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Abstract Objective To evaluate the effect of neuropathic pain on lower urinary tract symptoms (LUTS) scores in patients with primary Sjögren’s syndrome (pSS). Methods Seventy-two patients diagnosed with pSS were included in the study. The patients with pSS were divided into two groups according to the presence/absence of neuropathic pain. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire was recorded assess neuropathic pain. LUTS was evaluated using the International Prostate Symptom Score (IPSS), International Incontinence Consultation Questionnaire Short Form (ICIQ-SF) and Overactive Bladder Questionnaire (OAB-V8). Results The mean age of the patients was 52.4 ± 11.2 years. Neuropathic pain was recorded in 21 (29.2%) patients. Among the patients, the number of patients with mild symptoms was recorded as 41 (56.9%), moderate symptoms in 25 (34.7%), and severe symptoms in 6 (8.3%) according to IPSS. IPSS and IPSS voiding subscores were statistically significantly higher in patients with neuropathic pain than non-neuropathic pain group (p = 0.035; p = 0.001, respectively). Although ICIQ-SF, OAB-V8 and IPSS storage subscores were found to be higher in patients with neuropathic pain group, there was no statistically significant difference between the groups (p = 0.299; p = 0.283; p = 0.237, respectively). Conclusion Neuropathic pain concomitant with PSS patients may negatively affect bladder voiding functions.

This investigation seeks to explore the influences of renewable energy and foreign direct investment (FDI) on Egypt's economy. Due to the function of FDI in promoting GDP expansion and renewable energy technology advancement, it is crucial to analyze the nexus between the economy, FDI, and green power. Egypt's annual data from 1990 to 2021 were employed in this research. By applying unit root tests, the data's stationarity was evaluated. The autoregressive distributed lag (ARDL) method was used to look into the connection between the variables in the long- and the short-run. Moreover, the reliability of the findings was reviewed using dynamic ordinary least squares (DOLS), fully modified ordinary least squares (FMOLS), and canonical cointegration regression (CCR) methodologies. As per the ARDL conclusions, an intensification of 1% in both renewable energy usage and FDI will be responsible for a boost of 1.02% and 1.87% in GDP over the long term, moreover to an upsurge of 0.54% and 1.11% over the short run. These outcomes suggest appropriate suggestions for the Egyptian government toward equitable development through promoting sustainable innovation in energy, improving FDI, and advancing sustainable economic expansion.

Background: Since its emergence, coronavirus disease 2019 (COVID-19) has been a challenge to manage and has resulted in high mortality rates. Aim: This study aimed to reveal the differences in the parameters at the time during the first admission, according to age groups in patients who applied due to Covid-19 and died in the hospital. Methods: This was a retrospective, cross-sectional, and descriptive study covering the period from March 16 to May 9, 2021. The study population (1169 patients) included patients with COVID-19 who presented to the emergency department and died in the hospital. The data required for this study were obtained from the electronic medical records of the patients in the information system of our hospital. The patients were divided into three groups and analyzed. Results: It was determined that the highest mortality rate was 547 (46.8%) in the 65-80 age group. In terms of comorbidities, there was a statistically significant difference between the three groups only in the incidence of asthma (p = 0.037). When the laboratory parameters and patient age groups were compared; a statistically significant difference was found in D-dimer, ferritin, WBC, platelet, and neutrophil values (respectively: p=0.001, p=0.020, p=0.005, p=0.029, p=0.037). Conclusion: The highest death rate in Covid 19 patients is seen in the 65-80 age group. In patients over 80 years of age, the presence of asthma and the increase in D-dimer and ferritin levels among laboratory parameters can be used to predict mortality.

Task-specific training constitutes a core element for evidence-based rehabilitation strategies targeted at improving upper extremity activity after stroke. Its combination with additional treatment strategies and neurotechnology-based solutions could further improve patients' outcomes. Here, we studied the effect of gamified robot-assisted upper limb motor training on motor performance, skill learning, and transfer with respect to a non-gamified control condition with a group of chronic stroke survivors. The results suggest that a gamified training strategy results in more controlled motor performance during the training phase, which is characterized by a higher accuracy (lower deviance), higher smoothness (lower jerk), but slower speed. The responder analyses indicated that mildly impaired patients benefited most from the gamification approach. In conclusion, gamified robot-assisted motor training, which is personalized to the individual capabilities of a patient, constitutes a promising investigational strategy for further improving motor performance after a stroke.

Introduction: This study aims to understand the burden of invoice costs of outpatients with mild Covid-19 symptoms on Social Security Institution (SSI); also, how it may have influenced the current economic situation. Material and Method: This research is a cross-sectional, retrospective, and descriptive study. The study universe includes the cases who applied to the emergency room (ER) with the symptoms of Covid-19. The sample group was the patients who applied to the Sakarya Training and Research Hospital (SEAH) pandemic ER between 01/09/2020 and 30/06/2021. Results: During the study period, 130,975 patients were admitted to the pandemic ER. The mean emergency service bill of the cases was $10.6 (± 9), and the lowest was $2.2; the highest was $201.7. There was a weak but significant positive correlation between the patients' age and invoice amount (spearman= 0.051, p=0.001). It was perceived that the emergency service bills of the inpatients (mean=21.9 $) were more than twice that of the outpatients (mean=10.3 $). Conclusion: In pandemic ER, mild symptomatic young patients' bills can be cheap. It was observed that emergency physicians did not apply too many tests and imaging methods in this patient group and were content only with Rt-PCR scanning. Also, ER bills can increase with age.

The aim of this study is to investigate the effect of COVID-19 pandemic and the restrictions taken on the medication, thus treatment adherence of patients with psychiatric disorders. A semi-structured form prepared by the authors and the Morisky treatment adherence scale were applied to the patients who were regularly followed up in Gaziantep University Medical Faculty Psychiatry outpatient clinic for 6 months before March 11, 2020, which was the first date of the COVID-19 case in Turkey and who visited the outpatient clinic for follow-up after the pandemic. 206 patients who met the study criteria were evaluated. Of these patients, it was found that 29 (14.1%) had their medication adherence impaired due to non-pandemic reasons. Analysis was performed with the remaining 177 patients. The average age of patients was 41.73 ± 13.48. According to the general characteristics of the participants, 117 were women and 60 men. With regard to the treatment adherence rates, 69 patients (39%) were not affected by the pandemic in which treatment adherence was high, 46 (26%) had moderate treatment adherence, and 62 (35%) showed poor treatment adherence. The comparison of patients in terms of treatment adherence according to their diagnosis revealed no statistically significant difference (p = 0.100). To the best of our knowledge, this is the first study investigating the medication (treatment) adherence of patients with psychiatric disorders who were on treatment before the pandemic. Studies with large samples are warranted to better understand the effect of the pandemic on treatment adherence. [Med-Science 2021; 10(3.000): 720-4]

Aim: It is aimed to examine the status and demographic characteristics of COVID-19 Reverse Transcription Polymerase Chain Reaction (RT-PCR) positive staff working in the hospital during the pandemic period. Material and methods: This is retrospective, descriptive research. All hospital personnel working at Sakarya Training and Research Hospital and tested positive for COVID-19 RT-PCR between 01/11/2020-30/11/2020 were included in the study. Results: During the study period, the number of hospital staff who tested positive for COVID-19 RT-PCR was 340 people. Of the personnel, 228 (67.1%) were female, the mean age of all healthcare workers was 32.7 (±8.3) years. The number of non-physician healthcare workers was 162 (47.6%), workers were 143 (42.1%), and physicians were 35 (10.3%). Among all hospital personnel, the COVID-19 RT-PCR test was positive in emergency room workers, with a maximum of 61 people (17.9%). It was followed by 43 (12.6%) people working in non-COVID clean wards. Conclusions: It would be beneficial for all staff working in the hospital during the pandemic to pay attention to apply personal protective equipment during their work, notwithstanding whether the COVID-19 patient is caring or not. Simultaneously, healthcare professionals should be careful about COVID-19 transmission in their social life outside of the hospital.

The COVID-19 disease occurred in the final weeks of 2019. As part of the fight against COVID-19, countries have taken actions such as travel restrictions, suspension of border crossings and international flights, voluntary home isolation, public activities restriction, and curfews. The objective of this study is to identify the effect of curfew enforcement during the COVID-19 pandemic to determine and identify whether curfew has a positive effect on the health care workload. The number of patients admitted to Sakarya University Training and Research Hospital, their means of arrival, hospitalization-discharge, demographic characteristics were examined retrospectively for the period of curfew in April and May 2020 and the corresponding days in 2019. The significant statistical differences between the two periods were analyzed. The results of this research reveal that24.488 patients were admitted to our emergency department. Of these patients, 12813 (52.3%) were male, 11675 (47.7%) were female. The number of emergency department admissions of the pediatric age group decreased from 1822 (8.9%) to 33 patients (0.8%). Moreover, the number of patients admitted to the emergency service in the related period of 2019 was 20548 (83.9%), while this figure decreased to 3940 individuals (16.1%) during the curfew period. It was impliedthat curfew could reduce the unnecessary admissions to hospitals, the number of ambulance usage, and provide a positive contribution to the reduction in traumas, car accidents, work accidents, and forensic cases during pandemic.

Tourism industry is one of the primary sectors that contribute to economic growth of countries worldwide. Since it requires appropriate weather conditions and clean environment, climate changes can significantly affect the sector. Therefore, this study examines the causality and long-run relationship between the climate change and tourism sector in Turkey. To estimate the potential long-run relationship between variables, Granger-Causality test is applied to data from 1960 to 2016. The study uses World Development Indicator Data released by World Bank. For the analysis, carbon-dioxide emission, methane emission, energy use (oil equivalent), and forest land are standing for climate change indicators. International tourist arrivals and tourism revenues represent for tourism sector’s variables. The findings show that there is a negative and significant coefficient of climate change on tourism sector. Also, in average, climatic change indicators have unidirectional and negative impact on international tourism revenue. Another finding is that climate change deteriorates to environment by augmenting carbon dioxide emission and methane emission. As a result, climatic change can weaken the tourism industry which can decrease the speed of Turkey’s economic development. In the long run, this research can pioneer assessing the economic and environmental impacts of climate change in the tourism sector bases.

Even though globe luxation is a quite rare eye problem observed in the pediatric emergency department, it is quite vital since it causes loss of vision. An 8-month-old male patient presented with the complaint of spontaneous eye protrusion. Eye manipulations that would increase intraocular pressure were avoided and the eye was quickly covered with a dressing to keep the eye wet. The eyeball was placed back performing lateral canthotomy. Unlike the other cases in the literature, the present case is a case of spontaneous and recurrent globe luxation in an infant with a syndromic facial appearance. Early diagnosis and management of the cases will prevent the development of complications.

The studies about COVID-19 began to show that people who have already had COVID-19 were re-admitted to the hospital due to COVID-19 positivity. This study aims to identify recurrent positive patients and the demographic characteristics of these patients. The number of recurrent COVID-19 positive patients was 190. Of these patients, 97 (51.1%) were male, the average age was 43.98 years (±16.3), 147 (77.4%) were never hospitalized, Of the hospitalized patients, 28 (65.1%) were male and the average age of the inpatients was 54.67 years (±16.15). Looking at the duration of hospital stay of the inpatients, it was observed that the average was 11.16 days (±8.9). A positive correlation was found between the age of the patients and the duration of their hospital stay (r=0.386). The average time between the two positives was 52.92 days. Patients who have a recurrent positive result usually survive the disease with outpatient treatment for their mild illness. Hospitalization rates of male patients were higher than those of females, and the duration of hospital stay was found to increase as the age of the patients increases.

Background: An increasing lifespan and the resulting change in our expectations of later life stages are dependent on a good health state. This emphasizes the importance of the development of strategies to further strengthen healthy aging. One important aspect of good health in later life stages is sustained skilled motor function.Objective: Here, we tested the effectiveness of robotic upper limb motor training in a game-like scenario assessing game-based learning and its transfer potential.Methods: Thirty-six healthy participants (n = 18 elderly participants, n = 18 young controls) trained with a Pacman-like game using a hand-held Cellulo robot on 2 consecutive days. The game-related movements were conducted on a printed map displaying a maze and targets that had to be collected. Gradually, the task difficulty was adjusted between games by modifying or adding different game elements (e.g., speed and number of chasing ghosts, additional rules, and haptic feedback). Transfer was assessed by scoring simple robot manipulation on two different trajectories.Results: Elderly participants were able to improve their game performance over time [t(874) = 2.97, p < 0.01]. The applied game elements had similar effects on both age groups. Importantly, the game-based learning was transferable to simple robot manipulation that resembles activities of daily life. Only minor age-related differences were present (smaller overall learning gain and different effects of the wall-crash penalty rule in the elderly group).Conclusions: Gamified motor training with the Cellulo system has the potential to translate into an efficient and relatively low-cost robotic motor training tool for promoting upper limb function to promote healthy aging.

In this article we investigate the role of interactive haptic-enabled tangible robots in supporting the learning of cursive letter writing for children with attention and visuomotor coordination issues. We focus on the two principal aspects of handwriting that are linked to these issues: Visual perception and visuomotor coordination. These aspects, respectively, enhance two features of letter representation in the learner's mind in particular, namely the shape (grapheme) and the dynamics (ductus) of the letter, which constitute the central learning goals in our activity. Building upon an initial design tested with 17 healthy children in a preliminary school, we iteratively ported the activity to an occupational therapy context in 2 different therapy centers, in the context of 3 different summer school camps involving a total of 12 children having writing difficulties. The various iterations allowed us to uncover insights about the design of robot-enhanced writing activities for special education, specifically highlighting the importance of ease of modification of the duration of an activity as well as of adaptable frequency, content, flow and game-play and of providing a range of evaluation test alternatives. Results show that the use of robot-assisted handwriting activities could have a positive impact on the learning of the representation of letters in the context of occupational therapy (V = 1, 449, p < 0.001, r = 0.42). Results also highlight how the design changes made across the iterations affected the outcomes of the handwriting sessions, such as the evaluation of the performances, monitoring of the performances, and the connectedness of the handwriting.

With the advent of the Internet of Things, lightweight devices necessitate secure and cost-efficient key storage. Since traditional secure key storage is expensive, novel solutions have been developed based on the idea of deriving the key from noisy entropy sources. Such sources when combined with fuzzy extractors allow cryptographically strong key derivation. Information theoretic fuzzy extractors require large amounts of input entropy to account for entropy loss in the key extraction process. It has been shown by Fuller et al. (ASIACRYPT'13) that the entropy loss can be reduced if the requirement is relaxed to computational security based on the hardness of the Learning with Errors problem. Using this computational fuzzy extractor, we show how to construct a device-server authentication system providing outsider chosen perturbation security and pre-application robustness. We present the first implementation of a lossless computational fuzzy extractor, where the entropy of the source equals the entropy of the key on a constrained device. The implementation needs only 1.45 KB of SRAM and 9.8 KB of Flash memory on an 8-b microcontroller. Furthermore, we also show how a device-server authentication system can be constructed and efficiently implemented in our system. We compare our implementation to existing work in terms of security, while achieving no entropy loss.