Results:The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Conclusion:Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. K E Y W O R D Smedical error, pre-analytical, process flow, quality improvement, quality management, workflow

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ÖzPurpose: The aim of this study was to determine the impact level of improvements and positive contributions in clinical laboratory processes by using the six sigma protocol as quality management tool.

This prospective cohort study aimed to evaluate the efficacy of COVID-19 vaccine schemes, homologous versus heterologous vaccine strategies, and vaccine-induced anti-S-RBD-IgG antibody response in preventing COVID-19 among 942 healthcare workers 1 year after vaccination with the inactivated and/or mRNA vaccines. All participants received the first two primary doses of vaccines, 13.6% of them lacked dose 3, 50.5% dose 4, and 90.3% dose 5. Antibody levels increased with the increase in number of vaccine doses and also in heterologous vaccine regimens. In both inactive, mRNA vaccines and mixed vaccination, infection rates were significantly higher in two-dose-receivers, but lower in four- or five-dose receivers and increasing the total number of vaccine doses resulted in more protection against infection: the three-dose regimen yielded 3.67 times more protection, the four-dose 8 times, and five-dose 27.77 times more protection from COVID-19 infection, compared to any two-dose vaccination regimens. Antibody levels at the end of the first year of four- or five-dose-receivers were significantly higher than two- or three-dose receivers. To conclude, an increased number of total vaccine doses and anti-S-RBD antibody levels increased the protection from COVID-19 infection. Therefore, four or more doses are recommended in 1 year for effective protection, especially in risk groups.

Background/Aim: Primary ovarian insufficiency (POI) is defined as the depletion of the primordial follicle pool in women under the age of 40. New methods for stimulating ovarian follicle cells are being investigated in order to ensure the continuity of the menstrual cycle and fertility. The present study aimed to compare follicle reserves after ovarian striation or ovarian fragmentation in rats with ovarian insufficiency. Methods: Thirty adult female rats in the estrus phase were randomized into three groups. Group 1 and Group 2 were medicated with intraperitoneal 7.5 mg/kg paclitaxel to create ovarian insufficiency. Group 3 was the control group, and intraperitoneal 3 mL 0.9% sterile saline solution was administered. The first laparotomy was performed to evaluate ovarian insufficiency 1 week after chemotherapy. In Group 1, the right ovarian cortex was striated using an insulin injector. In Group 2, the right ovary was divided into five parts. These five pieces were transferred to the pocket created under the right pelvic peritoneum. In Group 3, only laparotomy was performed. After 1 month, all rats underwent a second laparotomy, and the number of ovarian follicles (primordial, primary, secondary, antral) were compared, as were their serum follicle-stimulating hormone (FSH) and estradiol (E2) levels. Results: There was a significant difference in the number of follicles among all three groups (P<0.05). The number of follicles (primordial, primary, secondary, antral) was significantly higher in the striated group than in the fragmented group (P<0.001). There were no statistically significant differences between the three groups in terms of mean serum FSH and E2 values measured at the second laparotomy (P>0.05). Conclusion:Ovarian striation on the ovary cortex may be a new method for the treatment of ovarian insufficiency.