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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: 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.

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.