ABSTRACT
Introduction: Treatment adherence is crucial for the success of Growth Hormone (GH) therapy. Non-adherence rates have varied over a wide range from 5% to 80% in the literature. Several factors may have an impact on treatment adherence. Besides, with the COVID-19 pandemic that affected the whole world, there were problems with the hospital admission and routine controls of the patients who used GH treatment. Objective(s): The survey's primary objective is to investigate adherence to treatment in patients with GH. The survey will also investigate potential problems in GH treatment during the pandemic. Material(s) and Method(s): The survey was sent to pediatric endocrinologists. Patient data, diagnosis, history of pituitary surgery, current GH doses, duration of GH therapy, who administers the therapy (mother and father, patient), duration of missed doses, reasons for missed doses as well as problems associated with GH therapy, and missed dose data in the recent year (after the onset of the pandemic) and causes were asked. The treatment adherence category was determined based on missed dose rates over the past month (0 to 5%, full adherence;5.1 to 10% moderate adherence;>10% non-adherence). Result(s): 427 cases from thirteen centers were evaluated. The median age of diagnosis of the cases (56.2% male) was 8.5 (0.13-16) years. GH treatment indications were isolated GH deficiency (61.4%), multiple pituitary hormone deficiency (14%), Turner syndrome (7.5%), idiopathic GH deficiency (7.5%), and SGA (2.8%), and other (6.8%). GH therapy was administered by 70% parents and 30% patients. Mean daily dose was 32.3 mcg/kg, the annual growth rate was 7.52+/-2.7 cm. GH adherence rate was good (70.3%), moderate (14.7%), and poor (15%), respectively. The reasons for non-adherence were mainly due to forgetting, being tired, inability to access medication, and pen problems. It was noteworthy that the COVID-19 pandemic had a negative effect on adherence in 22%. The problem with an appointment, taking the medication, and anxiety about going to the hospital were the main reasons. There was no difference between genders in the adherence rate. Non-adherence to GH treatment decreased statistically when the patient administered the treatment, increased age, the duration of the treatment, and COVID-19 pandemia. A non-statistical decrease was found in the annual growth rate as the skip rate increased. Conclusion(s): During the COVID-19 pandemic, poor adherence was found to be 15%, and the duration of hormone use and advanced age are important factors. The pandemic period negatively affected compliance.
ABSTRACT
COVID-19 virus, which is a member of the coronavirus family, is a virulent virus that is transmitted by physical contact or air and results in death in infected people. People infected by the COVID-19 virus must be kept in quarantine in a closed area. Therefore, it is very important for the health of the individuals (patient, doctor, nurse, etc.) in the isolation room that, where the area kept closed is completely free of virus. This study was conducted to examine the flow dynamics of the air in the isolation chamber. With the simultaneous operation of the sanitized air machine and the ventilation in the room, it is aimed to investigate the virus killing effect of the air mixed with each other. The flow dynamics, velocity, temperature and turbulence kinetic energy of the air in the isolation chamber were examined. Investigations were carried out to ensure that the mixture of the two air in the room was better and distributed throughout the room © 2022, Journal of Thermal Engineering.All Rights Reserved.
ABSTRACT
Artificial intelligence and machine learning have the potential to address many of the problems that have emerged in higher education due the rapid and haphazard transition to online learning brought about by the coronavirus pandemic. These problems include students' struggle to self-regulate their learning, the increase in curriculum planning and administrative workload for teachers, and the loss of personalized interaction between students and teachers. This chapter explores how artificial intelligence can be used to help students and teachers to adapt to the new realities of online learning, and how these technologies could further transform higher education in the future. By providing more personalized, flexible, inclusive, and engaging learning experiences, artificial intelligence has the potential to re-invigorate students and teachers both and to make virtual classrooms more meaningful and productive.
ABSTRACT
Vitamin D [25 (OH)D] plays a role in many of biological processes, such as bone metabolism, immunomodulation, cell proliferation, differentiation, and regulation. Also, it has anti-inflammatory, antifibrotic, and antioxidant effects. Due to the immunomodulatory effects of 25 (OH)D, its deficiency is blamed for a higher risk for COVID-19 infection. Serum concentrations of 25 (OH)D were inversely associated with proinflammatory cytokines such as increased IL-6, CRP levels, and increased risk of pneumonia or ARDS. Lower 25 (OH)D concentrations are associated with a higher risk for infections, especially from the respiratory tract [1]. Chronic vitamin D deficiency can induce the renin-angiotensin system activation and leads to fibrotic changes that can cause lung injury by inducing proinflammatory cytokine production in human monocytes/macrophages (2). Increased frequency of COVID-19 infection at high latitudes and worse prognosis of these cases made clinicians to think that 25 (OH)D levels may affect the risk and prognosis of COVID-19 infection [3]. In previous reports, in the early pandemic, a higher prevalence of vitamin D deficiency has been reported to be related to high rates of COVID-19 infection, higher risk of invasive mechanical ventilation (IMV), and mortality [6]. Whilst, it is reported that 25 (OH)D may not protect against COVID-19 infection in recent studies. Moreover, it was not associated with disease severity or lethality [4-6]. The active form of vitamin D binds to its receptor (VDR) and modulates its responses. VDR is located on chromosome 12q13, consisting of 9 exons. Vitamin D-VDR signaling regulates the expression of a wide range of physiological functions. Herein, VDR polymorphisms cause a dysfunctional receptor that affects VDR activity. Both innate and adaptive immune responses can vary according to different polymorphisms of VDR. Also VDR polymorphisms have been previously found to be associated with bacterial infections such as tuberculosis [7] and severe Respiratory Syncytial Virus (RSV) bronchiolitis in respect to vitamin D deficiency [8]. Moreover, it was demonstrated that different VDR polymorphisms such as FokI, BsmI, ApaI, and TaqI could change the course of RSV infection in several studies, respectively [8-10]. This study aimed to evaluate if there is any association between the VDR gene polymorphism at FokI, TaqI, BsmI, and ApaI alleles and the prognosis of COVID-19 in respect to vitamin D deficiency. Two-hundred ninety-seven (n=297) patients with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 who were admitted to Marmara University Education and Research Hospital between April and October 2020 were enrolled. The severity of COVID-19 patients was classified into 1-10 according to WHO criteria. The patients' requirement for noninvasive mechanical ventilation (NIMV) or reservoir mask, their requirement for admission to intensive care unit (ICU), mortality, and WHO clinical progression scales were reviewed. Four variant regions of vitamin D receptor (VDR);FokI, BsmI, ApaI, and TaqI were determined using the Restriction Fragment Length Polymorphism (RFLP) technique. To conclude;The effect of VDR polymorphisms on the receptor function causes intensive care unit treatment, disease severity and mortality differences among patients with covid-19 infection in the clinical set-up. VDR Ff genotype was related with disease severity, TT with disease severity and aa with mortality respectively. As a result we have detected that 25 (OH)D levels were not related to COVID-19 infection severity and mortality. Additionally, it indicated that VDR polymorphisms are independently associated with the severity of COVID-19 and the survival of patients. More extensive studies are needed to determine the impact of polymorphisms on COVID-19 and explain the underlying cause.
ABSTRACT
Objective: We aimed to investigate the content of Covid-19 news in the media before and after the declaration of the first Covid-19 case in Turkey, as well as the compatibility of their medical massages with World Health Organisation (WHO) data. Methods: In this descriptive cross-sectional study, Covid-19 news in Turkey's most visited webpages of five newspapers and five internet news sites was examined retrospectively for two months categorized as the periods of one month before and one month after the first Covid-19 case declaration in Turkey. The news was evaluated according to their content, sources, content and headline compatibility, evidence and accuracy levels in terms of WHO reports, its potential to evoke social negative emotions such as anxiety, fear, panic, and to produce negative bias against China. Statistical analysis was performed by using the SPSS 21 program and the results were expressed as numbers and percentages. Results: It was determined that in total of 7915 news, the most content was about the protection and prevention methods. In the news before and after the first case declaration in Turkey, the content-headline incompatibility rates were 50,8% and 1,1%;incompatibility rates of the medical information in the news with WHO reports were 7,1% and 2,9%;the rates of referencing were 74,3% and 66,9%, the rates of the news having the potential to produce anxiety and fear in the reader were 56,9% and 19,6% and to produce prejudice and negative attitudes towards China were 19,7% and 4,6%, respectively. Conclusions: It seems that the declaration of the first Covid-19 case changed the news making pattern of the media to a more responsible behaviour for the public. We suggest that it is a rational approach to use the power of the media correctly in enhancing public awareness towards Covid-19 pandemic.
ABSTRACT
Coronaviruses (CoV) are known to be important pathogens of humans and vertebrates. These viruses can cause respiratory, gastrointestinal and central nervous system infections in humans, animals, birds, bats, mice and many wild animals. Lung-related forms such as bronchitis and pneumonia are more severe than a mild cold-like clinical feature in humans. After the SARS epidemics in 2002 and MERS in 2012, the possibility of CoV transmission from animals to humans (zoonotic CoVs) has been proven. In December 2019, a pneumonia epidemic that started in Wuhan, China and whose cause is unknown, spread worldwide. In January 2020, this virus was identified as the new type of Coronavirus 2019 (nCoV-19) by the World Health Organization (WHO), and in February 2020, the World Health Organization (WHO) declared this epidemic a global emergency, and coronavirus disease 2019 (COVID-19) as explained. In this epidemic, thousands of seriously ill patients die every day due to the lack of specific antiviral treatment and inadequate clinical treatment. The high rate of nucleotide change and recombination of CoVs in recent years has been accelerating largely due to factors such as population, urbanization and modern agriculture and animal husbandry practices. These factors facilitated inter-species mixing and crossing species barriers and led to genomic recombination of CoVs. An effective way to prevent viral zoonotic infections is to protect barriers between natural reservoirs and human society, taking into account the concept of "one health".