Transnational Organized Crime and the UN Convention

The United Nations Convention against Transnational Organized Crime, as well as regional, national, and international collaboration to prevent and control transnational organized crime, are discussed in this paper. It investigates the transnational organized crime implementation mechanism and jurisdiction in light of international criminal law and the crimes and elements covered by the Convention. The paper recognizes that, as the importance of international criminal law in combating transnational organized crime grows, the ICC's approach to bringing transnational organized crime under its jurisdiction is gained importance. The main conclusion is that implementing the Convention's prevention and protection mechanism for transnational organized crime has been difficult; hence the ICC's jurisdiction would have an impact on the ground

Renal transplant alıcılarında transplant sonrası nötrofil-lenfosit oranı ve trombosit-lenfosit oranı ile graft fonksiyonu arasındaki ilişki

Aim: The aim of this study was to evaluate the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with acute rejection after kidney transplantation. Material and Methods: A total of 36 adult renal transplant recipients (33 males, 3 females) with a median age of 41 (range, 19-64) years were included in this retrospective study conducted between January 2016 and January 2019. Data on patient demographics and laboratory findings (neutrophil, lymphocyte, platelet, creatinine, eGFR, serum uric acid and C-reactive protein) were recorded. Acute rejection was defined via renal biopsy in accordance with Banff criteria. Results: Acute rejection occurred in 16 (44.4%) patients. NLR (median 3.75 vs. 1.99, p=0.001) and PLR (median 125.59 vs. 99.23, p=0.008) values were significantly higher in the acute rejection group than in the control group. Area under the curve was calculated to be 0.822 for NLR and to be 0.759 for PLR. Cut-off values were determined to be >2.5 (75% sensitivity and 75% specificity) for NLR and to be >108 (81% sensitivity and 65% specificity) for PLR. Univariate analysis revealed a strong correlation of acute rejection both with NLR >2.5 (Odds Ratio (OR)=0.267, 95% Confidence Interval (CI)=0.089-0.803, p=0.019) and PLR >108 (OR=0.231, 95% CI=0.066-0.810, p=0.022). Conclusion: In kidney transplant patients, there is a strong relationship between high NLR and PLR values and the development of acute rejection. As simple, easy-to-access, inexpensive and non-invasive methods, PLR, and particularly NLR, may be potential tests to diagnose posttransplant acute rejectio

Increased levels of cell wall degrading enzymes and peptidases are associated with aggressiveness in a virulent isolate of Pyrenophora teres f. maculata

Pyrenophora teres f. maculata (Ptm) is a fungal pathogen that causes the spot form of net blotch on barley and leads to economic losses in many of the world's barley-growing regions. Isolates of Ptm exhibit varying levels of aggressiveness that result in quantifiable changes in the severity of the disease. Previous research on plant -pathogen interactions has shown that such divergence is reflected in the proteome and secretome of the path-ogen, with certain classes of proteins more prominent in aggressive isolates. Here we have made a detailed comparative analysis of the secretomes of two Ptm isolates, GPS79 and E35 (highly and mildly aggressive, respectively) using a proteomics-based approach. The secretomes were obtained in vitro using media amended with barley leaf sections. Secreted proteins therein were harvested, digested with trypsin, and fractionated offline by HPLC prior to LC-MS in a high-resolution instrument to obtain deep coverage of the proteome. The subsequent analysis used a label-free quantitative proteomics approach with relative quantification of proteins based on precursor ion intensities. A total of 1175 proteins were identified, 931 from Ptm and 244 from barley. Further analysis revealed 160 differentially abundant proteins with at least a two-fold abundance difference between the isolates, with the most enriched in the aggressive GPS79 secretome. These proteins were mainly cell-wall (carbohydrate) degrading enzymes and peptidases, with some oxidoreductases and other pathogenesis-related proteins also identified, suggesting that aggressiveness is associated with an improved ability of GPS79 to overcome cell wall barriers and neutralize host defense responses

Risk of Malnutrition and Its Effects on the Quality of Life of Hospitalized Cancer Patients

Aim:Malnutrition is one of the most common clinical problems in cancer patients. Its frequency increases in hospitalized cancer patients. In this study, it was aimed to investigate the frequency of malnutrition and its effect on quality of life (QOL) in hospitalized cancer patients.Materials and Methods:In this cross-sectional study, Nutrition Risk Screening-2002 (NRS-2002) and European Organization for the Research and Treatment of Cancer (EORTC)-QLQ C30 scales were completed for patients with cancer diagnosed in the medical oncology service. The relationship between clinical and laboratory parameters, malnutrition risk and QOL was analyzed by statistical methods.Results:One-hundred thirteen patients were included in the study. According to the results of NRS-2002, 42.5% (n=48) patients were at risk of malnutrition. There was no difference between the groups in terms of gender and age. When the EORTC-QLQ C30 scale scores were compared, the risk of malnutrition had no effect on the overall health score (p=0.679). Physical function and role function scores were significantly lower in those at risk of malnutrition (worse QOL). There was no statistically significant difference between the groups in terms of other functional scales. When univariate logistic regression (LR) was applied to the factors affecting better general health score, only hemoglobin level was found to be a significant factor. Therefore, multivariate LR was not done.Conclusion:Malnutrition risk assessment should be performed routinely in every hospitalized cancer patient. Early nutritional support should be given to patients at risk. It was observed that patients with malnutrition risk had worse QOL compared to the EORTC-QLQ C30 scale

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The most cited articles on cancer immunotherapy: An update study

Purpose: The purpose of this bibliometric study was to point out the emergence and development of immunotherapy in cancer treatment and shifting tendencies on this field in the last years. We aimed to create an ease of access for the researchers of this dynamic field

The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients

Aim: The aim of this study was to evaluate the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with acute rejection after kidney transplantation. Material and Methods: A total of 36 adult renal transplant recipients (33 males, 3 females) with a median age of 41 (range, 19-64) years were included in this retrospective study conducted between January 2016 and January 2019. Data on patient demographics and laboratory findings (neutrophil, lymphocyte, platelet, creatinine, eGFR, serum uric acid and C-reactive protein) were recorded. Acute rejection was defined via renal biopsy in accordance with Banff criteria. Results: Acute rejection occurred in 16 (44.4%) patients. NLR (median 3.75 vs. 1.99, p=0.001) and PLR (median 125.59 vs. 99.23, p=0.008) values were significantly higher in the acute rejection group than in the control group. Area under the curve was calculated to be 0.822 for NLR and to be 0.759 for PLR. Cut-off values were determined to be >2.5 (75% sensitivity and 75% specificity) for NLR and to be >108 (81% sensitivity and 65% specificity) for PLR. Univariate analysis revealed a strong correlation of acute rejection both with NLR >2.5 (Odds Ratio (OR)=0.267, 95% Confidence Interval (CI)=0.089-0.803, p=0.019) and PLR >108 (OR=0.231, 95% CI=0.066-0.810, p=0.022). Conclusion: In kidney transplant patients, there is a strong relationship between high NLR and PLR values and the development of acute rejection. As simple, easy-to-access, inexpensive and non-invasive methods, PLR, and particularly NLR, may be potential tests to diagnose posttransplant acute rejectio

Blueschist facies overprint of late Triassic Tethyan oceanic crust in a subduction–accretion complex in north-central Anatolia, Turkey

The late Cretaceous accretionary complex along the İzmir–Ankara–Erzincan suture zone, northern Turkey, includes various types of metamorphic rock together with radiolarite, sandstone, mudstone, serpentinite, basalt and limestone. Meta-plagiogranite blocks (up to 5 m in diameter) and a meta-gabbro slice (800 × 500 m) cross-cut by meta-plagiogranite are observed in a matrix of serpentinite, mudstone and radiolarian chert. These meta-gabbros and meta-plagiogranites show subduction-related geochemical characteristics. Laser ablation inductively coupled plasma mass spectrometry U–Pb dating of zircons from two meta-plagiogranites yielded 222.3 ± 1.5 and 227.2 ± 1.6 Ma crystallization ages. This study shows that the meta-gabbro and meta-plagiogranite from the accretionary complex are remnants of the metamorphosed equivalents of the late Triassic lower crustal rocks of the subducted Tethyan oceanic crust. They are the oldest lower crustal rocks observed in the İzmir–Ankara–Erzincan suture zone. Both the meta-gabbros and meta-plagiogranites have Na–Ca amphiboles, indicating blueschist facies metamorphism. However, phengites from a blueschist facies rock yielded an 40Ar/39Ar age of 104.3 ± 0.7 Ma, indicating that blueschist metamorphism occurred during the Albian. All these data suggest that the oceanic crust formed during the Norian, metamorphosed during the Jurassic to early Cretaceous and then dismembered during accretionary complex formation in the late Cretaceous