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Properly assigning weights to decision makers in a group decision making environment is one of the essential processes of utmost importance as it can have a direct effect on the final outcome. This paper, basing on the entropy method, proposes a correct and efficient way to objectively assign weights to decision makers in a multi-criteria group decision making environment. Two approaches namely, constant and variable weighting, have been put forward whilst providing necessary proofs and numerical examples in order to show one of the existing ways in literature is erroneous as it is not resulting in weights that reflects entropy method’s basic intuition.

Objective: To evaluate the impact of vaginal microbiota on pregnancy outcomes in women undergoing assisted reproduction.Design: A prospective cohort study.Setting: A university-based assisted reproductive technology (ART) centre.Population: 223 women undergoing ART treatment.Methods: Prior to embryo transfer, vaginal samples were collected from the posterior fornix. Vaginal microbiota identification was carried out using next-generation sequencing and categorised according to the V3-V4 hypervariable region in the 16S rRNA gene region.Main Outcome Measures: ART clinical outcomes (implantation, clinical pregnancy rates and live birth rates).Results: The live birth rate in women with community state type (CST)-I (39%) was higher than that in women with CST-III (21.5%) but the difference was not statistically significant (P = 0.052). The relative abundance of Lactobacillus was lower in women who failed to become pregnant (NP group) (67.71%) than in women who became pregnant (PR group) (79.72%). However, this difference was not statistically significant (P = 0.06). In the NP group, the relative abundance of Streptococcus (7.81%) and Gardnerella (9.40%) was higher than that in the PR group (relative abundance of Streptococcus and Gardnerella was 2.28% and 5.56%, respectively). The abundance of Streptococcus was found to be statistically significantly different between the two study groups (P = 0.014). Linear discriminant analysis (LDA) further validated that Streptococcus had the highest contribution (LDA score >4.0) to the difference between these two groups.Conclusions: Streptococcus has the highest contribution to the distinction between the PR and NP groups.Tweetable Abstract: A relatively high abundance of Streptococcus in the vaginal microbiota may be associated with a lower ART success rate. [ABSTRACT FROM AUTHOR]

Objective: Our primary objective in our study was to review the side effect of MS patients vaccinated against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus from Istanbul University, Istanbul Faculty of Medicine, Multiple Sclerosis and Myelin Diseases Outpatient Clinic. The secondary objective of our research was to evaluate the demographic, clinical characteristics and disease-modifying therapies of patients who have been infected with coronavirus disease-2019 (COVID-19) and who have been vaccinated against the SARS-CoV-2 virus. Materials and Methods: A questionnaire was sent via text message or e-mail to patients who were followed up at the Multiple Sclerosis and Myelin Diseases Outpatient Clinic of the Department of Neurology of the Istanbul University, Istanbul Faculty of Medicine. The eligibility criteria were not being in the period of an attack and being volunteered to participate in the study. A questionnaire consisting of a total of 21 questions was answered by the patients and the results of 160 patients were evaluated statistically. Results: One hundred and seven of the 160 patients were women (67%), and 53 (33%) men. The mean age of the patients was 38 +- 10.9 years. As a majority of the patients, 128 of the patients (80%) were followed up with a diagnosis of relapsing remmitting multiple sclerosis (MS). The rate of COVID-19 infection among the patients was 17% (n = 27). 67.5% (n = 108) of the patients preferred the inactive SARS-CoV-2 vaccine, while 31.8% (n = 51) preferred the BNT162B2 (mRNA) vaccine. Pain at the site of vaccination (20%), fatigue (14%), myalgia (18%), headache (5%) and fever (4%) were side effects. When the side effects after the first dose were compared, the frequency of the side effects of mRNA vaccine was found to be significantly higher (71%) (P < 0.0001). Two (1.3%) of the patients after the first dose and 5 (3.8%) after the second dose had an MS attack. Conclusion: Inactive and mRNA vaccines showed similar side effects with the normal population in patients with MS, and there was no significant difference in the frequency of attacks between vaccines.

Background and Aim:Using two-dimensional speckle tracking echocardiography (2D-STE), the ventricular functions of hospitalized coronavirus disease-2019 (COVID-19) patients were assessed. However, there is limited information about cardiac functions in the first year after recovery from the intensive care unit (ICU). This research aims to assess the right ventricular functions of COVID-19 patients and their changes within the first year after ICU discharge using 2D-STE.Materials and Methods:The study was conducted prospectively. The study included 68 consecutive patients and 70 control patients. Echocardiography was performed in the ICU and the first year after discharge from the hospital. Right ventricular global longitudinal strain (RVGLS) was measured using the 2D-STE method.Results:The mean age of the study group was 48.67±8.10 and 37 (54.4%) patients were males. There were no substantial differences across the groups, including age, gender, body mass index, heart rate, diabetes, dyslipidemia, and smoking (P > 0.05). A substantially significant positive correlation was detected between right ventricular dimension (RAD) (r = 0.644, P < 0.001), right ventricular diastolic dimension (RVDD) (r = 0.573, P < 0.001), ferritin (r = 0.454, P < 0.001), D-dimer (r = 0.305, P = 0.011) values and RVGLS in the in-hospital and after-discharge first-year groups. The RVGLS values of the control, in-hospital, and after-discharge first-year groups were -20.36±3.06, -16.98±3.78, and -17.58±6.45, indicating a statistically significant difference across the groups (P < 0.001). Tricuspid annular plane systolic excursion was higher in the control group (P < 0.05).Conclusion:RVGLS was found to be depressed during the in-hospital period and showed no improvement in the 1 year post discharge.

Resumo Fundamento A cardiomiopatia hipertrófica (CMH) e a doença de Fabry (DF) são doenças herdadas geneticamente com características fenotípicas de hipertrofia ventricular esquerda (HVE) que causam resultados cardíacos adversos. Objetivos Investigar as diferenças demográficas, clínicas, bioquímicas, eletrocardiográficas (ECG) e ecocardiográficas (ECO) entre CMH e DF. Métodos 60 pacientes com CMH e 40 pacientes com DF foram analisados retrospectivamente como uma subanálise do “estudo LVH-TR” após exclusão de pacientes com fibrilação atrial, ritmo de estimulação, bloqueios de ramo e bloqueios atrioventriculares (AV) de segundo e terceiro graus. O nível de significância foi aceito como

IntroductionLung cancer (LC) is a leading cause of cancer-related mortality worldwide. Approximately 80% of LC cases are of the non-small cell lung cancer (NSCLC) type, and approximately two-thirds of these cases are diagnosed in advanced stages. Only systemic treatment methods can be applied to patients in the advanced stages when there is no chance of surgical treatment. Identification of mutations that cause LC is of vital importance in determining appropriate treatment methods. New noninvasive methods are needed to repeat and monitor these molecular analyses. In this regard, liquid biopsy (LB) is the most promising method. This study aimed to determine the effectiveness of LB in detecting EGFR executive gene mutations that cause LC.MethodsOne hundred forty-six patients in stages IIIB and IV diagnosed with non-squamous cell non-small cell LC were included. Liquid biopsy was performed as a routine procedure in cases where no mutation was detected in solid tissue or in cases with progression after targeted therapy. Liquid biopsy samples were also obtained for the second time from 10 patients who showed progression under the applied treatment. Mutation analyses were performed using the Cobas® EGFR Test, a real-time PCR test designed to detect mutations in exons 18, 20, and 21 and changes in exon 19 of the EGFR gene.ResultsMutation positivity in paraffin blocks was 21.9%, whereas it was 32.2% in LB. Solids and LB were compatible in 16 patients. Additionally, while no mutation was found in solid tissue in the evaluation of 27 cases, it was detected in LB. It has been observed that new mutations can be detected not only at the time of diagnosis, but also in LB samples taken during the follow-up period, leading to the determination of targeted therapy.DiscussionThe results showed that “liquid biopsy” is a successful and alternative non-invasive method for detecting cancer-causing executive mutations, given the limitations of conventional biopsies.

Strawberries rich nutrition, flavor, and aroma profiles make them popular. Many studies have tried to extend strawberries shelf life. In the current study, grape pomace extract (GPE) was combined with polyvinyl alcohol (PVA) and used to extend the shelf life of strawberries. Ascorbic acid content, total phenolic content, total anthocyanin content, and antioxidant activity determinations showed that PVA/GPE-coated strawberries were superior to the uncoated fruits during storage. Total mesophilic aerobic bacteria (TMAB) and yeast/mold counts in the uncoated strawberries were 2 and 2.68 log cfu/g at the start of storage, respectively, and 9.8 and 14.00 log cfu/g after 16 days of storage, respectively. Strawberries coated with the PVA solution with 2.5% ( w/v ) GPE showed 32% and 25% less TMAB and yeast/mold counts, respectively, at the end of storage. The PVA/GPE-coated strawberries showed significantly higher firmness compared to the control fruit. The PVA/GPE coating improved strawberry shelf life and functional properties.

BACKGROUND: There are conflicting results in studies investigating the effects of percutaneous coronary intervention (PCI) on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) during or outside of usual hospital working hours. While some researchers have reported higher mortality rates in STEMI patients admitted outside of working hours, others did not find a statistically significant difference. OBJECTIVES: Investigate the short-term endpoints and long-term outcomes of STEMI patients by time of admission. DESIGN: Retrospective SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS: Patients were grouped by admission, which consisted of four intervals: 06:00 to

Background: Male infertility is a global health issue caused by a combination of different factors. Specialists generally rely on semen analysis to diagnose male infertility. However, it is known that diagnostic semen analysis fails to identify about 50% of male infertility disorders. Recently, metabolomics has been proven to be a powerful technique for the diagnosis of different diseases. Objective: To determine whether metabolites could be used as potential biomarkers for the diagnosis of male factor infertility through comparing seminal plasma samples from infertile men with oligoasthenoteratozospermia (OAT) and samples from normozoospermic controls. Materials and methods: This study utilized high‐resolution 1H NMR spectroscopy to reveal whether the metabolomic changes of seminal plasma obtained from 31 patients with oligoasthenoteratozospermia (OAT) are different from the ones obtained from 28 normozoospermic controls. Results: Multivariate statistical analysis of NMR data concluded that the metabolomic profile of samples from patients with OAT exhibits statistically significant differences when compared to the controls. The differences were based on the metabolites lactate, citrate, lysine, arginine, valine, glutamine, creatinine, α‐ketoglutaric acid, spermine, putrescine, and tyrosine. Except the tyrosine, levels of the above metabolites were significantly decreased in patients with OAT compared to the controls. The levels of citrate, choline, spermine, putrescine, α‐ketoglutaric acid, valine, and tyrosine were significantly different (p < 5 × 10−4) between two groups. On the other hand, levels of lactate, creatinine, lysine, arginine, and glutamine were also statistically significant (0.001 < p < 0.05). However, considering the p‐values, the physiological relevance of these metabolites may be lower when compared to the others. A PLS‐DA model built on the NMR data achieved 89.29% sensitivity and 93.55% specificity results in a leave‐one‐out cross‐validation process. Discussion and conclusion: 1H NMR spectroscopy‐based metabolomic analysis could be used as a diagnostic tool for the diagnosis of oligoasthenoteratozospermia. [ABSTRACT FROM AUTHOR]

Objective:Systemic immune inflammation index (SII) and atherogenic plasma index (AIP) are indices that have been defined in recent years and play an important role in the process of atherosclerosis and inflammation. In this study, we aimed to investigate the relationship between the severity of atherosclerotic lesions detected and AIP and SII in patients who underwent fractional flow reserve (FFR) in coronary angiography.Method:In this study, 119 patients who underwent elective FFR in coronary angiography were retrospectively analyzed. According to the severity of FFR lesion, two groups were formed as FFR 0.8 group (42 patients). SII, AIP, demographic data and other parameters were compared between the two groups.Results:In the FFR applied groups, there was a statistically significant difference between the two groups in terms of high-density lipoprotein (p=0.001), platelet (p=0.007), mean platelet volume (MPV) (p=0.016), monocytes (p

Objectives: Lung cancer (LC) is one of the most prevalent cancers with the highest fatality rate worldwide. Long noncoding RNAs (lncRNAs) are being considered potential new molecular targets for early diagnosis, follow-up, and individual treatment decisions in LC. Therefore, this study evaluated whether lncRNA expression levels obtained from exhaled breath condensate (EBC) samples play a role in the occurrence of metastasis in the diagnosis and follow-up of patients with advanced lung adenocarcinoma (LA).Methods: A total of 40 patients with advanced primary LA and 20 healthy controls participated in the study. EBC samples were collected from patients (during diagnosis and follow-up) and healthy individuals for molecular analysis. Liquid biopsy samples were also randomly obtained from 10 patients with LA and 10 healthy people. The expression of lncRNA genes, such as MALAT1, HOTAIR, PVT1, NEAT1, ANRIL, and SPRY4-IT1 was analyzed using cfRNA extracted from all clinical samples.Results: In the diagnosis and follow-up of patients with LA, lncRNA HOTAIR (5-fold), PVT1 (7.9-fold), and NEAT1 (12.8-fold), PVT1 (6.8-fold), MALAT1 (8.4-fold) expression levels were significantly higher than those in healthy controls, respectively. Additionally, the distinct lncRNA expression profiles identified in EBC samples imply that decreased ANRIL–NEAT1 and increased ANRIL gene expression levels can be used as biomarkers to predict the development of bone and lung metastases, respectively.Conclusion: EBC is an innovative, easily reproducible approach for predicting the development of metastases, molecular diagnosis, and follow-up of LC. EBC has shown potential in elucidating the molecular structure of LC, monitoring changes, and discovering novel biomarkers.

Today, countries are shifting their energy policies towards to renewable energy sources. The main reasons for this can be summarized as the reduction of fossil fuel resources, resulting in cost increase and their harmful effect on the ecological balance. Since renewable energy sources are both economical and eco-friendly, for countries which have high solar energy potential such as Turkey, it is reasonable to direct their energy policies to solar energy which is a renewable energy source.In this study, the development of renewable energy legislation in Turkey, from past to present has been examined and implementation steps for the licenced and unlicensed generation of electricity from solar energy have been introduced. Ten impact factors have been identified as the first step for the implementation of the solar power plant site selection in Istanbul, which was determined as the pilot region. Impact factors weighted using Analytical Hierarchy Process (AHP) method. Concurrently, the weights of these determined impact factors were compared with the weights obtained by evaluating the results of the "Evaluation of Solar Energy Power Plant Site Selection Factors" survey conducted during the study. After obtaining the weights, the relevant data were collected and the necessary analyses were performed with the help of the GIS software and the most suitable places were provided for the solar power plant for Istanbul. [ABSTRACT FROM AUTHOR]

A comprehensive lipid profile was analyzed in patients with non-small cell lung cancer (NSCLC) using nanoflow ultrahigh-performance liquid chromatography–electrospray ionization–tandem mass spectrometry. This study investigated 297 and 202 lipids in saliva and plasma samples, respectively, comparing NSCLC patients to healthy controls. Lipids with significant changes (>2-fold, p < 0.05) were further analyzed in each sample type. Both saliva and plasma exhibited similar lipid alteration patterns in NSCLC, but saliva showed more pronounced changes. Total triglycerides (TGs) increased (>2–3-fold) in plasma and saliva samples. Three specific TGs (50:2, 52:5, and 54:6) were significantly increased in NSCLC for both sample types. A common ceramide species (d18:1/24:0) and phosphatidylinositol 38:4 decreased in both plasma and saliva by approximately two-fold. Phosphatidylserine 36:1 was selectively detected in saliva and showed a subsequent decrease, making it a potential biomarker for predicting lung cancer. We identified 27 salivary and 10 plasma lipids as candidate markers for NSCLC through statistical evaluations. Moreover, this study highlights the potential of saliva in understanding changes in lipid metabolism associated with NSCLC.

Introduction: Patients receiving anticoagulant therapy experience a serious problem at a time when the rates of outpatient visits for the international normalized ratio (INR) monitoring are gradually decreasing owing to the risk of virus transmission during the pandemic. The aim of this multicenter study was to investigate how the coronavirus disease 2019 pandemic affected the time in therapeutic range (TTR) value, which shows the use of effective doses of warfarin, and its monitoring in patients using warfarin. Materials and Methods: A total of 158 patients with 3 consecutive prepandemic INR levels and at least 3 postpandemic INR levels without time limitation were retrospectively evaluated. TTR values were calculated and the preepidemic and postepidemic values were compared. TTR was obtained using the conventional method. Results: The mean preepidemic and postepidemic TTR values were found to be 64.4 (61.8%–67.0%) and 34.9 (30.8%–39.0%), respectively. TTR rate was statistically significantly lower in the postpandemic period than in the prepandemic period (P < 0.001). While the prepandemic TTR of 68 (43%) patients was

Objective: Most lacunar strokes are sporadic, and hypertension, diabetes, smoking, and cardiovascular diseases are among its main risk factors. Strokes caused by small vessel diseases are generally associated with single-gene disorders with familial dominant and recessive inheritance. The most common condition is cerebral autosomal dominant arteriopathy, with subcortical infarcts and leukoencephalopathy (CADASIL), associated with the NOTCH3 gene. An infrequent form of this disease is the cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL), revealed with pathogenic HTRA1 gene variants related to distinct molecular pathways. The neurological and cranial magnetic resonance imaging (MRI) findings are very similar to CADASIL; however, earlier than expected onset of common alopecia in man, low back pain, and more severe memory impairment are the differences in terms of clinical presentations. Clinical findings of 22 patients from 16 families with widespread white matter lesions in the periventricular field in the brain were investigated with molecular genetic findings. Materials and Methods: Clinical examination results and cranial MRI findings are reported, and NOTCH3 and HTRA1 genes are sequenced stepwise by Sanger and next-generation sequencing techniques. Results: Missense changes in epidermal growth factor (EGF)-like domain in the NOTCH3 are found in 18 cases from 14 families. Two different homozygous pathogenic missense and non-sense variants, in the HTRA1 gene, were detected in four patients from two families. The disease onset age was approximately 16 years earlier in cases carrying pathogenic variants located in the encoding region of EGF-like domains 1-6 of NOTCH3. Conclusion: In the NOTCH3 gene with c.382T>C (p.C128R), c.555T>G (p.C185W), and c.1903C>T (p.R635C) and in the HTRA1 gene c.235C>T (p.Q79*) are presented for the first time in this study. Molecular genetic investigation of CADASIL and CARASIL is important to support the clinical diagnosis, determine the inheritance model, provide patient and family counseling, manage disease process, and evaluate possible treatment strategies.

Minimally invasive approaches for cancer diagnosis are an integral step in the quest to improve cancer survival. Liquid biopsies such as blood samples are matrices explored to extract valuable information about the tumor and its state through various indicators, such as proteins, peptides, tumor DNA, or circulating tumor cells. Although these markers are scarce, making their isolation and detection in complex matrices challenging, the development in polymer chemistry producing interesting structures, including molecularly imprinted polymers, branched polymers, nanopolymer composites, and hybrids, allowed the development of enhanced platforms with impressive performance for liquid biopsies analysis. This review describes the latest advances and developments in polymer synthesis and their application for minimally invasive cancer diagnosis. The polymer structures improve the operational performances of biosensors through various processes, such as increased affinity for enhanced sensitivity, improved binding, and avoidance of non-specific interactions for enhanced specificity. Furthermore, polymer-based materials can be a tremendous help in signal amplification of usually low-concentrated targets in the sample. The pros and cons of these materials, how the synthesis process affects their performance, and the device applications for liquid biopsies diagnosis will be critically reviewed to show the essentiality of this technology in oncology and clinical biomedicine.

Coronavirus disease 2019 (COVID-19) infection is a public health problem, which globally is considered a pandemic, causing a significant level of morbidity and mortality. It has been defined as a viral infection, the etiology of which is unknown, causing mostly respiratory tract infections. It is surely beyond doubt that vaccine development also plays an important role in ending such pandemics as well as hygiene rules and personal protective equipment. It is becoming gradually more apparent that cardiovascular complications associated with COVID-19, such as myocardial damage, arrhythmia, acute heart failure, and venous thromboembolism, occur more frequently than what was thought before. The precise pathophysiological mechanisms of myocardial damage remain unclear but are thought to be the main pathway, with microthrombi, cytokine storm, and plaque rupture due to hypoxic damage, coronary spasm, direct endothelial, or vascular injury. In this study, we wanted to present a 32-year-old coronary thrombus case with no medical history and no risk factors, which we think may develop due to the Sinovac inactivated COVID-19 vaccine or as a late complication of COVID-19 disease. While cardiac side effects associated with inactive COVID-19 vaccines are still limited in the literature, this issue can be clarified if there are more case reports.

Point of care (PoC) devices are highly demanding to control current pandemic, originated from severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Though nucleic acid-based methods such as RT-PCR are widely available, they require sample preparation and long processing time. PoC diagnostic devices provide relatively faster and stable results. However they require further investigation to provide high accuracy and be adaptable for the new variants. In this study, laser-scribed graphene (LSG) sensors are coupled with gold nanoparticles (AuNPs) as stable promising biosensing platforms. Angiotensin Converting Enzyme 2 (ACE2), an enzymatic receptor, is chosen to be the biorecognition unit due to its high binding affinity towards spike proteins as a key-lock model. The sensor was integrated to a homemade and portable potentistat device, wirelessly connected to a smartphone having a customized application for easy operation. LODs of 5.14 and 2.09 ng/mL was achieved for S1 and S2 protein in the linear range of 1.0–200 ng/mL, respectively. Clinical study has been conducted with nasopharyngeal swabs from 63 patients having alpha (B.1.1.7), beta (B.1.351), delta (B.1.617.2) variants, patients without mutation and negative patients. A machine learning model was developed with accuracy of 99.37% for the identification of the SARS-Cov-2 variants under 1 min. With the increasing need for rapid and improved disease diagnosis and monitoring, the PoC platform proved its potential for real time monitoring by providing accurate and fast variant identification without any expertise and pre sample preparation, which is exactly what societies need in this time of pandemic.

The objective of this study was to determine the hydraulic properties of a flat type emitter using Computational Fluid Dynamics with different turbulence models and model options. In addition, it is aimed to investigate the effects of the emitter hydraulic properties on the design when the same emitter is used in drip irrigation pipes with different wall thicknesses. The lowest mean percentage deviation between the measured flow rates and the calculated flow rates with turbulence models was found as 0.70% and 0.74% in the SST k- and Stress-Omega RSM turbulence model for the wall thickness of 0.25 mm pipe, respectively. Also, the mean percentage deviation for the laminar turbulence model was found to be -1.01%. The minimum MAE (0.021 L h-1) and RMSE (0.028 L h-1) values were found in the SST k- low-Re corr. turbulence model and the minimum MAPE (1.068%) was found in the laminar turbulence model.

Objective: Clinical studies in childhood multiple sclerosis (MS) are very limited compared with adults. Although first-line injection therapies are well tolerated in this patient group, there are difficulties in the long-term treatment of patients due to the difficulty and adverse effects of injections for children. Oral therapies are better tolerated for use and adverse effects compared with injection therapies. This study aimed to evaluate the clinical features and treatment outcomes of patients aged under 18 years with relapsing-remitting MS (RRMS) who received fingolimod treatment. Materials and Methods: In this study, the clinical records of 22 patients with RRMS who received fingolimod treatment were examined. The patients were prospectively followed up between February 2015 and December 2018. The patients were evaluated in terms of relapse rate, Expanded Disability Status Scale (EDSS) scores, brain and cervical magnetic resonance imaging, and adverse effects before and after fingolimod treatment. Results: The median age of 13 (59%) female and 9 (41%) male patients was 18 (range: 10-21) years. The median fingolimod treatment duration was 2.5 (range: 1.3-3.9) years. The median age of disease onset was 13 (range: 8-17) years. Fifteen patients (68%) received a first-line treatment prior to fingolimod. The reason for switching to fingolimod was inefficacy in 33%, adverse effects in 40%, and both in %27 of patients. In 32% of patients, fingolimod was started as a first-line treatment. A total of three patients had recurrent relapses under treatment with fingolimod. The median annualized relapse rate (ARR) before fingolimod was 1.9 (range: 0.3-8.0), and the ARR with fingolimod was 0 (range: 0-2.0) (Wilcoxon’s signed-rank test; p

ABSTRACT Background: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p

The objective of this study was to predict total friction losses in drip irrigation laterals with cylindrical integrated inline emitters at different spacing using Computational Fluid Dynamics (CFD) simulation method. Two types of drip irrigation laterals with different technical specifications were used in the study. In the laboratory, the total friction losses were measured in the laterals for different velocities. In CFD analysis, standard k-ε, RNG k-ε, realizable k-ε, Reynolds Stress (RSM) with Linear Pressure-Strain (LPS) turbulence models and standard wall function, non-equilibrium wall function, enhanced wall treatment were considered. CFD simulation results were compared with experimental total friction losses in laterals. The highest prediction was obtained by RSM turbulence model with LPS using standard wall function with the lowest values of MAPE (2.96%) and RMSE (369 Pa).

As the competition gets more and more fierce in today’s markets, companies have to have an effectively chosen strategy in order to acquire better place in the market in which they are active. The SPACE Matrix method was once a useful method to analyze the competitive position of an organization using internal and external dimensions. However within its basic idea it is pointed out that it has some drawbacks. Therefore it has become obsolete nowadays because of those drawbacks and in order to resuscitate it, in this study, some of those drawbacks are pointed out and a way of coping with it using well known Analytic Hierarchy Process (AHP) and Analytic Network Process (ANP) methods is presented. Thus a hybrid strategy determination tool has been presented.

Objective: In this study, the effects of social and health indicators affecting the number of cases and deaths of the COVID-19 pandemic were examined. For the determinants of the number of cases and deaths, four models consisting of social and health indicators were created. Methods: In this quantitative research, 93 countries in the model were used to obtain determinants of the confirmed cases and determinants of the COVID-19 fatalities. Results: The results obtained from Model I, in which the number of cases was examined with social indicators, showed that the number of tourists, the population between the ages of 15 and 64, and institutionalization had a positive effect on the number of cases. The results obtained from the health indicators of the number of cases show that cigarette consumption affects the number of cases positively in the 50th quantile, the death rate under the age of five affects the number of cases negatively in all quantiles, and vaccination positively affects the number of cases in 25th and 75th quantile values. Findings from social indicators of the number of COVID-19 deaths show that life expectancy negatively affects the number of deaths in the 25th and 50th quantiles. The population over the age of 65 and CO2 positively affect the number of deaths at the 25th, 50th, and 75th quantiles. There is a non-linear relationship between the number of cases and the number of deaths at the 50th and 75th quantile values. An increase in the number of cases increases the number of deaths to the turning point; after the turning point, an increase in the number of cases decreases the death rate. Herd immunity has an important role in obtaining this finding. As a health indicator, it was seen that the number of cases positively affected the number of deaths in the 50th and 75th quantile values and the vaccination rate in the 25th and 75th quantile values. Diabetes affects the number of deaths positively in the 75th quantile. Conclusion: The population aged 15–64 has a strong impact on COVID-19 cases, but in COVID-19 deaths, life expectancy is a strong variable. On the other hand, it has been found that vaccination and the number of cases interaction term has an effect on the mortality rate. The number of cases has a non-linear effect on the number of deaths.

IntroductionJUNIPER compared the efficacy and safety of abemaciclib, a selective cyclin-dependent kinase 4 and 6 inhibitor, with erlotinib in patients with non-small cell lung cancer (NSCLC) harboring a Kirsten rat sarcoma (KRAS) mutation.MethodsJUNIPER was a Phase III, multicenter, randomized, open-label trial of abemaciclib versus erlotinib in patients with stage IV NSCLC and a detectable mutation in codons 12 or 13 of the KRAS oncogene, who progressed after platinum-based chemotherapy and 1 additional therapy (could include immune checkpoint inhibitor therapy). Randomized patients (3:2) received either 200 mg abemaciclib twice daily or 150 mg erlotinib once daily with best supportive care until disease progression or unacceptable toxicity. The primary endpoint was overall survival (OS); secondary endpoints included overall response rate (ORR), progression-free survival (PFS), and safety.ResultsBetween December 2014 and April 2017, 453 patients were randomly assigned to receive abemaciclib (N = 270) or erlotinib (N = 183). Median OS was 7.4 months (95% confidence interval [CI]: 6.5, 8.8) with abemaciclib and 7.8 months (95% CI: 6.4, 9.5) with erlotinib (hazard ratio [HR] = 0.968 [95% CI: 0.768, 1.219]; p = .77). Median PFS was 3.6 months (95% CI: 2.8, 3.8) with abemaciclib and 1.9 months (95% CI: 1.9, 2.0) with erlotinib (HR = 0.583 [95% CI: 0.470, 0.723]; p

Abstract Background A minority of European countries have participated in international comparisons with high level data on lung cancer. However, the nature and extent of data collection across the continent is simply unknown, and without accurate data collection it is not possible to compare practice and set benchmarks to which lung cancer services can aspire. Methods Using an established network of lung cancer specialists in 37 European countries, a survey was distributed in December 2014. The results relate to current practice in each country at the time, early 2015. The results were compiled and then verified with co-authors over the following months. Results Thirty-five completed surveys were received which describe a range of current practice for lung cancer data collection. Thirty countries have data collection at the national level, but this is not so in Albania, Bosnia-Herzegovina, Italy, Spain and Switzerland. Data collection varied from paper records with no survival analysis, to well-established electronic databases with links to census data and survival analyses. Conclusion Using a network of committed clinicians, we have gathered validated comparative data reporting an observed difference in data collection mechanisms across Europe. We have identified the need to develop a well-designed dataset, whilst acknowledging what is feasible within each country, and aspiring to collect high quality data for clinical research.

Background: The aim of the present study was to evaluate gum productivity of a local strain, Xanthomonas axonopodis pv. vesicatoria, isolated from pepper plant, and its rheological behavior for the first time compared to the standard strain, Xanthomonas campestris DSM 19000 (NRRL B-1459). The influence of operational conditions (agitation rate and inoculum volume) on gum production and rheological properties of gums from the Xanthomonas strains were investigated. Results: The isolated strain of Xanthomonas showed similar xanthan yield compared to the standard strain. Furthermore, this study clearly confirmed that gum yield depended on bacterial strain, agitation rate, and inoculum size. The most suitable conditions for the gum production in an orbital shaker in terms of agitation rate and inoculum size were 180 rpm and 5%, respectively, resulting in an average production of 10.96 and 11.19 g/L for X. axonopodis pv.vesicatoria and X. campestris DSM 19000, respectively. Regarding the rheological properties, Ostwald-de-Waele and power law models were used to describe flow and oscillatory behavior of the gum solutions, respectively. Consistency of the novel gum solution remarkably was much higher than the commercial xanthan gum solution. Flow and oscillatory behavior and their temperature ramps showed that weak gel-like structure could be obtained with less gum concentrations when the novel gum was used. Conclusion: Therefore, yield and technological properties of the aqueous solutions of the exopolysaccharide synthesized by X. axonopodis pv. vesicatoria were observed to be more suitable for industrial production. Keywords: Agitation rate, Biodegradation, Flow behavior, Gum productivity, Gum solutions, Inoculum volume, Natural polymers, Oscillation test, Pepper plant, Xanthan yield, Xanthomonas campestris

Aim and Objective In general, cigarette smoking is linked to increased risk of occurrence of MS and rate of progression. Extended disability status scale (EDSS) is used for measuring disability status of MS patients. Higher EDSS score indicates a worse neurological dysfunction In our study, we aimed to reveal the effect of smoking on disability progression in Turkish patients with MS. Methods Patients were divided into two groups according to smoking status (smokers and non-smokers). Demographic characteristics and clinical parameters of disease progression including time to reach EDSS 3 and EDSS 6 were compared between both groups using chi-square, student's t-test, log-rank test, and ANOVA. Results Overall, 280 smokers (108 males, 172 females) and 685 non-smokers (171 males, 514 females) were included in the study. There was no difference between the two groups in terms of gender, age at onset, the duration between first two relapses, and MS subtypes (p>0,05). As expected, women smoked less than men (p

Introduction Ege University is a pioneering university at Ege region with its 70 000 students and approximately 3000 academic staff. Tobacco control policies, parallel to the current regulations in the country, are an important issue for Ege University too, yet it bares important opportunities as well as barriers for an integrative approach for tobacco control on University Campus. Aim This study aims to explain the construction of Smoke-Free Ege Working Group, its formal initiation at the World No Tobacco Day (May 31st) and its subsequent action plan structured in the light of MPOWER. Methods Since 1999, smoking cessation outpatient service delivery points have been the main units of motivation for tobacco control policies at Ege University. Although Turkey is moving well about tobacco regulations, adherence to regulations is deficient and high prevalence of smoking among university staff and students remains as a major concern throughout the years. In March 2018, the administrative bodies of Medical School, have dealt their concerns to the units serving care for cessation and have gathered them at a first meeting. The Dean and Medical Manager of Medical Faculty, with a non-smoker administrative team, mentored and facilitated these efforts. Starting at this point, with regular meetings, the representatives determined their objectives, current barriers and opportunities. The construction of Smoke-Free Ege Working Group has rooted from these consecutive meetings. In the light of MPOWER, specific objectives at University Campus were listed. The major aim of the group was recognized as “changing the norms and culture for smoking”. This needed a good promotion strategy as well as collaboration with staff, students and administrative units. The efforts were collaborated with the Communications Unit of the University. A logo was created, brochures to raise awareness for the Smoke Free issue and the Working group, were prepared. The formal presentation of the Working Group was planned as a colorful activity on World No Tobacco Day, May 31st. To gather more visibility at the social media and press, representatives from three major opponent sports teams of Izmir city were invited. Results The Working Group was introduced to the media in the presence of the Rector, Dean, Medical managerl and all administrative units of the Medical School. Staff who succeeded to stop smoking, at the cessation service of the University, were awarded with certificates. The media showed great interest in the activity as it was put as “the famous sportsmen are supporting the efforts for a Smoke-free university”. Students and staff attended and shared the activity in social media as the entrance of the meeting was also colorfully designed for such promotion. Conclusions The Working Group has achieved to attract attention of staff, students and responsible bodies of the University and now moving forward for Smoke –Free Councils with students and staff representatives. Barriers and opportunities will be discussed, actions in the light of MPOWER, will be planned at these Councils. Smoke –Free Unit certifications and awards, designing smoking points outside of education and hospital settings and changing the “norm” are targeted.

Tick-borne diseases are increasing all over the word, including Turkey. The aim of this study was to determine the bacterial and protozoan vector-borne pathogens in ticks infesting humans in the Corum province of Turkey.From March to November 2014 a total of 322 ticks were collected from patients who attended the local hospitals with tick bites. Ticks were screened by real time-PCR and PCR, and obtained amplicons were sequenced. The dedected tick was belonging to the genus Hyalomma, Haemaphysalis, Rhipicephalus, Dermacentor and Ixodes. A total of 17 microorganism species were identified in ticks. The most prevalent Rickettsia spp. were: R. aeschlimannii (19.5%), R. slovaca (4.5%), R. raoultii (2.2%), R. hoogstraalii (1.9%), R. sibirica subsp. mongolitimonae (1.2%), R. monacensis (0.31%), and Rickettsia spp. (1.2%). In addition, the following pathogens were identified: Borrelia afzelii (0.31%), Anaplasma spp. (0.31%), Ehrlichia spp. (0.93%), Babesia microti (0.93%), Babesia ovis (0.31%), Babesia occultans (3.4%), Theileria spp. (1.6%), Hepatozoon felis (0.31%), Hepatozoon canis (0.31%), and Hemolivia mauritanica (2.1%). All samples were negative for Francisella tularensis, Coxiella burnetii, Bartonella spp., Toxoplasma gondii and Leishmania spp.Ticks in Corum carry a large variety of human and zoonotic pathogens that were detected not only in known vectors, but showed a wider vector diversity. There is an increase in the prevalence of ticks infected with the spotted fever group and lymphangitis-associated rickettsiosis, while Ehrlichia spp. and Anaplasma spp. were reported for the first time from this region. B. microti was detected for the first time in Hyalomma marginatum infesting humans. The detection of B. occultans, B. ovis, Hepatozoon spp., Theileria spp. and Hemolivia mauritanica indicate the importance of these ticks as vectors of pathogens of veterinary importance, therefore patients with a tick infestation should be followed for a variety of pathogens with medical importance.

This study was performed to determine the effect of field pea silages which were the organic acid (OA) alternative of oregano and cinnamon essential oils on fermentation quality and aerobic stability. Whole crop pea was harvested at full pod stage and wilted in the laboratory at the 48 h. The chopped pea was mixed and divided into equal portions allocated to five groups: CON (non-treated), distilled water, denoted as control group; OA group, a mixture of 60% formic acid, 20% sodium formate and 20% water applied at a rate of 5 g/kg fresh forage (Silofarm Liquid, Farmavet); origanum (ORE) group, Origanum onites essential oil at 400 mg/kg fresh forage; cinnamon (CIN) group, cinnamon essential oil at 400 mg/kg fresh forage; origanum+cinnamon (ORECIN) group, a mixture of ORE and CIN applied at an equal rate of 400 mg/kg fresh forage. Cinnamon decreased acetic acid (AA), ammonia nitrogen (NH3-N) and weight loss (WL) at the end of 60 days silage. Crude protein (CP) and dry matter (DM) increased by cinnamon essential oil. Yeasts were not detected in any treatments, including the control, after 7 days of air exposure. The CO2 amount decreased and the formation mold was inhibited in the aerobic period by the addition of cinnamon oil. Oregano did not show a similar effect, but when it was used with cinnamon, it showed synergic effect on AA and during aerobic period, it showed antagonistic effect on mold formation and DM losses. It was found in this study that cinnamon can be an alternative to organic acids.

This paper presents the results of a study on mathematical modelling of convection drying of artichoke (Cynara scolymus L.) leaves. Artichoke leaves used for drying experiments were picked from the agricultural faculty experimentation fields on the campus area of Ege University. Chopped artichoke leaves were then used in the drying experiments performed in the laboratory at different air temperatures (40, 50, 60 and 70 °C) and airflow velocities (0.6, 0.9 and 1.2 m s) at constant relative humidity of 15±2%. Drying of artichoke leaves down to 10% wet based moisture content at air temperatures of 40, 50, 60 and 70 °C lasted about 4.08, 2.29, 1.32 and 0.98 h respectively at a constant drying air velocity of 0.6 m s while drying at an air velocity of 0.9 ms took about 3.83, 1.60, 0.96 and 0.75 h. Increasing the drying air velocity up to 1.2 m s at air temperatures of 40, 50, 60 and 70 °C reduced the drying time down to 3.5, 1.54, 1.04 and 0.71 h respectively. Different mathematical drying models published in the literature were used to compare based on the coefficient of multiple determination (R), root mean square error (RMSE), reduced chi-square (χ) and relative deviation modulus (P). From the study conducted, it was concluded that the Midilli et al drying model could satisfactorily explain convection drying of artichoke (Cynara scolymus L.) leaves under the conditions studied.

Production and consumption relationship shows that marketing plays an important role in enterprises. In the competitive market, it is very important to be able to sell rather than produce. Nowadays, marketing is customer- oriented and aims to meet the needs and expectations of customers to increase their satisfaction. While creating a marketing strategy, an enterprise must consider many factors. Which is why, the process can and should be considered as a multi-criteria decision making (MCDM) case. In this study, marketing strategies and marketing decisions in the new-product-development process has been analyzed in a macro level. To deal quantitatively with imprecision or uncertainty, fuzzy sets theory has been used throughout the analysis.

In a continuously changing environment, like globalization, technological innovation, restructuring and outsourcing, organizations can no longer cope without continually developing their competencies and human resources. As a result academic research and company practices have actively started to develop decision making models in operation and practices to meet toughening competence demands that, moreover, need to be developed at an ever faster pace. In this research paper, we bring together several processes and components in order to provide a comprehensive overview in search for conceptual representations designed to support and develop organizational competence mapping at the individual and organizational level. According to recent research, as a decision making tool Analytic Network Process (ANP) methodology may mitigate the elusiveness of the architecturing competence concept by assisting to determine the importance of criteria and selecting the best alternative between competency models.

It is a critical issue for the continuity of an organization to efficiently evaluate the performance of its employees. The evaluation process has to guarantee a sufficient level of objectivity and a limited level of subjectivity in order to answer the employees' expectancies. In this study, a multi-criteria approach to this problem has been proposed since the employees' performance depends on various criteria simultaneously. It is also considered that those criteria may have interaction. Hence, Choquet Integral has been used to handle this situation. To illustrate the use of the proposed method, the performance of a set of employees working in a company in medical sector is evaluated.