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The coronavirus disease is one of the most severe public health problems globally. Governments need policies to better cope with the disease, so policymakers analyze the country's indicators related to the pandemic to make proper decisions. The study aims to cluster OECD (Organisation for Economic Co-operation and Development) countries using COVID-19, health, socioeconomic, and environmental indicators. A self-organizing map (SOM) clustering method, an unsupervised artificial neural network (ANN) method and a hierarchical clustering method are used. The data comprises 38 OECD countries, and 16 different variables are selected. As a result, the countries are grouped into 3 clusters. Cluster 1 contains 33 countries, the USA is Cluster 2, and Cluster 3 has 4 countries, including Turkey. COVID-19 mortality is highly related to mortality from chronic respiratory diseases. In addition, environmental indicators show differences in clusters. [ABSTRACT FROM AUTHOR]

• Nine different models were compared • Ensemble models have better prediction accuracy in this study. • Age, transfer day and oestradiol concentration are significant predictors of IVF implantation Which machine learning model predicts the implantation outcome better in an IVF cycle? What is the importance of each variable in predicting the implantation outcome in an IVF cycle? Retrospective cohort study comprising 939 transferred embryos between 2014 and 2018 in an IVF centre in Turkey with 17 selected features. The algorithms were Logistic Regression (LR), Decision Tree (DT), Naïve Bayes (NB), Random Forest (RF), Support Vector Machine (SVM), Neural Network (Nnet), Gradient Boost Decision Tree (GBDT), eXtreme Gradient Boosting (XGBoost) and Super Learner (SL). The results were evaluated with performance metrics (F1 score, specificity, accuracy and area under the receiver operating characteristic curve [AUROC]) with 10-fold cross-validation repeated ten times. RF and SL models achieved the highest performance and showed F1 scores of 74% and 73%, specificity of 94%, an accuracy of 89%, and AUROC of 83%. In addition, the model identified the top features as maternal age, embryo transfer day, total gonadotrophin dose and oestradiol concentration. The present study revealed that machine learning algorithms successfully predicted implantation rates in an IVF attempt. In addition, maternal age is by far the most important predictor of IVF success when compared with other variables. [ABSTRACT FROM AUTHOR]

Purpose: The rapid increase in the share of health expenditures in recent years and the efforts of the countries to use the limited resources efficiently have been the essential factor that accelerated the efficiency studies at the macro level in the health sector. This research was conducted to Turkey to examine the efficiency of the health system at the provincial level (NUTS-3). This study also investigates sources of inefficiency and the factors influencing that efficiency in Turkey. Materials and Methods: In the research, Data Envelopment Analysis (DEA) for efficiency and multivariate Tobit regression analysis were used to determine the factors related to efficiency. Efficiency analysis were performed in the study with input-oriented CCR, BCC and RTS methods. In the analysis for each province is taken total hospital beds (per 1 000 population), physicians density (per 1 000 population), nurses density (per 1 000 population) as an input and infant mortality (per 1000 live births), and life expectancy at birth as output. Results: According to the research findings, 10 provinces were found to be total efficiency (CCR) and 14 provinces were technically efficiency (BCC). The average total efficiency score of the provinces was found to be 0.8051 (CCR), and the technical efficiency score was 0.8332 (BCC). The average scale efficiency score of the provinces is 0.9649. Conclusion: The inefficiency in the inputs of the provinces is partly due to the inefficiency of scale, while the technical inefficiency is largely due to resource use. The research findings provided information to managers and policymakers about the technical efficiency of the provinces and the changes to be made in health inputs to make the inefficient provinces relatively efficient. [ABSTRACT FROM AUTHOR]

Objective: Classical regression analysis model assumes that trend remain constant in the given time scale. However, in epidemiological research, due to some involvements such as structural changes, risk factors and changes in policies, health indicators may not remain constant in the given time scale. In order to locate these segmented trends on the time scale Joinpoint Regression Analysis (JRA) is used. JRA employs Annual Percent Change (APC) to locate these segments, and using those segmented trends, Annual Average Percent Change (AAPC) is calculated through geometric mean. The study at hand aims to analyze the changes in the health indicators brought about with the reforms carried out by the Ministry of Health since 2003. Material and Methods: In line with this, JRA is used to analyze data from the years of 2003 to 2016, retrieved from OECD database, focusing on 15 variables which were formulated with reference to categories health status, risk factors, health services coverage and healthcare system determined by World Health Organization (WHO). Results: There observed a statistically significant decrease in the infant mortality rates by 12.8% (p<0.001) between the years of 2003 and 2010. As for the years from 2010 to 2016, there is a statistically not significant decrease by 2.8% (p=0.147). There is a statistically significant increase by 6.6% (p<0.001) between 2005 and 2012, and 0.8% (p=0.049) between 2012 and 2016 in the number of nurses. As for the number of doctors in the given period of time, there is a statistically significant increase by 2.1% (p<0.001). Conclusion: When OECD countries are compared, in order to improve the health indicators, it is observed that Turkey is below the average in the infant mortality rates and indicators regarding healthcare professionals. These emerge as the areas of need for improvement requiring new health policies. [ABSTRACT FROM AUTHOR]

This study was carried out to investigate the influence of boric acid (BA) on blood chemistry in rabbits. Forty, 16 weeks old, New Zealand rabbits were assigned to 4 groups consisting of 10 rabbits in each group. The groups received the following treatment: group 1: control group without treatment, group 2: 31.25 mg /kg, group 3: 62.5 mg/kg and group 4: 125 mg/kg (bw./day) boric acid (H3BO3) was administered with drinking water for 5 weeks. At the end of the experiment, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and creatine kinase (CK) activities, glucose, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, globulin, urea, creatinine, calcium (Ca), inorganic phosphorus (Pi), magnesium (Mg), sodium (Na), potassium (K), iron (Fe), copper (Cu), zinc (Zn), manganese (Mn), selenium (Se), chromium (Cr) and boron (B) levels were determined. Alkaline phosphatase enzyme activity (P<0.001) and Pi concentrations (P<0.001) in serum in all of the BA groups, Zn (P<0.05) and B (P<0.001) concentrations in 62.5 and 125 mg/kg (bw.) BA given groups were significantly higher. Other blood parameters were not affected by BA. As a result, 31.25, 62.5 and 125 mg/kg (bw/day) boric acid increased serum ALP enzyme activity, Pi, Zn and B concentrations related to bone metabolism, but no effect on other enzymes and metabolites have been identified, therefore, further studies with different doses and different forms of B may be valuable in rabbits. [ABSTRACT FROM AUTHOR]

This study was carried out to investigate the influence of boric acid (BA) on blood chemistry in rabbits. Forty, 16 weeks old, New Zealand rabbits were assigned to 4 groups consisting of 10 rabbits in each group. The groups received the following treatment: group 1: control group without treatment, group 2: 31.25 mg /kg, group 3: 62.5 mg/kg and group 4: 125 mg/kg (bw./day) boric acid (H3BO3) was administered with drinking water for 5 weeks. At the end of the experiment, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and creatine kinase (CK) activities, glucose, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, globulin, urea, creatinine, calcium (Ca), inorganic phosphorus (Pi), magnesium (Mg), sodium (Na), potassium (K), iron (Fe), copper (Cu), zinc (Zn), manganese (Mn), selenium (Se), chromium (Cr) and boron (B) levels were determined. Alkaline phosphatase enzyme activity (P<0.001) and Pi concentrations (P<0.001) in serum in all of the BA groups, Zn (P<0.05) and B (P<0.001) concentrations in 62.5 and 125 mg/kg (bw.) BA given groups were significantly higher. Other blood parameters were not affected by BA. As a result, 31.25, 62.5 and 125 mg/kg (bw/day) boric acid increased serum ALP enzyme activity, Pi, Zn and B concentrations related to bone metabolism, but no effect on other enzymes and metabolites have been identified, therefore, further studies with different doses and different forms of B may be valuable in rabbits. [ABSTRACT FROM AUTHOR]

In present study, we aimed to investigate the effect of seasonal variation on ICSI results both in fresh and frozen embryo transfer cycles. Between January 2007 and December 2019, a total of 4039 ICSI cycles (3227 fresh and 812 frozen ET) which resulted in embryo transfer were included in the study. We found no significant difference in the pregnancy outcome among different seasons and months. The best results were obtained for spring (41.0%) and the least for winter (37.1%) in fresh cycles and the best for spring (42.5%) and the least for winter (29.7%) in FET cycles. In monthly distribution, the best results were obtained for September (57.0%) and the least for November (24.1%) in fresh cycles and the best for October (49.3%) and the least for December (20.2%) in FET cycles. Our study did not show any significant influence of the months or seasons on clinical pregnancy rates in either fresh and frozen embryo transfers. However, the difference among months in frozen cycles was notable although it did not reach statistical significance. It can be suggested that the strict control of reproductive hormones especially in fresh cycles as well as the standardized laboratory temperature minimize the influence of seasonal effect on ICSI outcome. [ABSTRACT FROM AUTHOR]

ICSI is one of the most commonly used techniques to treat infertility. The sperm selection for the procedure is done 'randomly' by the embryologist according to the motility and morphology parameters which is known not to reflect the potential of a sperm for fertilization, pregnancy and a healthy childbearing. Since the apoptosis rate is higher in sperm cells of infertile patients, it is more likely to choose an apoptotic sperm by the 'random selection method'. We recently introduced a novel sperm selection technique namely 'Annexin-V coated polystrene bead technique'(APB-Tech), for the selection of non-apoptotic sperm cells. The principal of the technique is based on the binding affinity of an apoptotic sperm to 'Annexin-V covered beads' enabling to distinguish a viable and a healthy sperm by light microscopy. The aim of the present study was to observe the effects of this technique on ICSI outcomes in mice. Sibling-oocyte trial was conducted and the outcome measures were compared with the results of traditional sperm selection method. Embryo and blastocyst qualities and blastocyst development rates were significantly increased in APB-Tech group, while the other parameters were not affected. Promising results obtained from the technique reflect its promising potential as a new and powerful tool for sperm selection and thus infertility techniques. [ABSTRACT FROM AUTHOR]

Background: Atherosclerosis, which is one of the leading causes of death all over the world, can create major or minor thromboembolic complications with the exponentially increasing diabetic status. Despite all the studies, the mechanism by which endothelial damage in atherosclerosis is triggered in diabetic setting is still not fully understood. Methods: In this study, tissue factor (TF), which is thought to act together in the formation of vasular endothelial growth factor (VEGF-A) and coagulopathy in diabetic atherosclerotic patients, may be an important indicator in this regard, a total of 100 cases who were undergone off-pump coronary artery bypass (OPCAB) which were at same risk group examined by dividing into diabetic status. Early postoperative process and biochemical parameters analyzed in terms of TF and VEGF-A levels measured before and after the operation. Results: TF and VEGF-A expression of the T1DM group were statistically high compared to non-diabetics. Significantly longer hospital stays with changes in TF and VEGF-A were found in patients in the diabetic group compared to pre- and postoperatively, respectively; TF (95% CI: 0.879–0.992; p = 0.025), VEGF-A (95% CI: 0.964–0.991; p = 0.001) and hospital stay (95% CI: 1.96–7.49; p = 0.0001). Preoperatively measured carotid intima-media thickness (CT) was higher in diabetics and was significantly associated with atrial fibrillation (AF), (r = 0.873). Surgical team and protocols were same and OPCAB procedures were routinely applied to all patients in our clinic. No minor or major events were observed in any of the cases. Conclusion: TF and VEGF-A values in patients with diabetic atherosclerosis may be important in the early detection of thromboembolic complications. [ABSTRACT FROM AUTHOR]

Background: Atherosclerosis, which is one of the leading causes of death all over the world, can create major or minor thromboembolic complications with the exponentially increasing diabetic status. Despite all the studies, the mechanism by which endothelial damage in atherosclerosis is triggered in diabetic setting is still not fully understood. Methods: In this study, tissue factor (TF), which is thought to act together in the formation of vasular endothelial growth factor (VEGF-A) and coagulopathy in diabetic atherosclerotic patients, may be an important indicator in this regard, a total of 100 cases who were undergone off-pump coronary artery bypass (OPCAB) which were at same risk group examined by dividing into diabetic status. Early postoperative process and biochemical parameters analyzed in terms of TF and VEGF-A levels measured before and after the operation. Results: TF and VEGF-A expression of the T1DM group were statistically high compared to non-diabetics. Significantly longer hospital stays with changes in TF and VEGF-A were found in patients in the diabetic group compared to pre- and postoperatively, respectively; TF (95% CI: 0.879–0.992; p = 0.025), VEGF-A (95% CI: 0.964–0.991; p = 0.001) and hospital stay (95% CI: 1.96–7.49; p = 0.0001). Preoperatively measured carotid intima-media thickness (CT) was higher in diabetics and was significantly associated with atrial fibrillation (AF), (r = 0.873). Surgical team and protocols were same and OPCAB procedures were routinely applied to all patients in our clinic. No minor or major events were observed in any of the cases. Conclusion: TF and VEGF-A values in patients with diabetic atherosclerosis may be important in the early detection of thromboembolic complications. [ABSTRACT FROM AUTHOR]

Infertility is a growing health problem that affects 20% of couples who want to conceive. 'Intracytoplasmic sperm injection' (ICSI) is a commonly used assisted reproduction treatment technique that offers the couples to overcome a wide variety of infertility reasons, including female, male and unexplained infertility. A crucial step in ICSI is choosing the correct sperm with the highest potential to form a healthy embryo and thus a healthy offspring. The sperm selection strategies aim to obtain a sperm population with better motility and morphology, which are insufficient to predict a sperm's reproductive potential. The elimination of apoptotic sperms, which is shown to be higher in infertile males and which is shown to affect embryo development and reproductive cohort significantly should also be included in the selection strategies. Among all sperm selection methods, there are only a few which can eliminate apoptotic sperm, but because they need extra types of equipments, a long training period, and high costs, they couldn't find place in the most commonly used techniques in an IVF lab. Selecting the non-apoptotic sperm cells will help us choose a sperm that is more likely to be chosen by the natural selection mechanisms and thus will help to mimic the natural conception more. The study aimed to develop a novel, easy and a harmless individual sperm selection technique to enable choosing non-apoptotic viable sperm cells via light microscopy without any need for extra equipment, education and cost to be used for ''ICSI'. The technique is based on the binding ability of Annexin-V covered polystrene beads to the externalized phosphatidylserine at the outer leaflet of an apoptotic sperm's plasma membrane. After Annexin-V covered polystyrene beads were prepared, beads obtained were attached to BALB-c mice sperm, and the technique is optimized to obtain the most efficient attachment conditions. The results are then compared with the results of four well-known reliable apoptosis detection techniques to test the validity and sperm survival test to test the toxicity of the technique. The method is proven to be '''reliable' by comparing it with the results of well-known techniques, including TUNEL and SCSA (sperm chromatin structure assay), and '''safe' by showing its non-toxicity via sperm survival test (SST). In addition, the method enables the selection of sperm cells more closer to naturally-chosen ones from a pool of sperm that should not be allowed to be randomly chosen during microinjection. To date, it was impossible to distinguish a non-apoptotic sperm without harming it or without needing additional equipment other than a routine IVF lab and extra training other than routine andrology work. The technique is named as 'Annexin-V coated polystyrene bead technique (APB-Tech)'. Based on our results, further studies on APB-Tech should be focused on the possible improvement of ICSI outcomes and, thus, success rates. • A novel, easy and a harmless sperm selection technique is described. • It enables to choose the non-apoptotic and viable sperm cells by light microscopy. • The method is demonstrated to be 'reliable' and 'safe' by several methods. • The technique is named as 'Annexin-V coated polystrene bead technique (APB-Tech)'. • The technique is suggested to improve ICSI outcome. [ABSTRACT FROM AUTHOR]

Objective: Normal defecation pattern is one of the health indicators for children. Stool number and patterns in children can show differences depending on factors such as age and feeding type. To know normal defecation patterns prevents unnecessary treatment via distinguishing normal defecation from abnormal and reduces health costs via informing parents who have serious concerns about this issue. The aim of this study was to investigate the effect of breast feeding on defecation pattern of 0-6 months-old breast-fed infants. Material and Methods: The study was carried out at Well Child Clinic of the Istanbul Medical School in Istanbul University, between June 2010 and January 2011 and included 100 infants aged 0-6 months. A structured questionnaire was filled on the day when families arrived at the Well Child Clinic and infants' anthropometric measurements were recorded. Stools that infants passed in the last 24 hours were collected and analyzed in the laboratory. Color, consistency, pH and steatocrit of stools were evaluated. Data analyses were performed in SPSS 15.0 and SigmaStat 3.5 programs. Significance level was accepted as p<0.05 in statistical comparisons. Results: Seventy four percent of infants defecated daily. Stool frequency of infants decreased with age and infants breastfed in frequent intervals defecated more frequently (p<0.05). Exclusively breast-fed infants had more frequent defecation than the ones receiving complementary foods/ formula in addition to breast milk. Conclusion: In conclusion, our results led us to think that defecation and growth patterns of infants aged 0-6 months show diversity according to the age and feeding characteristics. [ABSTRACT FROM AUTHOR]

Professional metrobus drivers are at greater risk than the other occupational groups due to daily stress, bad eating habit and sedentary behavior. The nature of the occupation may cause several health-related problems. The aim of the study to compare the health and nutritional status of metrobus drivers (high occupational risk group-HORG) and revision workers (low occupational risk group-LORG) working in Istanbul and to define the lipid profiles associated with the obesity risk. This crosssectional study was conducted on 557 metrobus drivers and 375 revision workers between March and June 2013. All participants were male, with a mean age of 43.3(4.94) years. Demographic, anthropometric and nutritional data were taken by a questionnaire. Blood samples were obtained after an overnight fast, and the lipid profiles were analyzed. The comparison of LORG with HORG revealed unbalanced nutritional status for drivers. The prevalence of obesity among drivers was higher than revision workers. The biochemical parameters between two groups separated by BMI showed that the values of triglyceride and VLDL cholesterol were statistically significant for overweight subjects; VLDL cholesterol was statistically significant for obese subjects. The findings of the present study showed higher prevalence of obesity among the drivers than the revision workers. The comparison of two groups resulted in unbalanced nutritional status and high blood lipid levels for drivers. [ABSTRACT FROM AUTHOR]