A System Design with Deep Learning and IoT to Ensure Education Continuity for Post-COVID

In this paper, an IoT and deep learning-based comprehensive study to reduce the effects of COVID-19 on the education system is presented. The proposed system consists of an edge device, IoT nodes, and a neural network that runs on a server. The purpose of the proposed system is to protect students and staff against infectious diseases and increase the students performance during classes by monitoring the environmental conditions via an IoT-based sensor network, during the current pandemic to ensure the use of masks in closed areas by training a customized deep learning model, and to monitor the student attendance data by deep learning and IoT-based solution. Furthermore, effective heating and cooling can be done to save energy by transmitting the environmental conditions of the indoor environment to the relevant destinations. The experiment is conducted with five different networks to classify the faces in the images as masked or unmasked, and their performances were examined. The networks were trained on the Face Mask Detection Dataset which contains a total of 7553 masked and unmasked images. The best results were obtained as 99.5% for the F1 Score and 99% for MCC by the model trained on the InceptionV3 network. IEEE

Digital Divide vs. Inclusive Thinking: The Educational Television in Turkey

Due to the COVID-19 pandemic, schools closed down in many countries, and the students participate in virtual-only classes. However, as there is no equality in access to technology and connectivity among the populations, this has become a major problem for the millions, intensifying the digital divide. Thus, in order to mitigate this digital gap, many countries have taken several measures to use educational technology in different ways. Turkey is one of them and has supported distance education through the use of educational television. Therefore, this chapter explores the implementation of educational television by introducing its background, use, and contributions to foreign language instruction and contextualises it in a scholarly discussion of the digital divide and inclusive education within the local context of Turkey. Ultimately, the chapter provides recommendations for the policymakers to support inclusive education to embrace wide masses of learners. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Evaluation of the Effect of Omicron Variant on Case Numbers in Children

Background. SARS-CoV-2 Omicron variant has become dominant in many countries, and a significant increase in the number of cases has been noted due to this highly contagious variant. This study aimed to determine the changes in case numbers, age distribution and hospitalized patients' characteristics in children with COVID-19 by comparing the Omicron variant that was dominant before. Methods. 5647 pediatric patients with SARS-CoV-2 PCR positive between 11 March 2020 and 28 February 2021 at Ege University Hospital were included in the study. Two time periods of 2.5 months were determined: Omicron predominant period (16 December 2021 and 28 February 2022) and the pre-Omicron period (1 October and 15 December 2021). The information was obtained from the files of patients retrospectively. Results. The Omicron variant caused a significant increase in pediatric patients after December 15, 2021 (Graphic 1). There were 2893 pediatric patients since the beginning of the pandemic, while 2754 pediatric patients after the Omicron variant only the 2.5 months. While the test positivity rate was 10.4% on average before the Omicron, it increased to 30.37% on average after Omicron (Graphic 2). The comparison of the epidemiological characteristics of the Omicron and the pre-Omicron period is given in Table 1. In the Omicron period, 17.1% of the cases were 0-4 years old, and 0-6 months was 3.9%. While the disease was more common in children over 5 years old in the pre-Omicron period, a 4.6-fold increase was observed in 0-4 years after Omicron. Children under the age of 5 constitute 51.9% of the hospitalized children;a 4.5-fold increase occurred in the Omicron period. While hospitalization rates increased after the Omicron, no significant difference was found in intensive care unit admission. There was a significant decrease in the number of patients receiving oxygen and the need for mechanical ventilation. Number of SARS-CoV-2 PCR positive children by months in Ege University Hospital Conclusion. The number of cases in children increased with the effect of the Omicron variant, especially the increase was more pronounced between 0-4 years of age. Despite this increase in the cases, no serious increase was observed in the severity of the disease, but a decrease in pneumonia, oxygen demand, and mechanical ventilator requirement was observed. While the number of tests decreased, test positivity rates increased. (Figure Presented).

Cardiac Assessment in Children with MIS-C: Late Magnetic Resonance Imaging Features

Background. Multisystem Inflammatory Syndrome (MIS-C), a new entity in children which developed 2-4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a severe condition. It can affect the multisystem, while the most severe manifestation is cardiac involvement. Left ventricular dysfunction, cardiogenic shock, coronary artery dilatation/aneurysm, valvulitis, pericardial effusion, arrhythmia, and conduction abnormalities were reported in approximately 80% of children with cardiovascular system involvement. It is still unclear the duration of the cardiac symptoms, and even they are permanent or persistent. Few studies evaluated persistent cardiac abnormalities by cardiac magnetic resonance imaging (MRI). Therefore, we aimed to assess persisting cardiac abnormalities with MIS-C by cardiac MRI and compare them with echocardiograms. Methods. A retrospective study was conducted at a tertiary-level University Hospital between June 2020-July 2021. Thirty-four children diagnosed with MIS-C according to the criteria defined by the Centers for Disease Control and Prevention were retrospectively evaluated. Results. The study included 17 males and 17 females with a mean age of 9.31 +/-4.72 years. Initial echocardiographic evaluation showed cardiac abnormality in 18 (52.9%) patients;4 (11.8%) pericardial effusion, 4 (11.8%) left ventricular ejection fraction (LVEF) < 55%, 5 (14.7%) LV fractional shortening < 30%, 5 (14.7%) coronary artery dilatation. Echocardiography showed normal LV systolic function in all patients at follow-up;coronary dilatation persisted in 2 of 5 (40 %) patients at the 6th-month visit. Cardiac MRI was performed in 31 (91.2%) patients. We didn't detect abnormal T1 levels, whereas 9 (29%) had isolated elevated T2 values. 19 (61.3%) of 31 patients had at least one of the followingfindings: pericardial effusion, right ventricular dysfunction, LVEF abnormality. Conclusion. Cardiac involvement persisted at a higher rate which was shown by cardiac MRI in the late period, particularly pericardial effusion. Cardiac MRI may be suggested for all MIS-C patients at a later phase. Prospective studies with larger sample sizes are needed to determine long-term cardiac effects.

Quantitative Antibody Levels Against SARS-CoV-2 Spike Protein in Children with COVID-19 and MIS-C

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has different clinical courses in children and adults. The majority of coronavirus diseases 2019 (COVID-19) caused by SARS-CoV-2 are either mild or asymptomatic in children. This report aimed to determine quantitative antibody levels against SARS-CoV-2 spike protein in children with COVID-19 and MIS-C. Methods. A single-center retrospective study was conducted at a tertiary-level university hospital. Seventy-five pediatric patients diagnosed with COVID-19 and MIS-C were included between September 2021 and February 2022. The demographic, clinical and laboratory data of cases were extracted from medical records. The duration of hospitalization, management, and outcomes was reported. Quantitative antibody levels against SARS-CoV-2 spike protein in the third month after the initial diagnosis was measured, and patients were also evaluated for post-COVID-19 syndrome symptoms . Results. The patients were categorized into three disease phenotypes;there were 36 (48%) patients with mild/asymptomatic (group1)( M/F 20/16, mean age, 11.4 years) 22 (29.3%) patients with moderate to severe SARS-CoV-2 infection (group 2)(M/F 13/9, mean age, 13 years) and 17 (22.6%) patients with MIS-C (group 3)( M/F 9/8, mean age, 10.1 years). The majority of the children in group 1 (80.6%), in group 2(90.9%), and in group 3(82.4%) had a detectable IgG antibodies to SARS-CoV-2 spike protein(p=0.567). The mean antibody values against SARS-CoV-2 spike protein was 321.9+/-411.6 in group 1, 274+/-261 in group 2, and 220+/-299 in group 3 (p >0.05). The antibody positivity rate was similar in patients with COVID-19(85.5%) and MIS-C (82.4%) (p=0.833). The mean antibody value against SARS-CoV-2 spike protein was 303.9+/-360.3 in the COVID-19 group and 220 +/-299 in the MIS-C group(p >0.05). Conclusion. The majority of the children had a detectable IgG antibody level to SARS-CoV-2 spike protein. There was no difference between asymptomatic/mild disease, moderate/severe disease, and MIS-C groups in mean antibody levels. Long-term studies are needed to examine antibody responses over time in children with COVID-19 and MIS-C for different vaccination schedules.

How does COVID-19 fear affect job insecurity and stress for hospitality employees? A moderated mediation model for age and financial status

This study aims to understand the integrated effect of COVID-19 fear, age, financial situation, and job insecurity on the perceived stress of employees of five-star hotels during the COVID-19 pandemic by proposing a moderated mediation model. A survey was administered to 631 hotel employees working in 22 different five-star hotels in Alanya, Turkey. Moderator, mediation, and moderated mediation relationships were tested with the SPSS macro PROCESS. It was found that COVID-19 fear has both direct and interactive effects on stress and job insecurity, and the indirect effect of COVID-19 fear on stress through job insecurity varies according to the age of the employees and their financial status. The results, which contribute to a better understanding of the effects of COVID-19 on hospitality employees, point out the importance of financial support (organisational and governmental) and transparent communication between the management and employees in times of crisis, such as the COVID-19 pandemic. It is also suggested that hotels should review their unpaid leave policies. The limitations of the study are discussed at the end.

Comparison of Code Blue Practices Between the First Year of COVID-19 and the Previous Year

Aim: After the coronavirus disease-2019 (COVID-19) infection was declared a pandemic, there were some changes made to the code blue and resuscitation practices. We compared code blue practices between the first year of COVID-19 and the previous year. Methods: We accepted the pre-pandemic (group 1) period from March 11(th), 2019 to March 11(th), 2020, and the post-pandemic (group 2) period from March 11(th), 2020 to March 11(th), 2021. The study was designed as a cross-sectional study. We investigated the incidence of code blue, the unit where the call was made, the team's time of arrival, the return of spontaneous circulation (ROSC), the duration of cardiopulmonary resuscitation, and the general outcomes. We analyzed the 6 month follow-ups of the patients. Results: There was an increase in the incidence of code blue in group 2 (0.4-0.9%). The two groups showed a significant difference in the time of arrival, ROSC, and 1 month and 6 month survival. The ROSC rate and 1 month survival were lower in COVID-19 patients (p < 0.001). Six month survival was lower in COVID-19 patients (p=0.031). We identified 63 faulty calls, and 38 of these patients died within 6 months. Conclusion: The faulty code blue calls may be a predictor of poor prognosis, and early warning systems should be developed for patients with poor conditions.

Impact of the COVID-19 pandemic on the family and social lives of healthcare professionals

Purpose: In this study, it was aimed to evaluate the impact of the novel coronavirus-2019 (COVID-19) on the family and social lives of frontline healthcare workers during the pandemic. Materials and Methods: A total of 136 frontline healthcare workers working in COVID-19 clinics and wards, intensive care units (ICUs), and emergency units were included. A questionnaire consisting of 19 questions was applied to all participants through face-to-face interviews. The demographic and occupational characteristics and family and social lives of the participants were documented. Results: While 95 (69.9%) of the participants experienced negative consequences in their family life, 91 (66.9%) of them were found to have negative consequences in their social life. 51 of the healthcare professionals (37.5%) used spirituality as a strategy to cope with negative thoughts and emotions. During the pandemic, a statistically significant relationship was found between frontline work and family life, especially for those with children. Conclusion: The family and social lives of healthcare professionals who care for patients with Covid are adversely affected.

Evaluation of Covid-19 cases that applied to the hospital at the first peak of the pandemic

Early diagnosis in COVID-19 is essential in terms of treatment and prevention of contagiousness. In this study, we aimed to find an alternative diagnosis method by using fewer laboratory parameters in the early diagnosis of COVID-19 disease by creating a fast, easily accessible, costeffective index and has a diagnostic accuracy rate of over 90%. All patients over the age of 18 who applied to Hitit University Erol Olcok Training and Research Hospital Emergency COVID Outpatient Clinic with a pre-diagnosis of COVID-19 between March and April 2020 were evaluated retrospectively. Patients were divided into two groups as COVID-19 positive and COVID-19 negative. It was aimed to create a HITIT-19 index by evaluating the cases according to the clinical and laboratory results. Between March and April 2020 (in the first peak of the pandemic), 1586 patients were applied to the Emergency COVID-19 outpatient clinic with a pre-diagnosis of COVID-19. According to COVID- 19 RT-PCR, card test, and CT involvement, 285 (13%) patients were diagnosed with COVID-19. PCR was positive in 285 (18%) of 1586 patients, and PCR was negative in 1301 (82%). While 153 (53.7%) of the patients diagnosed with COVID-19 were male and the median age was 45 (28-62.75), 883 (55.7%) of the patients not diagnosed with COVID-19 were male, and the median age was 43 (31-65). Hypertension (HT) was the most common underlying disease in 10.5% of patients applied to the emergency room with a diagnosis of COVID-19, while 38.9% dyspnea and 35.1% fever were the most common symptoms. While 76% of Plaquenil and 58% azithromycin were the most frequently started treatments, 31.4% (28.4% of them were hospitalized in the service, 3% in the intensive care unit) of them hospitalized. It was to create a HITIT-19 index that is fast, easily accessible, cost-effective, and has a diagnostic accuracy rate of over 90% by using laboratory tests. However, we could not achieve this goal due to the low accuracy of the diagnostic tests and the lack of significant change in the laboratory levels of the patients at admission. Considering that the pandemic is continuing rapidly, there is still a need to develop practical diagnostic methods that are easier and cheaper in diagnosis. In this sense, we believe that our study will be a guiding study for other studies that will be designed for diagnostic index studies.

Management of Patients with Hereditary Angioedema During the COVID-19 Pandemic

Objective: The aim of this study was to determine the clinical course and treatment outcomes of patients with hereditary angioedema (HAE) after infection with coronavirus disease 2019 (COVID-19). Materials and Methods: Thirty-nine patients with HAE were included in this study. These patients were regularly followed up over phone calls since the first COVID-19 case was seen in our country. Patients were asked to visit the hospital if there was a history of contact with a confirmed COVID-19 patient or if the patient developed clinical symptoms of COVID-19. Results: There were 21 (54%) patients with type I HAE, and 18 (46%) with type II HAE. All patients received treatment for angioedema attacks (C1-inhibitor [C1-INH], icatibant), and seven (20%) received long-term prophylaxis (danazol). Treatment for attacks was continued for all patients during the pandemic. Patients taking danazol were switched to long-term prophylaxis using the C1-INH concentrate. Eleven (28%) patients with HAE developed COVID-19 during this study. Only one patient had severe COVID-19. Six patients (54.5%) were diagnosed with type II HAE, and five (45.5%) were diagnosed with type I HAE. The most common COVID-19 symptoms were fever (7/11;64%) and myalgia (6/11;55%). Mild angioedema attacks were experienced by 36% (4/11) of the HAE patients diagnosed with COVID-19. Icatibant was used in all patients. Conclusion: Agents used for HAE block the kallikrein-kinin system and may be useful in the treatment of COVID-19. Considering their beneficial effects on COVID-19, it is recommended that HAE patients should continue the use of agents blocking the kallikrein-kinin system.

The situation of regional concentration of tomato foreign trade in Turkey

World trade in agricultural products, tends to increase. Turkey is among the countries in foreign trade advantages with its agricultural potential. As one of the most important tomato producer countries, monitoring of developments in the world tomatoes trade is extremely important for Turkey. The aim of this study was to evaluate Turkey's position in world tomato trade. The developments of tomato foreign trade between Turkey and importer countries were analysed using Trade Intensity Analysis Method. Turkey supplied %75 of total tomato exports to Russia. Ukraine, Saudi Arabia, Iraq, Syria and Israel are important markets for tomato export. The epidemic (Covid-19 virus) has also been reflected in the international trade balances in tomato production. Giving importance to Turkey's political relations and to boost its exports by providing market diversity, it is important for the sustainability of tomato exports. In this context, market researches should be conducted specially to find and entrance into new markets. Besides the fresh tomato, the activities for the export of tomato paste and canned tomato should be implemented.

Solving Channel Assignment Problem in Cognitive Radio Networks with Immune Plasma Algorithm

The new Coronavirus or COVID-19 pandemic has focused researchers from various disciplines including computer sciences on existing diagnosis and treatment methods. As a result of this increasing interest, Immune Plasma algorithm (IP algorithm or IPA) that is a new meta-heuristic referencing a treatment method called immune or convalescent plasma has been introduced recently. In this study, IP algorithm was modified by considering the channel assignment problem on cognitive networks and its performance was investigated on solving mentioned problem. Moreover, the results of the IPA based technique were compared with the results of the Brute force search. Comparative studies showed that IP algorithm is capable of obtaining better solutions than the Brute force search. © 2021 IEEE

Toll-like receptor 3 c.1377C/T and -7C/A polymorphisms in COVID-19 infection

Aim: The Sars Corona Virus (SARS CoV) belongs to the Nidovirales order, the Coronaviridae family, and the genus Coronavirus. The SARS CoV has enveloped, linear, positive sense and single-stranded RNA. The disease caused by SARS-CoV 2 as named as COVID-19. Toll-like receptors (TLRs) initiate signaling cascades leading to the activation of the innate immune system. TLR3 activates antiviral immune responses through the production of inflammatory cytokines and type I interferons. In this study we aimed to investigate TLR 3 c.1377C/T and -7C/A polymorphisms in COVID-19 infection. Methods: In this study, we investigated the frequencies of TLR3 (c.1377C/T and -7 C/A) polymorphisms in 150 COVID-19 patients and 171 healthy adults as controls in Sivas Cumhuriyet University. Firstly, DNA was isolated using phenol-chloroform methods. Then we performed polymerase chain reaction (PCR) based restriction fragment length polymorphism (RFLP). We also investigated whether these polymorphisms were related to the severity of COVID-19 disease. Results: We found that both TLR3 polymorphisms were associated with COVID-19 disease. TLR3 c.1377C/T TT genotype frequencies were found statistically significant between patients and controls (p=0.019). In TLR3 -7C/A polymorphism we found statistically significant difference in A allele frequencies (p=0.03). There is an also statistically significant difference in distribution of TLR3 -7C/A CT genotype frequency between patients and controls (p=0.04). However, there is no statistically significant association between severe/non-severe and two TLR3 polymorphisms. Conclusion: Our findings suggest that TLR3 c.1377C/T and -7C/A polymorphisms may be important on susceptibility or clinical course of COVID-19.

Use of Monoclonal Antibody Therapy in Hematologic Patients with Mild-to-Moderate COVID-19: A Retrospective Single-Center Experience

Background: In November 2020, the U.S. Food and Drug Administration (FDA) issued emergency use authorization (EUA) for monoclonal antibody (mAb) therapy in patients with mild to moderate COVID-19 who are at high risk for disease progression. These mAbs reduce the risk of hospitalization in the general population. However, its efficacy and safety in immunocompromised hematology patients are not known. Methods: From November 9th, 2020, until February 28th, 2021, all adult hematology patients with mild to moderate COVID-19 disease who received monoclonal antibodies within 10 days of symptoms onset were included. Patients who were asymptomatic, had severe or critical COVID-19 disease, or were hospitalized at the time of COVID-19 diagnosis were excluded. Baseline demographic, clinical outcomes, and hematologic-related data were extracted. All statistical analysis was performed using SAS statistical software. Results: Thirty-eight hematology patients with mild to moderate COVID-19 disease who received mAb therapy under EUA were included in this study. Thirty (79%) patients received bamlanivimab and 8 (21%) casirivimab-imdevimab. Baseline characteristics prior to mAB administration include: 53% female, median age of 51 years (range: 21-80), with 18% above 65 years old. Twenty-eight (74%) patients received cellular therapy: 18 (47%) had undergone allogeneic hematopoietic cell transplantation (HCT), 9 (24%) autologous HCT, and 1 (3%) chimeric antigen receptor T-cell (CAR T) therapy. Among the 17 patients who had COVID-19 disease after HCT, the median time to COVID-19 diagnosis was 22.8 months (range: 2.6-274.4) from HCT to COVID-19 diagnosis. Twelve out of 17 (71%) alloHCT patients were being managed for active graft-vs-host disease (GvHD) at the time of COVID-19 diagnosis (chronic GVHD: n=11 [mild: 4, moderate: 4, severe: 3], acute GVHD (grade 2): n=1). Ten (59%) alloHCT patients were on immunosuppressant therapy at the time of COVID-19 diagnosis. Fifteen (39%) patients were on active treatment for their hematologic malignancy (HM) at the time of COVID-19 diagnosis with a mean of 3 previous lines of treatment (range: 1-6). Additional patient characteristics are shown in Table 1. mAb therapy under EUA was well tolerated in this patient population with only 1 (3%) patient having experienced an adverse reaction characterized as headache. Four (11%) patients were hospitalized due to COVID-19, and 2 (5%) progressed to severe disease. All four patients had received bamlanivimab. The median time for hospitalization from diagnosis of COVID-19 to admission date was 8 days (range: 1-20) while median time from mAB infusion to hospitalization was 7.5 days (range: 0-17). One patient (3%) died within 30 days of COVID-19 diagnosis;the cause of death was COVID-19 disease. Most patients (n=34, 89%) ultimately tested negative for SARS-CoV-2 by PCR after mAb infusion. 34% of patients (n=13) cleared the virus within 2 weeks of receiving mAb infsuion. The median time to clearance of viral shedding was 25.5 days (range: 7-138). After mAb infusion, most patients (10/15;67%) who were previously on active treatment for HM prior to diagnosis of COVID-19 resumed therapy for their HM with a median delay of 21.5 days (range: 12-42). We observed a significant difference in hospitalization was amongst patients who received a HCT vs. non-HCT (0%, 0/26 and 36%, 4/11 respectively;p<0.01). None of the other patient characteristics, which included: gender, ethnicity, age, BMI, smoking, obesity, chronic kidney disease, diabetes mellitus, hypertension, coronary vascular disease, and lung disease, were associated with significantly increased rate of hospitalization. Conclusion: This study demonstrates that SARS-COV2 specific mAb use in malignant hematology patients under EUA was safe and may reduce hospitalization as reported in the literature amongst those at high risk for disease progression. Thus, the access to SARS-COV2 mAb in this population who is at increased risk for complications from SARS-COV2 infection is critical in reducing progression to severe COVID-19 disease and hospitalization. [Formula presented] Disclosures: Ali: Incyte: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;CTI BioPharma: Membership on an entity's Board of Directors or advisory committees;BMS: Speakers Bureau. Aribi: Seagen: Consultancy. Artz: Radiology Partners: Other: Spouse has equity interest in Radiology Partners, a private radiology physician practice. Koller: Novartis: Consultancy. Nikolaenko: Rafael Pharmaceuticals: Research Funding;Pfizer: Research Funding. Shouse: Beigene: Honoraria;Kite Pharma: Speakers Bureau. Stein: Amgen: Consultancy, Speakers Bureau;Celgene: Speakers Bureau;Stemline: Speakers Bureau. Marcucci: Abbvie: Other: Speaker and advisory scientific board meetings;Novartis: Other: Speaker and advisory scientific board meetings;Agios: Other: Speaker and advisory scientific board meetings. Forman: Mustang Bio: Consultancy, Current holder of individual stocks in a privately-held company;Lixte Biotechnology: Consultancy, Current holder of individual stocks in a privately-held company;Allogene: Consultancy. Dadwal: AlloVir: Research Funding;Merck: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Astellas: Speakers Bureau;Shire/Takeda: Research Funding;Aseptiscope: Consultancy;Janssen: Other: Investigator;Karius: Other: Investigator. Al Malki: CareDx: Consultancy;Rigel Pharma: Consultancy;Jazz Pharmaceuticals, Inc.: Consultancy;Neximmune: Consultancy;Hansa Biopharma: Consultancy.

Evaluation of patient relatives applying to the emergency department in terms of intolerance to uncertainty and adult separation anxiety during the COVID-19 pandemic process

BACKGROUND: Intolerance to uncertainty is defined as a tendency to perceive uncertain events and situations as causes of danger, and to respond emotionally and behaviorally negatively. Separation anxiety disorder is defined as excessive anxiety, fear or avoidance behavior that occurs when separating from the attached figure. In this study, we aimed to measure the separation anxiety and intolerance of uncertainty of the patients' relatives when they brought their relatives to the emergency service. METHODS: This study was conducted as a prospective cross-sectional descriptive study. Relatives of patients who presented to the emergency department with COVID-19 between December 2020 and January 2021 were included in the study. Questionnaires containing demographic information and measurement tools were filled in for each participant. RESULTS: Eighty-one of the 154 participants (52.6%) got 25 point or above from ASA. The averages of the scores the participants got from the scales;It was 36.5 for the Intolerance of Uncertainty Scale (forward anxiety: 22.14, preventive anxiety: 14.35) and 27.85 for ASA.Asmall positive correlation (r=0.187) was determined between adult separation anxiety (M=27.85, SD=13.84) and intolerance to uncertainty (M=36.5, SD=10.36). In the analysis, there was a significant relationship between education level, whether sufficient information was provided or not, and intolerance to uncertainty. CONCLUSIONS: Emergency departments are areas where uncertainty and separation anxiety are likely to be experienced by patient relatives. Therefore, we would like to emphasize that it is important that the psychological conditions of the patients' relatives should not be forgotten or ignored by healthcare professionals.

In vitro REGULATION OF THE EXPRESSION OF THE SARS-CoV-2 RECEPTOR ANGIOTENSIN-CONVERTING ENZYME (ACE2) IN LUNG CANCER CELLS BY NATURAL PRODUCTS

The COVID-19 pandemic continues infecting people causing deaths globally. Although various medicines have been tried to combat with COVID-19, there is no medicine or treatment that has been validated yet. People have been using natural products for centuries against bacterial and viral illnesses. This study aimed to test the effects of the biomolecule oleuropein, whey collected from industrial waste and soaproot extracts obtained from Gypsophila arrostii Guss. var. nebulosa Boiss. & Heldr. and Saponaria officinalis L. on the expression of the human ACE2 gene as SARS-CoV-2 receptor on the A549 adenocarcinoma cell-line by Real-Time Quantitative Polymerase Chain Reaction (qPCR). According to the cytotoxicity tests, G. arrostii var. nebulosa and S. officinalis extract treatments showed a dose dependent cytotoxic effect on the cells. The EC50 values of G. arrostii var. nebulosa and S. officinalis were found to be 54.3 mu g/ml and 17.3 mu g/ml, respectively. Oleuropein showed moderate cytotoxic effects with the EC50 value over 250 mu g/ml. Whey (fermented and non-fermented) did not show any cytotoxic effect at the applied doses. The qPCR results showed that the ACE2 mRNA level decreased by 89.8% and 35.2% due to the fermented and non-fermented whey extracts, respectively. Similarly, G. arrostii var. nebulosa and S. officinalis downregulated ACE2 by 79.8% and 90.1%, respectively. In contrast, oleropein upregulated ACE2 (102.8%). Our results showed that the natural supporting products produced from soaproot extracts and fermented whey can be used against COVID-19 by both cancer patients and people in potential risk groups.

The impact of SARS-CoV-2 transmission fear and the COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders and severe asthma, and other high-risk groups

Objective: The effect of the COVID-19 pandemic on mental health in the long term is unclear. We evaluated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–related transmission fear and mental-health disorders in populations at high risk for COVID-19. Materials and Methods: Healthcare workers and patients with primary immunodeficiency disorders (PIDs), severe asthma, malignancy, cardiovascular disease, hypertension, and diabetes mellitus were included in the study. The hospital anxiety and depression scale (HADS) and Fear of Illness and Virus Evaluation (FIVE) scales were applied during face-to-face interviews. Results: There was a total of 560 participants, 80 per group;306 (55%) were female. The FIVE and HADS-A scale scores of health care workers were significantly higher than the other groups (p = 0.001 and 0.006). The second-highest scores were in patients with PID. There was no significant difference between the groups in HADS-D scores (p = 0.07). There was a significant positive correlation between FIVE scale scores and anxiety (r = 0.828;p < 0.001) and depression (r = 0.660;p < 0.001). The FIVE scale had significant discriminatory power for anxiety (AUC = 0.870, 95% confidence interval [CI] = 0.836–0.904;p < 0.0001) and depression (area under the curve = 0.760, 95% CI = 0.717–0.803;p < 0.0001). Conclusion: During the COVID-19 pandemic, mental-health disorders may develop in patients with comorbidities, especially healthcare workers. They should be referred to mental-health centers.

Correlation of chest ct and rt-pcr testing in coronavirus disease 2019 (Covid-19) in Turkey

Aim: Chest CT plays an important role in the treatment and diagnosis of COVID-19. It is important to remember that patients with RT-PCR test positive for COVID-19 infection may have normal chest CT. Material and Methods: This study included patients who underwent RT-PCR and chest CT tests, as well as patients with suspected and confirmed COVID-19 positive cases according to the algorithm of the Institute of Science of Ministry of Health in Turkey were included in this study. The patients were divided into two groups as positive and negative according to RT-PCR results. These groups were divided into two subgroups: with CT findings compatible with COVID-19 and without them. When the RT-PCR test was taken as the gold standard, the specificity, sensitivity, PPV, NPV, and accuracy rates of chest CT were investigated in detecting COVID-19 infection. Results: RT-PCR was positive in 192 patients and negative in 418 patients. The chest CT scan was positive in 43% (82/192) of 192 patients whose RT-PCR results were positive. Chest CT scan was positive in 25% (108/418) of 418 patients whose RT-PCR results were negative. In 31% of the patients (190/610), chest CT findings were positive for COVID-19. When RT-PCR results were taken as a reference, accuracy, specificity, and sensitivity values in terms of COVID-19 infection of chest CT were 44% (95% CI, 392/610 patients), 43% (95% CI, 82/192 patients), and 74% (95% CI, 310/418 patients) respectively. Discussion: According to these data, we think that chest CT is not very successful in detecting patients infected with COVID-19, contrary to the literature. Clinicians should always be careful to identify patients with COVID-19 infection with normal thorax CT or negative RT-PCR testing.