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.

A Comprehensive Validated Model of Innovation and Performance: An Empirical Study of Turkish Companies

Organizations should maintain their innovation trajectories by developing products, processes, marketing, and organizational methods to achieve and sustain competitive advantage. However, by itself, creating value through innovation is not enough for companies: transforming these innovations into firm performance is also crucial. This study aims to validate the relationships among innovation and firm performance components and to explore the effect of innovation culture on innovation components and personnel performance. In our model, the innovation construct is comprised of innovation input, innovation process, and innovation output components, while firm performance construct includes four performance components such as financial, customer, market, and personnel performance. Moreover, this comprehensive model was proposed based on the literature, and structural equation modeling (SEM) was performed by employing data gained from 353 companies in Turkey to validate the model. According to the results, there is a sequential relationship within innovation components and firm performance components, while the relationships among innovation components and firm performance components are observed holistically. This paper contributes to the innovation literature by introducing a validated model to clarify these relationships. This model can be evaluated by company leaders to identify not only their firm’s innovation path but also short and long-term innovation results. Furthermore, the findings indicate that companies should manage the system from innovation input to financial gains without delicately compromising the whole sequential and holistic relationship. Managers should also be aware of the power of innovation culture on innovation path and personnel performance directly to create a convenient atmosphere.

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.

Effect of Organizational Learning, Transformational Leadership, and Market Orientation on Firm Performance

The purpose of this study is to examine the effects of organizational learning, market orientation, and transformational leadership on the organizational innovation and firm’s performance amongst the firms performing in Turkey. Using LISREL, structural equation-model, the data gathered from 330 employees were used to identify the variables that significantly affect the firm’s performance. The results indicated that 32% of firm’s performance is explained by the organizational innovation and market orientation, and organizational innovation has the strongest effect. However, organizational learning has no substantial effect on firm’s performance, and transformational leadership is also found to have an insignificant impact on the organizational innovation.

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.

A novel slurry sampling analysis of lead in different water samples by electrothermal atomic absorption spectrometry after coprecipitated with cobalt/pyrrolidine dithiocarbamate complex

A preconcentration/separation technique based on the coprecipitation of lead with cobalt/pyrrolidine dithiocarbamate complex (Co(PDC)(2)) and subsequently its direct slurry sampling determination by electrothermal atomic absorption spectrometry (AAS) was described. For this purpose, at first, lead was coprecipitated with cobalt/pyrrolidine dithiocarbamate complex formed using ammonium pyrrolidine dithiocarbamate (APDC) as a chelating agent and cobalt as a carrier element. The supernatant was then separated and the slurry of the precipitate prepared in Triton X-100 was directly analyzed by electrothermal atomic absorption spectrometry with respect to lead concentration. The effects of experimental conditions on coprecipitation of lead with gathering precipitate as well as homogeneity and stability of the slurry were investigated. After the optimization of experimental parameters, a 100-fold enrichment of the analyte with quantitative recovery (>90%) and high precision (<10% R.S.D.) were obtained. By using the proposed technique, the lead concentrations in heavy matrices of Certified Sea-water and wastewater samples could be practically and rapidly determined in the range of 95% confidence level. The detection limit of the described method for lead using sample-matching blanks was 1.5 ng/L (3 sigma, N=10).

Survey of lead and copper in Turkish raisins

Lead and copper levels in various types of Turkish raisins, collected from the most important production centers, were determined by electrothermal atomic absorption spectrometry. Samples were principally the products of 2005; however, two different and important raisin types produced between 2003 and 2006 were also analyzed. To investigate the source of pollution, the lead and copper content of all samples were separately determined after successive treatment with water, then with acetone and, finally, complete decomposition in a HNO(3)/H(2)SO(4)/H(2)O(2) mixture. Metal levels in raisin seeds were also determined. The results were statistically evaluated, indicating that the raisins taken from different regions and years contained a mean (range) of 0.056 (0.012-0.359) mg kg(-1) lead and 2.542 (0.770-4.706) mg kg(-1) copper. Lead concentrations in Turkish raisins were significantly lower than those found in a previous study.

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.