A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey.

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027).  Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.

Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study.

BACKGROUND: Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. METHODS: In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. RESULTS: A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92-483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. CONCLUSION: We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection.

Predictive Role of Biomarkers in COVID-19 Mortality.

Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in high mortality among patients in critical intensive care units. Hence, identifying mortality markers in the follow-up and treatment of these patients is essential. This study aimed to evaluate the relationships between mortality rates in patients with COVID-19 and the neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic inflammation response index (SII), and systemic inflammatory response index (SIRI). Methodology In this study, we assessed 466 critically ill patients diagnosed with COVID-19 in the adult intensive care unit of Kastamonu Training and Research Hospital. Age, gender, and comorbidities were recorded at the time of admission along with NLR, dNLR, MLR, PLR, SII, and SIRI values from hemogram data. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and mortality rates over 28 days were recorded. Patients were divided into survival (n = 128) and non-survival (n = 338) groups according to 28-day mortality. Results A statistically significant difference was found between leukocyte, neutrophil, dNLR, APACHE II, and SIRI parameters between the surviving and non-surviving groups. A logistic regression analysis of independent variables of 28-day mortality identified significant associations between dNLR (p = 0.002) and APACHE II score (p < 0.001) and 28-day mortality. Conclusions Inflammatory biomarkers and APACHE II score appear to be good predictive values for mortality in COVID-19 infection. The dNLR value was more effective than other biomarkers in estimating mortality due to COVID-19. In our study, the cut-off value for dNLR was 3.64.

Does prolonged prone position affect intracranial pressure? prospective observational study employing Optic nerve sheath diameter measurements.

BACKGROUND: Our aim in this observational prospective study is to determine whether the prone position has an effect on intracranial pressure, by performing ultrasound-guided ONSD (Optic Nerve Sheath Diameter) measurements in patients with acute respiratory distress syndrome (ARDS) ventilated in the prone position. METHODS: Patients hospitalized in the intensive care unit with a diagnosis of ARDS who were placed in the prone position for 24 h during their treatment were included in the study. Standardized sedation and neuromuscular blockade were applied to all patients in the prone position. Mechanical ventilation settings were standardized. Demographic data and patients' pCO2, pO2, PaO2/FiO2, SpO2, right and left ONSD data, and complications were recorded at certain times over 24 h. RESULTS: The evaluation of 24-hour prone-position data of patients with ARDS showed no significant increase in ONSD. There was no significant difference in pCO2 values either. PaO2/FiO2 and pO2 values demonstrated significant cumulative increases at all times. Post-prone SPO2 values at the 8th hour and later were significantly higher when compared to baseline (p < 0.001). CONCLUSION: As a result of this study, it appears that the prone position does not increase intracranial pressure during the first 24 h and can be safely utilized, given the administration of appropriate sedation, neuromuscular blockade, and mechanical ventilation strategy. ONSD measurements may increase the safety of monitoring in patients ventilated in the prone position.

Ferritin / albumin ratio could be a new indicator of COVID-19 disease mortality.

INTRODUCTION: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality. METHODOLOGY: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared. RESULTS: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity. CONCLUSIONS: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care.

Evaluation of possible COVID-19 reinfection in children: a multicenter clinical study

Background Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. Methods In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. Results A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92–483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p=1.000). Also, there was no significant difference in duration of symptoms (p=0.498) or in hospitalization rates (p=1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. Conclusion We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection.

Lethal encephalitis in a pediatric patient with SARS-CoV-2.

BACKGROUND: SARS-CoV-2 mostly affects the respiratory system. Some studies have reported neurological disorders associated with SARS-CoV-2. Despite an increase in reported instances, encephalitis caused by COVID-19 infection is still poorly understood. CASE: We reported a rare presentation of SARS-CoV-2 in a 15-year-old patient. He had a fulminant course with encephalitis. He had mild symptoms of a COVID-19 infection five months ago and recovered without any sequel. Despite appropriate treatment, the patient had a devastating course. CONCLUSIONS: This was a severe presentation of SARS-CoV-2 with central nervous system manifestations.

Impact of the COVID-19 pandemic on Pennsylvania and its healthcare system.

Background and Aims: Coronavirus disease 2019 (COVID-19) has taken a toll on Pennsylvania, and the fight against the pandemic continues, with the commonwealth's hospitals and health systems at the epicenter. This report aims to demonstrate the magnitude of the impact of the pandemic on Pennsylvania, with specific attention to its hospitals and health systems and their financial status during the very first year of the pandemic. Methods: To measure this magnitude, publicly available US and Pennsylvania COVID-19 data is analyzed, including more detailed geographical, rural/urban, and race/ethnicity analyses. Results: The results show that the case counts started with just two cases on March 6, 2020, and rose to approximately a million by the first anniversary of the pandemic's arrival in the commonwealth. Tragically, the death toll totaled nearly 25,000 during the first year. Philadelphia County had the highest number of total COVID-19 cases, while Forest County had the highest incidence rate. The Southeast region had the highest number of total COVID-19 cases, while the Lehigh Valley had the highest incidence rate. The incidence rate also was higher in rural counties than in urban counties. Black and Latino/a/x populations of Pennsylvania were disproportionally affected by the virus. Several reports measured the financial impact of the pandemic on the state's hospitals to be $4.1-$5 billion during this year. Conclusion: Hospitals are economic anchors of their communities. To fulfill their critical mission during the pandemic and beyond-and remain economic and community anchors-they need ongoing state and federal support.

Investigating the relationship between the depression levels of midwives and nurses and their emotional labor and secondary traumatic stress levels in the COVID-19 pandemic period with structural equation modelling.

In this study, it was aimed to investigate the relationship between depression levels in midwives and nurses and their emotional labor and secondary traumatic stress levels in the COVID-19 pandemic process structural equation modelling. This cross-sectional study was conducted with 313 midwives and nurses. According to the model formed based on the presence of depression, as the Emotional Labor scores of the participants increased, their Beck Depression scores decreased 0.947-fold, while as their Secondary Traumatic Stress Scale scores increased, their Beck Depression scores increased 1.116-fold. It was determined that the scores of the participants in the Emotional Labor and Secondary Traumatic Stress Scales explained 42.8% of their Beck Depression Inventory scores. It was concluded that the depression statuses of the participants were affected by their emotional labor and secondary traumatic stress statuses.

Neurological Symptoms and Signs Observed in Critical COVID-19 Patients may be Precursors of Existing Cerebrovascular Disease

Objective: Health professionals have had difficulties in diagnosing many previously known diseases due to COVID-19 disease, neurological diseases being one of them. We aimed to evaluate neurological manifestations in critical COVID-19 patients. Materials and Methods: Five hundred ninety five critical COVID-19 patients admitted to the COVID intensive care unit between January and June 2020 were evaluated retrospectively. The patients were divided into two groups as patients with neurological symptoms and diagnosed with cerebrovascular disease (group 1) and patients with neurological symptoms but not diagnosed with cerebrovascular disease disease (group 2). Neurological symptoms and findings, radiological evaluations, demographic data, laboratory values, hospitalization days, mechanical ventilator needs and mortality of patients were retrospectively analyzed. Results: Neurological signs and symptoms were observed in 148 (24.8%) of a total of 595 critic COVID-19 patients. Of 148 patients with neurological symptoms/signs, 44 were diagnosed with a cerebrovascular disease (group 1) and 104 could not be diagnosed with any cerebrovascular disease (group 2). The distribution rates of the symptoms and signs of the patients included in the study were change of consciousness 6.5%, headache 5.6%, dizziness 6.5%, plegia 4.3%, paresis 5.8%, anisocoria 2.1%, taste-smell 5.8%, epileptic seizure 3.6% and numbness 13.4%. observed (Table 1). In general, neurological symptoms and signs were observed at a higher rate in group 1 patients (Figure 1). Conclusion: The presence of cerebrovascular disease should be more strongly suspected in COVID-19 patients with paresis, change of consciousness, numbness, taste/smell disturbance, and plegia. The rate of ischemic cerebrovascular disease in COVID-19 patients is approximately 7 times higher than the rate of hemorrhagic cerebrovascular disease. [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 ve ECMO

Amaç: Koronavirüs hastalığı-2019 (COVID-19) ciddi solunum yetmezliğine neden olabilir. 2019 yılının son aylarında tüm dünyaya yayılmaya başlayan bu hastalık için kesin bir tedavi maalesef bulunamamıştır. Uygulanan tedavi ve solunum cihazı manüplasyonlarına yanıt alınamayan hastalar için ekstrakorporeal memranöz oksijenasyon (ECMO) uygulaması bir seçenek olarak görünmektedir. VV-ECMO desteği alan hastalarımızla ilgili deneyimlerimizi paylaşmak istiyoruz. VV-ECMO’ya alınan hastalarımızın üçünün de aşısız olduğunu belirtmek isteriz. Olgu: Olgu 1: Kırk bir yaş ek hastalığı olmayan erkek hasta acile gelişinin 3. günü yoğun bakıma, 5. gün mekanik ventilatöre ve 12. günü VV-ECMO’ya alınmış, 7 gün ECMO sonrası 19. gün eksitus olmuştur. Olgu 2: Kırk iki yaş bilinen hastalığı olmayan erkek hasta acile geldiği gün yoğun bakıma, 8. gün mekanik ventilatöre ve yine 8. gün VV-ECMO’ya alınmış, 23. gün ECMO sonrası 31. günde eksitus olmuştur. Olgu 3: Kırk altı yaş ek hastalığı olmayan kadın hasta acile gelişinin 3. günü yoğun bakıma, 9. gün mekanik ventilatöre ve 10. günü VV-ECMO’ya alınmış 8 gün ECMO sonrası 2 gün de yoğun bakım takibi yapılmış ve 20. günde eksitus olmuştur (Tablo 1, 2). Sonuç: COVID-19 hastalığı birçok hastada orta hafif seyredeken %5-10 olguda ciddi ve mortal olabilir. Mortalite yaklaşık %2’dir. Sromicki J ve ark. deneyimlerini paylaştıkları yazıda toplam 9 hastayı VV-ECMO’ya aldıkları ve hastaların 2 tanesini kaybettiklerini bildirmişlerdir. Bu yazıda hastaların mortalite nedenleri belirtilmemiştir. Yapılan bir çalışmada 234 ARDS’si olan COVID-19 hastasından 17 (%7,2) tanesine ECMO’ya alınmış, mortalite %94,1 bulunmuş oysa aynı merkezin konvansiyonel tedavi hastalarının mortalitesi %70,9 bulunmuş. COVID-19 pandemisi öncesinde 35 yaş, bilinen hastalığı olmayan 55 dakika resüsitasyonlu 35 yaş erkek hastamızı 8 gün VV-ECMO desteği ile sağlıklı şekilde taburcu edebilmiştik. Hastanemiz yoğun bakımında son 2 yılda 1000’in üzerinde COVID-19 yoğun bakım hastası takip edilmiş olup COVID-19 hastalığında ECMO sınırlı tecrübemiz olmasına rağmen sonuçların yüz güldürücü olmadığını paylaşmak istedik. Hepimizin çaresiz kaldığı genç, aşısız, kritik ARDS hastalarında çaresiz kaldığımız bir gerçek olup bu hastalar için tedavi ve destek arayışlarımız devam edecektir. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Spontan Pnömomediastinum ve COVID-19

Amaç: Hem pnömotoraks (PNX) hem de pnömomediastinum (PNM) mekanik ventilasyonun bilinen komplikasyonlarıdır. Bununla birlikte, barotravma olmasa bile, PNX veya PNM veya daha nadiren her ikisi de koronavirüs hastalığı-2019’a (COVID-19) bağlı olarak gelişebilir. PNM, mediasten içinde bulunan serbest hava veya gaz olarak tanımlanır. Spontan PNM (SPNM), göğüs travması gibi gözle görülür herhangi bir neden ile ilişkili olmayan mediasten içinde bulunan serbest hava veya gaz olarak tanımlanır. Olgu: 01.01.2021-31.12.2021 tarihileri arasında Kastamonu Eğitim ve Araştırma Hastanesi COVID-19 Yoğun Bakım Üniteleri’nde takip edilen 7 hastada SPNX/SPNM saptanmıştır. Toplanan veriler arasında yaş, cinsiyet, IMV veya N-IMV tedavisi altında iken, yoğun bakımda yatışın kaçıncı gününde ve SPNX/SPNM hangisinin geliştiği, tüp torakostomi ihtiyacı ve şifa-eks durumu mevcuttur. Yedi hastamızın üçü kadın, dördü erkektir. Íki hastamızda SPNX ve SPNM birlikte görünmüş ve bu hastalara tüp torakostomi uygulanmıştır. SPNX/SPNM, iki hastamızda N-IMV altında gelişmişken, beş hastamızda IMV altında gelişmiştir. SPNX/SPNM, hastalarımızın yoğun bakıma alındıktan sonra ortalama 5. gününde gelişmiştir. Beş hastamız eksitus olmuş, iki hastamız ise servise devredilmiştir. Sonuç: COVID-19, ARDS’nin önemli bir yeni nedenidir. Beş ARDS hastalarında barotravma insidansının daha yüksek olduğu, çeşitli çalışmalarda COVID öncesi dönem kadar erken bir tarihte bildirilmiştir. Gerçekten de, COVID-19 pandemisi nedeniyle ARDS olgularının artmasıyla birlikte, PNX ve PNM olgularının insidansında da bir artış olmuştur. PNM’nin kesin mekanizması bilinmemekle birlikte, SPNM genellikle kendi kendini sınırlayan bir hastalıktır. Bununla birlikte, potansiyel olarak ciddi dolaşım ve solunum patolojisine neden olabilir. Bu nedenle, COVID-19 hastalarında SPNM oluşumu, kötüleşen hastalığın potansiyel bir göstergesi olarak yakından izlenmelidir. COVID-19 hastalarında PNX/ PMN’nin insidansı, patogenezi ve öngörücüleri şu anda belirsiz ve hatta çelişkilidir. Sonuç olarak tüm bu nedenler, PNX’in ve PNM’nin COVID19’un ciddi bir komplikasyonu olduğunu düşündürmektedir. Bu durumun kötü prognozun belirteci olup olmadığını anlamak için daha kapsamlı çalışmalar gerekmektedir. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Change of Critical COVID-19 Disease in Time/a Randomized Controlled Study

Objective: COVID-19 disease is unfortunately not yet understood and a definitive treatment has not been found. The aim of this study is to investigate the changes in clinical and laboratory tests of critical COVID- 19 patients followed in the intensive care unit between March/2020 and December/2020 and to evaluate the factors that cause these changes with literature information. Materials and Methods: In the study, during the beginning of the pandemic and its progress;50 COVID-19 patients treated in the intensive care unit (ICU) between March-April-May/2020 were defined as group 1, and 50 COVID-19 patients treated in the ICU between October-November- December/2020 were defined as group 2. Clinical, laboratory and intensive care processes of the patients in the groups were analyzed retrospectively and compared. Results: Age and gender distribution in terms of demographic data was similar between group 1 and group 2. APACHE-II score average of group 1 was 22, and APACHE-II score average of group 2 was 25. There was no statistically significant difference between the demographic data of the groups (Table 1). As a result of statistical analysis, while there was no significant difference between the groups in terms of CRP and ferritin values, there was a significant difference between the D-dimer values. The values of the patients in group 1 were found to be higher than in group 2 (Table 2). Group 2 patients had higher 28-day mortality, and this result was statistically significant (p=0.006). Transfer rates of group1 patients to the service after intensive care were found to be statistically higher (p=0.029) (Table 3). Conclusion: As a result of this study, 28-day mortality was found to be different between similar patient groups who were admitted to intensive care during different periods of the pandemic.The reasons for this may be: changes in pathogenicity as a result of viral mutations, different immune responses of hosts to viral infection. Another factor influencing this outcome may be the presence of less experienced healthcare professionals in critically ill care. [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19-Related Rhino-Orbital-Cerebral Mucormycosis in a Renal Transplant Recipient.

Coronavirus disease 2019 increases transplant recipients' susceptibility to rare opportunistic infections as a consequence of the impairment that COVID-19 can cause in the immune system. Mucormycosis is a rare complication but has a high risk of fatal outcome. A 50-year-old woman who received a kidney transplant 10 years previously was admitted to the hospital with COVID-19. During follow-up by the inpatient service, the patient developed pain, edema, and proptosis in the right eye. She was diagnosed with rhino-orbitalcerebral mucormycosis. This is the first reported case of rhino-orbital-cerebral mucormycosis in a renal transplant recipient with COVID-19 infection.

Competency Trap in Organizational Learning: Turkish E-Government Gateway Application During the COVID-19 Pandemic

The purpose of this study is to depict the competency trap in E-Government Gateway Application and its reactions during the COVID-19 Pandemic. A case study with the Delphi method is carried out to examine Turkish E-Government Gateway Application during COVID-19 Pandemic as Extraordinary Condition. The major finding of the study is, as a virtual organization, Turkish E-Government Gateway Application has dapperly adapted itself without falling into the competency trap during the transition from routine to the time in COVID-19. In the wake of gathering, synthesizing, and summarizing the ideas on the digital interactions from specialists among citizens, government and other government agencies, employees, and businesses/commerces comprehensive, detailed reactions are identified according to governmental agencies' and institutions course of action during routine and time in COVID- 19. This is the first study that unfolding e-governmental solutions without a competency trap within the unexpected, extraordinary condition.

Adenoviral vaccines promote protective tissue-resident memory T cell populations against cancer.

BACKGROUND: Adenoviral vectors emerged as important platforms for cancer immunotherapy. Vaccination with adenoviral vectors is promising in this respect, however, their specific mechanisms of action are not fully understood. Here, we assessed the development and maintenance of vaccine-induced tumor-specific CD8+ T cells elicited upon immunization with adenoviral vectors. METHODS: Adenoviral vaccine vectors encoding the full-length E7 protein from human papilloma virus (HPV) or the immunodominant epitope from E7 were generated, and mice were immunized intravenously with different quantities (107, 108 or 109 infectious units). The magnitude, kinetics and tumor protection capacity of the induced vaccine-specific T cell responses were evaluated. RESULTS: The adenoviral vaccines elicited inflationary E7-specific memory CD8+ T cell responses in a dose-dependent manner. The magnitude of these vaccine-specific CD8+ T cells in the circulation related to the development of E7-specific CD8+ tissue-resident memory T (TRM) cells, which were maintained for months in multiple tissues after vaccination. The vaccine-specific CD8+ T cell responses conferred long-term protection against HPV-induced carcinomas in the skin and liver, and this protection required the induction and accumulation of CD8+ TRM cells. Moreover, the formation of CD8+ TRM cells could be enhanced by temporal targeting CD80/CD86 costimulatory interactions via CTLA-4 blockade early after immunization. CONCLUSIONS: Together, these data show that adenoviral vector-induced CD8+ T cell inflation promotes protective TRM cell populations, and this can be enhanced by targeting CTLA-4.

Pregnancy and birth planning during COVID-19: The effects of tele-education offered to pregnant women on prenatal distress and pregnancy-related anxiety.

AIM: This study aims to examine pregnancy and birth planning during COVID-19 and the effects of a tele-education offered to pregnant women for this planning process on prenatal distress and pregnancy-related anxiety. METHOD: The population of this quasi-experimental study was composed of pregnant women who applied for the antenatal education class of a public hospital in the east of Turkey during their past prenatal follow-ups and wrote their contact details in the registration book to participate in group trainings. The sample of the study consisted of a total of 96 pregnant women, including 48 in the experiment and 48 in the control groups, who were selected using power analysis and non-probability random sampling method. The data were collected between April 22 and May 13, 2020 using a "Personal Information Form", the "Revised Prenatal Distress Questionnaire (NuPDQ)" and the "Pregnancy Related Anxiety Questionnaire-Revised 2 (PRAQ-R2)". An individual tele-education (interactive education and consultancy provided by phone calls, text message and digital education booklet) was provided to the pregnant women in the experiment group for one week. No intervention was administered to those in the control group. The data were statistically analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, min-max values) and t-test in dependent and independent groups. RESULTS: The posttest NuPDQ total mean scores of pregnant women in the experiment and control groups were 8.75±5.10 and 11.50±4.91, respectively, whereby the difference between the groups was statistically significant (t=-2.689, p=0.008). Additionally, the difference between their mean scores on both PRAQ-R2 and its subscales of "fear of giving birth" and "worries of bearing a physically or mentally handicapped child" was statistically significant (p<0.05), where those in the experiment group had lower anxiety, fear of giving birth and worries of bearing a physically or mentally handicapped child. CONCLUSION: The tele-education offered to the pregnant women for pregnancy and birth planning during COVID-19 decreased their prenatal distress and pregnancy-related anxiety.