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IntroductionThe presentation of the course of COVID-19-related T-cell responses in the first week of the disease may be a more specific period for adaptive immune response assessment. This study aimed to clarify the relationship between changes in peripheral blood lymphocyte counts and death in patients with COVID-19 pneumonia.MethodsThirty-three patients (14 females and 19 males) admitted for severe and desaturated COVID-19 pneumonia confirmed by polymerase chain reaction were included. Lymphocyte subsets and CD4+/CD8+ and CD16+/CD56+ rates were measured using flow cytometry from peripheral blood at admission and on the day of death or hospital discharge.ResultsTwenty-eight patients survived and five died. On the day of admission, the CD4+ cell count was significantly higher and the saturation of O2 was significantly lower in the deceased patients compared to the survivors (P < 0.05). The CD16+/CD56+ rate was significantly lower on the day of death in the deceased patients than in discharge day for the survivors (P = 0.013).ConclusionCD4+ lymphocyte percentages and O2 saturation in samples taken on the day of admission to the hospital and CD16+/CD56+ ratios taken at the time of discharge from the hospital were found to be associated with the mortality in patients with severe COVID-19.

Objectives: Patients with hepatitis B e antigen-negative chronic infection (inactive carriers) account for most of the people living with hepatitis B virus (HBV). This study investigated the direct medical cost of monitoring patients within this group.Materials and Methods: A total of 293 outpatients receiving regular monitoring in a large university hospital were included in the study. Direct medical costs included laboratory tests, imaging, liver biopsies and co-payments. Linear mixed effect models were applied to investigate the effect of follow-up time on the annual cost of monitoring. We made quarterly, semi-annual and annual monitoring cost trajectories in accordance with international guideline recommendations.Results: The average annual direct medical cost per patient was 160 USD and the average laboratory visit cost per patient was 68.5 USD. HBV DNA testing contributed to a majority percentage of the total cost (59.6%). As follow-up time increased, the total annual cost (beta=-2.07) and annual cost for DNA testing (beta=-1.03) decreased. The cost trajectory of the first two years of monitoring remained above the semi-annual follow-up strategy. After three years, the cost trajectory of monitoring, while reducing slightly, remained between the semi-annual and annual follow-up strategy trend lines. Conclusion: Due to high-patient numbers, the total cost of monitoring presents a large economic burden. Taking into consideration the generally benign nature of the disease; the length of intervals between outpatient hospital visits could be reviewed and alternative strategies implemented with the aim of reducing expenditure.

Background : Durability of immune response by the COVID-19 natural infection and the necessity of vaccines in recovered patients are important inquiries for the healthcare provider. Research design and methods : Here, we investigated the characteristics and the rate of cases with reinfection that have been admitted to our tertiary hospital. Results : A total of 119985 patients were applied between March 2020 and May 2021. Of these patients, 32607 (27%, 32607/119985) tested positive. A total of 27 (0.08%, 27/32607) patients were found to be reinfected beyond 90 days. Only one of these reinfected patients (0.003, 1/32607) had novel COVID-19 pneumonia and was hospitalized for the second time. Other 26 reinfected patients were followed up as outpatients. Conclusions : COVID-19 reinfection is extremely rare. However, the reinfection may be severe in patients with immune deficiency. Healthcare providers may prioritize uninfected and immune-compromised patients for vaccination.

Rabies is a highly fatal encephalitis. Currently, there is no approved treatment. Inducing therapeutic coma during the first week of symptomatic rabies patient, called Milwaukee protocol, had been suggested as promising. However, recent evidence failed to support the use of the Milwaukee protocol. This mini-review analyzed the reports of patients managed with therapeutic coma since 2014 to provide an update for the critical appraisal of this protocol.

Introduction The Development of the SARS-CoV-2 virus vaccine and its update on an ongoing pandemic is the first subject of the world health agenda. Areas covered First, we will scrutinize the biological features of the measles virus (MV), variola virus (smallpox virus), influenza virus, and their vaccines to compare them with the SARS-CoV-2 virus and vaccine. Next, we will discuss the statistical details of measuring the effectiveness of an improved vaccine. Expert opinion Amidst the pandemic, we ought to acknowledge our prior experiences with respiratory viruses and vaccines. In the planning stage of observational Phase-III vaccine effectiveness studies, the sample size, sampling method, statistical model, and selection of variables are crucial in obtaining high-quality and valid results.

Hepatitis B virus (HBV) is a partially double-stranded DNA virus associated with hepatocellular carcinoma (HCC). The viral integration into the hepatocyte genome, the viral protein-induced oncogenesis, the increased hepatocyte turnover and the chronic inflammatory response towards HBV are all hypothesized mechanisms for the development of HCC. The fact that HBV infection and HCC prevalence show different correlations in various regions of the world indicates that there may be virus-independent phenomena for cancer development in these regions. From this point of view, it is important to review our knowledge and to examine the relationship between HBV and HCC in the light of current data. In this article, we investigate the relationship between HBV and HCC by presenting epidemiological and microbiological data, accompanied by the principles of viral oncogenesis.

Prosthetic joint infections cause serious morbidity and mortality among joint arthroplasty patients. Rifampin-accompanied antibiotic regimens are recommended for gram-positive infections. This study aimed to combine current evidence supporting the rifampin supplement to an effective antibiotic in the treatment of prosthetic joint infections. We conducted a random-effects meta-analysis with frequentist and Bayesian approaches. A total of 13 studies, all observational, were included in the final analysis. The predominant bacteria in eight, two, and three studies were Staphylococcus spp., Propionibacterium spp., and Streptococcus spp., respectively. We pooled data from 568 patients in the staphylococcus subset (OR, 1.18; 95% CIs, [0.76; 1.82]; I2 = 23%) and data from 80 patients in the propionibacterium subset (REM OR, 1.61; 95% CIs [0.58; 4.47]; I2 = 0%). Both were insignificant with little heterogeneity. We pooled data from 483 patients in the streptococcus subset; the pooled estimate in this subset favored the use of rifampin supplemented regimens (1.84; [0.90; 3.76]) with moderate to high unaccounted heterogeneity (I2 = 57%). Bayesian random-effects models produced a posterior probability density indicating that future studies will not favor rifampin supplementation in Staphylococcus infections (μ, 0.074; τ, 0.570; 89% HPD, [- 0.48; 0.54]). Bayesian posterior distribution in the Streptococcus subset displayed a tendency toward rifampin supplementation. Studies had a substantial selection bias. Available evidence did not encourage rifampin-accompanied regimens for staphylococcal infections.

This manuscript aims to present a treatment algorithm we applied to manage COVID-19 patients admitted to our hospital. During the study period, 2043 patients with suspected COVID-19 were admitted to the emergency department. Molecular tests indicated that 475 of these patients tested positive for COVID-19. We administered hydroxychloroquine plus doxycycline to mild cases (isolated at home) for 3 days and lopinavir plus doxycycline to moderate and severe cases (hospitalized) for 5 days. The overall case fatality rate was 4.2% (20/475).

In this study, hazelnut shell and walnut shell which are the agricultural wastes existent abundantly in many countries were pyrolyzed at different temperatures in the temperature range of 400-700 degrees C in order to optimize the physicochemical properties of biochars. The biochars with large surface area were used to removal of lead (Pb2+) ions, one of the most important heavy metal pollutant, from aqueous solutions. The characterization of raw biomass and also biochars produced by pyrolysis were performed using FT-IR, BET, SEM, partial and elemental analysis techniques. In order to determine the adsorption characteristics of both biochars, batch adsorption experiments were carried out under different experimental conditions. The optimum conditions were determined by investigating the effect of adsorption parameters (initial heavy metal concentration, temperature, adsorbent amount, pH, contact time and mixing speed) for efficient removal of Pb2+ ions from aqueous solution. The experimental results were investigated in terms of Langmuir, Freundlich and Temkin isotherm models. Together with the calculated thermodynamic parameters, the adsorption mechanism was tried to be explained. In order to determine the kinetic model of the adsorption process, the experimental data were applied to pseudo first-order, pseudo second-order and intra-particle diffusion model, and the model constants were investigated. Hitit UniversityHitit University; Ondokuz Mayis UniversityOndokuz Mayis University The authors would like to thank Hitit University and Ondokuz Mayis University for their support. WOS:000532015600001 2-s2.0-85085056697

Historical environments are tissues that establish a connection between the past and the present and reveal the history as a whole. Historical environments an important conservation area in the world and Turkey, it is also worth examining these areas when viewed from this perspective. However, in recent years, there has been an increase in studies examining protected areas, including historical environments, from a holistic perspective. In some of these studies, protected areas are examined in terms of their relations with local people in their regions. This study aims to examine the Metropolis Ancient City, which is an important ancient city in its region, in terms of the relationship between the protected area and the local people. In this study, a mixed research method was used which combines quantitative and qualitative research. In this context, was examined in various periods between 2016-2018 in Torbali where the ancient city is located. A total of 396 people were surveyed in Torbali and its vicinity. The survey included 30 statements prepared according to the 5-point Likert scale. The data obtained from the survey were analyzed with SPSS program. Also, interviews were conducted in Yenikoy and Ozbey neighborhoods where the ancient city is located. The data obtained after the interviews using semi-structured questionnaire were examined together with the observations made in the field.

We analysed a carbapenem-resistant

At the beginning of the Coronavirus disease (COVID-19) pandemic due to the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), scientists primarily have focused on diagnostic tests. At the 9th month of the pandemic, discussions are being continued on preventive and therapeutic drugs. Meanwhile, vaccine development strategies like “operation warp speed” gave their early results in developed countries. Nowadays, these vaccines are at the forefront of the world health agenda. Numerous social media posts, conspiracy theories, and some health professional’s statements that raise vaccination hesitancy are the equipment of anti-vaxxers propaganda. On the other hand, declarations like ballyhoo of nationalism with the claims of scientific quacksalvers have intertwined, and that has been led to the loss of trust in the scientific community to the vaccine. We have to admit that this propaganda has affected millions of people in an unwanted direction. Scientific declarations have to rely on researches that have accurate and reliable statistical methods supported with basic biological knowledge. Scientific research results should be disclosed transparently and its methods must have reproducibility to provide replicability. Here, we scrutinize the biological features of the respiratory transmitted and successfully prevented measles virus (MV) and variola virus (smallpox virus) and their vaccines to compare them with the SARS-COV-2 virus and vaccine. Next, we will discuss the statistical details of measuring the effectiveness of an improved vaccine.

BackgroundHerpes simplex encephalitis (HSE) is the most common form of sporadic encephalitis which is caused by herpes simplex virus type 1 (HSV-1). Current guidelines recommend intravenous Acyclovir for 14–21 days in cases of HSE.ObjectivesOptimizing the Acyclovir treatment duration is important in regards to preventing Acyclovir-related neurotoxicity and nephrotoxicity.Study designWe retrospectively evaluated 13 patients, who were diagnosed with HSE by molecular testing (HSV-1 PCR positivity in cerebrospinal fluid), in two university hospitals in Istanbul, between 2010 and 2021. The patients were treated either 10 days or less as a short-term treatment regimen of Acyclovir or for 14 days or more as long-term treatment regimenResultsThe median age was 58 years (range 24–82 years) and 54% of them were male. The median follow-up time was 79 days (range 20-670 days) after discharge. Long-term treatment was used in 6 and a short-term treatment regimen was used in 7 cases. One of the patients died on the 4th day of Acyclovir treatment. One patient never received Acyclovir treatment. Of the 5 patients who received long-term treatment, 3 (21-28 days) had amnesia and orientation-cooperation restriction, one (21 days) died on the 2nd day of treatment, while the other (14 days) had no sequelae. There were no sequelae in three out of 5 patients who received short-term treatment.ConclusionsWe believe that it is necessary to determine the optimal Acyclovir therapy duration should be evaluated in a prospective randomized clinical trial in large patient population.

This paper presents the results of SHREC’21 track: Quantifying Shape Complexity. Our goal is to investigate how good the submitted shape complexity measures are (i.e. with respect to ground truth) and investigate the relationships between these complexity measures (i.e. with respect to correlations). The dataset consists of three collections: 1800 perturbed cube and sphere models classified into 4 categories, 50 shapes inspired from the fields of architecture and design classified into 2 categories, and the data from the Princeton Segmentation Benchmark, which consists of 19 natural object categories. We evaluate the performances of the methods by computing Kendall rank correlation coefficients both between the orders produced by each complexity measure and the ground truth and between the pair of orders produced by each pair of complexity measures. Our work, being a quantitative and reproducible analysis with justified ground truths, presents an improved means and methodology for the evaluation of shape complexity.

We analysed a carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak in the coronavirus disease (COVID) ICU. We retrospectively collected data from ICU records. We identified 25 cases between 12 November 2020 and 19 December 2020, and compared them to 42 controls present in the ICU during the same period. The presence of a femoral haemodialysis catheter was strongly associated with invasive CRKP infections (cases, 9 [36%]; controls, 0 [0%]; odds ratio [OR] 95% confidence intervals [CIs], 21 (5; 89)). We found a significant association between old age and CRKP infection with adverse outcomes. Sequence analysis revealed three distinct carbapenemase genes: blaNDM-1, blaOXA-48 and blaKPC-2. We launched rectal swab sampling upon admission to the ICU, cohorted colonized patients and cases and conducted an intensive training programme for newly employed staff. This study revealed that the emergence and dissemination of CRKP in COVID ICUs were associated with increased adverse outcomes. The presence of a femoral haemodialysis catheter was a significant risk factor for CRKP infections.

Background and Aim: We aimed to analyze the demographic, laboratory, and clinical characteristics of patients with HBeAg positive chronic hepatitis B infection in tertiary care centers in Istanbul. Materials and Methods: We conducted an observational cohort with >= 18-year-old patients with HBeAg positive chronic hepatitis B infection, who were followed up in three tertiary care centers in Istanbul between January 2000 and August 2018, were evaluated by reviewing electronic and recorded files. The Ethical Committee of Istanbul Medipol University approved this study (Protocol no: 10840098-604.01.01-E.44136). During the polyclinic interview, consent was obtained from patients for analysis and publication. Results: The mean age of the 64 patients was 30 (range 18-39) years, and 50% (32) of them were males. The mean follow-up period of the patients was 67 (18-180) months. Twenty-four patients were treated with at least one antiviral in their follow-up, and only 2 (3.1%) of these patients developed HBeAg seroconversion without antiviral treatment. HBeAg (+) chronic hepatitis B developed in 4 of the patients after the immune-active period. None of the patients and first-degree relatives had hepatocellular carcinoma (HCC). Conclusion: The rationality of antiviral treatment and HCC development risk in these patients still remains elusive.

Shape complexity is a hard-to-quantify quality, mainly due to its relative nature. Biased by Euclidean thinking, circles are commonly considered as the simplest. However, their constructions as digital images are only approximations to the ideal form. Consequently, complexity orders computed in reference to circle are unstable. Unlike circles which lose their circleness in digital images, squares retain their qualities. Hence, we consider squares (hypercubes in $\mathbb Z^{n}$ ) to be the simplest shapes relative to which complexity orders are constructed. Using the connection between $L^\infty $ norm and squares we effectively encode squareness-adapted simplification through which we obtain multi-scale complexity measure, where scale determines the level of interest to the boundary. The emergent scale above which the effect of a boundary feature (appendage) disappears is related to the ratio of the contacting width of the appendage to that of the main body. We discuss what zero complexity implies in terms of information repetition and constructibility and what kind of shapes in addition to squares have zero complexity.

Turkey has entered a rapid process of industrialization after the proclamation of the republic in order to enter the category of developed countries. However, the continuous increase in population with industrialization has also caused an increase in the demand for energy. Trying to meet the increasing energy demand for imported fossil fuels for many years brought with it some problems. At the forefront of these problems are energy supply security and external dependence on energy. Unlike fossil fuels, renewable energy sources with a rich potential in Turkey and a policy have begun to be implemented for the use of renewable energy resources in recent years. The energy atlases that show the solar, wind and biomass energy potentials prepared in this direction are a result of this policy. But there is a need to determine renewable energy potentials at the local level as well as country-wide energy atlases in order to make the most of the current potential. This study aimed to reveal the renewable energy potential and current use of Aliaga that an industry and port city. It’s found out that Aliaga has a high potential in wind and geothermal but it has low energy potential in terms of the solar, water and biomass in the results of this study.

Introduction: Studies are still conducted on the presence and prevalence of osteopenia/osteoporosis among HIV positive individuals and associated factors. Data on this subject is scarce in developing countries. Materials and Methods: Medical records of 135 HIV positive individuals followed at our clinic between 2010-2015 were retrospectively reviewed. Male individuals aged between 18-65 years without any comorbid conditionS and with normal parathormone (PTH), thyroid stimulating hormone (TSH), testosterone, calcium and phosphorus levels not receiving vitamin D were included. CD4 counts, smoking and alcohol consumption habits, antiretroviral treatment (ART) status, body mass index (BMI), 25 (OH) vitamin D levels and T-scores of the individuals at the time of DEXA (Dual Energy X-Ray absorptiometry) examination were retrieved from the records. Individuals receiving and not receiving ART were compared in terms of presence of osteopenia/osteoporosis. Results: Mean age was 35 years (range, 18-65). Mean CD4 count was 431 cells/µl and individuals with CD4 count < 200 constituted 12.8% of the group (17/132). Majority had a normal BMI between 18.5-24.9 (81/135, 60%) kg/m2 71.2% of patients had vitamin D deficiency. Osteoporosis and osteopenia were present in 16.3% (22/135) and 54.8% (74/134), respectively. Patients receiving and not receiving ART did not differ with regard to the presence of osteopenia or osteoporosis (p= 0.3 and p= 0.2 respectively). Conclusion: As it is the case for overall population, new studies examining itamin D deficiency prevalence and osteopenia/osteoporosis rates among HIV positive individuals are warranted.

Data on the efficacy and duration of nucleos(t)ide analogue (NUC) therapies to prevent the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B (CHB) patients are scarce and heterogeneous. This study aimed to summarize the clinical and laboratory results of the patients with CHB infection who discontinued oral antiviral therapy.A single-centered cohort study was conducted with CHB infection. NUCs were discontinued in patients who were under viral suppression for at least two years with undetectable HBV DNA levels for 18 months. Risk factors for clinical relapse (CR) were evaluated.A total of 77 patients were recruited. HBeAg status showed that 9.4% of the patients underwent HBeAg seroconversion with NUCs. HBeAg reversion was noted in four (31%) of these patients. Severe hepatitis, which resolved after antiviral therapy was restored, was reported in two out of 77 patients (4%). None of the patients with CR had clinical or biological signs of hepatic decompensation or died during the study period.We found no benefits of the discontinuation of antiviral therapy after viral suppression in patients with initially severe fibrotic HBV infection. In patients with mild to moderate fibrosis, cessation of antiviral treatment is not associated with adverse outcomes.Kronik hepatit B (KHB) hastalarında siroz ve hepatoselüler karsinom gelişimini önlemek için nukleos(t)id analog (NUK) tedavilerinin etkinliği ve süresine ilişkin veriler az ve heterojendir. Bu çalışma, oral antiviral tedaviyi bırakan KHB enfeksiyonlu hastaların klinik ve laboratuvar sonuçlarını özetlemeyi amaçlamaktadır.KHB enfeksiyonlu hastalarda tek merkezli bir kohort çalışması yapılmıştır. En az iki yıldır viral baskılama altında olan ve 18 aydan beri saptanamayan HBV DNA düzeyleri olan hastalarda NUK’lar kesilmiştir. Klinik relaps (KR) için risk faktörleri değerlendirilmiştir.Çalışmaya toplam 77 hasta alındı. HBeAg durumu, hastaların% 9.4’ünün NUK’larla HBeAg serokonversiyonu geçirdiğini gösterdi. Bu hastaların dördünde (%31) HBeAg reversiyonu kaydedildi. Antiviral tedavisi yeniden başlandıktan sonra düzelen şiddetli hepatit, 77 hastanın 2’sinde (%4) bildirilmiştir. KR’li hiçbir hastada klinik veya biyolojik hepatik dekompansasyon belirtisi görülmemiştir veya çalışma süresi boyunca ölmemiştir.Başlangıçta şiddetli fibrotik HBV enfeksiyonu olan hastalarda viral baskılamadan sonra antiviral tedavinin kesilmesinin herhangi bir faydası bulamadık. Hafif ile orta şiddette fibrozlu hastalarda, antiviral kesilme, olumsuz sonuçla ilişkili değildir.

Introduction: Though there is currently no approved treatment for COVID-19, potential medications include lopinavir and doxycycline. Lopinavir is a broad-spectrum protease inhibitor successfully used during the SARS outbreak. Doxycycline is an antibiotic with immunomodulatory effects, which successfully treats dengue hemorrhagic fever. Comparing lopinavir combined with doxycycline with other commonly implemented COVID-19 treatment regimens is of medical significance. Methods: We conducted a retrospective study comparing two cohorts. One cohort strictly adhered to a treatment protocol of lopinavir combined with doxycycline (Lop/Dox), while the other cohort (Others) applied protocols based on combinations of favipiravir, hydroxychloroquine, and azithromycin. The outcomes evaluated were death from coronavirus and intubation. Results: During the study period, 161 and 114 patients were followed in the Lop/Dox cohort and the Others cohort, respectively. The Lop/Dox cohort was older and had lower O2 saturation at admission. The proportion of patients needing intubation did not differ between the cohorts (Lop/Dox, 15∙5%; Others, 16∙7%). The overall fatality rate likewise did not differ (12∙4%) in Lop/Dox and 8∙7% in the Others cohort). Older age and elapsed time between the onset of symptoms and hospitalization, O2 saturation at admission, and the lymphocyte to white blood cell ratio were independent risk factors for poor outcomes of the illness. Conclusion: This study showed that lopinavir plus doxycycline therapy is an effective treatment amongst moderate to severe COVID-19 patients.

This study aims to provide both a model by using cumulative cases and cumulative death toll for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak in four countries, China, Italy, South Korea, and Turkey, starting from the first diagnosis and to compare associated indicators. The most successful estimation was obtained from the cubic model with natural logarithm for China, Italy, South Korea, and Turkey. The success of the models was around 99%. However, differences began to emerge in China, Italy, and South Korea after the second week. Although the highest number of new cases per 1 million people in China was 9.8 on February 28, 2020; it was 108.4 on March 21, 2020, in Italy; and this was 16.6 on March 5, 2020, in South Korea. On the other hand, the number of new cases was 24.6 per 1 million people on March 27, 2020, in Turkey. The log-cubic model proposed in this study has been set forth to obtain successful results for aforementioned countries, as well as to estimate the course of the COVID-19 outbreak. Other factors such as climacteric factors and genetic differences, which may have an impact on viral spreading and transmission, would also have strengthened the model prediction capacity.