The impact of Covid-19 pandemic on public transit use: Case study of Konya city

Since March 2019, Turkey has been enforcing various measures on the policies based on the trends in the COVID-19 cases. To restrain the spread of virus, policies limiting the mobility of people (i.e. lock downs, remote working and travel bans) were applied as in many other countries. Furthermore, social distancing calls for health concern directly caused a major reduction in public transit (PT) use. However, economic activities and new normal conditions required return of a part of the commute travels, which brought the issue of use of PT modes. This study focuses on the comparison of the PT mobility during the month of April in the 2019 (pre-pandemic), in 2020 during restrictions and in 2021 under new normal condition using the Smart Card (SC) data in Konya, Turkey. Monthly, daily and hourly distribution of ridership patterns are compared as well as usage patterns and characteristics of different bus lines are examined in detail. The results suggested that during the restrictions, the ridership was about one eight of the pre-pandemic periods, while it increased to 2.5 million ridership in 2021 which is still very low. Daily ridership in 2020 showed no PT mobility due to lockdowns, while during weekdays, hourly ridership distributions were changed parallel to changes in the work/education activity schedules. Evaluation of the bus lines having highest ridership in 2019 with 2020 and 2021 showed some of the bus lines were cancelled during the pandemic and routes/frequencies changed. The results showed the importance of PT management during pandemic which is very challenging due to economic loss and fear of infection by public. However, it should be emphasized the importance of continuation of public transportation in terms of accessibility and equity for all. © 2023 The Authors. Published by ELSEVIER B.V.

Fatigue And Dyspnea In Young Adults Recovered From COVID-19

Background: Fatigue and dyspnea are the most common long-COVID symptoms in people who recovered from COVID-19. It is important to understand related factors with fatigue and dyspnea in young adults for early detection of the existing or future chronic disease risk and secondary prevention. Objective(s): To investigate the relationship between fatigue, dyspnea, respiratory functions, functional exercise capacity, physical activity, and anxiety in young adults who recovered from COVID-19. Method(s): Twenty-seven individuals (4 male, 23 female) aged 18-25/years (mean age=21.4+/-1.8/years), diagnosed with COVID-19 and at least 12 weeks passed after diagnosis (mean 231.84+/-118.1/days) were included in the study. Dyspnea-12 and Fatigue Severity Scale (FSS) were used to evaluate dyspnea and fatigue. Respiratory functions and respiratory muscle strength (maximal inspiratory pressure-MIP, maximal expiratory pressure-MEP) were assessed using spirometry and intraoral pressure gauge. Functional exercise capacity was evaluated with the "6-minute walking test (6MWT)". International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Coronavirus Anxiety Scale (CAS) were used to evaluate physical activity and anxiety Results: Of the subjects, %63 reported fatigue and 37% reported dyspnea. None of the subjects were treated at the hospital during the disease. There were significant moderate negative correlations between Dyspnea-12 and %peak expiratory flow-PEF (p=0.020), and FSS and MEP (p=0.009). Time after PCR, age, 6MWT, IPAQ-SF, and CAS were not correlated with FSS or Dyspnea-12. Conclusion(s): Our results showed that fatigue and dyspnea are related with expiratory muscle strength and PEF in young adults who recovered from COVID-19.

U-Net Based Covid-19 Infected Lesion Detection and Deep Learning Based Classification on CXR

The Covid-19 disease, which emerged in China in December 2019 and caused by the coronavirus virus, soon became a pandemic all over the world. The fact that the Transcription Polymerase Chain Reaction (RT-PCR) test produces false negatives in some studies and the diagnosis time is long, has led to the search for new alternatives for the diagnosis of this virus, which can result in death, especially with the damage it causes to the lungs. Therefore, chest images have become suitable tools for diagnosis from chest images with data obtained from Computed Tomography or CXR imaging techniques. Deep learning studies have been proposed to provide diagnosis with these tools and to determine the infected region of Covid-19 and Pneumonia disease. In this paper, a two-stage system is proposed as segmentation and classification. In the segmentation process, infected regions segmented from the labeled data were determined. In the classifier stage, Covid- 19/Pneumonia/Normal classification was performed using three different deep learning models named VGG16, ResNet50 and InceptionV3. To the best of our knowledge, this is the first attempt to sequentially design classification and segmentation systems into a more precise diagnosis. As a result of the study, 95% segmentation accuracy was obtained. Classifier models achieved 99%, 90% and 98% accuracy, respectively. © 2022 IEEE.

Clinical follow up of renal transplant recipients with COVID-19: a case series

COVID-19 has been recognized to become a worldwide health concern at an alarming rate over time and to be more progressive and fatal in specific risk populations. This study aims to determine the clinical features of COVID-19 in kidney transplant recipients (KTRxs) and contribute to the regulation of these patients' immunosuppressive treatments and COVID-19 treatment protocols. The trial comprised eleven KTRxs with COVID-19. Immunosuppressive treatments such as antimetabolite cessation, calcineurin inhibitor dosage adjustments based on blood levels, and low-dose corticosteroids were all controlled. All patients received antiviral medication and low-molecular-weight-heparin (LMWH) as part of initial treatment. The steroid dose was then raised, and anti-cytokine therapies were provided in the setting of clinical worsening. The mean age of the patients was 50.3 +/- 11.2 years and 8 (73%) of them were male. The average time since transplantion was 6.82 +/- 3.34 years. Due to COVID-19 progression, the steroid dosage was raised in eight patients, anakinra and tocilizumab was added in five and one of the patients respectively. In five (%45) patients, the need for critical care arose and plasmapheresis was used in three of them. At the end of the follow-up, nine of our patients had made a complete recovery, whereas two (18.2%) had perished. Consistent with the literature, the data in presented study may also support the severe and fatal course of COVID-19 in KTRxs. It may be proposed that KTRxs with COVID-19 should be admitted to the hospital and constantly monitored, and certain effective management techniques should be initiated early depending on clinical circumstances.

Effective Therapeutic intervention for LAA thrombus: Percutaneous LAA closure

Background And Aim: Left atrial appendage occlusion is a feasible and effective therapeutic intervention for thromboembolic prevention in patients with non-valvular AF. Some procedural difficulties, such as thrombus formation in LAA, can be challenging for operators and increase periprocedural complication risk. In this clinical study, outcomes of LAA closure in patients with LAA thrombus were evaluated. Method(s): One hundred and fifty consecutive patients had undergone percutaneous LAA closure in our clinic between 2015 and 2021. Sixteen patients had thrombus formation in LAA before occlusion and enrolled in the study. Patients were apprised of a paravalvular leak and thrombus formation on the device with transesophageal echocardiography 1, 6, and 12 months after the procedure. One year after the closure, evaluation with transesophageal echocardiography was done only under clinical suspicion. Major adverse clinical events during follow-up, including disabling stroke, clinically relevant hemorrhage, myocardial infarction, and all-cause mortality, were recorded. Result(s): Sixteen patients had been followed for a median of 36 months (1-60 months). The median age was 71.1 +/- 6.7 years. Nine patients were male (56.3%). CHA2DS2-VASc and HAS-BLED scores were calculated at 5 (2-8) and 5 (1-6), respectively. In four patients, LAA occlusion was indicated due to malign LAA. LAA occlusion was performed with Amplatzer Amulet Device in all patients. Postprocedural antiplatelet treatment was decided on clopidogrel, DAPT, or oral anticoagulant plus clopidogrel in 3, 9, and 4 patients, respectively. Five patients died during follow-up. Covid-19 related respiratory failure was responsible for death in three patients. Five patients were hospitalized due to heart failure, and 2 of them died during the hospitalization. Any clinically significant cerebrovascular event or major bleeding was not observed during follow-up. The first month and sixth-month echocardiographic evaluations were done on all patients. Peridevice leak or thrombus formation was not observed in any patients. Conclusion(s): LAA closure in patients with LAA thrombus is a feasible and effective method to reduce thromboembolic risk. It can be performed as an alternative therapy to OACs in patients who have contraindications to OACs or malign LAA. (Figure Presented).

Optimum utilization of on-demand manufacturing and laser polishing in existence of supply disruption risk

3D printing has moved from being a rapid prototyping tool to an additive manufacturing method within the last decade. Additive manufacturing can satisfy the need in dire situations where spare parts distribution is an issue but access to a 3D printer is much more likely and rapid than access to original parts. Managing inventories of spare parts can be tackled with more ease thanks to the reduced part types with additive manufacturing. While quality (in terms of reliability) of additively manufactured spare parts in terms of mechanical properties seem to be lower than original parts (particularly due to the inherent staircase appearance and the corresponding stress concentration zones that can lead to premature fatigue failure), use of post-processing subtractive techniques to correct such surface irregularities are found to improve reliability. While each process adds another layer of complexity to the cost minimization problem, demand uncertainty and risk of supply disruption represent the modern global problems faced recently. The problem tackled in this study is the joint optimization of the supply reliability considering the effect of laser polishing parameters and the demand uncertainty. In this problem, a condition of random breakdowns of identical products is considered. Also, the original supplier of machine components is subject to exogenous disruptions, such as strikes, raw material scarcity, or the COVID-19 pandemic. As a result, the optimum control policy with the right cost parameters was shown via numerical experiments originated from mathematical analyses. This optimality can be critical in managing the system in the best possible way, particularly during times of unforeseen circumstances such as pandemics. (C) 2022 Society of Manufacturing Engineers (SME). Published by Elsevier Ltd. All rights reserved. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Peer-review under responsibility of the Scientific Committee of the NAMRI/SME.

THE LONGITUDINAL EVOLUTION OF COVID-19 OUTCOMES AMONG HEMODIALYSIS PATIENTS: A NATIONWIDE MULTICENTRE CONTROLLED STUDY

BACKGROUND AND AIMS: Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD: We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS: A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients;15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION: In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. (Table Presented).

Cross-cultural classroom: Virtual case-based learning utilizing MRI and extendedreality technology delivered to American and Turkish medical students

Due to the COVID-19 pandemic, there is increased interest to effectively deliver educational curricula remotely to diverse student populations. Case-based cadaveric MRI visualization and extended reality (XR) technology enhances learning experiences in medicine. The purpose of this study was to demonstrate that a virtual, multi-departmental workflow utilizing MRI, XR technology, and a “patient” group, represented by the John A. Burns School of Medicine (JABSOM) Willed Body Program, supplements case-based learning and promotes student exploration and engagement equally in cross-cultural cohorts represented by American and Turkish medical students. Virtual case-based learning activities were developed and presented to American medical students at JABSOM and Turkish medical students, selected based on education and English proficiency, via Zoom. Subject, medical history, and physical exam data were presented to students who were then divided into breakout rooms where hypotheses regarding cadaveric, neurological findings were generated. Students then reviewed radiology and pathology reports and accessed relevant 3D segmented, photogrammetric and illustrative models. An optional survey was completed to evaluate student opinion based on a 5-point Likert scale. Comparisons between groups were performed using a non-parametric Mann Whitney U test. Data was reported as mean, median (min-max), and percentile. Significant differences (two-tailed P) less than 0.05 were significant. Results revealed significant differences between American (n=40) and Turkish (n=16) student opinion. The Turkish scale was significantly higher when asked if MRI scans of cadavers were useful as online learning tools (p =0.002), if MRI scans of cadavers provided an understanding of relevant anatomy (p<0.001), if 3D models provided a better understanding of anatomical relationships (p<0.001), whether students would like more interactive sessions using MRI scans (p<0.001), and if students would use similar resources in the future (p<0.001). The American scale was higher when asked if students were able to communicate effectively with their breakout groups (p=0.037). The learning activity was positively received by both cohorts as shown by no average score less than a 4 out of 5 for each question. The American scales may have been lower due to having previous experience with similar activities, whereas the learning activity was novel and exciting to Turkish students. Differences in communicating effectively in breakout rooms can be explained by the fact that American students were broken into longitudinal dissection groups, whereas Turkish students were randomly assigned. Based on these results, case-based learning, utilizing MRI and XR technology, enhances the learning experience of medical students and can be expanded to cross-cultural student populations.

Effectiveness of Video-Based Exercises on Quality of Life during COVID-19 Pandemic

Objective: In this study, we aimed to investigate the effectiveness of video-based exercise program on quality-of-life (QoL) domains. Material and Methods: A total of 68 participants, aged 18–35 years, were included in the study. The participants were divided into two groups on the basis of their willingness to exercise-the exercise group (n=39, 26.74±3.91 years, 28.2% men) and the control group (n=29, 27.59±2.82 years, and 41.4% men). Both groups were evaluated with Rapid Assessment of Physical Activity and World Health Organization Quality of Life BREF through web-based forms, and the exercisers’ aerobic capacities were evaluated with a two-minute walk test (2MWT). The exercise group attended 35 minutes of video-based exercise intervention three times a week for six weeks, whereas the control group continued their regular life. At the end of the study, the change in the general health status of the participants was rated with the Global Rating of Chance Scale (GRCS) and exercise satisfaction with the 10-point Likert scale. Results: There were no differences in the QoL domains within or between the groups (P > .05) except within the group change in 2MWT total walking distance parameter in the exercise group (P < .001). However, GRCS scores were statistically higher in the exercise group (P < .001). The overall satisfaction with the video-based exercise program was 8.28±1.76 points. Conclusion: There was no significant increase in QoL domains with video-based exercises compared to the control group. However, these exercises may contribute to the preservation of aerobic capacity during periods when face-to-face exercises cannot be performed. © 2022 Archives of Health Science and Research. All rights reserved.

Effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia

Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined. Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 +/- 14.5 (2390). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients. Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality.

Optimal Inventory Share Policy Search for e-Grocery Food Supply Network

The study focuses on intercompany inventory share policies between e-groceries. Companies are attempting to adapt to the Internet of Things environment considering, the increased amount of e-commerce throughout the world, as well as the effect of the COVID-19 pandemic. The goal of the study is to create a strong bond between companies by taking advantage of today's technology and helps in the reduction of capital risk. These relationships may also lead to greater market share, reduced inventory, enhanced delivery services, higher quality, and faster product development cycles with the help of inventory visibility. This research studies two inventory sharing strategies among e-grocers to improve the supply network's efficiency and responsiveness. The policies considered in this study include share policies based on expiration dates and share policies based on distance - inventory. We use a simulation modeling technique to represent such policies. Besides, in an effort to compare how lateral inventory share implementation affects the system performance, non-inventory sharing policy has been modeled and these three policies were compared. The goal of this study is to determine the best s, S inventory management levels in e-groceries under those rules. Here, s and S represent, re-order and order-up-to levels for replenishment of products. We are motivated to do this study to decrease food waste in such a food network since management of perishable food products is important owing to their perishable feature. Distance, average freshness, average inventory, and waste product numbers were compared in this project based on the lowest inventory number in line with three main policies. The opt quest tool was used in the arena to find the results. Consequently, company owners should choose Expiration Date policy as it has advantages such as total number of waste products and average inventory level. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Investigation of the Changes in the Physical Parameters of Fitness Members During the Covid-19 Pandemic Process (Sample Province of Kayseri)

Background: The period of Covid 19 epidemic effect not only illness people but also human lives. A lot of People, participating some of activities in gym center from Kayseri. Some of restraint during the covid 19 epidemic by the ministry of interior was affected people who went to fitness center. This situation affected people of Body Weight, Body Mass Index, Body Fat Index unfavorable. Aim: The purpose of this study was to determine the physical changes of the participants who actively attended fitness centers during the Covid-19 pandemic. Aim: The purpose of this study was to determine the physical changes of the participants who actively attended fitness centers during the Covid-19 pandemic. Methods: In this study, 211 participants (male:155, female:56) enrolled in fitness centers in the experimental group were checked for 2 months and their Body Weight (BW), Body Mass Index (BMI), Body Fat Index (BFI) and were recorded twice. The findings obtained were evaluated statistically with the package program Results: In our study, n=55 over the age of 18, 26.1% were female;n=156, 73.9% of the male individuals voluntarily participated. At the end of the study, it was found that there was an increase in BW, BMI and BFI values of male and female participants and that they were significant at the level of paired sample t test findings (p<0.05). Although there was an increase in MMI values, these findings were found to be at the level of (p>0.05). Conclusion: At the end of the research, it was found that individuals who actively continued in fitness centers during the Covid-19 pandemic in Kayseri province experienced restrictions and an increase in BW, BMI, and BFI due to sedentary life.

A Case with Avascular Bone Necrosis Developing as a Complication of COVID-19 Treatment

As our knowledge and experience of COVID-19 increases, our treatment approaches may change. For patients with respiratory failure due to COVID-19 disease, the disease table can be better controlled with systemic glucocorticoids, and mortality rates and hospitalization periods can also be reduced. Steroid therapy can be applied for the long-term, especially in cases with organized pneumonia, and patients can be discharged from hospital with maintenance treatment. Complications have been noted in patients in the post-COVID period resulting from the use of glucocorticoids. While mostly bacterial and fungal lung infections are seen, another side-effect of glucocorticoids is their negative effect on bone metabolism. We present here a case in which avascular bone necrosis developed as a result of long-term steroid use for the treatment of COVID-19.

A Multi-criteria Approach to Usability Research for Digital Platforms in Fuzzy Environment

COVID-19 outbreak was announced as a “Public Health Emergency of International Concern” on 30 January 2020, then declared as the most challenging crisis that the World have ever faced [1]. With all challenges, restrictions, obligations brought by pandemic, people all around the globe have been compelled to adopt new conditions and new ways of older practices, where, “the new normal” concept introduced to our lives deeply changed preferences, expectations and consumption patterns. The world is just in the midst of COVID-19 pandemic today [1], which means the pandemic is expected to have repercussions over the coming periods. As digital solutions became more accessible, digitalization began to gain importance. Usability analysis is a new and complex problem for companies who are trying to keep pace with the change of expectations and to adjust the new normal conditions. In this study, usability factors were determined and then identified for digital marketing platforms in a general framework threefold, in terms of the main factors, sub-factors, and over-all importance levels and effects, aside from existing studies. Fuzzy logic and fuzzy numbers were employed in order to represent the linguistic expressions best, and, to minimize data loss while reflecting the input data into the results. Five main usability factors and related 11 sub-factors were analyzed with Fuzzy SWARA methodology. Differing results and priorities obtained in local and global extents, and each result set was interpreted separately. Some recommendations to facilitate digitalization process and suggestions for future researches were presented within the usability framework. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Fuzzy Multi-criteria Analysis of Factors Affecting the Digitalization Success of Public Services

In the year since the COVID-19 pandemic emerged in 2019, all countries have taken different measures to prevent the spread of this virus (i.e. learning distance, travel restriction, using masks, etc.). In addition, some scientific advances have been conducted in various treatment modalities and vaccine development. However, the common view of the science world is that we may not return to our old order and our social life will continue in a controlled manner. For this reason, many countries have conducted rapid progress in providing public services digitally to protect both public officials and their citizens and prevent gathering people unnecessarily. There are critical factors that should be taken into account that will bring success in the digitalization of public services, which have increased with the impact of COVID-19 (ie. to what extent services can be provided digitally, how user-friendly online interfaces, ensuring security.). In this paper, a study was conducted to prioritize these critical success factors. A fuzzy scale was employed to handle the fuzziness of the data in decision-making processes. The interval valued type-2 fuzzy Analytical Hierarchy Process technique, which is based on pairwise comparison logic, was utilized to obtain the priorities. According to the results, the most critical success factor was determined as ergonomics criterion expressing the interface design and usability of the provided service. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Pulmonary embolism after COVID-19 infection in two non-hospitalized cases

SARS-CoV2 infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) may result in thrombosis development in both venous and arterial systems under the effects of inflammation increase, thrombocyte activation, endothelial dysfunction and stasis in blood flow. Accordingly, although many guidelines recommend thrombosis prophylaxis for hospitalized patients, it is not recommended for outpatients. Pulmonary embolisms were detected on computed tomography examinations performed in the emergency department in the two patients in the present study, who were being treated for coronavirus disease-19 (COVID-19) infection, but who did not require hospitalization, and who presented with complaints of shortness of breath and chest pain after treatment. We deemed it appropriate to present these cases in non-hospitalized patients to emphasize the need for thrombosis prophylaxis, considering the balance of bleeding and thrombosis.

Embodied reflections of body-oriented clinical psychology students during covid-19

The world has encountered a pandemic named Covid-19 that has affected people's lives in numerous dimensions. During this ongoing dramatic and stratified period, we have been shattered globally in various layers. As 12 students of the first Body-Oriented Clinical Psychology master's program at Maltepe University in Turkey, we experienced uncertainty caused by the pandemic accompanied with online Body-Oriented Psychotherapy classes. Our experiences in Turkey, mostly Istanbul between mid-March and June, 2020 can be an example of reacting with uncertainty to the unexpected Covid-19 pandemic and may highlight the role of the body coping. In this article, we intended to reflect our pandemic experiences of significant changes in our lives. We examined our perception of the new normal as 'Body-Oriented Clinical Psychology students' in our reflections with distinct and common experiences. In addition, we covered the experiences of body awareness, embodiment, emotions, and interpersonal relationships while coping with the coronavirus. Our reflections revealed that the uncertainty of online education and other circumstances during this time caused anxiety and anger, while body-oriented courses helped us feel regulated and attuned. Sharing our experiences and evaluating the effects of our education on these experiences of lock-downs were important in gaining a better understanding of the circumstances in order to determine helpful solutions. © 2021, Vesnu Publications. All rights reserved.