Rapid initiation of antiretroviral therapy in Turkey: a modeling study.

Background: To effectively control the HIV epidemic and meet global targets, policymakers recommend the rapid initiation of antiretroviral therapy (ART). Our study aims to investigate the effect of rapid ART programs on individuals diagnosed with HIV, considering varying coverage and initiation days after diagnosis, and compare it to standard-of-care ART treatment in Turkey. Methods: We used a dynamic compartmental model to simulate the dynamics of HIV infection in Turkey. Rapid treatment, defined as initiation of ART within 7 days of diagnosis, was contrasted with standard-of-care treatment, which starts within 30 days of diagnosis. This study considered three coverage levels (10%, 50%, and 90%) and two rapid periods (7 and 14 days after diagnosis), comparing them to standard-of-care treatment in evaluating the number of HIV infections between 2020 and 2030. Results: Annual HIV incidence and prevalence for a 10-year period were obtained from model projections. In the absence of a rapid ART program, the model projected approximately 444,000 new HIV cases while the number of cases were reduced to 345,000 (22% reduction) with 90% of diagnosed cases included in the rapid ART program. Similarly, 10% and 50% rapid ART coverage has resulted in 3% and 13% reduction in HIV prevalence over a 10-year period. Conclusion: Rapid ART demonstrates the potential to mitigate the increasing HIV incidence in Turkey by reducing the number of infections. The benefit of the rapid ART program could be substantial when the coverage of the program reaches above a certain percentage of diagnosed population.

Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis.

AIMS: This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years. BACKGROUND: HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV. METHODS: We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis. The model generated the number of new HIV cases by transmission risk and CD4 level, HIV diagnoses, HIV prevalence, continuum of care, the number of HIV-related deaths, and the expected number of infections prevented from 2020 to 2040. We also explored the cost impact of HIV and the cost-effectiveness of improving testing and diagnosis. RESULTS: Under the base case scenario, the model estimated an HIV incidence of 13,462 cases in 2020, with 63% undiagnosed. The number of infections was estimated to increase by 27% by 2040, with HIV incidence in 2040 reaching 376,889 and HIV prevalence 2,414,965 cases. Improving testing and diagnosis to 50%, 70%, and 90%, would prevent 782,789, 2,059,399, and 2,336,564 infections-32%, 85%, and 97% reduction in 20 years, respectively. Improved testing and diagnosis would reduce spending between $1.8 and $8.8 billion. CONCLUSIONS: In the case of no improvement in the current continuum of care, HIV incidence and prevalence will significantly increase over the next 20 years, placing a significant burden on the Turkish healthcare system. However, improving testing and diagnosis could substantially reduce the number of infections, ameliorating the public health and disease burden aspects.

The effects of daily growth in COVID-19 deaths, cases, and governments' response policies on stock markets of emerging economies.

Since the beginning of COVID-19, human beings have been threatened by various aspects. As of February 14, 2022, this global pandemic has caused about 412 million cases and 5.8 million deaths worldwide. Stock markets are one of the most agile economic indicators. In this context, this study investigates how daily growth in deaths, daily growth in cases, and governmental interventions affect stock market returns in 21 emerging economies from January 22 to December 31, 2020. Our results indicate that government response policies to Covid-19 positively impact stock returns. Besides, the daily growths in deaths and cases negatively affect stock market returns. The results also indicate that government response policies also have an indirect positive effect on stock market returns by weakening the negative impact of the daily growth in COVID-19 confirmed cases and deaths.

The relative importance of factors influencing the surgeons' choice between mastectomy and breast-conserving surgery for women with breast cancer.

The authors' aim is to provide breast surgeons' perspectives on the relative importance of the criteria for choosing an appropriate surgery method between mastectomy (total removal of a breast) and breast-conserving surgery (removal of a breast cancer tumor and some of the normal tissue that surrounds it) for women with breast cancer by using the multicriteria decision-making method (MCDM). The Analytic Hierarchy Process (AHP), the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), and Vise Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) methods are utilized. A decision hierarchy is set with a goal, criteria, and alternatives. We developed our model based on three main criteria, tumor-related, patient-related, and post-operative process-related factors and nineteen sub-criteria, as well as two alternatives, mastectomy and breast-conserving surgery (BCS). An online questionnaire was sent to the breast surgeons; we showed that the most important criteria are post-operative process-related factors, especially the demand for esthetic appearance based on 39 breast surgeons. Conversely, the least significant criteria are tumor-related factors. Furthermore, breast-conserving surgery is selected as the most appropriate surgery method for breast cancer patients using the AHP, TOPSIS, and VIKOR.

Examining the Factors Affecting PDA Acceptance among Physicians: An Extended Technology Acceptance Model.

This study aims at identifying the factors affecting the intention to use personal digital assistant (PDA) technology among physicians in Turkey using an extended Technology Acceptance Model (TAM). A structural equation-modeling approach was used to identify the variables that significantly affect the intention to use PDA technology. The data were collected from 339 physicians in Turkey. Results indicated that 71% of the physicians' intention to use PDA technology is explained by perceived usefulness and perceived ease of use. On comparing both, the perceived ease of use has the strongest effect, whereas the effect of perceived enjoyment on behavioral intention to use is found to be insignificant. This study concludes with the recommendations for managers and possible future research.

Healthcare Engineering Defined: A White Paper.

Engineering has been playing an important role in serving and advancing healthcare. The term "Healthcare Engineering" has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of "Healthcare Engineering" remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects.

Young drivers' decision making and safety belt use.

Past research in safety belt use has primarily focused on describing the relationship between drivers' demographic characteristics and safety belt use. This study compared the impact of situational factors (the direction of collision, the type of road, and the presence of an airbag system), demographic factors, and constructs (criteria) elicited from subjects regarding safety belt use. Based on the results obtained, a conceptual model was developed. The model indicated that drivers' decision-making process when judging the level of accident risk and usefulness of safety belts differs from those that determine actual behavior. Perceived risk was related to road type, perceived consequences of an accident, perceived usefulness of safety belts, self responsibility, the time available for the driver to warn the other driver, dangerous behavior, and gender. These variables showed that people were able to rationally judge the risk. Despite the fact that people judge behavior in what appeared to be a rational manner, risk perception was not a good predictor of belt use. Belt use was mainly influenced by individual factors such as gender, grade point average (GPA), and age. Other factors impacting safety belt use included the perceived frequency of an accident and the S.D. of perceived usefulness of safety belts.