Real-world efficacy and safety of Ledipasvir + Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir ± Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population. Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed. Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%). Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL)The present study was supported by The Turkish Association for the Study of The Liver (TASL)

Correlates of loneliness among university students

Background The purpose of this study was to investigate level of loneliness, essential needs during university education, and relationships between loneliness, essential needs, and characteristics of university students. A sample comprising 721 students participated in the study. The mean age was 21.58 (SD = 1.73) with a range from 18 to 25. The majority of the students were female (70.6%) and were living in students' dormitory (67.5%) with low (87.8%) income, away from their parents. Methods The UCLA-R loneliness scale and sociodemographic questionnaire which includes an open-ended question on essential needs during university education were administered. Pearson-Product-Moment correlations were used to explore the relationships between participants' loneliness, needs, and characteristics. Results It was found that 60.2% of the participants experienced loneliness. Economical support (81.6%), social interaction (46.9%) and psychosocial support (35%) were the essential needs during university education reported by the participants. The study findings indicate that there were significant relationships between the needs of economical support, social interaction, and loneliness level of university students. Results also show that there were significant relationships among romantic relationship, parents' status and loneliness. Participants' loneliness levels were relatively higher who had not any romantic relationship and were not from married families. Conclusion The findings of this study provided essential information, about Turkish university students, concerning: level of loneliness and relationships that exist among loneliness, needs and sociodemographic characteristics. The findings also suggest implications for psychosocial practice. Because of the mean of loneliness were found to be high (45.49 ± 10.07), for this study, professionals need to pay attention to Turkish university students' psychosocial state, and need to empower them in establishing social relations

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

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

Reactivation risk of Hepatitis B Virus in both HBsAg negative and HBcIgG positive patients with solid malignancy. Is antiviral prophylaxis really necessary?

Prophylactic antiviral treatment is controversial due to a lack of studies in both HBsAg negative/HBcIgG positive patients who treated conventional chemotherapy with solid malignancy, unlike HBsAg positive. In this cross-sectional and retrospective study, we analyzed that the reactivation risk of Hepatitis B Virus (HBVr) of totally 457 HBcIgG positive patients with solid cancer in archives records between 2011 and 2018 years of two different centers. Totally 217 HBcIgG positive patients with solid cancer were included in the study. Anti-HBs positive and negative patients were 119 (54.8%) and 98 (45.2%), respectively. Frequent diagnosis of the patients was lung (28.1%), colorectal (19.4%), breast (17.5%) and hepatobiliary tract cancers (8.3%), respectively. Most of the study population had stage 4 disease (48.8%) and received palliative chemotherapy. When the patients were stratified due to American Gastroenterological Association Institute (AGA) guideline, HBVr risk of chemo regimen was moderate in 21 patients (17.5%), low in 8 patients (3.7%). The majority of the patients were undefined risk group (78.8%). We did not determine any HBVr in the patients who have received different conventional chemotherapy regimens and have different primer tumor site despite all the patients did not receive the prophylactic antiviral drug. [Med-Science 2019; 8(2.000): 418-21

Kayıp Veriler Yerine Yaklaşık Değer Atamak için Kullanılan Gelişmiş Yöntemlerin Farklı Koşullar Altında Karşılaştırılması

In this study, it is aimed to comparatively research of data sets obtained imputation for missing values that is formed by different ratios (%15 and %25) and in different structures (MCAR and MAR) with different methods. This study has been conducted on data set formed by points of 3129 students who participated in mathematics selfefficacy survey and answered it completely among 4848 students -age group of 15- who participated in PISA 2012 from Turkey. Missing data sets have been constituted by deleting data in different ratios to be constitute different structures in the data set. These data sets have been completed by six different nearby value imputation including EM, BIM, PSM, MCMC, MDIM, and RIM. Obtained data sets have been compared with full data sets by scale points of students. in the scope of the research, correlation between obtained scale points and scale points of real data has been seen quite high. Similarly, when scale points is considered, correlation of missing data imputation methods with each other have also been found quite high. Considering the difference between the totals and avarages of student scores calculated from the full data set and imputed data sets EM and MCMC is founded that the best missing data imputation methods under all conditions.Bu araştırmada, farklı oranlarda (%15 ve %25) ve yapılarda (TROK ve ROK) oluşturulan kayıp veriler yerine farklı yöntemlerle yaklaşık değer atanması sonucu elde edilen veri setlerinin tam veri setleriyle karşılaştırılarak incelenmesi amaçlanmıştır. Bu araştırma, PISA’ya (2012) Türkiye’den katılan 15 yaş grubundaki 4848 öğrenci arasından matematik özyeterliği anketine katılan ve eksiksiz bir şekilde yanıtlayan 3129 öğrencinin puanlarından oluşan veri seti üzerinde yürütülmüştür. Söz konusu veri seti içerisinden farklı yapılar oluşturulacak şekilde farklı oranlarda veri silinerek eksik veri setleri oluşturulmuştur. Bu eksik veri setleri BM, BVA, ESE, MUA, MZMC ve RA olmak üzere altı farklı gelişmiş değer atama yöntemiyle tamamlanmıştır. Söz konusu yöntemlerle yapılan yaklaşık değer atamaları sonucu elde edilen ölçek puanları ile tam veri ölçek puanları arasındaki korelasyon değerlerinin yüksek olduğu görülmüştür. Benzer şekilde farklı yöntemlerle tamamlanmış veri setlerinden elde edilen ölçek puanları arasındaki korelasyon değerleri de yüksek bulunmuştur. Tam veri seti ile tamamlanmış veri setlerinden hesaplanan ölçek puanları arası farkların mutlak değer toplamları ve ortalamaları göz önünde bulundurulduğunda belirlenen koşullar altında en iyi çalışan yaklaşık değer atama yöntemlerinin MZMC ve BM olduğu sonucuna ulaşılmıştır

Does Bosentan Protect Diabetic Brain Alterations in Rats? The Role of Endothelin-1 in the Diabetic Brain

Cayir, Yasemin/0000-0001-9133-5460; UN, Harun/0000-0003-1772-282X; Yayla, Muhammed/0000-0002-0659-3084; ATMACA, HASAN TARIK/0000-0001-8379-4114WOS: 000350099600008PubMed: 25200216Diabetes mellitus (DM) is a major problem all over the world, affecting more people in recent years. Individuals with diabetes are more prone to disease than non-diabetics, especially vascular complications. The aim of this study was to examine the roles of the endothelin (ET)-1 in brain damage formed in a streptozocin (STZ)-induced diabetes model, and the effect of bosentan, which is the non-specific ET1 receptor blocker in the prevention of the diabetes-induced brain damage. To examine the effects of bosentan (50mg/kg and 100mg/kg) in this study, the rats were given the drug for 3months. The rats were divided into four groups: the sham group (n=10), the diabetic control group (n=10), the group of diabetic rats given bosentan 50mg/kg (n=10) and the group of diabetic rats given bosentan 100mg/kg (n=10). Diabetes was induced in the rats by STZ (60mg/kg i.p.). On day 91, all rats were killed. Brain tissues of the rats were measured by molecular, biochemical and histopathological methods. Antioxidant levels in the therapy groups were observed as quite near to the values in the healthy group. In this study, while the brain eNOS levels in the diabetic groups decreased, the ET1 and iNOS levels were found to be increased. However, in the diabetes group, hippocampus and cerebellum, pericellular oedema and a number of neuronal cytoretraction were increased in neuropiles, whereas these results were decreased in the therapy group. Based on all of these results, ET1 will not be ignored in diabetes-induced cerebral complications

Examining the Views of Engineering Students about Massive Open Online Courses

30th Annual Conference of the European-Association-for-Education-in-Electrical-and-Information-Engineering (EAEEIE) -- SEP 01-03, 2021 -- Prague, CZECH REPUBLICToday, one of the most important tools of open and distance learning, Massive Open Online Courses (MOOC) has emerged as a continuation of the Open Educational Resources approach. The Open Education Resources (OER) approach was first introduced in 1999, and gained a great momentum in 2002 with the help of the Massachusetts Institute of Technology (MIT). MOOCs are defined as a scalable, free online course with open access that supports learning in different fields. Thanks to these platforms, an interaction between learner-learner and learner-intructor is established and a flexible learning environment is provided. MOOCs, which first appeared in 2008, have increased their popularity with MOOC platforms that include hundreds of courses such as edX, Coursera, Udemy and Udacity with the support of many important universities in the world such as MIT and Harvard. In this study, the thoughts of engineering students about MOOCs were asked with a questionnaire which was used as a data collection tool developed by the researchers. The study was attended by 307 students studying Electrical and Electronics Engineering, Civil Engineering, Industrial Engineering, Aerospace Engineering, Mechanical Engineering, and Food EngineeringEuropean Assoc Educ Elect ; Informat Engn,Czech Convent Bur,Czech Tourism,Eunis CZ,IEEE,IEEE Czechoslovakia Sect,Czech Tech Univ Prague, Fac Elect Engn, Dept Telecommunicat Engn,Ind Applicat Soc Ind Elect Soc Joint Chapter, Czechoslovakia Sect IEEE,Univ Vzdelavani, Ceska Asociace Distancnih