Dualisation of the Symmetric Space Sigma Model with Couplings

The first-order formulation of the G/K symmetric space sigma model of the scalar cosets of the supergravity theories is discussed when there is coupling of (m-1)-form matter fields. The Lie superalgebra which enables the dualized coset formulation is constructed for a general scalar coset G/K with matter coupling where G is a non-compact real form of a semi-simple Lie group and K is its maximal compact subgroup.Comment: 17 page

Dualisation of the D=7 Heterotic String

The dualisation and the first-order formulation of the D=7 abelian Yang-Mills supergravity which is the low energy effective limit of the D=7 fully Higssed heterotic string is discussed. The non-linear coset formulation of the scalars is enlarged to include the entire bosonic sector by introducing dual fields and by constructing the Lie superalgebra which generates the dualized coset element.Comment: 20 page

Determination of Immunization Status of Pregnant Women Who Attending The Family Health Center

Amaç: Araştırmanın amacı, aile sağlığı merkezlerine başvuran gebelerin bağışıklama durumlarının belirlenmesidir. Gereç ve Yöntem: Karşılaştırmalı-tanımlayıcı desendeki araştırma, İzmir merkez ilçesinde yer alan 10 aile sağlığı merkezinde görüşülen 1021 gebe ile gerçekleştirilmiştir. Veriler, görüşme formu ile toplanmıştır. Veriler sayı, yüzde, varyans ve ki-kare analizi ile değerlendirilmiştir. Bulgular: Gebelerin yaş ortalaması 27,96±4,89 olup %43,9’u lise mezunudur. Gebelik sayısı medyanı iki ve canlı doğum sayısı birdir. Gebelerin %82,2’si aşılanma ile ilgili bilgi almış olup, bunlardan %75,8’inin bilgi kaynağı sağlık çalışanlarıdır. Gebelerin %37,8’i aşı kartı olmadığını bildirmiştir. Gebelik döneminde gebelerin %63,2’si tetanoz, %10,3’ü hepatit B, %11,9’u grip, %3,4’ü pnömokok, %3,0’ü kuduz aşısı yaptırmıştır. Gebelerin eğitim, gelir düzeyi, çalışma durumu, son bir yılda aile sağlığı merkezine gelme durumu, planlı gebelik durumu ile aşılarla ilgili bilgi alma ve aşı kartı bulunma durumu arasında anlamlı fark olduğu saptanmıştır (p<0,001). Eğitim ve gelir düzeyi yüksek, planlı gebeliği olan ve son bir yıl içinde aile sağlığı merkezine başvuran gebelerin aşıya ilişkin bilgileri artmaktadır (p<0,000). Sonuç: Araştırmaya katılan gebelerden yaklaşık beşte birinin aşı yaptırmamış olması ve gebelik dönemi bağışıklamayla ilgili bilgisinin olmaması ana çocuk sağlığı açısından göz ardı edilmemesi gereken bir durumdur. Birinci basamakta çalışan hemşireler tarafından bağışıklama konusunda planlı ve sürekli eğitimlerin yapılması hem anne hem bebek sağlığı açısından önemlidir.Objective: The aim of this study is to determine the immunization status of pregnant women who attend family health centers. Material and Method: Descriptive- comparative research design was carried out with 1027 pregnant women interviewed in 10 family health centers in the İzmir central district region. The data was collected with the interview form. Number, percentage, variance, and chi-square analysis were used to analyze the results. Results: The pregnant women’s average age was 27.96±4.89, 43.9% of the pregnant women were high school graduates. The median number of pregnancies was two, and the number of live births was one. Of the pregnant women, 82.2% received information about immunization, and 75.8% received information from healthcare workers. Of the pregnant women, 37.8% reported that they did not have an immunization card. During pregnancy, 63.2% of pregnant women were vaccinated against tetanus, 10.3% against hepatitis B, 11.9% against influenza, 3.4% against pneumococcus, and 3.0% against rabies. There was a significant difference in the pregnant women's education, the level of income, and the employment status, as well as the status of last years’ attendance at the family health center, the planning status of the pregnancy, and the status of obtaining information about vaccines and having a vaccination card (p<0.001). Those who have a high level of education and income, have been planned pregnancy, and have been applied at the family health center for the past year are increasing their knowledge (p<0.000). Conclusion: Approximately one fifth of the pregnant women in the sample were not vaccinated, and the lack of awareness about immunization during pregnancy is a situation that should not be overlooked in terms of maternal and child health. Planned and ongoing immunization training by nurses working in primary care is crucial for the health of both the mother and the infan

State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS)

PCOS, a heterogeneous disorder characterized by cystic ovarian morphology, androgen excess, and/or irregular periods, emerges during or shortly after puberty. Peri- and post-pubertal obesity, insulin resistance and consequent hyperinsulinemia are highly prevalent co-morbidities of PCOS and promote an ongoing state of excess androgen. Given the relationship of insulin to androgen excess, reduction of insulin secretion and/or improvement of its action at target tissues offer the possibility of improving the physical stigmata of androgen excess by correction of the reproductive dysfunction and preventing metabolic derangements from becoming entrenched. While lifestyle changes that concentrate on behavioral, dietary and exercise regimens should be considered as first line therapy for weight reduction and normalization of insulin levels in adolescents with PCOS, several therapeutic options are available and in wide use, including oral contraceptives, metformin, thiazolidenediones and spironolactone. Overwhelmingly, the data on the safety and efficacy of these medications derive from the adult PCOS literature. Despite the paucity of randomized control trials to adequately evaluate these modalities in adolescents, their use, particularly that of metformin, has gained popularity in the pediatric endocrine community. In this article, we present an overview of the use of insulin sensitizing medications in PCOS and review both the adult and (where available) adolescent literature, focusing specifically on the use of metformin in both mono- and combination therapy

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Results of Scoliosis Screening in Primary School Students

Amaç: Bu çalışmanın amacı üç ilköğretim okulunda eğitim gören 10-14 yaş arasındaki okul çocuklarında skolyoz prevalansını incelemek, skolyoz farkındalığını arttırmak ve politika yapıcılar için veri kaynağı sağlamaktır. Gereç ve Yöntem: Kesitsel tipte planlanan bu çalışmaya tarama yapılmasına ailesi izin veren, taramaya katılmaya gönüllü olan öğrenciler dâhil edilmiştir (n: 963). Veri toplamada Skolyoz Tarama Formu kullanılmış olup, Adam’s Öne Eğilme Testi (Adam’s Forward Bending Test) ve vertebra palpasyonu yapılmıştır. Veri analizinde SPSS 22.0 (Statistical Package for Social Sciences) paket programı kullanılmıştır. Bulgular: Skolyoz şüphesi olan öğrencilerin (n: 73) %8.2’si hekim tanısı almıştır. Skolyoz prevalansı kızlar için 0.099, erkekler için 0.052’dir. Öğrencilerin %55.5’i okulda yazı yazarken sıraya eğilmek zorunda kaldığını, %58,1’i okul çantasının ağırlığından dolayı rahatsız olduğunu belirtmiştir. Ayrıca %13.6’sı yatakta sırt ağrısı çektiğini, %25.8’i sırada otururken kendini rahatsız hissettiğini ifade etmiştir. Düzenli olarak spor yapanların oranı %58.4’dür. Sonuç: Araştırma sonuçları tarama yolu ile skolyozun erken tanılanabileceğini göstermiştir. Okul sağlığı alanında yürütülecek programlarda hemşirelerin omurga deformitelerini önlemek üzere öğretmenlerle işbirliği içerisinde, postür eğitimi, ağırlık taşıma yöntemleri, egzersizin önemi konularında eğitim programları düzenlemesi ve bunların okul idaresi ve rehber öğretmenlerle birlikte düzenli aralıklarla tekrarlanması önerilmektedirObjective: The purpose of this study is to investigate the prevalence of scoliosis in 10- to 14-year-old children attending three primary schools, to raise awareness of scoliosis, and to provide a data source for policy makers. Material and Methods: Volunteer students whose parents gave permission for screening were recruited to this cross-sectional study (n: 963). For data collection, the Scoliosis Screening Form was used. In addition, Adam’s Forward Bending Test was administered and vertebra palpation was performed. The SPSS 22.0 (Statistical Package for Social Sciences) was used for the data analysis. Findings: Of the students suspected to have scoliosis (n: 73), 8.2% were diagnosed with scoliosis by the physician. The prevalence of scoliosis was 0.099 in girls and 0.052 in boys. Of the students, 55.5% stated that they had to lean on the desk while writing at school, 58.1% said they were uncomfortable due to the heavy weight of the school bag. Also 13.6% stated that they had back pain in bed, 25.8% said they felt uncomfortable in the sitting position. Ratio of students exercising regularly was 58.4%. Conclusion: The results of the study demonstrated that scoliosis could be diagnosed early through screening. It is recommended that to prevent spinal deformities, school health programs should include training programs organized by nurses on the importance of achieving the correct upright posture, weight bearing methods and exercise, and that nurses should repeat these training programs in cooperation with school administration and school counselors

Flow Calculations in Straight-Through Labyrinth Seals by Using Moody\u27s Friction-Factor Model

In this work, the gas flow in the straight-through labyrinth seal is studied. Leakage flowrate and pressure distributions are calculated by using Neumann Modifed Method and circumferential velocity distributions are calculated by using Moody\u27s Friction-Factor Model. Results are compared to the other papers

Effects of perinatal loss on current pregnancy in Turkey

Objective: to evaluate how a history of pregnancy loss in the perinatal period (from 20 weeks of gestation to seven days post partum) affects women during subsequent pregnancies