agreement, and to achieve long-term sustainability goals. Türkiye has established a target to achieve net-zero emissions by 2053. This objective is consistent with both the nation's domestic energy strategy and its international commitments. Nevertheless, the transition from fossil fuels to renewable energy sources is impeded by geographical, economic, and technological constraints. The present study aims to assess the capacity and efficiency of renewable energy in Türkiye with environmental protocols and future electricity demand projections. Electricity generation, transmission data, and national energy plans are used to identify future electricity generation and capacity trends. In the context of this study, a range of machine learning models is executed across diverse scenarios, yielding a series of outcomes. Consequently, the repercussions of regulatory measures and financial investments were examined, and prospective inferences were derived. The findings underscore the pivotal role of scenario-based modeling in formulating sustainable energy policies and directing investment decisions within the context of climate change mitigation.
Malignancy in Toxic Thyroid Adenoma: Revisiting Risk Assessment and Identifying Predictors
(Springer, 2026) Calapkulu, Murat; Cayir, Derya; Sencar, Muhammed Erkam; Cakal, Erman; Sakiz, Davut; Unsal, Ilknur Ozturk; Tekinyildiz, Merve
Background Toxic adenomas have traditionally been considered benign due to chronic TSH suppression, which is believed to inhibit thyroid tumorigenesis. However, emerging data challenge this dogma, reporting non-negligible malignancy rates even in toxic adenoma. This study aimed to assess thyroid cancer frequency and characteristics in surgically selected patients with toxic adenomas and to compare outcomes with propensity score-matched, surgically treated non-functioning nodules. Methods This retrospective, cross-sectional study included 204 surgically treated patients at a tertiary referral center, comprising 102 surgically selected toxic adenomas and 102 propensity score-matched, surgically treated non-functioning nodules. Clinical, biochemical, sonographic, scintigraphic, and histopathological data were analyzed. Multivariate logistic regression analysis was used to identify independent predictors of malignancy among toxic adenomas. Results In this surgically selected cohort, the malignancy rate was 16.7% for toxic adenomas and 40.2% for non-functioning nodules (p < 0.001). Papillary thyroid carcinoma comprised 82.4% of all cases, making it the leading histotype (82.4%). Among toxic nodules, higher fT4/fT3 ratio (cut-off:2.58, sensitivity:93.3%, specificity:54.2%) and European Thyroid Imaging and Reporting Data System categories 4-5 were independent predictors of malignancy. No significant differences were found between groups in terms of tumor size, invasion, American Thyroid Association risk stratification, or 5-year response rates. Conclusion Among surgically treated patients, the observed malignancy rate in toxic adenomas appears to be higher than traditionally expected. Elevated fT4/fT3 ratio and suspicious ultrasound features warrant closer evaluation. These findings support using ultrasound and biochemical markers in risk assessment of all thyroid nodules, regardless of functional status.

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