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Vancomycin-resistant Enterococcus faecium (VRE) has been detected in Türkiye. Only limited information is available on its dissemination in the central regions of the country. This study describes the first epidemiological characterization of VRE clinical isolates detected in patients in a hospital in the province of Aksaray. In this one-year study conducted between 2021 and 2022, stool samples from intensive care unit patients were screened for VRE using the phenotypic E-test method, and the antibiotic sensitivity test was analyzed by using the VITEK® 2 system. A molecular assay for confirmation of species level was carried out by 16S rRNA gene-based sequencing and testing for antibiotic resistance (vanA or vanB) and virulence factor-encoding genes (esp, asa1, and hyl). Further, genotypic characterization was determined by macro-restriction fragment pattern analysis (MRFPA) of genomic DNA digested with SmaI restriction enzyme. Of the total 350 Enterococcus positive patients from different hospital intensive care units, 22 (6.3%) were positive for VRE using the phenotypic E-test method. All isolates showed resistance to ampicillin, ciprofloxacin, vancomycin, and teicoplanin and positive amplification for the vanA gene. However, none of the isolates was positive for the vanB gene. The most prevalent virulence gene was esp. The results indicate that the isolates are persistent in the hospital environment and subsequently transmitted to hospitalized patients, thus representing challenges to an outbreak and infection control. These study results would also help formulate more effective strategies to reduce the transmission and propagation of VRE contamination in various hospital settings.

Network slicing is a promising technology for realizing the vision of supporting a wide range of services with diverse and heterogeneous service requirements. With network slicing, the network is partitioned into multiple individual dedicated networks tailored and customized for specific services. However, this causes extra energy consumption to reserve resources for each slice. On the other hand, minimizing the energy consumption in radio access network (RAN) may result in increasing the energy consumption in the cloud and the fronthaul due to higher required processing and data transport. Therefore, the energy should be evaluated from an end-to-end perspective. In this study, we address the problem of minimizing the end-to-end energy consumption of a network with network slicing by jointly reserving communication and computation resources among slices. First, we propose an end-to-end delay and energy model for each slice. We take into account the delays and energy consumption of the radio site, midhaul/fronthaul transport, and the cloud site in an Ethernet-based cloud RAN (C-RAN). Then, we formulate a non-convex optimization problem to minimize the total energy consumption of the network by jointly allocating transmission bandwidth and processing resources in the digital unit pool of the cloud, respectively, to each slice. The constraints of the optimization problem are the total delay requirement of each slice, the maximum allowable bandwidth at each radio unit, the maximum rate limitation of the Ethernet links, and the total processing limit of the cloud. To solve the problem optimally, we transform it into a convex quadratic programming problem. The simulation results show that end-to-end network slicing can decrease the total energy consumption of the network compared to only RAN slicing. We also investigate the impact of the 5G numerology on the allocated resources to each slice and the total energy consumption. We show that using mixed numerology depending on the slice type, we can interplay between delay and energy consumption for each slice.

Araç motorlarında petrol kökenli yakıtlara bağımlı kalındığı sürece çevre kirliliğinin tehlikeli boyutlara ulaşması yadsınamaz bir gerçektir. Ayrıca fosil yakıt kaynaklarının azalması farklı yakıt arayışlarını zorunlu hale getirmiştir. Dolayısıyla günümüzde alternatif yakıtları geliştirme çabaları ve bu yakıtların araç motorlarında kullanılması yaygınlaşmaktadır. Bunun yanı sıra egzoz emisyon standartlarındaki kısıtlayıcı yasalar gereği yenilenebilir alternatif yakıtlarla birlikte emisyon azaltıcı yöntemlerin de kullanılması gereklidir. Bu amaçla bu çalışmada, tek silindirli direkt püskürtmeli ve tam yükte çalışan bir dizel motoruna farklı oranlarda biyodizel (B10, B20 ve B50) ve egzoz gazı resirkülasyonu (EGR) (%10, %15 ve %20) uygulanarak motor performans ve NO emisyonlarındaki değişimler deneysel olarak araştırılmıştır. Deney tasarımının Taguchi optimizasyon yöntemi ile yapıldığı çalışmada L16 ortogonal dizisi kullanılmış, böylece deneyler esnasında zaman ve maliyetten tasarruf edilerek motor performansı ve NO emisyonunun optimizasyonu yapılmıştır. Motor performansı ve NO emisyonu üzerinde etkili faktörler olarak biyodizel, EGR ve devir seçilmiş ve bu faktörlerin farklı seviyeleri kullanılmıştır. Sinyal/Gürültü (S/N) analizi sonucunda motor parametreleri açısından en iyi kombinasyonlar belirlenmiştir. Daha sonra faktörlerin etki dereceleri ANOVA (varyans) analizi ile test edilmiştir. Son olarak doğrulama deneyleri yapılmış ve Taguchi optimizasyonu sonucu elde edilen iyileşmeler standart motor sonuçlarıyla karşılaştırmalı olarak verilmiştir. Motor döndürme momenti ve özgül yakıt sarfiyatı (ÖYS) açısından optimum sonuçlar B20 yakıtında, EGR uygulanmadığında (EGR0) ve 1600 d/d’da elde edilmiştir. Taguchi optimizasyonu sonucu momentte %1,11’lik, ÖYS’de ise %0,67’lik bir iyileşme kaydedilmiştir. NO emisyonunda ise Taguchi optimizasyonu sonucunda %92,3’lük bir iyileşme meydana gelmiştir. ANOVA analizi sonucunda faktörlerin performans parametreleri üzerinde %99 ile %99,99 arasında etkili oldukları saptanmıştır.

Duchenne musculer dystrophy (DMD) is a X linked disorder caused by a deficient or abnormal synthesis of dystrophine protein. Children with DMD are rarely symptomatic at birth or in early infancy, and the diagnosis is extremely difficult and even depends on happenstances. In this article a 5.5-month-old infant in whom increases in liver function tests were detected in routine tests performed for general anesthesia and later diagnosed to have DMD is presented. DMD, as a rare disease should be considered in etiological investigations in infants with elevations in liver function tests of any origin and with normal physical examination findings, and the utility of simple biochemical markers such as creatinin kinase in establishing diagnosis before performing further detailed investigations should be remembered.

The heated 5G network deployment race has already begun with the rapid progress in standardization efforts, backed by the current market availability of 5G-enabled network equipment, ongoing 5G spectrum auctions, early launching of non-standalone 5G network services in a few countries, among others. In this paper, we study current and future wireless networks from the viewpoint of energy efficiency (EE) and sustainability to meet the planned network and service evolution toward, along, and beyond 5G, as also inspired by the findings of the EU Celtic-Plus SooGREEN Project. We highlight the opportunities seized by the project efforts to enable and enrich this green nature of the network as compared to existing technologies. In specific, we present innovative means proposed in SooGREEN to monitor and evaluate EE in 5G networks and beyond. Further solutions are presented to reduce energy consumption and carbon footprint in the different network segments. The latter spans proposed virtualized/cloud architectures, efficient polar coding for fronthauling, mobile network powering via renewable energy and smart grid integration, passive cooling, smart sleeping modes in indoor systems, among others. Finally, we shed light on the open opportunities yet to be investigated and leveraged in future developments.

Nation-State and Western based modernization process is one of the main aims since the foundation of Turkish Republic. In this process, modernization of cities was considered very important. Starting from the 1950s, a big migration process from rural areas to urban areas started in Turkey. This situation accelerated the social change process. Present social structure of the country emerged with the effect of this social change process. While people from different social classes were living together during the traditional neighborhood life, this social structure changed. People from the same social classes preferred living in same/ similar places. But, this structure also started to change in recent years with the effect of government’s housing projects. Aim of this study is to examine the opinion that people from different social classes are living in Housing Development Administration of Turkey’s (TOKİ) cluster housing areas because of their economical price advantages since their location is very far away from the city center and thus, a social structure where people from different social classes are living together may emerge. Throughout this aim, in-depth interviews were done with families living in TOKİ Ankara Yapracık houses

Background : The increasing incidence of drug-resistant Mycobacterium tuberculosis necessitates therapeutic alternatives. The fluoroquinolones fulfill most of the criteria for an ideal class of antimycobacterial drugs. The aim of the present study was to determine to in vitro activities of cipro-floxacin, ofloxacin, and levofloxacin against M. tuberculosis strains. Methods : Susceptibility to four antituberculous drugs used in first-line treatment of tuberculosis was tested in 100 strains isolated from clinical samples. Nineteen strains (19%) were resistant to at least one of the four antituberculous drugs and 13 were multidrug resistant. The in vitro antimycobacterial activity of ciprofloxacin, ofloxacin, and levofloxacin was then determined against 100 M. tuberculosis strains using standard agar proportion dilution method. Results : Ciprofloxacin, ofloxacin, and levofloxacin were active against all tested strains of M. tuberculosis in vitro. Conclusions : Ciprofloxacin, ofloxacin, and levofloxacin have relative-ly potent in vitro activity against M. tuberculosis. Further in vivo studies are needed to determine the role of these compounds in the treatment of tuberculosis, but use should be limited to special circumstances rather than first-line treatment.

Abstract: The first BVR light curves of the eclipsing binary V821 Cas are used to derive the physical parameters of the system. The light curves were obtained during 2000 and 2001 observational seasons at Ege University Observatory (EUO). Period variation of the system was also investigated. For the first time apsidal motion elements of the system were obtained from the O–C curve analyses. Preliminary absolute parameters of the components were computed taking into account the results of light curves analysis. Observational and theoretical internal structure constants were estimated to be , respectively. [Copyright &y& Elsevier]

Introduction: Giant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more than two vertebral segments and have an extraspinal extension of over 2.5 cm. In this case, we report on a 5-year-old boy with a purely extradural giant schwannoma without accompanying neurofibromatosis., Clinical Presentation: A 5-year-old male patient was admitted to the orthopedics and traumatology outpatient clinic with complaints of difficulty in walking following waist and left leg pain after falling from a chair. Contrast-enhanced spinal MRI and cranial MRI showed an extradural spinal lesion measuring 22 × 18 × 35 mm that pushed the spinal cord to the right at the T10-12 level and extended into the left foramen at the T11-12 level. The patient was operated. The tumor was removed completely by performing bilateral laminoplasty at the T10-11-12 levels. Histopathology result reported schwannoma., Conclusion: Giant schwannomas are slow-growing tumors that rarely occur in childhood. In these patients, spinal traumas can lead to serious neurological deficits. Early diagnosis and successful surgery can prevent permanent neurological damage., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study compared the clinical presentations and disease severity between influenza A and B (FLUA and FLUB). The study included children hospitalized with virologically confirmed influenza between 2010 and 2020. The severity of the disease was evaluated based on admission to the pediatric intensive care unit (PICU), mechanical ventilation requirement, length of hospital stay, length of stay in the PICU, and death. Influenza viruses were compared within predefined age groups (0-2, 3-9, and 10-18 years) and in all age groups. Of 343 patients, FLUA and FLUB were detected in 75.8% and 24.2% of children, respectively. FLUB was associated with a higher incidence of headache and abdominal pain (P < .001 and P = .01). Children with FLUB were prescribed antibiotics and antivirals 0.56 and 0.58- fold fewer than those with FLUA. Headache and abdominal pain rates were higher in patients between 3 and 9 years with FLUB. Children between 0 and 2 years with FLUA were more frequently admitted to the PICU than those with FLUB (23.6% vs. 4.0%; P < .004). Eight patients with FLUA died, while only 1 with FLUB died (P = .69). The clinical presentation of FLUA and FLUB appeared similar, except for headache and abdominal pain, which were more prevalent in older patients with FLUB. Our study revealed that children between 0 and 2 years with FLUA were at a significantly higher risk for admission to the PICU. As a result, greater attention and awareness should be paid to children under 2 years old with FLUA.

One of the drugs that has been suggested for the treatment of SARS-CoV-2 infection is tenofovir disoproxil (TDF). Herein, it was aimed to evaluate the outcomes of TDF receiving COVID-19 cases in terms of day 7-10 PCR negativity and day 30 survival. Patients who received TDF due to PCR-confirmed COVID-19 between 27.04.2021 and 31.12.2021 were included in our study. The primary outcome was considered to be 7-10 days of PCR negativity, while the secondary outcome was considered 30-day survival after diagnosis of COVID-19. Patients who died before completing the treatment period (7-10 days) were also considered as PCR failures. Data were analyzed both in terms of intention to treat basis and in the subgroup that survived to the end of treatment. A total of 78 patients (30 women, mean age: 61.15±18.5 years) met the inclusion criteria. In the intention to treat analysis group, one-month-mortality was 44.87% (35/78) in the overall cohort. In the end of treatment analysis group, one-month-mortality was 29.5% (18/61) in the overall cohort. Day 7-10 PCR negativity was detected in 55.7% of the overall EOT cohort. Our data suggest that TDF may be an alternative salvage treatment option in antiviral unresponsive patients. We suggest evaluating TDF in well-designed controlled trials involving treatment-naïve cases.

Background/aim: Although seasonal human coronaviruses (HCoVs) have long been recognized as respiratory tract viruses, the newly identified SARS-CoV-2 caused a pandemic associated with severe respiratory failure. We aimed to evaluate the incidence of COVID-19 infection in patients diagnosed in three tertiary teaching hospitals, both with and without prior confirmed HCoV infection, and to compare these cohorts in terms of COVID-19 contraction., Materials and Methods: In our study, we examined HCoV PCR-positive cases obtained retrospectively between January 2014 and March 2020 from three University Hospital Microbiology Laboratories (Cohort 1), as well as PCR-negative patients detected in the same PCR cycle as the positive cases (Cohort 2). We also evaluated subgroups of HCoV-positive cases., Results: There was no difference in COVID-19 contraction rates between Cohort 1 and Cohort 2 (p = 0.724). When previous HCoV subgroups of COVID-19-positive patients were examined, no significant difference was found between the betacoronavirus and alphacoronavirus subgroups (p = 0.822), among the four groups (NL63, 229E, OC43, HKU-1) (p = 0.207), or between the OC43 subgroup and the other groups (p = 0.295)., Conclusion: Being previously infected with HCoV did not provide protection against COVID-19 in our study group. We suggest evaluating the possible effect of previous OC43 infection on COVID-19 contraction in larger cohorts., Competing Interests: Conflict of interest: The authors declare that they have no competing interests., (© TÜBİTAK.)

Various clinical outcomes, reinfections, vaccination programs, and antibody responses resulted from the COVID-19 pandemic. This study investigated the time-dependent changes in SARS-CoV-2 antibody responses in infected and/or vaccinated and unvaccinated individuals and to provide insights into spike and nucleocapsid antibodies, which fluctuate during infectious and non-infectious states. This cohort study was carried out at the Ege University Faculty of Medicine hospital in İzmir (western Turkey) and the Erciyes University Faculty of Medicine hospital in Kayseri (central Turkey) between December 2021 and January 2023, which coincided with the second half of COVID-19 pandemic. The study included 100 COVID-19 PCR-positive patients and 190 healthcare workers (HCWs). Antibody levels were followed up via quantitative anti-SARS-CoV-2 spike and qualitative anti-nucleocapsid immunoassays (Elecsys™). Antibody levels declined after infection but persisted for at least 6-8 months. Individuals who had received only CoronaVac had higher anti-nucleocapsid antibody levels in the early months than those who received mixed vaccination. However, anti-spike antibodies persisted longer and at higher levels in individuals who had received mixed vaccinations. This suggests that combining two different vaccine platforms may provide a synergistic effect, resulting in more durable and broad-spectrum immunity against SARS-CoV-2. The study provides information about the vaccination and antibody status of healthcare workers in the second half of the pandemic and provides valuable insights into the dynamics of antibody responses to COVID-19 infection and vaccination.

Background: This study focused on timelines of infection episodes and dominant variants and aims to determine disease severity and outcome of pediatric patients with reinfection., Materials and Methods: This study retrospectively evaluated the medical records of the hospitalized patients and/or outpatients aged 0-18 with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction between March 2020 and September 2022 at Ege University Children's Hospital., Results: Ninety-one pediatric patients reinfected with SARS-CoV-2 were included in the study. There was an underlying disease in 26.4% of the patients. The median time between the two infection episodes was 184 (90-662) days. There were 24 patients (26.3%) with the first infection in pre-Delta period; 17 (18.6%) of them were reinfected in Omicron BA.1 period, while 7 (7.6%) in Omicron BA.4/BA.5 period. Forty-five patients (49.4%) were infected initially in the Delta period; 35 patients (38.4%) were reinfected in the Omicron BA.1 period, while 10 patients (10.9%) were reinfected in the Omicron BA.4/BA.5 period. Twenty-two patients (24.1%) had the first infection in the Omicron BA.1 period and then reinfected in the Omicron BA.4/BA.5 period. Patients with reinfection more frequently displayed a symptom (84.6% vs. 94.5%, p = 0.03). The hospitalization rate significantly declined in reinfection (15.3% vs. 7.6%, p = 0.03). Severe disease, treatment needs and steroid use were decreased in reinfections without a significant difference (p > 0.05). Intensive care unit admission was not altered., Conclusion: This study revealed that reinfections frequently develop in previously healthy children but do not cause more severe outcomes. The risk of symptomatic reinfections is still high due to the effect of the Omicron variant., (© The Author(s) [2023]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)