Endosimbiotske bakterije u krpeljima pokrajine Kırşehir, Srednja Anadolija

Ticks are parasites and vectors, whose diet is blood and hosts are vertebrates. Therefore, they are a risk factor for both, public health and farm animals. Ticks have a cosmopolitan distribution, and their prevalence and incidence of diseases caused by them are increasing with the effect of various environmental factors such as global warming. The use of endosymbiotic bacteria (EB) to control pests is a promising environment-friendly approach as an alternative to chemical methods. Therefore, it is necessary to elucidate the ticks symbionts to develop potentially alternative strategies for managing their populations. Aim of this study, was to search for EB in ticks obtained from livestock in Kırşehir, Central Anatolia. EB were identified by morphological and molecular methods. Investigation was conducted on most studied EB in Haemaphysalis spp. and Hyalomma spp. using Arsenophonus, Cardinium, Hamiltonella, Rickettsia, Spiroplasma and Wolbachia specific primers. As a result of the survey, Rickettsia was detected in all locations and samples, while Spiroplasma was detected only one sampling locality. It was that Rickettsia is not species specific and has a wide wide distribution incidence. Spiroplasma was found only in Ha. sulcata. In contrary Arsenophonus, Cardinium, Hamiltonella and Wolbachia were not found in the sampled ticks. On the other hand, although the reason could not be explained, PCR products thought to be the result of non-specific binding with Arsenophonus primers and sequence data similar to Coxiella-like endosymbiont were obtained. This study does not explain the tick-symbiosis relationship, but the findings are considered important for future studies of tick biology and/or tick-borne diseases.Krpelji su paraziti i vektori koji se hrane krvlju, a domaćini su im kralježnjaci. Zbog toga su rizičan čimbenik i za javno zdravlje i za životinje u farmskom uzgoju. Krpelji se nalaze širom svijeta, a prevalencija i incidencija bolesti koje uzrokuju u porastu su zbog utjecaja različitih čimbenika okoliša, poput globalnog zatopljenja. Upotreba endosimbiotskih bakterija (EB) u svrhu kontrole štetočina obećavajuća je ekološki prihvatljiva alternativa kemijskim metodama. Kako bi se razvile potencijalne alternativne strategije za upravljanje populacijama krpelja, potrebno je razjasniti njihove simbionte. Cilj je ovog istraživanja bio izdvojiti EB iz krpelja pronađenih u stoke u Kırşehir pokrajini Srednje Anadolije. Endosimbiotske bakterije identificirane su morfološkim i molekularnim metodama. Istraživanje je provedeno na najčešće promatranim endosimbiotskim bakterijama u vrstama Haemaphysalis spp. i Hyalomma spp. upotrebom primera specifičnih za Arsenophonus, Cardinium, hamiltonele, rikecije, spiroplazme i volbahije. Kao rezultat istraživanja rikecija je pronađena na svim mjestima i u svim uzorcima, a spiroplazma na samo jednom mjestu uzorkovanja. Pokazalo se da rikecija nije specifična za vrste i da je široko rasprostranjena. Spiroplazma je pronađena samo u vrsti Ha. sulcata. Nasuprot tome, Arsenophonus, Cardinium, hamiltonela i volbahija nisu pronađeni u uzorcima krpelja. S druge strane, premda razlog nije otkriven, dobiveni su produkti PCR-a za koje se smatralo da su rezultat nespecifičnog vezanja s primerima Arsenophonus i sekvencom koja se podudara s Coxiellasličnom endosimbiontom. Ovo istraživanje ne objašnjava odnos između krpelja i simbionata, no rezultati se smatraju važnima za buduća istraživanja biologije krpelja i bolesti koje oni prenose

Screening stored wheat beetles for reproductive parasitic endosymbionts in central Turkey

Stored-product pest insects cause significant loss in stored wheat worldwide. In Turkey, an important wheat producer and historic centre of wheat domestication, almost 60 stored-product pest insects have been reported so far, most of them being coleopteran species. Using reproductive parasitic endosymbionts (RPEs) is a promising recent approach among control methods alternative to insecticides. For planning and studying pest management with these bacteria, first of all, their presence in the natural pest populations should be investigated. The present study focused on screening the RPEs in Central Anatolian stored wheat pests. We collected pests in granaries in Kırşehir province and identified 10 coleopteran species both morphologically and genetically; namely, Ahasverus advena, Cryptolestes ferrugineus, C. pusillus, Carpophilus obsoletus, Oryzaephilus surinamensis, Rhyzopertha dominica, Sitophilus granarius, S. oryzae, S. zeamais, and Tribolium castaneum. In these pests, we screened the most commonly studied RPEs worldwide, Arsenophonus, Cardinium, Fritschea, Hamiltonella, Rickettsia, Spiroplasma, and Wolbachia, by using specific genetic primers. As a result, we detected RPE presence in almost all sampling localities visited. The RPEs that we found were Rickettsia, Spiroplasma, and Wolbachia. We found no infection caused by Arsenophonus, Cardinium, Fritschea, nor Hamiltonella. Rickettsia presence was only in S. granarius populations, whereas Spiroplasma and Wolbachia presence were not species specific. 22% of all sampled beetle individuals were Wolbachia positive. The highest detection rate per granary was that of Spiroplasma (80%). Wolbachia and Spiroplasma were the most frequently detected RPEs per insect species. We also found several cases of coinfections. This study is the first attempt to screen stored-product pests for seven RPEs together. © 2020 Elsevier Lt

Butterfly Cartilage Tympanoplasty Long-term Results: Excellent Treatment Method in Small and Medium Sized Perforations

Objectives The aim of this study was to evaluate and report the long-term results of the butterfly cartilage tympanoplasty. Short-term and long-term hearing outcomes were compared according to age and perforation location as well. Methods Ninety-three patients who were diagnosed with noncomplicated chronic otitis media and underwent microscopic transcanal butterfly cartilage tympanoplasty due to anterior, posterior, and central tympanic membrane perforation were included. Age, gender, follow-up time, pre- and postoperative pure tone audiometry thresholds (both air and bone conduction), pre- and postoperative air-bone gaps (ABGs), if any residual perforation was noted. Results At the end of the follow-up period, successful closure occurred in 88 of 93 patients and success rate is 94.6%. In all patients, including those with residual perforations, the mean preoperative bone conduction threshold was 15.9 dB (range, 5 to 50 dB) among all groups whereas mean air conduction threshold was 36.4±15.1 dB (range, 10 to 90 dB) preoperatively and 28.8±14.3 dB in 6th month follow-up and 24.9±14.1 dB 24th month follow-up. Preoperative mean ABG was 22.1±7.1 dB (range, 5 to 40 dB) whereas 13.3±5.9 dB 6 months after surgery and 11.9±5.5 dB 24 months after surgery. There was a significant difference between pre- and postoperative ABG in both 6th and 24th month follow-up (P6 mo-24 mo<0.05). Furthermore, preoperative mean air conduction differed significantly from postoperative 6th and 24th month follow-up mean air conduction thresholds (P<0.05). Conclusion We suggested that butterfly cartilage tympanoplasty can be safely performed in small, moderate, and even large perforations, as the hearing outcomes and successful closure rate are similar to those of other surgical methods. Moreover, it can be performed under local anaesthesia and it has low complication rates

Kablosuz Vücut Algılayıcı Ağları Ve Uzaktan Hasta Takip Sistemi

TÜBİTAK EEEAG Proje01.07.2017Bu projede, kalp yetmezligi, yüksek tansiyon, diyabet ve kronik obstrüktif akciger hastalıgı(KOAH ) gibi kronik hastalıklara sahip hastaların uzaktan izlenmesi için günümüz bilgi vemobil iletisim teknolojilerini kullanan bir teletıp sisteminin gerçeklestirilmesi amaçlanmıstır.Çalısmanın baslangıcını 2010 yılında dünya saglık örgütü (WHO) nun tele-tıp alanındagereksinim duydugu arastırmalar ve aynı yıllarda Eric TOPOL un yaptıgı bir dizi konferans vekitap yayınları olusturmustur. Ancak son yıllarda bu alanda yapılan yayınlar, konferanslar veendüstriyel girisimler öyle artmıstır ki; yaptıgımız çalısmanın öneminden çok endüstriyelyeterliligimizin ve akademik girisimlerimizin gölgelenmemesi endisesi ile projetamamlanmıstır.Proje içeriginde Bluetooth ve Zigbee gibi alternatif teknolojilerde karsılasılan güç tüketimi vegirisim problemlerinin üstesinden gelebilecek IEEE 802.15.6 radyosu yazılım ve donanımıylabirlikte gerçeklestirilmistir. Söz konusu standart 2.36 ile 2.4 GHz arasında 600 kHz likkanallarda sadece saglık verilerinin aktarılabilecegi haberlesme kanallarını öngörmektedir.IEEE 802.15.6 standardının öngördügü haberlesmeyi gerçeklestirecek radyo ve uygulamalarıdestekleyecek yazılımın mevcut olmamasından dolayı projenin önemli bir is yükünü buçalısmalar olusturmustur. Projeyle birlikte uygulamaların gerektirdigi cihazlar arası otomatikhaberlesme, ag kurulumu ve servis tanıma gibi makinadan makinaya haberlesme protokolüde gerçeklestirilmistir. Projenin hedefledigi kablo esdegeri güvenilirlik ve düsük güçlü radyoihtiyacı önemli ölçüde karsılanmıstır.Projenin diger iki temel bileseni insan vücudundan saglık verisini toplayacak algılayıcılar vehasta ile saglık personeli arasında iletisimi saglayıp, saglık personeline yardımcı olacak karardestek sistemi yazılımıdır. Algılayıcılar olarak EKG, Solunum, SPO2, tansiyon, vücut ısısı,agırlık ve ivme ölçüm sensörleri gelistirilmistir. Karar destek yazılımı iki ana bölümdenolusmaktadır. Bunlardan birincisi ölçülen verilerden alarmların üretilmesidir. Burada daha çokEKG verisinden alarm üretilmesine yogunlasılmıstır. Ikincisi ise, EKG aritmilerininsınıflandırılması ile olusturulan karar destek yazılımıdır.This project involves development of a telemedicine system utilizing today's information andmobile communication technologies for remote monitoring of patients with chronic diseasessuch as diabetes, asthma, heart attacks and high blood pressure. Initialization of this study isbased on the publications of Eric TOPOL and The World Health Organization about theimportance of telemedicine and remote patient monitoring in 2010.An important part of the project involves to develop software and hardware for the emergingstandards IEEE 802.15.6, since the power consumptions and interference problems ofZigBee and Bluetooth technologies, which are main rivals for the health industry, are foundunsuitable for a business model of remote patient monitoring. IEEE 802.15.6 offers acommunication highway for health data in 2.36 to 2.4 GHz with 600 kHz of its channels.However there was no hardware and software to implement such a communication andsupport applications required for health industry based on IEEE 802.15.6 standards. So, animportant part of the project is dedicated to implement the required hardware including radioand software. The software also realizes machine to machine communication to implementdevice to device communication to collect health data, as a fashion of machine-to-machinecommunication. The aim of the project, which is obtain a cable equivalent reliablecommunication for health data, has been mostly achieved.Other two essential part of the projects are sensor devices to measure the health data anddecision making system from the measurements. The circuits for ECG, respiration, SPO2,blood-pressure, body temperature and acceleration sensors are developed in a way that theirperformances equivalent to devices used in an intensive care unit. And, a software forgenerating alarms and classification of the disease during the remote monitoring of patientsis developed in order to assist health personnel. The obtained accuracies are published inseveral conferences.Keywords: eHealth, telemedicine, tele-monitoring, IEEE 802.15.6, BAN, M2M, ECG,respiration, SPO2, blood-pessure

The genetic structure of the Turkish population reveals high levels of variation and admixture

The construction of population-based variomes has contributed substantially to our understanding of the genetic basis of human inherited disease. Here, we investigated the genetic structure of Turkey from 3,362 unrelated subjects whose whole exomes (n = 2,589) or whole genomes (n = 773) were sequenced to generate a Turkish (TR) Variome that should serve to facilitate disease gene discovery in Turkey. Consistent with the history of present-day Turkey as a crossroads between Europe and Asia, we found extensive admixture between Balkan, Caucasus, Middle Eastern, and European populations with a closer genetic relationship of the TR population to Europeans than hitherto appreciated. We determined that 50% of TR individuals had high inbreeding coefficients (≥0.0156) with runs of homozygosity longer than 4 Mb being found exclusively in the TR population when compared to 1000 Genomes Project populations. We also found that 28% of exome and 49% of genome variants in the very rare range (allele frequency < 0.005) are unique to the modern TR population. We annotated these variants based on their functional consequences to establish a TR Variome containing alleles of potential medical relevance, a repository of homozygous loss-of-function variants and a TR reference panel for genotype imputation using high-quality haplotypes, to facilitate genome-wide association studies. In addition to providing information on the genetic structure of the modern TR population, these data provide an invaluable resource for future studies to identify variants that are associated with specific phenotypes as well as establishing the phenotypic consequences of mutations in specific genes

Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Publisher Copyright: © 2021 The Authors, some rights reserved.Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-alpha and/or IFN-omega are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-alpha and/or IFN-omega (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-beta. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-alpha and/or IFN-omega are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-beta do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases.Peer reviewe

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6&nbsp;years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P &lt; 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100&nbsp;years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

SignificanceThere is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population