bluuebunny/crossref_metadata_2025_split huggingface dataset:
VULVOVAJİNAL KANDİDİYAZİSLİ HASTALARDAN İZOLE EDİLEN CANDİDA TÜRLERİNDEKİ INT, HWP, PLB, SAP VE ALS GENLERİNİN MOLEKÜLER TESPİTİ
Authors: TOKAK Semih , KILIÇ İbrahim Halil , GÜLBAHÇE MUTLU Elif , BEYAZYÜZ Fadime , ERİÇ HORASANLI Jule , ESENKAYA TAŞBENT Fatma 
Published: December 2023

Amaç: Vulvovajinal kandidiyazis, kadınların yaklaşık %75’inde yaşamları boyunca en az bir kez görülen yüzeysel mantar enfeksiyonudur. Bazı genler, Candida türlerinin vajina mukozasına ve epitel hücrelerine yapışmasında ve patogenezinde rol oynamaktadır. Bu çalışmanın amacı, vulvovajinal kandidiyazisli hastalardan izole edilen Candida suşlarındaki HWP1 (hifal duvar proteini), ALS1 (agglutinin benzeri sekans), SAP1 (sekrete aspartil proteaz), PLB1 (fosfolipaz B), INT1 (integrin A) genlerinin sıklığının araştırılmasıdır.
Gereç ve Yöntemler: Çalışmaya moleküler teknik kullanılarak tanımlanan 100 vajinal Candida izolatı dahil edildi. İzole edilen tüm Candida suşlarında, enfeksiyon da önemli rol oynayan INT1, HWP1, PLB1, SAP1 ve ALS1 genlerinin varlığı PCR yöntemi kullanılarak araştırıldı.
Bulgular: SAP1, INT1 ve HWP1 virülans genleri Candida suşları arasında en yaygın, PLB geni en az tespit edilen gen olmuştur. Candida albicans suşlarında SAP1 (%93.0) geni en çok saptanan virülans geni olurken, bunu HWP1 geni (%86) takip etmiştir. Benzer şekilde non-albicans Candida türlerinde saptanan virülans genleri arasında SAP1 geni (%86) en fazla saptanan virülans geni olmuştur. Farklı Candida türlerinin %95’inde VVK’ya neden olabilecek en az iki virülans faktörü tanımlanmıştır.
Sonuç: Bu çalışmada elde edilen sonuçlar, vulvovajinal kandidiyazis enfeksiyonu sırasında eksprese edilen INT, HWP, PLB, SAP ve ALS genlerinin, Candida suşlarının vajinaya adezyonuna ve biyofilm oluşumuna katkıda bulunmuş olabileceğini düşündürmektedir.
AN ANALYSIS OF INJURIES DUE TO TRACTOR ACCIDENTS: A TEN YEAR RETROSPECTIVE STUDY
Authors: KASAR Orhan , COMERTPAY Ertan , ILHAN Bugra , EROĞLU Oğuz , DENİZ Turgut 
Published: December 2023

Objective: Although tractors are highly inadequate in terms of safety equipment compared to other vehicles, they are still frequently employed for agricultural activities and even human transportation. This study investigated patients presenting to the emergency department (ED) due to tractor accidents.
Material and Methods: Tractor accidents occurring over a ten year period were examined retrospectively. Victims’ demographic data, the cause of the accident, trauma scores (Glasgow Coma Score, Injury Severity Score, Revised Trauma Score and Pediatric Trauma Score), injury localizations, imaging results, and clinical outcomes were recorded.
Results: One hundred sixty-five patients were included. Their mean age was 46.48±23.24 years, 82.4% were men, and 41.8% were tractor drivers. The most frequent cause of accidents was “falling from the tractor”. The thorax was the most frequently injured anatomical region. Rates of head and thoracic injury were significantly higher in drivers compared to passengers (p=0.005 and p=0.039, respectively). The post-accident exitus rate was 3.6%. The incidence of abdominal and pelvic injuries was significantly higher in the exitus group than in the survivors (p=0.018 and p=0.015, respectively). Glasgow Coma Score and Revised Trauma Score levels were significantly lower in the exitus group than in the survivors (p
THE EVALUATION OF THE KNOWLEDGE AND OPINIONS OF FACULTY OF MEDICINE TERM VI STUDENTS ON NOTIFIABLE DISEASES AND RELEVANT PRACTICES BASED ON THEIR PUBLIC HEALTH INTERNSHIP STATUS
Authors: DAYMAZ Didem , KURTULUŞ Necibe , GÜNEŞ Çağla , AKSOY Talha Akif , BATIR Gaye Nur , YAZICI Mehmet Semih , İMAN Zeynep Nesibe , AL Muhammed Musab , ÖZTÜRK HAKTANIYAN Zekiye Nur , ŞAHİN Ayça Naz , YAĞMUR Ünal , AKARSLAN Elif , TAŞKIRAN Metehan , KOLTUK İsmail , GÜNAY İbrahim , SAYGUN Meral 
Published: December 2023

Objective: The primary purpose of this study is to evaluate the knowledge and opinions of pre-physicians, term VI students in the 2021-2022 academic year, who participated and did not participate in a public health internship program appertaining to the notifiable diseases process.
Material and Methods: The participants of this study consisted of term VI students from 126 faculty of medicine. We used a data collection form, consisting of 25 questions in total, to assess the knowledge of term VI students on their sociodemographic characteristics, their educational background, and internship process, in addition to their opinions on the notifiable diseases. Considering knowledge questions, correct answers were worth one point each, while the other answers were worth zero points and evaluated over the total score. The data were collected through observation method of data collection.
Results: 48.7% of the 115 participants had completed their public health internship program A statistically significant difference was found between public health internship and having knowledge and being skilled in the notifiable diseases (p
TAURİN TEDAVİSİNİN DENEYSEL MİYOZİT OLUŞTURULMUŞ RATLAR ÜZERİNDEKİ YARARLI ETKİLERİ
Authors: TORLAK-KOCA Nadide , ÖZÜDOĞRU ÇELİK Tuğba 
Published: December 2023

Amaç: Taurin iskelet kasında bol miktarda bulunan bir amino asittir. Hücre zarının korunması, anti-inflamatuar ve anti- apoptotik etkiler dahil olmak üzere sitoprotektif özelliklere sahiptir. Bildiğimiz kadarıyla, bu çalışma, taurinin asetik asit ile deneysel olarak oluşturulan miyozitteki kas hasarı ve inflamasyonu azaltmadaki faydalı etkilerini araştırmak amacıyla ilk kez yapılmıştır.
Gereç ve Yöntemler: Çalışmaya 20 haftalık 24 adet Wistar albino türü sıçan dahil edildi. Sıçanlar kontrol grubu (n=8), %1 asetik asit (miyozit) grubu (n=8) ve miyozit + taurin 500 mg/kg/gün grubu (n=8) olmak üzere üç gruba ayrıldı. Miyozit indüksiyonu için %1 asetik asit kullanıldı. Taurin tedavisi 15 gün süreyle yapıldı ve ratlar sakrifiye edildi. Gastroknemius kası histopatolojik ve immünohistokimyasal olarak değerlendirildi. Elde edilen sonuçlar istatistiksel olarak karşılaştırıldı.
Bulgular: Gruplar arasında konjesyon, dejenerasyon, nekroz, inflamasyon ve dezorganizasyon açısından istatistiksel olarak anlamlı fark vardı (p
Ekstirpasi Polip Plika Vokalis Dekstra dengan Laser Dioda
Authors: Putra Dian Pratama , Nukman Novialdi 
Published: December 2023

Pendahuluan: Polip plika vokalis merupakan suatu lesi jinak, sering terjadi karena penyalahgunaan suara yang berakibat trauma pada plika vokalis. Disfonia merupakan gejala utama kelainan ini. Penatalaksanaan polip plika vokalis dengan terapi konservatif dan tindakan pembedahan. Pada polip plika vokalis yang berukuran besar, tindakan pembedahan menjadi terapi pilihan. Tindakan pembedahan menggunakan laser dioda menjadi pilihan dalam terapi polip plika vokalis, dengan kekurangan dan kelebihannya jika dibandingkan dengan instrumen lainnya. Laporan kasus: Dilaporkan satu kasus polip plika vokalis kanan pada seorang laki-laki usia 62 tahun dengan keluhan utama suara serak. Suara serak pada pasien membaik setelah dilakukan ekstirpasi polip plika vokalis dekstra dengan laser dioda. Kesimpulan: Polip plika vokalis memberikan gejala disfonia. Penyalahgunaan suara dan faktor iritan seperti merokok merupakan penyebab polip plika vokalis. Tindakan ekstirpasi polip plika vokalis dekstra dengan laser dioda memberikan hasil yang memuaskan terhadap keluhan suara pasien.
Kata kunci: polip plika vokalis, laser dioda, disfonia, penyalahgunaan suara
ABSTRACT
Introduction: Vocal cord polyp is a benign lesion, often occurs due to voice abuse resulting in phonotrauma. Dysphonia is the main symptom of this disorder. Management of vocal cord polyps with conservative therapy and surgery. In large vocal cord polyps, surgery is the treatment of choice. Surgery using a diode laser is an option in the therapy of vocal cord polyps, with its advantages and disadvantages when compared to other instruments. Case report: Reported one case of right vocal cord polyp in a 62-year-old man with chief complaint of hoarseness. Hoarseness in the patient improved after surgical therapy with diode laser. Conclusion: Vocal cord polyps will give symptoms of dysphonia. Voice abuse and irritants such as smoking are the causes of vocal cord polyps. Surgery using a diode laser provides satisfactory results for the patient's voice complaints
Keywords: vocal cord polyps, diode laser, dysphonia, voice abuse
Management of Bilateral Sudden Deafness
Authors: Wulandari Yunita , Munilson Jacky 
Published: December 2023

Introduction: Sudden deafness or sudden sensorineural hearing loss (SSNHL) is defined as sensorineural hearing loss of more than 30 dB at three consecutive frequencies within 3 days of onset, often unilateral, and only 0,4-3,4 % of patients with bilateral of sudden deafness. The definite cause of sudden deafness is only found in 10-15% cases and most of the cause was unkown (idiophatic). The management of systemic corticosteroid injection is the first choice in the treatment of SSNHL and can be combined with corticosteroid intratympanic injection. One case reported, A 33-year-old male patient with diagnosis of bilateral sudden deafness which is performed systemic corticosteroids and combined with dexamethasone injection intratympanic with the good result. Keywords: Sudden deafness, sensorineural hearing loss, intratympanic injection

ABSTRAK
Pendahuluan: Tuli mendadak didefinisikan sebagai kehilangan pendengaran sensorineural yang lebih dari 30 dB pada 3 frekuensi berturut-turut dalam onset 3 hari, sering unilateral, hanya sekitar 0,4-3,4% dari pasien yang mengalami tuli mendadak bilateral. Penyebab pasti tuli mendadak hanya ditemukan pada 10–15% kasus, sebagian besar penyebabnya tidak diketahui (idiopatik). Tatalaksana injeksi kortikosteroid sistemik menjadi pilihan utama pada tatalaksana tuli mendadak dan dapat dikombinasikan dengan kortikosteroid injeksi intratimpani. Dilaporkan satu kasus pasien laki-laki, 33 tahun yang didiagnosis dengan tuli mendadak bilateral yang dilakukan terapi kortikosteroid sistemik dan dikombinasikan dengan injeksi deksametason intratimpani dengan hasil yang baik. Kata Kunci: Tuli mendadak, tuli sensorineural, injeksi intratimpani
Rinitis Alergi pada Anak
Authors: Julianda Wahyu 
Published: December 2023

Pendahuluan: Rinitis alergi merupakan reaksi inflamasi dari mukosa hidung yang diperantai oleh Imunoglobulin E yang ditandai dengan sumbatan hidung, rhinorrhea dan atau mata gatal dan atau bersin. Kompleksitas dan variabilitas rinitis sangat terlihat pada masa anak, dimana pada saat ini terjadi pematangan anatomis, fisiologis dan imunologis yang menghasilkan pola klinis yang sulit untuk dikaji dan juga dikelola. Tujuan: Memberikan pengetahuan mengenai diagnosis dan penatalaksanaan penyakit rinitis alergi pada anak sehingga dapat ditangani dengan tepat dan akurat. Tinjauan Pustaka: Prevalensi rinitis pada anak usia prasekolah 0-6 tahun bervariasi. Genetika memainkan peran penting sekitar 20% hingga 30% dari populasi umum dan 10% hingga 15% anak-anak mengalami atopik. Perkembangan penyakit atopik pada anak mengikuti pola atopic march, dimulai dari dermatitis atopik pada saat bayi, kemudian diikuti oleh alergi makanan, rinitis alergi dan asma. Kerjasama yang optimal antara pasien, pengasuh dan tenaga medis yang profesional dapat membantu memaksimalkan respons terhadap pengobatan rinitis alergi pada anak Kesimpulan: Rinitis alergi pada anak lebih bersifat intermiten dan memiliki lebih sedikit gejala tetapi lebih banyak komorbiditas dibandingkan dewasa. Keadaan RA tidak hanya menurunkan kualitas hidup dan kualitas belajar, tetapi juga meningkatkan risiko beberapa kondisi seperti asma, rinosinusitis dan otitis media efusi. Penatalaksanaan farmakoterapi rinitis alergi dapat menggunakan antihistamin generasi kedua, intranasal kortikosteroid, dekongestan nasal spray, mast stabilizer, irigasi nasal saline dan imunoterapi yang disesuaikan menurut usia dan berat badan.
Kata kunci: rinitis alergi pada anak, atopic march, imunoglobulin e
Ototoksisitas akibat Penggunaan Cisplatin dan Pendekatan Otoprotektif untuk Pencegahannya
Authors: Saputra Rizki , Rosalinda Rossy , Rahman Sukri , Aliska Gestina 
Published: December 2023

Latar Belakang: Peningkatan secara statistik angka harapan hidup pasien kanker setelah diterapi membuat pemantauan efek samping jangka panjang kemoterapi sangat dibutuhkan. Cisplatin menjadi agen kemoterapi pilihan pada kanker kepala dan leher karna sifatnya yang sangat poten. Bertentangan dengan manfaat terapiutik tersebut, pemakaian cisplatin memiliki potensi masalah ototksik yang dapat menyebabkan gangguan pendengaran. Tujuan: Untuk mengetahui dan memahami mekanisme ototoksisitas akibat penggunaan cisplatin dan upaya otoprotektif. Tinjauan Pustaka: Sebagai agen kemoterapi, cisplatin memiliki beberapa efek samping salah satunya bersifat ototoksik. Mekanisme ototoksik akibat cisplatin dihubungkan dengan pembentukan radikal bebas yang menyebabkan apoptosis pada sel rambut luar koklea dan jaringan penunjang di organ Corti. Pasien yang menerima pengobatan cisplatin harus dilakukan evaluasi fungsi pendengaran secara berkala. Sampai saat ini belum ada obat-obatan yang menjadi pilihan utama dalam upaya preventif ototoksik akibat cisplatin. Penggunaan obat golongan seperti N-asetilsistein, sodium tiosulfat, vitamin E, amifostin membuka harapan untuk pengembangan terapi preventif ototoksik. Kesimpulan: Efek samping ototoksik yang ditimbulkan merupakan salah satu masalah yang harus ditatalaksana. Monitoring pendengaran dibutuhkan untuk mendeteksi pemasalahan ini. Beberapa agen otoprotektif seperti antioksidan dan kortikosteroid dapat menjadi pilihan tatalaksana dalam upaya preventif. Pemberian agen otoprotektif secara sistemik dan intratimpani memiliki kelebihan dan kekurangan dalam penggunaannya.
Kata kunci: ototoksik, cisplatin, preventif, intratimpani
Analisis Nilai Peak Nasal Inspiratory Flow pada Kejadian Rinitis Alergi
Authors: Faathira Ken Rabbani , Asyari Ade , Afdal Afdal 
Published: December 2023

Latar Belakang: Gejala hidung tersumbat sering merupakan gejala yang dominan pada rinitis alergi. Peak Nasal Inspiratory Flow (PNIF) adalah alat yang sangat bermanfaat untuk mengukur sumbatan hidung pada rinitis alergi karena terkait erat dengan tanda-tanda rinitis alergi berdasarkan pemeriksaan klinis dan berkorelasi baik dengan derajat keparahan rinitis alergi dan memiliki kelebihan yang sederhana, murah, nyaman, dan cepat. Penelitian ini bertujuan untuk menganalisis perbedaan nilai PNIF antara orang dengan rinitis alergi dan non-rinitis alergi. Metode: Penelitian ini merupakan penelitian analitik komparatif dengan menggunakan pendekatan cross sectional. Skrining rinitis alergi menggunakan kuesioner Score For Allergic Rhinitis (SFAR) kemudian dilakukan anamnesis, nasoendoskopi, dan pengukuran PNIF di poliklinik THT BKL RSUP Dr. M. Djamil Padang. Populasi adalah seluruh mahasiswa Program Studi Kedokteran Universitas Andalas yang mengidap rinitis alergi dan non-rinitis alergi dengan total sampel sebanyak 36 orang. Teknik pengambilan sampel dilakukan dengan convenience sampling. Hasil: Hasil penelitian didapatkan median nilai PNIF pada kejadian rinitis alergi sebesar 100 (50-120) L/m. Rata-rata nilai PNIF pada kejadian non-rinitis alergi sebesar 130,56 ± 24,36 L/m (Maks = 190 L/m, Min = 90 L/m). Dari hasil uji statistik Mann-Whitney didapatkan analisis beda nilai PNIF pada kejadian rinitis alergi dan non-rinitis alergi dengan nilai p < 0,001. Kesimpulan: Kesimpulannya terdapat perbedaan nilai PNIF yang signifikan antara kejadian rinitis alergi dan non-rinitis alergi.
A Study of Nuclear Structure of (Mo^96,98) by Using Interacting Boson Model-1
Authors: Ghafoor Berun Nasralddin 
Published: December 2023

In this study, the interacting Boson Model (IBM-1) was used to find the best Hamiltonian structure for studying the (Mo^96,98) structure. For generating the Hamiltonian structure, the calculated energy levels (ground, beta, and gamma bands) and B(E2) transitions for (Mo^96,98) were explored using the optimal parameter values. According to this study and the IBM test findings, (Mo^96,98) are stable isotopes of Molybdenum, and their transition behaviors are close to the SU(5) limitations. When comparing the findings to the experimental data, they demonstrated a good agreement.
The Effects of Zinc Oxide nanoparticles synthesized from Eucalyptus plant extracts against mealworm stages Tenebrio molitor L., 1758 (Tenebrionidae: Coleopetera)
Authors: Omar Saher Taher , Ali Wand Khalis , Karim Ayoub Sabir 
Published: December 2023

Despite the widespread utilization of Zinc Oxide nanoparticles (ZnO NPs) in different areas, there have been several studies regarding their toxicity. Thus, this study aimed to produce zinc oxide nanoparticles using a simple and eco-friendly biosynthesis process, utilizing the Eucalyptus (Eucalyptus camaldulensis Dehn.) as a reducing agent. It also aimed to estimate their insecticidal efficacies toward the mealworm's stages (Tenebrio molitor L.,1758(. The produced ZnO nanoparticles were characterized by X-ray diffraction, UV–visible, and transmission electron microscopy (TEM). The laboratory experiment was carried out with one way of exposure, using the feeding method through immersing the leaf in ZnO NPs solution with different concentrations. The mortality effects on insect's stages were recorded in various periods of time. The statistical analysis results indicated the presence of noteworthy variations in the average mortality rate according to insect's stage, showing a different effect on the average of larval mortality rate. In this regard, the highest average of larval mortality rate was recorded at 5000ppm (61.25%); while the general average percentage of adult emergence was (42.53%). After three weeks, the highest general mean of adult mortality was obtained at 5000ppm (87.48%). Similarly, the LC50 value of the ZnO NPs derived from the used plant extract against the larval stage was (3630.78 ppm). This result revealed that Zinc Oxide Nanoparticles from plant extract sources have both larvicidal and adulticidal properties and they could serve as an eco-friendly alternative to synthetic insecticides for controlling insect's stages. Hence, the biogenic Zinc Oxide Nanoparticles can be used as a potential bio-insecticidal agent for the future.
Barriers to timely lung cancer diagnosis and treatment in a Philippine tertiary hospital
Authors: Ericson Chan King Rich , Reuben Bolos Angeles Roland , Viray Chua Alfredo , Garcia Ignacio Jorge , Pasion Benedicto Jubert 
Published: December 2023

Objectives
Timeliness of care is crucial to optimize outcomes in lung cancer. In the Philippines, the causes of delays in lung cancer diagnosis and treatment have not yet been explored.

Material and Methods
We reviewed records of patients diagnosed with lung cancer in our institution between September 2017 and August 2019 after biopsy or resection of a pulmonary lesion. Time to specialist consultation, biopsy, cancer diagnosis, and treatment were measured and compared with standards set by the British Thoracic Society.

Results
Eighty patients were included in the analysis. The median time to pulmonology consult and biopsy was 5 and 18 days, respectively. Cancer diagnosis was made within 28 days for 48% of patients. Causes of delay include late pulmonology referral (21%), delayed biopsy (38%), need for repeat biopsy (24%), and performing outright resection (10%).
Out of 25 patients who received systemic treatment, only four were treated within 28 days of their cancer diagnosis. Curative resection was delayed beyond 56 days for two out of four patients.

Conclusion
Each step in the management of lung cancer is a potential cause for delay. This study revealed opportunities for improvement in multiple areas of care that can allow more patients to benefit from treatment.
Genre uniqueness of the documentary novel: the case of Kharyskhal's "The Roads of Bygone Years"
Authors: Shishigina V. R. 
Published: December 2023

The article deals with the genre features of the documentary novel "By the Roads of Bygone Years" ("Aaspytyt kem aartyktarynan", 2021) written by the Yakut writer V. Е. Vasiliev – Kharyskhal. He is the author of historical dramas, which are staged in the theaters of our republic. The writer has created dramas based on archival documents, which reflect the history of Yakut life in the early twentieth century. His work "By the Roads of Bygone Years" ("Aaspytyt kem aartyktarynan") is a novel by genre. It is also based on archive materials, memoirs and letters, and is truly documentary. At the same time, the work is characterized by a peculiar artistic form, which is expressed in a special lyrical narration of the author himself, as well as in the ways of revealing the image of the protagonist.The purpose of the research is to study the concept of the documentary novel and to identify its specific features. The article emphasizes that the documentary novel tells about little-known periods and events that are still mysteries. The writer uses personal experiences, including his own impressions and experiences, to create a more emotional connection with the topic and characters. This allows the reader to better understand the author's motivation and special relationship to the story being told.Thus, the study of the documentary novel and its genre features is of great relevance as it allows us to expand our understanding of art and literature. The documentary novel provides a unique opportunity to combine reality and fiction writing, which allows us to better understand and appreciate history, as well as develop our imagination and emotional perception of texts.
SARS-CoV-2 Antibody Responses in Newly Recovered Patients from Covid-19 Infection
Authors: A Lateef, Imad , K Attallah , Younus , G Khalil , Khalil , A  Ahmad Arshed 
Published: December 2023

Background: The coronavirus disease 2019 pandemic continues, causing considerable morbidity and mortality worldwide. Real-time reverse transcription polymerase chain reaction (RT-PCR) diagnostic assays are a goal standard for case ascertainment and diagnosis. Comparing to PCR, serological testing is advantageous with faster turn-around time, high-throughput and less workload. However, the clinical value of antibodies largely depends on the understanding of host antibody responses during infection.
Immunoglobulin G (IgG)) in response to SARS-CoV-2 in patients newly recovered from different severity Covid-19 infection in Baquba-Iraq.
Patients and Methods: In this cross sectional study a (93) patients with recent covid-19 infection who came to the central blood bank of Diyala for convalescent plasma donation for the period from the 1st June 2020 till 1st August 2020 were enrolled. The questionnaire form were filled regarding the time of infection, clinical manifestations, severity and polymerase chain reaction (PCR) results. While blood were taken for antibody titer measurement using the SARS-CoV-2 IgM and IgG VIDAS test.
Results: Male constitute about 91% of the study population. About 74% of the cases were below 40 years old. Fifty four of the patients had mild disease, 28% had moderate severity while the other 18% had severe type of the disease. fatigue and fever were the most common symptoms and seen in 87%,84% respectively. IgM Antibodies start to be positive before 21 days post infection mainly in mild and moderate cases 100%, While 0% of severe cases were positive at this time. After 49 day from the time of the infection 67%and 75% of the mild and moderate cases where IgM positive respectively and 100% of the severe cases where IgM positive. IgG Antibodies were positive in 100%, 0% of the mild and severe cases respectively at 21 day post infection but it's positive in 100% of both mild and severe cases after 49 day post infection.
Conclusion: : Although the serological response for SARS-CoV-2 appears in the first three weeks from the disease onset this response differs from patient to another according to the time from the infection and the severity of the infection.