The effectiveness of an education program based on healthcare transition in adolescents with asthma: A randomized controlled trial.

BACKGROUND: Adolescents diagnosed with asthma make a transition to adult care when they reach a certain age. Besides, these adolescents need specialized education for them to become autonomous, competent, and adult patients and gain the necessary knowledge and skills related to their disease. In this study, by using a prospective randomized controlled trial design, we evaluated the effectiveness of an education program based on healthcare transition provided to adolescents diagnosed with asthma. METHODS: After obtaining the consent of adolescents and their parents, 52 adolescents aged between 14 and 18 years who were diagnosed with asthma were randomly assigned to the intervention group (individual four face-to-face and six online education sessions) or the control group (standard care). The primary outcome was the differences between the Transition Readiness Assessment Questionnaire (TRAQ) scores of the two groups. The secondary outcomes included the differences between the Self-Efficacy Scale for Children and Adolescents with Asthma and Mind the Gap scores of the two groups. The outcomes were measured at two different time points: baseline (first assessment; Week 0) and immediately after the intervention (last assessment; Week 12). RESULTS: In the initial evaluations, there was no significant difference between the groups in terms of the primary or secondary outcomes (p > .05). In the final assessments, the TRAQ (Z = -4.740, p < .001) and Self-Efficacy Scale for Children and Adolescents with Asthma (t = 6.344, p < .001) scores of the intervention group were found to be significantly higher than the scores of the control group, while their Mind the Gap Scale scores were significantly lower (t = 6.146, p < .001). CONCLUSION: It was determined that the educational intervention integrated with pediatric care based on readiness for transition from pediatric care to adult care was effective in increasing the transition readiness and self-efficacy of the adolescents. The study was registered at ClinicalTrials.gov with the ID code NCT05550922.

White Tears: A Phenomenological Study of Perinatal Loss.

Perinatal loss is a traumatic experience for parents. This research was conducted to evaluate the experiences and needs of parents after perinatal loss. An interpretative phenomenological study was carried out between January 2021 and July 2022 with 6 parental pairs (12 people in total, 6 mothers and 6 fathers) who experienced a perinatal loss. Participants were reached by snowball sampling method. Data were collected using semi-structured audio recording interviews that were transcribed and analyzed using thematic analysis. The themes of this study were determined as "attributing meaning to loss", "fragmented parenting roles and expectations", "changing relationships", "expectations from healthcare professionals", and "emotional responses". Five sub-themes were created from the emotional responses theme which included. These are sadness and pain, denial, anger, guilt and fear. In the study, it was concluded that the experience of perinatal loss may have negative consequences on the psychological health of the parents. Therefore, specific, professional, adequate nursing support and continuity of support are needed to help parents cope with perinatal losses.

Removal of Ni(II), Cu(II), Pb(II), and Cd(II) from Aqueous Phases by Silver Nanoparticles and Magnetic Nanoparticles/Nanocomposites.

The intake of heavy metals into the body, even at very low concentrations, may cause a decrease in central nervous system functions; deterioration of blood composition; and liver, kidney, and lung damage. Therefore, heavy metal ions must be removed from water. In this study, silver, magnetic iron/copper, and iron oxide nanoparticles were synthesized using Lathyrus brachypterus extract and then Fe/Cu-AT, Fe3O4-AT, Fe/Cu-CS, and Fe3O4-CS magnetic nanocomposite beads were synthesized using alginate and chitosan. The removal of Cd(II), Pb(II), Ni(II), and Cu(II) ions from aqueous phases using synthesized nanoadsorbents was investigated by single and competitive (double and quaternary) adsorption techniques. The kinetic usability of the magnetic iron oxide chitosan (Fe3O4-CS) nanocomposite beads with the highest removal efficiency was evaluated. Based on experimental results, the order of removal was found to be 98.39, 75.52, 51.54, and 45.34%, and it was listed as Pb(II) > Cu(II) > Cd(II) > Ni(II), respectively. The Dubinin-Radushkevich, Freundlich, Langmuir, and Temkin isotherm models were used, and experimental results revealed that the experimental data fit the Langmuir model better. The maximum adsorption capacities (qm) obtained from the Langmuir isotherm model of Fe3O4-CS were found to be 8.71, 23.75, 18.57, and 12.38 mg/g for Ni(II), Pb(II), Cu(II), and Cd(II) ions, respectively. When the kinetic data were applied to the Lagergren, Ho-McKay, and Elovich models, it was observed that the adsorption kinetics mostly conformed to the Ho-McKay second-order rate equation. The binary and quaternary competitive adsorption data showed that Fe3O4-CS were selective toward Cu(II) and Pb(II). The reusability of the Fe3O4-CS nanoadsorbent was performed as three cycles with the same concentration. The adsorption capacities were found to be 95.81, 70.65, 50.50, and 42.75%, in turn for Pb(II), Cu(II), Cd(II), and Ni(II) ions after three cycles, which revealed that the Fe3O4-CS nanoadsorbent can be used after three cycles without losing its efficiency.

Hospital classroom experiences of hospitalized school-age pediatric oncology patients: A qualitative study.

PURPOSE: In this study, it was aimed to examine the hospital classroom experiences of school-age children who received treatment and care at a pediatric oncology-hematology clinic in Turkey. METHODS: The study was conducted using the in-depth interview method with the participation of 17 children who were hospitalized in the pediatric oncology-hematology clinic of a research and training hospital in the Ankara province of Turkey. The data were collected using a "Semi-Structured Interview Form". The interviews started with the question "How do you perform the assignments given by your teacher while you are hospitalized?", and the interviews were recorded as audio with the consent of the children and their parents. RESULTS: As a result of the interviews, three main themes, (1) Learning, (2) Maintaining normalcy, and (3) Expectations, and 9 subthemes (teacher, continuation of learning, learning through play, feeling good, continuation of routines, peer interaction, communication with the school-teacher, basic sport activity, and tablet/internet access) were generated from the data. CONCLUSIONS: Hospital classrooms had a significant role in increasing the children's adaptation to hospital conditions and ensuring the continuation of school/learning. PRACTICE IMPLICATIONS: Pediatric nurses can refer children with long and repeated hospitalizations (e.g., pediatric oncology patients and children with chronic diseases) to hospital classrooms. Thus, children can adapt more easily to the procedures performed in the hospital.

Determining Knowledge and Opinions of Neonatal Intensive Care Unit Nurses on Wet-Nursing and Human Milk Banks: A Cross-Sectional Study in Türkiye.

BACKGROUND: Wet nursing and human milk banks are vital sources of human milk for infants unable to breastfeed. RESEARCH AIM: This study aims to determine the knowledge and opinions of neonatal intensive care unit nurses regarding wet-nursing and human milk banks in Türkiye. METHODS: This descriptive cross-sectional study was conducted with 219 neonatal intensive care unit nurses using an online survey comprising 20 questions. The data were collected between August and September 2021. RESULTS: Among the participants, 64.4% (n = 141) expressed that they would be a wet-nurse and 59.8% (n = 131) would search for a wet-nurse if necessary. Some, 47.0% (n = 103) of participants did not know if there were any human milk banks in Türkiye, 53.9% (n = 118) would like to be a donor if human milk banks were established, and 71.7% (n = 157) stated that the establishment of human milk banks should be supported. Religious concerns were the basis for reluctance to donate milk to human milk banks for 60% (n = 51) of the participants. Knowledge was greater and opinions about wet-nursing and human milk banks were more positive for participants with higher education, more time in the neonatal intensive care unit, or work at a tertiary care center. CONCLUSION: The approaches of neonatal intensive care unit nurses towards personally being wet-nurses and milk sharing were generally positive, although more information about human milk banks is needed. Religious beliefs are an important consideration when providing information about milk sharing.

Pulmonary functions and life quality assessment results two years after COVID-19 comparison with the sixth month results.

INTRODUCTION: We aimed to investigate the effects of COVID-19 on patients 24 months after severe COVID-19 pneumonia. METHODOLOGY: Fifty-four patients with severe COVID-19 pneumonia were evaluated on the 24th month after discharge from the hospital. Spirometry and short form of health-related quality of life scale (SF-36) were used. Chest computed tomography (chest-CT) was performed and the findings were grouped according to lung involvement. RESULTS: Forced expiratory volume in 1 second (FEV1) % values of 19 patients (35.18%) and forced vital capacity (FVC) % values of 23 patients (42.54%) were found lower than expected on the 24th month. Physical function, energy-vitality, social functionality and general health parameters were found lower than normal on the SF-36 scale. 27 (50.00%) patients had a chest-CT abnormality. There was a correlation between FEV1% and FVC% values and group 3: medium-lower lobe dominant, reticulation + traction, 10-50% surface area. Chest-CT of 6 patients was fully recovered. No correlation was found between chest-CT findings on the 24th month and BMI, length of hospitalization, white blood cell (WBC), lymphocyte, C-reactive protein (CRP), ferritin and D-dimer values at the time of hospitalization. CONCLUSIONS: Functional and radiological abnormalities were detected in a significant number of patients on the 24th month. A systematic monitoring plan must be established to assess and properly manage the long-term problems that may arise.

Do Attitude, Awareness and Intention to Perform Female Genital Mutilation or Cutting for Their Daughters of Women Healthcare Providers Differ from Mothers in Somalia?

Aim: This study aimed to determine whether there were differences in attitude, awareness, and intention to perform female genital mutilation or cutting for their daughters in the future between female healthcare providers and mothers. Methods: A comparative cross-sectional study design was used. Results: A total of 508 women were included in the study. Of the participants, 68.7% (n = 349) were mothers (Group I) who visited the hospital and 31.3% (n = 159) were women healthcare professionals (Group II) [27% (n = 137) nurses and 4.3% (n = 22) doctors]. It was found that 8 (1.6%) of the participants did not have FGM/C and the FGM/C ratio was lower in group II (95%) than in group I (100%) (p < 0.001). In group I, 99.7% (n = 299) of the participants and 30.6% (n = 19) of those in group II reported intending to perform FGM for their daughters in the future (p < 0.001). The reasons for FGM/C most cited by participants were a traditional rite of passage into womanhood (78%), religious requirement (69.3%), and preservation of their virginity until marriage (59.3%). "Stop FGM" was given as a message on FGM/C by 60% of the participants (n = 79) who answered (n = 127, 100%) to open-ended questions. Conclusion: The results of this study show that female health professionals with higher education and monthly income had less positive perception of their FGM/C and less intention to allow their daughters to undergo FGM/C.

Development of a Sensitive Method for Cadmium Determination in Fish Tissue and Drinking Water Samples by FAAS Using SQT In Situ Atom Trapping.

A sensitive and robust trap method was developed for the determination of cadmium (Cd) by using a slotted quartz tube. Using this method at a sample suction rate of 7.4 mL/min for 4.0 min collection, a 1467-fold increase in sensitivity was obtained compared to the flame atomic absorption spectrometry method. Under the optimized conditions, a limit of detection of 0.075 ng mL-1 was obtained for the trap method. The interference effects of hydride-forming elements, transition metals, and some anions on the Cd signal were investigated. The developed method was evaluated by analyzing "Sewage Sludge-industrial origin (BCR no: 146R)", "NIST SRM 1640a Trace elements in natural water", and "DOLT: 5 Dogfish Liver". There was a good agreement between the certified and found values at the 95% confidence level. This method was applied successfully for the determination of Cd in drinking water and some fish tissue samples (liver, muscle, and gill) obtained from Mugla province.

Quantifying the impact of COVID-19 on immigration in receiving high-income countries.

Previous studies have examined the impact of COVID-19 on mortality and fertility. However, little is known about the effect of the pandemic on constraining international migration. We use Eurostat and national statistics data on immigration and ARIMA time-series models to quantify the impact of COVID-19 on immigration flows in 15 high-income countries by forecasting their counterfactual levels in 2020, assuming no pandemic, and comparing these estimates with observed immigration counts. We then explore potential driving forces, such as stringency measures and increases in unemployment moderating the extent of immigration change. Our results show that immigration declined in all countries, except in Finland. Yet, significant cross-national variations exist. Australia (60%), Spain (45%) and Sweden (36%) display the largest declines, while immigration decreased by between 15% and 30% in seven countries, and by less than 15% in four nations where results were not statistically significant. International travel restrictions, mobility restrictions and stay-at-home requirements exhibit a relatively strong relationship with declines in immigration, although countries with similar levels of stringency witnessed varying levels of immigration decline. Work and school closings and unemployment show no relationship with changes in immigration.

Triangle technique: An effective tool for improving nursing students' ability to calculate safe pediatric medication dosages.

Calculating the correct medication dosage for pediatric patients can be difficult for nurses to determine, as the pediatric dose is typically a small fraction of the adult dosage. This study aims to examine the impact of the Triangle Technique on the ability of nursing students to calculate low and high safe dosage ranges in children. To evaluate how this educational tool could improve a nurse's skill in this area, a quasi-experimental pre-/post-test research design was employed including one hundred fifty-eight third-year nursing students. The Pediatric Medication Administration Form and Pediatric Safe Dosage Calculations Quiz (PSDCQ) were used to measure the effectiveness of the Triangle Technique. While <50% (n < 79) of students gave correct answers to each question in PSDCQ before this intervention, all of the participants (N = 158, 100%) gave a correct answer to one question, and >89.2% (n > 141) of the students correctly answered the other four questions of PSDCQ. The change in scores (pre-PSDCQ median score = 0, IQR = 60; post-PSDCQ median score = 100, IQR = 0) post-intervention was statistically significant (z = 10.633, p ≤ .001), indicating that this teaching technique was effective for improving students' ability to calculate pediatric safe dose ranges. Nursing students (n = 144, 91.1%) were satisfied with using Triangle Technique. Using the Triangle Technique can increase nursing students' understanding of how they calculate safe pediatric medication dosages.

Determination and speciation of methyl mercury and total mercury in fish tissue samples by gold-coated W-coil atom trap cold vapor atomic absorption spectrometry.

A sensitive analytical technique was developed where gaseous mercury formed by sodium tetrahydroborate reduction is transported to and trapped on a resistively heated gold-coated Tungsten-coil atom trap for in situ preconcentration. This technique was applied successfully for determination and speciation of methyl mercury and total mercury in some fish tissue samples (liver, muscle and gill) obtained from Mugla province. The analytical parameters were optimized both for trap and no-trap studies. Under the optimized conditions, a limit of detection (LOD) of 6.0 ng/L was obtained. The precision was evaluated by relative standard deviation (RSD%) corresponding to 4.1% (n = 11). Accuracy of the proposed method was evaluated by analyzing "DOLT:5 Dogfish Liver", "NIST SRM 1640a Trace elements in natural water" and "NIST 1946 Lake Superior fish tissues". The measurements of the certified reference materials were in good agreement with the certified values at the 95% confidence level.

Projections of adult skills and the effect of COVID-19.

In this paper, we project Skills in Literacy Adjusted Mean Years of Schooling (SLAMYS) for the working age population in 45 countries and quinquennial time periods until 2050 according to various population scenarios. Moreover, we integrate the effect of school closures due to the COVID-19 pandemic on these projections. Adult skills are projected using the cohort components method. They can help in assessing the potential consequences of the recent trends for the adult population, particularly the workforce, whose skills are essential for the jobs contributing to economic growth and development outlooks. Our projections are novel as they take into account both the amount of schooling and quality of education and also consider the changes in adult skills through lifetime. Projections show that the adult skills gap between countries in the Global North and countries in the Global South will likely continue to exist by 2050, even under very optimistic assumptions-but may widen or narrow depending on the demographic development trajectories specific to each country. Moreover, the loss of learning due to school closures during the COVID-19 pandemic further exacerbates inequalities between countries. Particularly, in countries where schools have been closed for a prolonged period of time and the infrastructure for effective online schooling is lacking, the skills of cohorts who were in school during the pandemic have been severely affected. The fact that the duration of school closures has been longer in many low- and middle-income countries is a serious concern for achieving global human capital equality. The impact of the COVID-19 pandemic is projected to erase decades-long gains in adult skills for affected cohorts unless policies to mitigate learning loss are implemented immediately.

Remdesivir treatment for patients with moderate to severe COVID-19.

BACKGROUND: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. METHODS: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 × the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. RESULTS: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO2 level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. DISCUSSION: Remdesivir is a safe and well-tolerated drug and older age, low SpO2 level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.

Bioaccumulation and health risk assessment of heavy metals in European eels taken from Lakes Köycegiz (Turkey) and Võrtsjärv (Estonia).

Monitoring heavy metal contaminants in fish is important for the assessment of environmental quality as well as food safety. In this study, European eel samples were collected from Lake Köycegiz and Lake Võrtsjärv in 2017 and 2018. The concentrations of Mn, Cd, Zn, Pb, and Cu metals were measured by using GF-AAS in four selected tissues of eel, including liver, gill, skin, and muscle in both lakes. The pollution index (Pi, MPI) values were calculated for both lakes and the health risk for consumers was assessed for both adults and children in Turkey and Estonia. The estimated weekly intake (EWI), hazard index (HI), and lifetime cancer risk values (CRs) for the metals were calculated for both lakes. According to the results of this study, a significant difference was determined between the metal concentrations (especially Cu, Cd, and Pb) in the tissues of the eel samples taken from the two lakes. These results show that besides the pollution levels in the aquatic environment, physiological needs and metabolic activities in different habitats have a significant effect on metal accumulation in eels. In addition, HI was found to be < 1 for both adult and child consumers in both lakes, which indicates that consumers would not experience non-carcinogenic health effects. However, the values of CR for Pb and Cd were found negligible in Lake Köycegiz, while the CR value for Pb was found to be very close to the danger limits in Lake Võrtsjärv.

Effects of comorbid disorders on reward processing and connectivity in adults with ADHD.

ADHD is a neurodevelopmental disorder with a long trajectory into adulthood where it is often comorbid with depression, substance use disorder (SUD) or obesity. Previous studies described a dysregulated dopaminergic system, reflected by abnormal reward processing, both in ADHD as well as in depression, SUD or obesity. No study so far however tested systematically whether pathologies in the brain's reward system explain the frequent comorbidity in adult ADHD. To test this, we acquired MRI scans from 137 participants probing the reward system by a monetary incentive delay task (MIDT) as well as assessing resting-state connectivity with ventral striatum as a seed mask. No differences were found between comorbid disorders, but a significant linear effect pointed toward less left intrastriatal connectivity in patients depending on the number of comorbidities. This points towards a neurobiologically impaired reward- and decision-making ability in patients with more comorbid disorders. This suggests that less intrastriatal connectivity parallels disorder severity but not disorder specificity, while MIDT abnormalities seem mainly to be driven by ADHD.

Years of good life is a well-being indicator designed to serve research on sustainability.

Sustainable development (SD) as popularized by the Brundtland Commission and politically enshrined in the Sustainable Development Goals has been the explicit focus of sustainability science. While there is broad agreement that the trend of human well-being (W) over time should serve as a sustainability criterion, the literature so far has mostly addressed this in terms of its determinants rather than focusing on W itself. There is broad agreement that an indicator for W should have multiple constituents, clearly going beyond gross domestic product. Here, we propose a tailor-made indicator to serve precisely this purpose following a set of specified desiderata, including its applicability to flexibly defined subnational populations by gender, place of residence, ethnicity, and other relevant characteristics. The indicator, years of good life (YoGL), reflects the evident fact that in order to be able to enjoy any quality of life, one has to be alive and thus is primarily based on life expectancy. However, since mere survival is not considered good enough, life years are counted conditional on meeting minimum standards in two dimensions: the objective dimension of capable longevity (consisting of being out of absolute poverty and enjoying minimal levels of physical and cognitive health) and the subjective dimension of overall life satisfaction. We illustrate the calculation of this indicator for countries and subpopulations at different stages of development and with different degrees of data availability.

Efficacy and safety of co-formulated elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in HIV-positive patients: real-world data.

OBJECTIVES: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naïve or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. METHODS: ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naïve patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. RESULTS: The study included a total of 614 switched and treatment-naïve patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 ± 12 years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 ± 29 months. The median duration of E/C/F/TAF use was 20 ± 36 months and that of previous treatment was 23 ± 18 months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively (p > 0.05). Mean CD4 counts were 708 ± 287 cells/µL and 802 ± 305 cells/µL at baseline and month 12, respectively (p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211 mg/dL (p < 0.01), LDL-cholesterol 104 and 138 mg/dL (p < 0.01), HDL-cholesterol 39 and 49 mg/dL (p < 0.01) and triglycerides 134 and 174 mg/dL (p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient's decision: 1). Of 184 treatment-naïve patients, 88% (162) were men, and the mean age was 36.5± 12 years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 ± 17.1 months. The mean duration of E/C/F/TAF use was 16 ± 4 months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 ± 223 cells/µL and 740 ± 298 cells/µL, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211 mg/dL (p < 0.01), LDL-cholesterol 108 and 143 mg/dL (p < 0.01), HDL-cholesterol 41 and 47 mg/dL (p < 0.01) and triglycerides 136 and 172 mg/dL, respectively (p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient's decision: 1). CONCLUSION: Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment. E/C/F/TAF use was associated with an increase in LDL-cholesterol and triglyceride levels along with an increase in HDL-cholesterol levels.

Skills-adjusted human capital shows rising global gap.

Human capital, broadly defined as the skills acquired through formal education, is acknowledged as one of the key drivers of economic growth and social development. However, its measurement for the working-age populations, on a global scale and over time, is still unsatisfactory. Most indicators either only consider the quantity dimension of education and disregard the actual skills or are demographically inconsistent by applying the skills of the young cohorts in school to represent the skills of the working-age population at the same time. In the case of rapidly expanding or changing school systems, this assumption is untenable. However, an increasing number of countries have started to assess the literacy skills of their adult populations by age and sex directly. Drawing on this literacy data, and by using demographic backprojection and statistical estimation techniques, we here present a demographically consistent indicator for adult literacy skills, the skills in literacy adjusted mean years of schooling (SLAMYS). The measure is given for the population aged 20 to 64 in 185 countries and for the period 1970 to 2015. Compared to the conventional mean years of schooling (MYS)-which has strongly increased for most countries over the past decades, and in particular among poor countries-the trends in SLAMYS exhibit a widening global skills gap between low- and high-performing countries.

Evaluation of the metal concentrations of wild mushroom species with their health risk assessments.

The ability of mushrooms to accumulate heavy metals has increased concerns over their toxic effects on human health in recent years. The aim of this study was to determine the metal contents (Zn, Fe, Co, Mn, Cu, Pb, Ni, and Cd), daily intake of metal (DIM) and health risk index (HRI) values of nineteen different mushroom species (edible, inedible, and poisonous) collected from Uzungol, Trabzon (Turkey). Although the area where mushrooms were collected has the status of "Natural Park," there has been an excessive human settlement in recent years. Elemental analyses have shown that Fe, Mn, Cu, Zn, Co, Cd, Pb, and Ni concentrations in mushrooms were in the following ranges: 49.0-1713.0, 3.0-425.0, 3.0-154.0, 16.0-134.0, 0.17-1.79, 0.28-7.88, 0.07-5.68, and 0.24-6.82 mg/kg dry weight, respectively. As a result of DIM analysis, while it was determined that the daily consumption of Hygrophorus pudorinus, Meripilus giganteus, and Sarcodon imbricatus was safe for all the metals examined, HRI analysis showed that only M. giganteus and S. imbricatus can be consumed safely. The content of Cd was found to be above the legal limits determined by the competent authorities. According to Pearson correlation analysis, the correlations between Fe-Pb, Cu-Zn, Cd-Co, Pb-Co, Cd-Fe, Co-Fe, Cd-Pb, and Fe-Mn pairs were statistically significant (p < 0.01). Although the data obtained from this study did not provide clear data on environmental pollution in the area where the samples were collected, it was concluded that the competent authorities should take measures regarding possible environmental pollution at this location.

Effectiveness and safety of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate single-tablet combination among HIV-infected patients in Turkey: results from a real world setting.

Background: Efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil (E/C/F/TDF) in treatment-naïve and experienced patients with HIV infection was demonstrated in phase 3 trials. The primary objective of this study was to evaluate effectiveness and safety of E/C/F/TDF in real world settings. Methods: Retrospective, observational data collected by the Turkish ACTHIV-IST study group between May 2015 and December 2016 were analysed. Results: A total of 387 patients were prescribed E/C/F/TDF; 210 patients with available data at 6th month were eligible; 91.5% were male, and mean age was 35.2 (SD: 10.8) years; 54.0% of males identified themselves as MSM. Sixty-three percent (133) of the study population were treatment-naïve patients, and 37% (77) were treatment experienced. HIV RNA level was below 100 copies/mL in 78.9% of treatment-naïve patients and 89.9% of treatment experienced patients at month 6. Median increase in CD4 T lymphocyte count was 218 copies/mL in treatment-naïve patients and remained stable or increased in treatment experienced patients. Adverse events were observed in 15% of the patients, and the regimen was discontinued in only six patients. Conclusion: Real world data on the effectiveness and safety of E/C/F/TDF is comparable with the phase 3 trial results Adverse events are uncommon and manageable.