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Assessing the Impact of Decentralization on COVID-19 Containment Measures, Public Trust in Government, and Trust in the Vaccine: A Multi-Country Study
No full textObjectives: Countries implemented COVID-19 containment measures based on their decentralization level, which influenced public trust in both the government and the vaccine. This study aimed to evaluate how decentralization influenced the effectiveness of COVID-19 containment measures, public trust in government, and trust in the vaccine across 18 countries.Design: A cross-sectional design was employed, drawing on a multi-country dataset from an international survey conducted in 2022. Data were collected through stratified random sampling, using an online survey administered via country-specific panels.Setting: Multiple states with 18 countries.Participants: 18 000 adult participants.Main Outcome Measures: Decentralization was assessed using the Regional Authority Index, and government containment responses were measured with the COVID-19 Government Response Stringency Index. Trust in government and trust in COVID-19 vaccines were evaluated through survey items on confidence in equitable vaccine delivery and perceived vaccine safety, respectively, both measured on a 5-point Likert scale. Sociodemographic characteristics (age, gender, education, and income) were included as individual-level covariates, while country-level indicators (GDP per capita, Socio-Demographic Index, Healthcare Access and Quality Index, Global Health Security Index, Sustainable Development Goals Index, health expenditure, COVID-19 case rates, and inflation) were incorporated as contextual variables.Results: Decentralization significantly increased public trust in government but was negatively associated with the stringency of containment measures. Vaccine trust and higher education were positively linked to trust in government and vaccine acceptance. However, higher COVID-19 case rates correlated with reduced public trust. Government stringency was driven more by outbreak severity than decentralization alone.Conclusions: Decentralization can bolster trust in government, but its impact on containment effectiveness depends on local capacity and coordination. These findings highlight the importance of institutional trust and governance structures in pandemic response outcomes.</p
Machine learning analysis of predictors for the development of severe erectile dysfunction after penile fracture repair
No full textDETERMINATION OF ATTITUDES TOWARDS HEALTHY EATING IN INDIVIDUALS WITH ALCOHOL AND SUBSTANCE USE DISORDERS
No full textHepatic artery augmented velocity index and steatosis/fibrosis in MAFLD
No full textPurpose: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease, and non-invasive methods are essential for evaluating hepatic steatosis and fibrosis. This study aimed to investigate the relationship between the hepatic artery augmented velocity index (HAVI) and the severity of hepatic steatosis and fibrosis in patients with MAFLD. Methods: This retrospective study included 197 patients who underwent hepatobiliary ultrasonography (US), shear wave elastography (SWE), and Doppler US between January 2021 and November 2023. HARI was calculated using the standard formula [(PSV − EDV)/PSV], while HAVI was calculated as [(LSV − ESV)/(PSV − EDV)]. Liver stiffness (kPa), biochemical parameters, and the FIB-4 score were compared among steatosis grades. Results: Patients were divided into four groups based on hepatic steatosis grade. Body mass index, ALT, AST, GGT, total cholesterol, and triglyceride levels increased significantly with steatosis severity (p < 0.01). FIB-4 differed significantly between grades (p < 0.01), whereas kPa did not show a significant difference (p = 0.11). HAVI values increased significantly with steatosis severity (p < 0.01), while HARI did not differ. HAVI showed strong positive correlations with kPa (r = 0.66, p < 0.01) and moderate correlations with ALT, AST, and GGT. No significant correlations were found between HAVI and platelet count, albumin, or triglycerides. Conclusions: HAVI showed significant associations with steatosis severity and non-invasive fibrosis markers, whereas no such relationships were observed for HARI in this study. These preliminary findings suggest that HAVI could be further investigated as a potential Doppler-derived parameter to support non-invasive evaluation of liver parenchymal and microvascular alterations in patients with MAFLD
THE DIAGNOSTIC ROLE OF OXIDATIVE STRESS AND INFLAMMATION BIOMARKERS: CURRENT EVIDENCE AND FUTURE DIRECTIONS
No full textValidity and reliability of the abbreviated technology anxiety scale in Turkish: A cultural adaptation study on nursing students
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A RARE CASE OF KOUNIS SYNDROME TYPE II PRESENTING WITH ST-ELEVATION MYOCARDIAL INFARCTION TRIGGERED BY BEE STING
No full textSingle Port Meshless Laparoscopic Pectopexy Procedure
No full textBackgroundLaparoscopic pectopexy has emerged as a novel alternative to sacrocolpopexy in the surgery of apicalprolapse, especially in cases where avoiding mesh-related complications is a priority. Originallyintroduced by Banerjee and Noé (1) using mesh for fixation to the pectineal ligaments, the techniquehas evolved toward mesh-free adaptations due to reports of erosion, pain, and other long-termcomplications (2,3). Minimally invasive approaches, including single-port laparoscopy, have furtheradvanced the technique by reducing surgical trauma and enhancing cosmetic outcomes.MethodsWe present the first reported case of mesh-free single-port laparoscopic pectopexy performed in a52-year-old woman with stage 4 uterine prolapse and a suspected 10 cm uterine leiomyoma. Theprocedure began with resection of a concomitant 8 cm umbilical hernia, followed by the insertion ofa V-port through the hernia site. A total laparoscopic hysterectomy was performed, after which theuterus and adnexa were removed via the single port. Meshless pectopexy was then initiated. Thevaginal cuff was manipulated transvaginally, and non-absorbable 2-0 polyester sutures were placedthrough the cuff without penetrating the mucosa. The peritoneum was dissected to expose thepectineal ligaments bilaterally, taking care to identify and preserve the iliac vessels. The sutures werepassed through the ligaments and tied intracorporeally without tension. The peritoneal defect wasclosed using a barbed absorbable suture to prevent potential bowel entrapment.Resultsnow.ConclusionsMesh-free single-port laparoscopic pectopexy is a promising technique that combines the safety ofmesh avoidance with the advantages of minimally invasive surgery. While our initial outcome wasfavourable, consistent with existing literature (4–7) further prospective studies are needed tovalidate the long-term efficacy and reproducibility of this approach.References:1. Banerjee C, Noé KG. Arch Gynecol Obstet. 2011;284(3):631–2. Bakir MS, et al. Gynecol Minim Invasive Ther. 2020;9(1):42.3. Obut M, et al. Gynecol Minim Invasive Ther. 2021;14;10(2):96-103.4.4. Erdem B, et al. Int Urogynecology J. 2025;1;5. Rovner E, et al. Neurourol Urodyn. 2020;39 Suppl 3:S132–9.6. Aleksandrov A, et al. Facts Views Vis ObGyn. 2021;13(2):179–81.7. Biyik I, et al. Gynecology and Minimally Invasive Therapy. 2025 (Article in press)https://player.vimeo.com/video/1090229166?autoplay=1https://esge.covr.be/cmdocumentmanagement/conferencemanager/documents/api/getdocument/14476/cmabstsms/0000147610/116e5ad2ec33c5d4d2bf8f59c5b8dde129ce10c3a9d4d74c1d37a3f9906bee39</p