Evaluation of Crimean-Congo Hemorrhagic Fever Cases During the COVID-19 Pandemic Period

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease that progresses with fever and bleeding and is endemic in our region. In this study, we aimed to determine the symptoms, transmission routes and risk factors in CCHF patients who have similar clinical features with COVID-19, and to investigate the relationship between CCHF cases and COVID-19 restrictions in our region where CCHF is endemic. Materials and Methods: One hundred fifty-nine patients diagnosed with CCHF in the infectious diseases and clinical microbiology clinic between April 2021 and September 2021 were included in the study. A questionnaire consisting of a set of questions was filled in for patients diagnosed with CCHF, in which demographic data, admission complaints, risk factors and habits during the COVID-19 pandemic were evaluated. Results: The mean age of the 159 CCHF patients included in the study was 50.9 +/- 18.5 years and 59.7% were male. The most frequently reported complaints by the patients were fatigue (94.5%), muscle-joint pain (79.9%) and fever (74.2%). During the disease period, COVID-19 was suspected in 62.3% of them, PCR test was applied to all of them, and the result was positive in only one patient. There was no change of residence of the patients during the illness period. There was no significant increase in the population of the residence area or the frequency of visits due to the pandemic. The number of patients who reported an increase in the number of ticks in their environment was 44 (27.8%). It was determined that there was no significant increase in the number of activities such as visiting rural areas or having a picnic due to the COVID-19 pandemic. Only 32.2% of patients engaged in animal husbandry or field work reported an increase in the frequency of these jobs compared to the pre-pandemic period. Conclusion: The reason for the increase in the number of CCHF cases in our center was not associated with the increase in the frequency of visits to rural areas or the change of residence during the COVID-19 pandemic period.

Investigation of the Prognostic Values of the Shock Index and Modified Shock Index in Predicting the Clinical Outcomes in Elderly Hospitalized Patients with Coronavirus Disease-2019

Introduction: Advanced age is an independent risk factor for increased mortality in coronavirus disease-2019 (COVID-19). However, the best method for estimating mortality in elderly patients with COVID-19 is still under debate. We performed this study to assess the shock index (SI) and the modified shock index (MSI) for the abovementioned problem. Methods: A retrospective study was conducted including elderly cases (>= 65 years) confirmed with COVID-19 who admitted to a tertiary university hospital between March-December 2020. The SI and MSI at the time of the emergency department visits were used to evaluate the intensive care unit admission, ventilator support, septic shock, and 30-day mortality in all patients. The receiver operating characteristic and area under the curve (AUC) were used to measure the overall ability of SI and MSI to predict clinical outcomes. Results: We recruited 334 consecutive COVID-19 patients with a mean age of 75.2 +/- 7.3 and an almost equal gender distribution [170 males (50.9%)]. In deceased and surviving patients, the SI was 0.66 +/- 0.16 and 0.6 +/- 0.1 (p=0.014), while the MSI was 0.95 +/- 0.22 and 1.09 +/- 0.34 (p=0.003), respectively. In predicting mortality, the AUC of the SI and MSI were 0.590 [95% confidence interval (CI): 0.535 to 0.643] and 0.608 (95% CI: 0.553 to 0.660), respectively. Conclusion: Increased SIs and MSIs are associated with 30-day mortality. SI and MSI can benefit the triage of elderly patients hospitalized for COVID-19. However, it was found that there is no single cut-off value of SI or MSI with optimum accuracy for predicting COVID-19-related clinical outcomes.

Consumer awareness about COVID-19 agency SARS-CoV-2 and protection methods in food safety

Objective: The aim of this research is to determine the methods used by consumers from all regions of the country to evaluate the COVID-19 factor SARSCoV-2 virus in terms of food safety and to protect against it. Materials and Methods: The data obtained as a result of the research were evaluated using the mean, probability value (p value), percentage values and squared (X2) importance test with the Minitab program. Results 74.35% of the 1006 people know that SARSCoV-2 Virus is the virus that causes COVID-19.41.25% think that the SARS-CoV-2 virus that causes COVID-19 is transmitted through food.65.90% of consumers think that SARS-CoV-2 virus will be protected by following all general hygiene rules and 53.67% by opting for packaged food that is not sold in the open. Conclusion: Based on the results of the survey, it was thought that the COVID-19 virus could be transmitted through food, but the accuracy of this information could not be definitively proven.

Anti-coronaviral Activity of Plant and Seaweed Secondary Metabolites: A Review

Background: Coronavirus Disease 2019 (COVID-19), one of the greatest challenges facing humanity, continues to affect millions of people worldwide. Vaccines approved and authorized for use are effective against COVID-19, but viral variants of concern may emerge in the near future. The discovery of novel antiviral agents will help humanity overcome COVID-19 and aid in any future viral pandemics. Objective(s): This review aimed to evaluate evidence from the plant-and seaweed-derived secondary com-pound-based interventions for viral diseases caused by coronaviruses. Method(s): A comprehensive search of several databases, including Cochrane Library, Web of Science and PubMed was conducted to identify available studies evaluating the outcomes of plant-and seaweed secondary metabolites in viral diseases such as Severe Acute Respiratory Syndrome, Middle East Respiratory Syndrome and COVID-19. Result(s): The volume of existing reports is irrefutable evidence that some plant-and seaweed-derived secondary compounds (e.g., mannose-specific lectins, griffithsin, cyanovirin-N, gallate, curcumin, luteo-lin, quercetin and betulinic acid) possess a potential antiviral ability against coronaviruses, including SARS-CoV-2. Conclusion(s): Plant and seaweed secondary metabolites with antiviral activity show their activity in different metabolic pathways. Besides reducing and preventing the metabolic damage caused by proinflamma-tory cytokines and oxidative stress, several plants and seaweed secondary metabolites can also be effective in improving some clinical indexes specific to COVID-19. Despite their effectiveness in preclinical studies, plant and seaweed-derived secondary compounds need more pharmacokinetic studies and safety measures concerning their mitogenic and allergenic properties.Copyright © 2022 Bentham Science Publishers.

Pre-Service Science Teachers' E-Learning Styles

E-learning is becoming more popular than conventional teaching methods, particularly in science education. The use of e-learning has increased worldwide, especially after the COVID-19 pandemic. Today, students' e-learning styles have gained even more importance. The participants of this survey, which aimed to examine e-learning styles for selected variables, consisted of 401 pre-service science teachers from two public universities in Turkey. The personal information form was used to obtain data on gender, university, personal computer ownership status, type of device used to connect to the internet, grade level, number of social network memberships, internet usage purpose, and duration of social media use. Another tool used in face-to-face data collection was the E-Learning Styles Scale (ESS). As a result of the analysis, it was understood that participants' e-learning style scores were generally on the positive side. In terms of gender, grade level, and duration of social media use variables, there were statistically significant differences in the ESS and some of its sub-dimensions, while differences were found in only some sub-dimensions for the university variables, internet usage purpose, and number of social network memberships. Several suggestions were made in conjunction with the results of the descriptive and inferential analyses.

Evaluation of Crimean-Congo Hemorrhagic Fever Cases During the COVID-19 Pandemic Period.

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease that progresses with fever and bleeding and is endemic in our region. In this study, we aimed to determine the symptoms, transmission routes and risk factors in CCHF patients who have similar clinical features with COVID-19, and to investigate the relationship between CCHF cases and COVID-19 restrictions in our region where CCHF is endemic. Material(s) and Method(s): One hundred fifty-nine patients diagnosed with CCHF in the infectious diseases and clinical microbiology clinic between April 2021 and September 2021 were included in the study. A questionnaire consisting of a set of questions was filled in for patients diagnosed with CCHF, in which demographic data, admission complaints, risk factors and habits during the COVID-19 pandemic were evaluated. Result(s): The mean age of the 159 CCHF patients included in the study was 50.9 +/- 18.5 years and 59.7% were male. The most frequently reported complaints by the patients were fatigue (94.5%), muscle-joint pain (79.9%) and fever (74.2%). During the disease period, COVID-19 was suspected in 62.3% of them, PCR test was applied to all of them, and the result was positive in only one patient. There was no change of residence of the patients during the illness period. There was no significant increase in the population of the residence area or the frequency of visits due to the pandemic. The number of patients who reported an increase in the number of ticks in their environment was 44 (27.8%). It was determined that there was no significant increase in the number of activities such as visiting rural areas or having a picnic due to the COVID-19 pandemic. Only 32.2% of patients engaged in animal husbandry or field work reported an increase in the frequency of these jobs compared to the pre-pandemic period. Conclusion(s): The reason for the increase in the number of CCHF cases in our center was not associated with the increase in the frequency of visits to rural areas or the change of residence during the COVID-19 pandemic period.Copyright © Telif Hakki 2022 Flora.

Evaluation of Crimean-Congo Hemorrhagic Fever Cases During the COVID-19 Pandemic Period

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease that progresses with fever and bleeding and is endemic in our region. In this study, we aimed to determine the symptoms, transmission routes and risk factors in CCHF patients who have similar clinical features with COVID-19, and to investigate the relationship between CCHF cases and COVID-19 restrictions in our region where CCHF is endemic. Materials and Methods: One hundred fifty-nine patients diagnosed with CCHF in the infectious diseases and clinical microbiology clinic between April 2021 and September 2021 were included in the study. A questionnaire consisting of a set of questions was filled in for patients diagnosed with CCHF, in which demographic data, admission complaints, risk factors and habits during the COVID-19 pandemic were evaluated. Results: The mean age of the 159 CCHF patients included in the study was 50.9 ± 18.5 years and 59.7% were male. The most frequently reported complaints by the patients were fatigue (94.5%), muscle-joint pain (79.9%) and fever (74.2%). During the disease period, COVID-19 was suspected in 62.3% of them, PCR test was applied to all of them, and the result was positive in only one patient. There was no change of residence of the patients during the illness period. There was no significant increase in the population of the residence area or the frequency of visits due to the pandemic. The number of patients who reported an increase in the number of ticks in their environment was 44 (27.8%). It was determined that there was no significant increase in the number of activities such as visiting rural areas or having a picnic due to the COVID-19 pandemic. Only 32.2% of patients engaged in animal husbandry or field work reported an increase in the frequency of these jobs compared to the pre-pandemic period. Conclusion: The reason for the increase in the number of CCHF cases in our center was not associated with the increase in the frequency of visits to rural areas or the change of residence during the COVID-19 pandemic period.

Subnational government responses to the Covid-19 pandemic: Expectations, realities and lessons for the future

Although national government and international actor responses to the Covid-19 pandemic have been very much in the public eye, the subnational government role has received less attention. Certain pandemic impacts were universal, but the mix and relative severity differed across countries, The actions taken had to reflect these variations, as well as to reflect country socio-economic, fiscal, institutional and political context. Diversity across areas within countries also required differentiated action. This article provides an overview of the potential subnational government role in pandemic response, summarizes what is known about what actually occurred, and raises the prospect that what was learned in the pandemic might help policymakers and managers both to identify ways to better respond in future crises and to create awareness of and opportunities for needed reforms in intergovernmental systems. This background sets the stage for other articles in this issue that focus on selected countries. Their experiences reinforce lessons from global experience and also provide insights from deeper analysis of specific cases. © 2023 John Wiley & Sons Ltd.

Factors affecting anxiety, depression, and stress among patients with hepatocellular carcinoma during COVID-19 pandemic.

OBJECTIVE: Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure. PATIENTS AND METHODS: 118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total. RESULTS: There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total. CONCLUSIONS: Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.

Geriatric Sepsis in the COVID-19 Era: Challenges in Diagnosis and Management

The elderly or geriatric patients represent a significant portion of emergency department (ED) admissions. Factors affecting poor outcome in these patients suspected or diagnosed with sepsis include shock, hyperlactatemia, and organ failure. Atypical presentations should be emphasized in the training of triage and ED personnel due to difficulties and pitfalls in diagnostic processes for sepsis. The vital organ functions of the elderly, who are among the highest risk groups in the management of sepsis, may deteriorate rapidly with very few precursors, and aggressive methods should be used rapidly when necessary. Interactions of drug doses in the elderly, problems in excretion and differences in metabolism should be considered in treatment regimens. Healthcare workers should try to eliminate colonization risks such as vascular catheterization, unnecessary vascular access and urinary catheters should be removed.In the long term after recovery from sepsis, heart failure, peripheral vascular disease, dementia, and diabetes are the most common entities recorded in the literature. This review was intended to provide an overview of the overall management and give some practical tips for this fragile group of patients in the post-pandemic era.

COVID-19-related biochemical and hematological parameters: a single-center population index study

Objective: We aimed to examine the effects of COVID-19 on biochemical and hematological parameters such as liver and kidney function tests, electrolyte levels and inflammatory markers.

Borderline, Narcissistic, Obsessive-Compulsive and Schizoid Personality Disorder Beliefs and Their Effects on Anxiety and Depression Levels in Inpatients with Covid-19

Objective: Mental-health problems among coronavirus disease 2019 (COVID-19) inpatients is an underinvestigated issue. The study reported herein was conducted to assess obsessive-compulsive, borderline, schizoid and narcissistic personality disorder beliefs and the influence of these dysfunctional beliefs on the anxiety and depression levels of COVID-19 inpatients.Methods: A total of 75 COVID-19 inpatients were recruited for the study. Their anxiety and depression levels were evaluated using Hospital Anxiety and Depression Scale, and the aforementioned personality disorder beliefs were evaluated using Personality Belief Questionnaire -Short Form.Results: According to the cut-off values, 9.3% (n = 7) of the inpatients were considered having anxiety and 34.7% (n = 26) were considered having depression. The mean scores for obsessive-compulsive, schizoid, borderline and narcissistic personality disorder beliefs were 15.1 +/- 6.2, 12.9 +/- 6.0, 10.0 +/- 5.5 and 9.4 +/- 5.6, respectively. The anxiety levels of the female inpatients were significantly higher than those of the male inpatients (z = 2.152;p = 0.031). The inpatients' borderline personality disorder belief scores were significantly correlated with their anxiety levels (r = 0.390;p = 0.001).Conclusion: The study participants' obsessive-compulsive personality disorder beliefs were higher than their other aforementioned personality disorder beliefs. Female gender and borderline personality disorder beliefs were found to be related with anxiety level. The influence of these factors should be considered in the evaluation of COVID-19 inpatients in daily clinical practice.

An Investigation on the Performance of Different Microbiological Methods Used in the Diagnosis of COVID-19

Introduction: Coronavirus disease 2019 (COVID-19) pandemic continues to be a global public health problem. The present study aimed to investigate SARS-CoV-2 antibodies and evaluate the results using an immunochromatographic method and an ELISA method, in patients with suspected COVID-19, who were tested by reverse transcription polymerase chain reaction (RT-PCR) technique to detect SARS-CoV-2 RNA. Materials and Methods: The study was conducted at the SARS-CoV-2 authorized diagnostic laboratory of our hospital at the beginning of the COVID-19 pandemic, between 27 March and 14 May 2020. The nasopharynx and oropharynx swab samples of the patients included in the study were tested by the SARS-CoV-2 RT-PCR (Bioeksen, Ístanbul, Turkey), where the serum samples were tested by an immunochromatographic test (Beijing Hotgen Biotech Co., Ltd, China) and Anti-SARS-CoV-2 ELISA IgG (Euroimmun, Luebeck, Germany) test. The dates the patients’ symptoms started and the samples were collected for RT-PCR and serological testing were recorded. The patients were divided into two groups based on the data retrieved from the files containing the clinical information and microbiological results of the patients: individuals, who were diagnosed with COVID-19, and individuals, for whom the COVID-19 diagnosis was excluded. Results: Of the 115 patients included in the study, 92 (80%) individuals presented to the clinic with COVID-19 similar symptoms, while 23 (20%) individuals had contact with patients diagnosed with COVID-19. Sixty-one (66.3%) of 92 patients with symptoms were diagnosed with COVID-19, where 6 (26%) individuals out of 23 without symptoms were diagnosed with COVID-19. Fifty-one (76.1%) individuals out of 67 patients diagnosed with COVID-19 had positive RT-PCR results. Sixteen individuals with COVID-19, who were tested negative for RT-PCR, had positive Euroimmun Anti-SARS-CoV-2 ELISA IgG results. Of the 67 patients diagnosed with COVID-19, 61 (91%) were symptomatic and the extended time periods between the onset of the symptoms and the date of sampling for the RT-PCR test was associated with lower rates of being tested positive for the RT-PCR test (p= 0.01). Conclusion: The present study investigated the performance of the COVID-19 tests and showed that antibody tests intended for patients with suspected COVID-19, even in cases where the RT-PCR test is negative, would contribute to the diagnosis. The study contributes in the relevant literature as to which tests would be more useful in certain conditions, considering the fact that there is no test available that can provide 100% accurate results for the diagnosis of COVID-19.

CAN PRE-TREATMENT INFLAMMATORY BIOMARKER LEVELS GUIDE to DETERMINE APPROPRIATE TIME of TOCILIZUMAB THERAPY in COVID-19

Background: Due to the pleiotropic cytokine interleukin-6 (IL-6) plays a pivotal role in the pathogenesis of COVID-19, tocilizumab, an inhibitor of the IL-6 receptors, was considered as an attractive therapeutic option. When the infamma-tion cascade is excessive and therapy is delayed, the efforts for suppression of infammation does not necessarily reduce mortality in all cases. Besides, early using anti-cytokine therapy may lead to both increased cost and risks including iatrogenic immunosuppression (1). Defning of patients who will beneft from tocilizumab and determining optimal timing of tocilizumab will prevent drug-related side effects and increased costs due to unnecessary drug use. Objectives: To investigate the reliability of pre-treatment levels of prognostic nutritional index (PNI), C-reactive protein/albumin ratio (CAR), systemic immune-in-fammatory index (SII), IL-6, lactate dehydrogenase (LDH) as a treatment response biomarker in hospitalized COVID-19 patients who administered tocilizumab. Methods: One hundred thirty three COVID-19 patients received tocilizumab were included. The end-points of treatment effectiveness were evaluated with the rate of death and emerging need for mechanical ventilation at 28 days of hospitalization. To determine independent mortality risk factors, multivariate logistic regression analyzes were performed for statistically different variables among groups that were statistically different in univariate analysis. The capacity of IL-6, CAR, PNI, SII and LDH values in predicting of tocilizumab response in COVID-19 patients were analyzed using receiver operating characteristic (ROC) curve analysis. Results: 34 (25.56%) patients died after tocilizumab therapy. Patients who improved after tocilizumab were signifcantly younger and had signifcantly lower IL-6, LDH, SII, CAR and higher PNI than patients who died. In univariate analyses, mortality was signifcantly associated with age, IL-6, LDH, PNI, SII, CAR and CRP. In multivariate analysis, age (OR:1.070, 95%CI:1.019-1.124, p:0.007) and LDH (OR:1.006, 95CI%:1.003-1.010, p<0.001) were found to be independent predictors of mortality after tocilizumab therapy. To identify of tocilizumab response in COVID-19 patients, IL6 had the highest area under curve (AUC) value (AUC:0.782, 95%CI:0694-0.870), followed by LDH (AUC:0.761, 95%CI:0.661-0.861), PNI (AUC:0.696, 95%CI:0.584-807), SII (AUC:0.671, 95%CI:0.551-0.790), CAR (AUC:0.682, 95%CI:0.578-0.786) and CRP (AUC:0.643, 95%CI:0.535-0.751). Predictive performance of infammatory biomarkers in the prediction of mortality after tocilizumab therapy was presented in Table 1. Conclusion: Although the patients with signifcantly lower IL-6, LDH, SII, CAR and higher PNI levels improved after tocilizumab therapy, only serum LDH levels and age were found to be as independent predictors of mortality. To specify the optimal time interval and the patients who will beneft from tocilizumab, these biomarkers may be used.

COVID-19 VACCINATION of SPONDYLOARTHRITIS PATIENTS RECEIVING BIOLOGICAL THERAPY: REALLIFE DATA

Background: Considering the concerns regarding COVID-19 vaccine safety among patients with rheumatic diseases due to a lack of data, an urgent need for studies evaluating safety profiles of vaccines emerged. Objectives: Vaccination against the coronavirus disease-2019 (COVID-19) started in March 2021 in the group using biological therapy in our country. In this study, post-vaccine real-life data of patients with spondyloarthritis (SpA) followed up with biological therapy were analyzed. Methods: Adult patients diagnosed with SpA who were followed up under biological therapy and vaccinated by CoronaVac inactive SARS-CoV-2 orBNT162b2 messenger RNA (mRNA) COVID-19 (Pfzer-BioNTech) vaccine were included in our observational, multicenter, prospective study. Results: A total of 287 patients (58.2% male;mean age: 47) were included in the study. 202 (%70,4) of patients were being followed up with the diagnosis of AS, 40 (%13,9) of them with PsA, 32 (%11,1) of them with nr-axSpA, 11 (%3,8) of them with enteropathic arthritis, and 2 (%0,7) of them with uSpA. The most common comorbidities were found to be HT (n:65;22.6%) and DM (n:38;13.2%). While 221 (77%) of the patients were receiving biological therapy alone, 27 (9.4%) patients were using methotrexate, 25 (8.7%) patients were using sul-fasalazine, and 12 (4.2%) patients were using lefunomide. The median duration of biological therapy was 40 weeks (19-75 IQR). The most commonly used treatment was infiximab (26.8%), adalimumab (23.3%) was the second (Table 1). It was determined that 207 (72.1%) of the patients preferred inactivated virus vaccine, while 80 (27.9%) preferred mRNA vaccine. When the time between the biological treatment and the day of vaccination is examined, detected median time between biological treatment and the frst dose of vaccination is 11.5 days (5-19 IQR), between the frst dose of vaccination and biological treatment is 14 days (7-21 IQR), between treatment and the second dose of vaccine is 14 days (5-23.5 IQR), and between the second dose of vaccine and the next biological treatment is 12.5 days (7-15 IQR). While 25 (8.7%) of the patients had COVID-19 infection before vaccination, 7 (2.4%) patients were found to have COVID-19 after vaccination (p<0.001). While two of the patients who had COVID-19 infection in the pre-vaccination period required hospitalization, none of the patients who had COVID-19 in the post-vaccination period required hospitalization. The rate of patients who developed side effects after the frst dose of the vaccine was 20.6%. The side effects seen, respectively, were detected as pain-redness at the injection site (16%), fatigue (11.8%), headache (8.4%), muscle-joint pain (7.3%) and fever (5.6%). The rate of patients reporting side effects after the second dose of the vaccine was 17.1%. The incidence of side effects after mRNA vaccine was found to be statistically signifcant compared to inactivated virus vaccine in terms of both doses (p=0.011, p<0.001). Major side effects such as myocarditis, ana-phylaxis-angioedema, myocardial infarction, and thrombosis were not observed in any of the patients included in the study. There was no evidence of disease activation in the median follow-up of 209 days (145-280 IQR) after vaccination. Conclusion: During the follow-up of the patients during the study, no major vaccine-related side effects, post-vaccine disease activation and the need for treatment change were not detected. In order to more accurately evaluate the efficacy of the vaccination program in the patient population using biologic agents, larger-scale studies including unvaccinated individuals are needed.

HEALTH CARE NEEDS OF RURAL OLDER ADULT CANCER SURVIVORS

Introduction Older (65+) cancer survivors have unique complications after chemotherapy, including physical and cognitive impairments and geriatric syndromes. Survivorship research has generally focused on younger and urban populations. We explored the survivorship needs of rural older adult survivors. Methods Thirteen rural older adults who finished curative-intent chemotherapy completed open-ended interviews and health surveys. Transcripts were coded independently by two coders using thematic analysis. Results Mean age was 74 (SD=5.1). Most participants were non-Hispanic White (92.3%), female (69.2%), and married (46.2%). All had health insurance and 76.9% had an annual income <$50k. Most were diagnosed with colon (46.2%) or lung (23.1%) cancer. Themes (Table 1) included: 1) No survivorship care plan developed (100%), 2) No coordination between primary and oncology team (100%), 3) Symptomatic toxicities present (100%), 4) No discussion on long-term chemotherapy effects (61.4%);5) Financial challenges (53.8%), 6) Isolation due to COVID19 pandemic (38.5%), 7) Organizational barriers to care (30.8%), 8) Patient does what doctor says (23.1%), and Recommendations included: 1) referral to support groups (23.1%), 2) discussion on survivorship care (23.1%), and 2) information on exercise (15.4%) Conclusions Rural older survivors have unmet survivorship needs. Aging-sensitive interventions may lead to improved survivorship health post-treatment among rural older adult survivors.

A European toolkit to support contingency and emergency planning for the blood supply

Background: In emergency situations, it is vital to ensure a safe and adequate supply of blood for all essential transfusions. The COVID-19 pandemic has affirmed the need for contingency and emergency planning. The organization of the blood systems in Europe varies widely: centralized or decentralized;managed via the public sector, supranational, private and/or military operators;under numerous different blood policies, legislation and regulation. Consequently, a wide variety of contingency and emergency measures currently exist across Europe. A growing need for contingency arrangements and blood supply backup increases the requirement for co-ordination between key stakeholders and interregional/intercountry collaboration. Therefore, it is important to find common approaches despite the diversity in organization. A standardized toolkit for contingency and emergency preparedness could be beneficial in facilitating such co-ordination and collaboration. To meet this need, and to support European countries to ensure continuity of blood and blood components, the Blood Supply Contingency and Emergency Plan (B-SCEP) project was established. Aims: The aim of the project was to develop practical tools to assist in establishing or strengthening contingency and emergency plans in European countries. Methods: A working group was nominated by the European Committee on Blood Transfusion (CD-P-TS) and EU national competent authorities for blood. Co-ordinated by the European Directorate for the Quality of Medicines and HealthCare (EDQM), the group assessed existing plans and frameworks in 27 European countries via a survey. The survey outcomes were used to identify needs and establish guidance tools on contingency and emergency preparedness, fit for all different organizational aspects of a country's blood system. Results: The project produced three deliverables: A survey report, a set of recommendations and a model preparedness plan. The Survey Report summarizes the state of play in European countries. It shows that although most countries have emergency measures in place, there is large variation in plan structure, content, level of detail, and view on key stakeholders and risk scenarios. The Recommendations include general recommendations on establishment, implementation and maintenance of a B-SCEP and specific recommendations on actions to be undertaken by key stakeholders. The model preparedness plan provides a B-SCEP template. It aids in structuring key elements of the blood system in relation to emergencies, and provides a risk assessment tool to define relevant risk scenarios, identify stakeholders and decide how and when the stakeholders should operate and interact. Summary/Conclusions: Our B-SCEP Recommendations and Model Preparedness Plan provide foundations to support European countries in preparedness for emergency situations that may impact the blood supply. This toolkit can be applied to any blood system, irrespective of organizational setting, and the standardized format facilitates contingency collaborations. By establishing a B-SCEP, in which key stakeholders and their expected actions are defined for different key risk scenarios, effective mitigation strategies and a rapid response can be implemented. This facilitates continuity of the blood supply in emergency situations.

Positive Approach to the Privacy Phenomenon in Digital Media

Humans are social beings;they constantly develop in a dynamic structure. They want to protect and strengthen their image in society. Individuals share their emotions, opinions, ideals, and values on social media to see how their social personalities are perceived by others. The aim is to shape a positive self- image for society. Social media tools contribute to the self- image depending on their activities and posts as well. The users of social media may interfere with the created self- image and have a positive or negative impact on them. In this research, I evaluated the Instagram posts (pictures/ videos) of celebrities, who followed the trend “stay home” in the Covid- 19 period in the USA and England. I examined the phenomenon of privacy with a positive approach concerning family (home) and Covid- 19 post and analyzed their motivating, self- image improving, and exemplifying sides as well as hashtags. This research suggests that the celebrities do not neglect privacy, moreover their posts are supportive and motivating. © Peter Lang GmbH Internationaler Verlag der Wissenschaften Berlin 2022.

Interobserver Agreement in the Analysis of Different Radiological Classifications of COVID-19 on Computed Tomography

Introduction: Computed tomography (CT) has approximately 98% sensitivity for Coronavirus disease-2019 (COVID-19). Various algorithms were designed using CT images. However, the interobserver agreement of different radiological classifications of COVID-19 is not yet known. Thus, this study aimed to investigate the interobserver agreement of different radiological classifications of COVID-19. Materials and Methods: This study included 212 patients who were positive on the polymerase chain reaction test and eligible for CT. Four radiologists examined all CT images simultaneously. They reached a consensus that CT images can provide definite findings of COVID-19. The Radiological Society of North America (RSNA) consensus statement, the British Society of Thoracic Imaging (BSTI) structured reporting statement, and COVID-19 Reporting and Data System (CO-RADS) were used. Fleiss' Kappa was used to detect interobserver agreement. Kappa values of 0.00- 0.20 were considered as slight, 0.21-0.40 as fair, 0.41-0.60 as moderate, 0.61-0.80 as substantial, and 0.81-1.00 as near-perfect agreement, and p<0.05 was accepted as significant. Results: A total of 137 patients did not have any pathological CT findings. The most prevalent radiological findings were ground-glass opacities and consolidations. The agreements on all classifications were at near-perfect levels: RSNA, 0.86 (0.82-0.90);BSTI, 0.83 (0.79-0.87), and CO-RADS, 0.82 (0.79-0.86). The RSNA classification has the highest consistency rate, followed by BSTI and CO-RADS. However, substantial and moderate agreements were found in the subcategories of each classification. Conclusion: In this study, some subcategories had a lower agreement, despite the high consistency rates for COVID-19 radiological classification systems in the literature. Therefore, improving the items without consensus can lead to the development of better radiological diagnostic approaches.

NUTRITION AND MICRONUTRIENTS IN CANCER PATIENTS POSITIVE FOR COVID-19

Nutrition is an important component of human health that influences the immune response, especially in those who are at risk of cancer. It is critical in the COVID-19 era to respond to cancer in a more coordinated and timely manner. So far, there are only a few systematic studies on the increased prevalence of COVID-19 or SARS-CoV2 symptomatic or asymptomatic infections in cancer patients with no comprehensive care plan. The goal of this research is to learn more about the function of diet in cancer patients with in COVID-19 period. The importance of diet in the predisposition, prevention, and management of COVID-19 in cancer patients, as well as the role of dietary supplementation with vitamins or minerals, and microbiota in the COVID-19 period, was discussed in this study. The results might aid in the development of nutritional maintenance and complication control guidelines for all patients with cancer during the continuing COVID-19 pandemic.