Carboxyethylsilanetriol-Coated Magnetic Nanoparticles as an Ultrasensitive Immunoplatform for Electrochemical Magnetosensing of Cotinine.

In the present study, an innovative and simple electrochemical magneto biosensor based on carboxyethylsilanetriol-modified iron oxide (Fe3O4) magnetic nanoparticles was designed for ultrasensitive and specific analysis of cotinine, an important marker of smoking. Anticotinine antibodies were covalently immobilized on carboxylic acid-modified magnetic nanoparticles, and the cotinine-specific magnetic nanoparticles created a specific surface on the working electrode surface. The use of magnetic nanoparticles as an immobilization platform for antibodies provided a large surface area for antibody attachment and increased sensitivity. In addition, the advantages of the new immobilization platform were reusing the working electrode numerous times, recording repeatable and reproducible signals, and reducing the necessary volume of biomolecules. The specific interaction between cotinine and cotinine-specific antibody-attached magnetic nanoparticles restricted the electron transfer of the redox probe and changed the impedimetric response of the electrode correlated to the concentration of cotinine. The magneto biosensor had a wide detection range (2-300 pg/mL), a low LOD (606 fg/mL), and an acceptable recovery (97.24-105.31%) in real samples. In addition, the current biosensor's measurement results were in good agreement with those found by the standard liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) methods. These results showed that a simple impedimetric immunosensing platform was generated for the cotinine analysis.

Segmentation and classification of skin burn images with artificial intelligence: Development of a mobile application.

AIM: This study was conducted to determine the segmentation, classification, object detection, and accuracy of skin burn images using artificial intelligence and a mobile application. With this study, individuals were able to determine the degree of burns and see how to intervene through the mobile application. METHODS: This research was conducted between 26.10.2021-01.09.2023. In this study, the dataset was handled in two stages. In the first stage, the open-access dataset was taken from https://universe.roboflow.com/, and the burn images dataset was created. In the second stage, in order to determine the accuracy of the developed system and artificial intelligence model, the patients admitted to the hospital were identified with our own design Burn Wound Detection Android application. RESULTS: In our study, YOLO V7 architecture was used for segmentation, classification, and object detection. There are 21018 data in this study, and 80% of them are used as training data, and 20% of them are used as test data. The YOLO V7 model achieved a success rate of 75.12% on the test data. The Burn Wound Detection Android mobile application that we developed in the study was used to accurately detect images of individuals. CONCLUSION: In this study, skin burn images were segmented, classified, object detected, and a mobile application was developed using artificial intelligence. First aid is crucial in burn cases, and it is an important development for public health that people living in the periphery can quickly determine the degree of burn through the mobile application and provide first aid according to the instructions of the mobile application.

Label-Free Electrochemical Immunosensor Based on Conjugated Polymer Film Coated Disposable Electrode for Ultrasensitive Determination of Resistin Potential Obesity Biomarker.

A new label-free immunosensor was designed for sensitive detection of resistin obesity biomarker in human biological fluids. To construct a sensing interface, the monomer of double epoxy groups-substituted thiophene (TdiEpx) was synthesized for the fabrication of the biosensing system. A disposable indium tin oxide sheet was first modified by electrochemical polymerization of the TdiEpx monomer, and this robust and novel surface was characterized using different spectroscopic and electrochemical analyses. The double epoxy ends were linked to the amino ends of anti-resistin, and they served as binding points for the covalent binding of biomolecules. The double epoxy ends present in each TdiEpx monomer ensured an extensive surface area, which improved the quantity of attached anti-resistin. The determination of resistin antigen was based on the specific coupling of resistin with anti-resistin, and this interaction hindered the electron transfer reaction. The immunosensor introduced a wide linear range of 0.0125-15 pg/mL, a low detection limit of 4.17 fg/mL, and an excellent sensitivity of 1.38 kohm pg mL-1 cm2. In this study, a sandwich enzyme-linked immunosorbent assay spectrophotometric method was utilized as a reference technique for the quantitative analysis of resistin in human serum and saliva samples. Both measurements in clinical samples displayed correlations and high-correlation coefficients. In addition, this immunosensor had good storage stability, acceptable repeatability and reproducibility, high specificity, and good accuracy. The proposed immunosensor provided a simple and versatile impedimetric immunosensing platform and a promisingly sensitive way for clinical applications.

Ultrasensitive detection of NSE employing a novel electrochemical immunosensor based on a conjugated copolymer.

In the current study a simple and highly specific label-free impedimetric neuron specific enolase (NSE) immunosensor based on a copolymer matrix-coated disposable electrode was designed and tested. The copolymer matrix was prepared using a very conductive EDOT monomer and semi-conductive thiophene-bearing epoxy groups (ThEp), and the combination of the two monomers enhanced the conductivity and protein loading capacity of the electrode surface. The P(ThEp-co-EDOT) copolymer matrix was prepared via a drop-casting process and anti-NSE recognition biomolecules were immobilized directly on the epoxy groups of the copolymer. After the coupling of NSE molecules on the P(ThEp-co-EDOT) copolymer matrix-coated electrode surface, the charge transfer resistance (Rct) of the biosensor changed dramatically. These changes in Rct were proportional to the NSE molecule amounts captured by anti-NSE molecules. Under optimized experimental conditions, the increment in the Rct value was proportional to the NSE concentration over a range of 0.01 to 25 pg mL-1 with a detection limit (LOD) of 2.98 × 10-3 pg mL-1. This copolymer-coated electrode provided a lower LOD than the other biosensors. In addition, the suggested electrochemical immuno-platform showed good selectivity, superior reproducibility, long-term stability, and high recovery of NSE in real serum (95.64-102.20%) and saliva (95.28-105.35%) samples. These results showed that the present system had great potential for electrochemical biosensing applications.

A new immunosensing platform based on conjugated Poly(ThidEp-co-EDOT) copolymer for resistin detection, a new obesity biomarker.

The design of a novel electrochemical impedimetric biosensor for label-free analysis of resistin, a biomarker for obesity, is reported. For the fabrication of the immunosensor, a novel approach composed of electrochemical copolymerization of double epoxy groups-substituted thiophene (ThidEp) and 3,4-Ethylenedioxythiophene (EDOT) monomers was utilized. Anti-resistin antibodies were covalently attached to the copolymer-coated electrode. The capture of resistin antigens by anti-resistin antibodies caused significant variations in charge transfer resistance (Rct) because of the immunoreactions between these proteins. Under optimum experimental variables, the changes in impedance signals were employed for the determination of resistin antigen concentration, and the prepared immunosensor based on conjugated copolymer illustrated a wide linear range between 0.0125 and 22.5 pg/mL, a low detection limit (LOD) of 3.71 fg/mL, and a good sensitivity of 1.22 kΩ pg-1mL cm2. The excellent analytical performance of the resistin immunosensor in terms of selectivity, sensitivity, repeatability, reproducibility, storage stability, and low detection limit might be attributed to the conductive copolymer film layer generation on the disposable indium tin oxide (ITO) platform. The capability of this system for the determination of resistin in human serum and saliva samples was also tested. The immunosensor results were in accordance with the enzyme-linked immunosorbent assay (ELISA) results. The matrix effects of human serum and saliva were also investigated, and the proposed immunosensor displayed good recovery ranging from 95.91 to 106.25%. The engineered immunosensor could open new avenues for obesity monitoring.

Evaluation of human error in oil spill risk in tanker cargo handling operations.

Cargo handling operations on board tankers pose a significant threat to the cleanliness and health of the ocean ecosystem. Incidents originating from these operations are often attributed to human error, as widely acknowledged. Therefore, it is crucial to control the human factor involved in these operations to enhance ship safety and foster a sustainable, clean marine environment. To tackle this problem, this paper presents a novel model that identifies the causal factors behind oil spills resulting from crew failure in these operations. To attain this, fuzzy Bayesian network (FBN) approach is used in this study to analyse the probabilistic correlations among the causal elements that are disclosed qualitatively and quantitatively. Sensitivity analyses and validation procedures are carried out to enhance the accuracy of results. Eliminating errors in cargo calculation is of paramount importance as research has shown that such errors lead to the largest impact on spill during loading and discharging (L&D) operations. The study's findings offer valuable insights into the causes of L&D operation-related spills. Ship management companies, the loss-prevention division of Protection and Indemnity Clubs (P&I), and regulatory bodies may employ the research results to prevent spill repetitions and protect the marine environment.

EFFICACY AND SAFETY OF GEMIFLOXACIN CONTAINING TREATMENT REGIMEN IN FIRST-LINE TREATMENT OF HELICOBACTER PYLORI.

•In eradication treatment of H. pylori gemifloxacin containing triple treatment regimen was as effective as bismuth containing quadruple treatment. •Drug adverse effects were fewer and milder in the gemifloxacin group. •Since treatment period was shorter and pills to be taken were fewer compared to quadruple treatment, patient compliance was significantly higher in the gemifloxacin group. Background - After eradication of Helicobacter pylori (H. pylori) chronic gastritis will resolve, complications due to H. pylori infection and recurrence of infection will be prevented. Objective - To determine efficacy and safety of gemifloxacin containing treatment regimen in first line treatment of H. pylori with comparison to bismuth containing quadruple therapy. Methods - This retrospective study was conducted in a tertiary care university hospital between January 2018 and January 2021 with 410 participants who were diagnosed to have H. pylori infection with biopsies obtained during upper gastrointestinal system endoscopy. Patients were distributed into two groups according to their first-line treatment regimens. First group patients were treated with amoxicillin, gemifloxacin and pantoprazole and second group patients were treated with amoxicillin, metronidazole, bismuth subcitrate and pantoprazole for seven days. Results - Intention to treat and per protocol ratios for gemifloxacin containing regimen were 90.0% and 91.2%, while quadruple treatment has these ratios as 91.7% and 93.8% respectively. Treatment success rate in both regimens were similar. But adverse effects were lower and patient compliance were better in patients who had gemifloxacin containing treatment (P<0.001). Conclusion - Gemifloxacin containing treatment regimen is as effective as bismuth containing quadruple treatment regimen for H. pylori infection and patient compliance is better in this group. Gemifloxacin containing treatment regimens may be novel and effective alternatives for eradication of H. pylori infection.

The effect of intercultural sensitivity and ethnocentrism on health tourism awareness level in nurses: Analysis with machine learning approach.

PURPOSE: In this study, the effects of intercultural sensitivity and ethnocentrism on health tourism awareness levels in nurses were examined. DESIGN AND METHODS: This quantitative cross-sectional study was conducted in Turkey between November 2022 and March 2023. Intercultural sensitivity scale, ethnocentrism scale, and health tourism awareness scale were used to collect the data. R programming language 4.1.3, G*Power 3.1 and SPSS-22 program were used in the analysis of the study. RESULTS: This study was conducted with 386 nurses. Intercultural sensitivity has a positive and significant effect on health tourism awareness levels (ß = 0.141; t(384) = 2.784, p = 0.006). Ethnocentrism has a positive and significant effect on health tourism awareness levels (ß = 0.184; t(384) = 3.659, p = 0.001). Random Forest regression was found to be the best performing algorithm among the machine learning algorithms for predicting the Health Tourism Awareness variable. Looking at the contributions of the variables to the model, according to the SHAP value (Shapley Additive Explanations), it was seen that the most important variable that should be in the model to predict the health tourism awareness variable is the ethnocentrism variable. CONCLUSION: It was determined that as the level of intercultural sensitivity and ethnocentrism of nurses increased, their awareness of health tourism increased. Longitudinal studies on health tourism awareness in nurses are recommended.

Efetividade e segurança do regime de tratamento contendo gemifloxacino no tratamento de primeira linha para Helicobacter pylori / Efficacy and safety of gemifloxacin containing treatment regimen in first-line treatment of helicobacter pylori

ABSTRACT Background: After eradication of Helicobacter pylori (H. pylori) chronic gastritis will resolve, complications due to H. pylori infection and recurrence of infection will be prevented. Objective: To determine efficacy and safety of gemifloxacin containing treatment regimen in first line treatment of H. pylori with comparison to bismuth containing quadruple therapy. Methods: This retrospective study was conducted in a tertiary care university hospital between January 2018 and January 2021 with 410 participants who were diagnosed to have H. pylori infection with biopsies obtained during upper gastrointestinal system endoscopy. Patients were distributed into two groups according to their first-line treatment regimens. First group patients were treated with amoxicillin, gemifloxacin and pantoprazole and second group patients were treated with amoxicillin, metronidazole, bismuth subcitrate and pantoprazole for seven days. Results: Intention to treat and per protocol ratios for gemifloxacin containing regimen were 90.0% and 91.2%, while quadruple treatment has these ratios as 91.7% and 93.8% respectively. Treatment success rate in both regimens were similar. But adverse effects were lower and patient compliance were better in patients who had gemifloxacin containing treatment (P<0.001). Conclusion: Gemifloxacin containing treatment regimen is as effective as bismuth containing quadruple treatment regimen for H. pylori infection and patient compliance is better in this group. Gemifloxacin containing treatment regimens may be novel and effective alternatives for eradication of H. pylori infection.

RESUMO Contexto: Após a erradicação do Helicobacter pylori (HP), a gastrite crônica será resolvida, as complicações devido à infecção por HP e a recorrência da infecção serão prevenidas. Objetivo: Determinar a eficácia e segurança do regime de tratamento contendo gemifloxacino no tratamento de primeira linha do HP, em comparação com a terapia quádrupla contendo bismuto. Métodos: Este estudo prospectivo foi conduzido em um hospital universitário de atendimento terciário entre janeiro de 2018 e janeiro de 2021, com 410 participantes diagnosticados com infecção por HP, obtidos por meio de biópsias durante a endoscopia do sistema gastrointestinal superior. Os pacientes foram divididos em dois grupos de acordo com seus regimes de tratamento de primeira linha. Os pacientes do primeiro grupo foram tratados com amoxicilina, gemifloxacino e pantoprazol, e os pacientes do segundo grupo foram tratados com amoxicilina, metronidazol, subcitrato de bismuto e pantoprazol por 7 dias. Resultados: As taxas de intenção de tratar e por protocolo para o regime contendo gemifloxacino foram de 90,0% e 91,2%, enquanto o tratamento quádruplo apresentou essas taxas como 91,7% e 93,8%, respectivamente. A taxa de sucesso do tratamento em ambos os regimes foi similar. No entanto, os efeitos adversos foram menores e a adesão dos pacientes foi melhor nos que receberam o tratamento contendo gemifloxacino (P<0,001). Conclusão: O regime de tratamento contendo gemifloxacino é tão eficaz quanto o regime de tratamento quádruplo contendo bismuto para a infecção por HP, e a adesão dos pacientes é melhor neste grupo. Os regimes de tratamento contendo gemifloxacino podem ser alternativas novas e eficazes para a erradicação da infecção por HP.

Changes in cancer screening process in primary care during the covid-19 pandemic. A record-based descriptive study.

OBJECTIVES: To reveal the number of cancer screenings in primary care during the pandemic period and whether there is a change in screening compared to the pre-pandemic period. METHODS: This record-based descriptive study was carried out by evaluating the number of people who applied to family health centers or cancer early diagnosis, screening, and education center (KETEM) units for cancer screening (breast, cervical, and colorectal) for any reason. The study data were scanned between January 2017 and December 2020 and were obtained from the Gaziantep Provincial Health Directorate Cancer Branch. RESULTS: Breast cancer screening was the highest in December 2019 (n=2971), cervical cancer screening was the highest in October 2019 (n=4693), and colon cancer screening was the highest in September 2019 (n=2464). Breast cancer screening was the lowest in August 2020 (n=0), cervical cancer screening was the lowest in May 2020 (n=6), and colon cancer screening was the lowest in February and March 2018. Although the target populations and percentages in breast cancer, cervical cancer and colon cancer screenings increased with the following years, the screening populations and percentages decreased in 2020 compared to other years (percentages, 4.4%, 6.2%, 1.9%). CONCLUSION: For cancers that can be prevented by early diagnosis, it is of great importance to increase cancer screenings, which have decreased with the pandemic, to the required level.

A novel electrochemical impedance immunosensor for the quantification of CYFRA 21-1 in human serum.

A sensitive, simple, and reliable immunosensor was constructed to detect the lowest alteration of a fragment of cytokeratin subunit 19 (CYFRA 21-1), a protein lung carcinoma biomarker. The proposed immunosensor was manufactured with a carbon black C45/polythiophene polymer-containing amino terminal groups (C45-PTNH2) conductive nanocomposite, resulting in an excellent, biocompatible, low-cost, and electrically conductive electrode surface. Anti-CYFRA 21-1 biorecognition molecules were attached to the electrode thanks to the amino terminal groups of the used PTNH2 polymer with a relatively simple procedure. All electrode surfaces after modifications were characterized by electrochemical, chemical, and microscopic techniques. Electrochemical impedance spectroscopy (EIS) was also utilized for the evaluation of the analytical feature of the immunosensor. The charge transfer resistance of the immunosensor signal was correlated with the CYFRA 21-1 concentration in the concentration range 0.03 to 90 pg/mL. The limit of detection (LOD) and the limit of quantification (LOQ) of the suggested system were 4.7 fg/mL and 14.1 fg/mL, respectively. The proposed biosensor had favorable repeatability and reproducibility, long storage stability, excellent selectivity, and low cost. Furthermore, it was applied to determine CYFRA 21-1 in commercial serum samples, and satisfactory recovery results (98.63-106.18%) were obtained. Thus, this immunosensor can be offered for clinical purposes as a rapid, stable, low-cost, selective, reproducible, and reusable tool.

Investigation of the Relationship Between Xenophobic Attitude and Intercultural Sensitivity Level in Health Education Students.

INTRODUCTION: Intercultural sensitivity and xenophobia levels of health education students can affect the care they give to the patient. It is important to know the level of intercultural sensitivity and xenophobia of students receiving health education and to determine the relationship between them. The purpose of the study was to examine the relationship between xenophobic attitudes and intercultural sensitivity among university students. METHODS: This quantitative cross-sectional research was conducted in between January and June 2022 with health education students. The study conducted with health education students at Gumushane University and Agri Ibrahim Cecen University. Child Development, Nursing, Emergency Management Services/Technicians, Nutrition and Dietetics, Elderly care, Social services, Medical Laboratory Techniques, and Disabled Care studying at these universities were included in the study. Students who received health education and wanted to participate voluntarily in the study were included. Students aged 18 and over, studying in the health education department of the university, studying in the 1, 2, 3, 4th classes and volunteering to participate in the study were included in the study. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. RESULTS: This study was conducted with 789 students. According to our study, a significant negative correlation was found between the students' xenophobia scale and the intercultural sensitivity scale total score means (p < .05). Intercultural sensitivity has a negative and significant effect on the level of xenophobia (ß = -0.116; t (787) = -3.283, p = .001). A significant difference was found between the students' Xenophobia Scale total score mean and gender, department, and grade (p < .05) as was the case between Intercultural Sensitivity Scale total score mean and gender, department, grade, immigrant acquaintance, and foreign language knowledge (English language) level (p < .05). DISCUSSION: Intercultural sensitivity has a negative and significant effect on the level of xenophobia. It can negatively affect the level of caregiving of students receiving health education. It is thought that intercultural sensitivity will be developed by including course content in the curriculum to increase students' intercultural effectiveness and awareness levels and to reduce xenophobic prejudices.

Biosensors for saliva biomarkers.

The analysis of salivary biomarkers has gained interest and is advantageous for simple, safe, and non-invasive testing in diagnosis as well as treatment. This chapter explores the importance of saliva biomarkers and summarizes recent advances in biosensor fabrication. The identification of diagnostic, prognostic and therapeutic markers in this matrix enables more rapid and frequent testing when combined with the use of biosensor technology. Challenges and future goals are highlighted and examined.

The Four Horsemen of the Apocalypse: Cancer, Depression, Vitamin D Deficiency, and Obesity: An Observational Study.

Objective: Studies aiming at illuminating the complex relationships between cancer, obesity, 25-hydroxy vitamin D (25-OHD) deficiency, and body fat percentage are ongoing. The objective of this study was to investigate the relationships between 25-OHD deficiency, visceral fat tissue, and the Beck Depression Inventory (BDI) in cancer patients. Methods: This study was conducted from 2013 to 2022. Patients' demographic data, such as age, sex, and body mass index (BMI), and laboratory parameters, including prealbumin, albumin, calcium, phosphorus, parathyroid hormone, 25-OHD, magnesium, hemoglobin, fat percentage, and C-reactive protein, were recorded. The Beck Depression Inventory was used to determine depression levels. Results: A total of 223 colon cancer patients aged 19-84 undergoing chemotherapy at our clinic were included in this prospective study. The male patients' mean BMI was 22.91 ± 3.74 kg/m2, whereas that of the female patients was 26.17 ± 3.75 kg/m2. The difference was statistically significant (p < 0.001). The mean total Beck Depression Inventory score was 13 ± 9. In this patient population, 105 (47.09%) patients had minimal depression, 69 (30.94%) had mild depression, 35 (15.70%) had moderate depression, and 14 (6.28%) had severe depression. The Beck Depression Inventory score was negatively and strongly associated with BMI and moderately and negatively associated with albumin levels. Conclusion: This study reveals a significant correlation between 25-OHD levels and the Beck Depression Inventory scores among cancer patients. We believe that 25-OHD levels may be used to determine the presence of depressive symptoms in cancer patients. However, further comprehensive multicentre studies are needed to draw more definitive conclusions.

A Simple and Low-Cost Electrochemical Immunosensor for Ultrasensitive Determination of Calreticulin Biomarker in Human Serum.

An early on time detection of breast cancer significantly affects the treatment process and outcome. Herein, a new label-free impedimetric biosensor is developed to determine the lowest change in the level of calreticulin (CALR), which is a new biomarker of breast carcinoma. The proposed immunosensor is fabricated by using reduced graphene oxide/amino substituted polypyrrole polymer (rGO-PPyNH2 ) nanocomposite modified disposable electrode. The anti-CALR antibodies are first attached on the rGO-PPyNH2 nanocomposite coated electrode through glutaraldehyde crosslinking; the CALR antigens are then immobilized with the addition of CALR antigens to form an immunocomplex on the sensing surface. This immunocomplex induces considerably larger interfacial electron transport resistance (Rct ). The variation in the Rct has a linear relationship with CALR level in the detection range of 0.025 to 75 pg mL-1 , with a detection limit of 10.4 fg mL-1 . The suggested biosensor shows high selectivity to CALR, good storage stability (at least 5 weeks) and suitable reproducibility results as shown in quality control chart. The designed immunosensor is utilized to analyze CALR levels in human sera with satisfying results. This immunosensor provides a novel way for the clinical determination of CALR and other cancer biological markers.

Impedimetric Detection of Calreticulin by a Disposable Immunosensor Modified with a Single-Walled Carbon Nanotube-Conducting Polymer Nanocomposite.

A label-free impedimetric immunosensing system was constructed for ultrasensitive determination of the calreticulin (CALR) biological marker in human serum samples utilizing an electrochemical impedance spectroscopy analysis technique for the first time. The new biosensor fabrication procedure consisted of electrodeposition of single-walled carbon nanotubes (SWCNTs) incorporating polymerization of an oxiran-2-yl methyl 3-(1H-pyrrol-1-yl) propanoate monomer (Pepx) onto a low-cost and disposable indium tin oxide (ITO) electrode. The SWCNTs-PPepx nanocomposite layer was prepared onto the ITO after the one-step fabrication procedure. The fabrication procedure of the immunosensor and the characteristic biomolecular interactions between the anti-CALR and CALR were characterized by electrochemical analysis and morphological monitoring techniques. Under optimum conditions, the proposed biosensor was responsive to CALR concentrations over the detection ranges of 0.015-60 pg/mL linearly, and it had a very low detection limit (4.6 fg/mL) and a favorable sensitivity (0.43 kΩ pg-1 mL cm-2). The reliability of the biosensor system in clinical analysis was investigated by successful quantification of CALR levels in human serum. Moreover, the repeatability and reproducibility results of the biosensor were evaluated by using Dixon, Grubbs, T-test, and F-tests. Consequently, the proposed biosensor was a promising method for scientific, rapid, and successful analysis of CALR in human serum samples.

Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians.

Background: In Turkey, childhood vaccination rates are decreasing in the context of increasingly visible antivaccination movements. Aims: To evaluate the antivaccination movement based on communication experiences between family physicians and antivaccine parents in Turkey. Methods: We conducted 39 face-to-face in-depth interviews with family physicians in Sakarya Province who had experiences of communicating with antivaccine parents during October-December 2019. With the permission of the participants, audio recording was obtained in all interviews except one; these were transcribed verbatim and checked. A thematic approach was used to analyse the data. Results: The most common concern about vaccination was the possible side-effects, followed by the origin of the vaccines, religious concerns and distrust of vaccines. The physicians said they assumed an inquisitive, informative and anxiety-relieving attitude towards antivaccine parents.They said they were able to persuade most parents to vaccinate their children and that highly educated parents or those whose attitudes and behaviours were strongly influenced by their religious leaders were the hardest to convince. Physicians emphasized the importance of trust in increasing vaccine acceptance and noted the need to educate religious leaders and families to introduce mandatory vaccination policies. Conclusion: Parents had various reasons for refusing childhood vaccinations, however, the family physicians used persuasive methods to convince them to accept the vaccinations. Strengthening the communication and persuasive skills of health care professionals regarding vaccination may help increase acceptance of childhood vaccinations.

A real-time analysis of intraoperative interruptions in relation to use of simple preventive measures including a sign on the door and a checklist-based team brief.

This study aimed to evaluate intraoperative interruptions by frequency, type, interference and source, and preventive measures. The interruptions in the operating theatre were evaluated for 52 surgical procedures based on real-time recordings and divided into routine operative procedures (ROP, n = 26, without intervention) and intervened operative procedures (IOP, n = 26, observed after team brief and placement of a warning sign for unnecessary door openings) groups. Intervened operative procedures vs. routine operative procedures was associated with a significantly lower number of interruptions (p = 0.014). Implementation of preventive measures was associated with a significantly lower number of entrances and exits (p = 0.001) and equipment issues (p = 0.003), interruptions that affected the circulating nurse or anaesthesia technician/associate (p = 0.003) and those caused by team members other than assisting surgeon and scrub nurse (p-value ranged from 0.015 to 0.009). Our findings revealed significantly reduced interruptions after a simple preventive measure including team brief and the placement of a warning sign for unnecessary door openings.

Previous Catheter Ablation Predicts In-Hospital Restoration of Sinus Rhythm in Patients Presenting with Recent-Onset Atrial Fibrillation-The Retrospective HAMBURG-AF Study.

Background and Objectives: Atrial fibrillation (AF) is the most common arrythmia of the human heart. Patients mostly present highly symptomatic with dyspnea and tachycardia and have a disproportionate risk of developing heart failure or stroke events. We aimed to evaluate the determinants of early conversion into sinus rhythm during initial stay at the emergency department of a large tertiary care center. Materials and Methods: A total of 1384 subjects with recent-onset AF were recruited between October 2014 and April 2017. Patients with longstanding AF were excluded, resulting in a total of 935 patients for the present analysis. Results: In multivariate adjusted logistic regression analyses, previous catheter ablation therapy was a strong predictor of conversion in sinus rhythm during the stay in the emergency department, with an odds ratio (OR) of 3.87 (95% CI 2.40, 6.54; p < 0.001). In contrast, existing antiarrhythmic medication showed no association with facilitated conversion [OR 0.89 (95%CI 0.65, 1.20); p = 0.44]. Likewise, conventional cardiovascular risk factors (hypertension, dyslipidemia, diabetes) were also not associated with conversion during hospital stay. Conclusion: This is the first report on the relevance of previous ablation therapy for early restoration of sinus rhythm in recent-onset AF. Although catheter ablation is associated with relevant risk of late recurrence of atrial fibrillation, it seems to have a large benefit for patients with recent-onset AF.

Ulcerative Colitis in a COVID-19 Patient: A Case Report.

BACKGROUND: COVID-19 pneumonia is a global viral disease and has been classified as a pandemic by the World Health Organization. The coronavirus that causes it can remain in the stool of some infected patients for a short period, even after recovery from COVID-19 pneumonia. Studies have increasingly reported the involvement of other organs, including the gastrointestinal system, in addition to the respiratory system. Ulcerative colitis is an inflammatory bowel disease with an unknown cause. Emerging data suggest that the gas trointestinal system may be influenced by COVID-19 via the expression of angiotensin-converting enzyme-2 (ACE-2), but data on the association between COVID-19 and inflammatory bowel diseases, including ulcerative colitis, are lacking. In this report, we describe a case of ulcerative colitis diagnosed in a 50-year-old male patient who presented with complaints of bloody diarrhea and abdominal pain following the completion of treatment for COVID-19 pneumonia. It is possible for the novel coronavirus to trigger ulcerative colitis. Hence, patients presenting with gastrointestinal com plaints should also be evaluated for COVID-19.