The effects of contract mechanisms between the government and private hospitals on the social utility

In this work, we deal with a real healthcare system, in which public and private hospitals with different characteristics co-exist. While public hospitals have lower costs, they also suffer from long waiting times, diminishing the perceived quality of care for patients. Conversely, private hospitals, with their higher fees, offer shorter waiting periods, resulting in a more favorable perception of quality. A balanced healthcare system could offer societal benefits. Pricing strategies greatly influence a patient's hospital selection. For instance, reduced fees in private hospitals attract more patients, consequently reducing overcrowding in public facilities and elevating the overall quality of services provided. This study aims to develop pricing models to foster a balanced and socially advantageous healthcare system. Within this system, private hospital pricing is determined through contract mechanisms with the government. Thus, we delve into the ramifications of various contract models between the government and private hospitals on social utility. Our findings underscore the communal advantages of contract mechanisms. Furthermore, we generalize the proposed models to be applicable to similar systems.info:eu-repo/semantics/publishedVersio

THE RELATION OF RELIGIOUS ATTITUDES AND BEHAVIOURS WITH DEPRESSION IN BOARDING QURAN COURSE STUDENTS

Background: Boarding Quran courses are religious institutions where course attendees spend large part of the year. Depression is an ever-increasing health problem. So, it is worth to study on the effects of religion concept and religious belief and behaviours’ that religion concept brings, on depression. The main purpose of this study, is to analyse the effect of religious attitudes and behaviours on depression in Quran course / hafiz students. Subjects and methods: The study is a cross sectional, case-control survey research. Boarding Quran courses and high schools were visited in Samsun city. A total of 956 participants enrolled between June 2015 and December 2015 were included into study from Samsun city of Turkey. Volunteers, 13 years and over ones without any psychiatric disorders were included in the study. Religious attitude-behaviour inventory and Beck’s depression inventory were used in the study. Results: Median point of case group attitude scale was 49, control group’s was 57 and difference among both has a statistical meaning (p<0.001). Beck’s depression score average of case group is 12.93±9.33, its control group’s average is 13.74±11.14 and difference between them is not important. Median score of both groups are 11. When scores of attitude and depression scales compared with each other in terms of demographic parameters, there is a difference among group, gender, age and education parameters (p<0.001). Conclusions: It was seen that religious attitudes and behaviours can be protective for boarding Quran course students but it cannot be enough by itself

DolphinNext: a distributed data processing platform for high throughput genomics

BACKGROUND: The emergence of high throughput technologies that produce vast amounts of genomic data, such as next-generation sequencing (NGS) is transforming biological research. The dramatic increase in the volume of data, the variety and continuous change of data processing tools, algorithms and databases make analysis the main bottleneck for scientific discovery. The processing of high throughput datasets typically involves many different computational programs, each of which performs a specific step in a pipeline. Given the wide range of applications and organizational infrastructures, there is a great need for highly parallel, flexible, portable, and reproducible data processing frameworks. Several platforms currently exist for the design and execution of complex pipelines. Unfortunately, current platforms lack the necessary combination of parallelism, portability, flexibility and/or reproducibility that are required by the current research environment. To address these shortcomings, workflow frameworks that provide a platform to develop and share portable pipelines have recently arisen. We complement these new platforms by providing a graphical user interface to create, maintain, and execute complex pipelines. Such a platform will simplify robust and reproducible workflow creation for non-technical users as well as provide a robust platform to maintain pipelines for large organizations. RESULTS: To simplify development, maintenance, and execution of complex pipelines we created DolphinNext. DolphinNext facilitates building and deployment of complex pipelines using a modular approach implemented in a graphical interface that relies on the powerful Nextflow workflow framework by providing 1. A drag and drop user interface that visualizes pipelines and allows users to create pipelines without familiarity in underlying programming languages. 2. Modules to execute and monitor pipelines in distributed computing environments such as high-performance clusters and/or cloud 3. Reproducible pipelines with version tracking and stand-alone versions that can be run independently. 4. Modular process design with process revisioning support to increase reusability and pipeline development efficiency. 5. Pipeline sharing with GitHub and automated testing 6. Extensive reports with R-markdown and shiny support for interactive data visualization and analysis. CONCLUSION: DolphinNext is a flexible, intuitive, web-based data processing and analysis platform that enables creating, deploying, sharing, and executing complex Nextflow pipelines with extensive revisioning and interactive reporting to enhance reproducible results

Hypertension and obesity in cardiology outpatients: a cross-sectional study

Introduction: Atherosclerotic cardiovascular diseases are the leading causes of death worldwide. Both hypertension and obesity are frequent in Turkey and are seen in around 30% of the population. This study aimed to determine the prevalence of hypertension and to investigate its relationship with obesity in patients admitted to a cardiology outpatient clinic. Methods: This descriptive cross-sectional study was conducted between the 15th of January and the 28th of February 2018 at the Medical Park İzmir Hospital Cardiology Polyclinics. Data were collected from 55 out of 256 people who were referred to the clinic on the specified dates. Data were collected about systolic and diastolic blood pressures, height, weight, gender, age category, educational status, marital status, and history of hypertension. Results: Of the participants, 35 (63.6%) were men, and 20 (36.4%) were women. The mean age and body mass index values were 44.60±11.03and 28.18±3.89kg/m2, respectively. In total, 85.4% were overweight or obese. The mean systolic and diastolic blood pressures were 140.09±7.99 mmHg and 90.69±7.07 mmHg, respectively. 31 (56.4%) patients had systolic, 34 (61.8%) had diastolic, and 37 (67.3%) had systolic or diastolic hypertension. Of those with hypertension, 26 (70.2%) were not aware of their condition. In the regression analysis, gender was the only independent factor predicting high blood pressure (p=0.005; odds ratio=6.4). Conclusion: Hypertension and obesity were common among patients in the cardiology outpatient clinics. Family physicians are expected to be competent in managing common health problems and are focused on preventive health practices, and thus, they should take a more active role in the struggle against hypertension and obesity

The clinical, cytogenetics and molecular characterization of inverted duplication/deletion of chromosome 8p in a boy with mental and motor retardation: Genotype-phenotype correlation in a case report

Background: Rearrangements that occur mainly through the non-allelic homologous recombination (NAHR) during maternal meiosis in short arms of chromosome 8 is relatively associated with various clinical spectrum.Aim: The objective of this study was to report cytogenetics and molecular characterization of a mental and motor retarded boy with short arm of chromosome 8 rearrangements [invdupdel(8p)] in this current case report. Subjects and methods: We report an 11-year-old boy with scoliosis, intellectual disability, mental-motor retardation and characteristic facial features. Agenesis of corpus callosum was detected with brain Magnetic Resonance Imaging (MRI) analysis. Derivative chromosome 8 structure was identified after conventional cytogenetics – karyotype analysis, Multiplex Ligation-Dependent Probe Amplification (MLPA) and Microarray-based Comparative Genomic Hybridization (aCGH) techniques. Genotype-phenotype correlation in the current proband case will be discussed.Results: Case was diagnosed as 46, XY, der (8), del (8) (p23.1) invdup (8) (p11.1-p23.1) by using advanced comparable techniques. Subtelomeric MLPA analysis showed deletion of FBXO25 gene which is located at 8p23.3 locus and FISH with subtelomeric probes for 8p shows also only deleted region. The microarray- CGH profilling showed 7,9 mb deletion for 8p23.1 and 31 mb duplication for 8p11.1 locuses.Conclusion: Results from the current case emphasized that the cases with clinical manifestations of such disorders extremely need to be examined by combined comparable genetics techniques such as; karyotyping, FISH, MLPA and chromosomal microarray for the accurate phenotype – genotype correlation.Keywords: Chromosomal rearrangement, Corpus callosum, Invdupdel(8p)Array-CGH, MLP

The impact of concurrent HPV infections on the presentation of high grade cervical intraepithelial lesions

Objectives: We investigate how concurrent high-risk (hr) HPV (human papillomavirus) genotypes affect CIN2-3 risk and evaluate the relationship of different genotype combinations with cervical epithelial lesions. Material and methods: This study included HPV positive patients between the ages of 30 and 60 who underwent liquid-based cervical smears and HPV screening through community-based, cervical cancer screening programs between June 2015 and June 2017. The impact of the increase in hrHPV types was calculated by estimating how it changed the odds ratio of CIN2-3 risk. Results: The rate of multiple concurrent HPV infections was 48.7% in the CIN2-3 group and 58.4% in the CIN1 group. Among patients in the CIN2-3 and CIN1 groups, the most common HPV coinfection was respectively HPV 16+31 and HPV 16+51. The HPV 51 ratio in CIN1 patients was 28.9% and the HPV 51 ratio in the CIN2-3 patient was 6.6%. With every increase in the number of hrHPV infection types, the frequency of CIN2-3 decreased [OR: 0.72, 95% CI: 0.54-0.95]. For all hrHPV combinations, the addition of HPV 16 was associated with a higher risk of CIN2-3. Conclusions: An increase in number of hrHPV types is associated with lower CIN2-3 risk. Further cohort studies with larger samples are needed to clarify this relationship. The available evidence suggests that HPV 16 genotype plays an important role in patients with high-grade cervical lesions and has a negative impact on the cervix in concurrent multiple HPV infections

Development of an optimum proliferation medium via the graph kernel statistical analysis method for genetically stable in vitro propagation of endemic Thymus cilicicus (Turkey)

Thymus cilicicus is an endemic Eastern Mediterranean element that has aromatic-medicinal properties. Its natural population spreads across gravelly ground and open rocky areas of South and Southwest Anatolia. The current study on in vitro propagation of T. cilicicus focused deeply on environmental applications such as the development of an optimum medium composition for efficient and genetically stable micropropagation and improved preservation procedures for long-time conservation of elite germplasms for further studies. For this purpose, MS and OM media were used individually and in combination with cytokinins, charcoal, AgNO3, Fe-EDDHA, and H3BO3. The raw data were statistically analyzed via the graph kernel method to optimize the nonlinear relationship between all parameters. The optimal proliferation medium for T. cilicicus was OM supplemented with a combination of 10 g L-1 charcoal and 1 mg L-1 KIN and the calculated averages of the best regeneration rate, the best shoot number and the best shoot length were 96.89%, 3 and 1.24 respectively on this medium. The determination of genetic stability of in vitro grown plants on the optimum medium compositions obtained by the graph kernel method was carried out with the use of the ISSR-PCR technique. All the ISSR primers produced a total of 192 reproductive band profiles, none of which were polymorphic. Furthermore, the micropropagated plants were successfully rooted and acclimatized to greenhouse conditions. In this study, we present a graph kernel multiple propagation index which considers all the possible parameters needing to be analyzed. Such an index is used for the first time for the determination of the optimum proliferation medium

Attitudes and Behaviors Regarding Smoking in Friends and Relatives of Patients in Emergency Room: A New Frontier in the Fight against Tobacco

Background: Emergency rooms (ERs) are usually crowded with friends and relatives (F&Rs) of the patients. This experience may result in changes in smoking behaviors and create opportunities for smoking cessation interventions. The study aims to investigate these changes and offers a new frontier in the fight against smoking.Methods: This cross-sectional study was conducted in the ERs of two universities in different cities. A questionnaire consisting of 18 questions was applied to F&Rs of the emergency patients. Statistical analysis was performed using Jamovi program.Findings: A total of 603 respondents were included in the study. Of them, 71.3% were first-degree relatives, 51.7% waited 5 or more times in ER before, and 68.6% spent 0-2 hours in a day around the ER. Upon witnessing patients in the ERs, 53.4% of the F&Rs had the idea of quitting smoking and 42.9% wanted to have smoking cessation therapy during their wait in the hospital. While 76.1% of the participants were not using different brands of cigarettes when offered in normal life, this rate was lower around the ERs (64.6%) (P < 0.001). Participants smoked 0.82 ± 0.34 cigarette per hour in normal life excluding sleeping time; this number raised almost 6 folds during the wait (4.85 ± 2.11) (P < 0.001).Conclusion: F&Rs smoked more during waiting around ERs. However, they also expressed desire to quit smoking and receive smoking cessation intervention during the wait. Providing smoking cessation counseling to F&Rs in the ER may be a valuable intervention