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BMC Pediatr 2019 Jan 31;19(1):40. Epub 2019 Jan 31.

Department of Pediatric Emergency Department, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

Objective: Smartphones and associated messaging applications have become the most common means of communication among health care workers and the general population. The aim of this study was to evaluate the reliability and accuracy of smartphones for the diagnosis of rash in children admitted to emergency departments during the night shift.

Methods: The images of the children who were admitted to the paediatric emergency department with rash were included in this study, and at least two images taken with smartphones by residents or paediatric infectious disease fellows were re-directed to the chief consultant of the Paediatric-Infectious Department via smartphone. Read More

PLoS One 2019 30;14(1):e0210504. Epub 2019 Jan 30.

Institute of Immunology/Molecular Pathogenesis, Center for Biotechnology and Biomedicine, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany.

ORF virus (ORFV) is the causative agent of contagious ecthyma, a pustular dermatitis of small ruminants and humans. Even though the development of lesions caused by ORFV was extensively studied in animals, only limited knowledge exists about the lesion development in human skin. The aim of the present study was to evaluate a three-dimensional (3D) organotypic culture (OTC) as a human skin model for ORFV infection considering lesion development, replication of the virus, viral gene transcription and modulation of differentiation of human keratinocytes by ORFV. Read More

BMC Infect Dis 2019 Jan 25;19(1):85. Epub 2019 Jan 25.

Department of Internal Medicine, St Antonius Hospital, Nieuwegein/ Utrecht, Koekoekslaan 1, 3435, CM, Nieuwegein, The Netherlands.

Background: Ecthyma gangrenosum is a cutaneous infectious usually associated with P. aeruginosa. It usually develops In patients with an underlying immunodeficiency. Read More

J Eur Acad Dermatol Venereol 2019 Jan 11. Epub 2019 Jan 11.

Department of Dermatology, University Hospital Antwerp (UZA) and University of Antwerp (UA), Wilrijkstraat 10, B-2650, Antwerp, Belgium.

Background: Ecthyma gangrenosum (EG) is characterized by the occurrence of erythematous, violaceous or hemorrhagic macules and/or vesicles, often evolving into necrotic ulcers, with a central gray-black eschar. It is a rare skin condition, usually occurring in immunocompromised patients suffering from bacterial sepsis caused by Pseudomonas aeruginosa. However, seemingly healthy children have been diagnosed with this skin disease as well. Read More

BMC Vet Res 2019 Jan 7;15(1):13. Epub 2019 Jan 7.

State Key Laboratory of Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agriculture Science, Lanzhou, 730046, China.

Background: Contagious ecthyma (CE) appears in the countries and regions containing goat and sheep farms, and it is considered a global epidemic. CE not only severely endangers the healthy development of the sheep and goat industries but also threatens human health. For viral infectious diseases, fast and effective isolation and culture of the pathogen is critical for CE diagnosis, and for disease prevention and control. Read More

Afr J Lab Med 2018 5;7(1):756. Epub 2018 Dec 5.

Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Introduction: Ecthyma gangrenosum (EG) is a cutaneous lesion commonly caused by that involves mainly the lower limbs and gluteal region, seen more in immunosuppressed patients with neutropenia. Cancrum oris (Noma) is a gangrenous necrosis of the face that begins as a gingival ulcer and progresses rapidly to destroy contiguous tissues in malnourished children.

Case Presentation: This article reports a case of facial EG which was similar to Noma in a malnourished child: a 16-month old girl with fever, cough, weight loss, watery stool and swelling on right cheek. Read More

Cold Spring Harb Mol Case Stud 2018 Dec 17;4(6). Epub 2018 Dec 17.

Division of Infectious Disease, Department of Pediatrics, UCSD, San Diego, California 92093, USA.

X-linked agammaglobulinemia (XLA, OMIM#300300) is a rare monogenic primary immunodeficiency caused by mutations in the Bruton tyrosine kinase () gene. XLA is characterized by insufficient immunoglobulin levels and susceptibility to life-threatening bacterial infections. We report on a patient that presented with ecthyma gangrenosum and septicemia. Read More

Int J Dermatol 2018 Dec 12. Epub 2018 Dec 12.

Dermatology Department, University Hospital of Heraklion, Crete, Greece.

Plast Reconstr Surg Glob Open 2018 Oct 3;6(10):e1953. Epub 2018 Oct 3.

Department of Pediatric Surgery, Meyer Children Hospital, Florence, Italy.

Ecthyma Gangrenosum is a manifestation of infection, usually occurring in immunocompromised patients, which can be associated with bacteremia with potentially lethal outcome. The clinical appearance is of an inflammatory cutaneous lesion with a central necrotic spot; the lesion then rapidly progresses to a gangrenous ulcer with a gray-black eschar extending in the deep soft tissues. Treatment of Ecthyma Gangrenosum includes both aggressive systemic antibiotic therapy and surgical procedures. Read More

Med Mal Infect 2018 Dec 7. Epub 2018 Dec 7.

Service de médecine intensive et de réanimation polyvalente, CHU de Reims, 51092 Reims, France.

Case Rep Dermatol Med 2018 29;2018:2094086. Epub 2018 Oct 29.

Dermatology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Orf is a highly contagious skin disease commonly seen in goats and sheep that can be transmitted to people who have direct contact with infected animals. Here, we report the clinical manifestation, dermoscopy, and scanning electron microscopy in two women who developed skin lesions on their hands after handling goats with wounds in the udders. Human orf is usually self-limiting and no specific treatment is needed. Read More

Open Vet J 2018 19;8(2):208-211. Epub 2018 Jun 19.

National Veterinary Research Institute, Vom, Nigeria.

Camel contagious ecthyma (CCE) is a viral disease of camelids that is caused by a Parapoxvirus (PPV) which is a DNA virus of the viral family: . Diseases affecting camels in Nigeria are scarcely reported. CCE or the laboratory detection of camel PPV (CPPV) has not been reported in Nigeria. Read More

Pan Afr Med J 2018 5;30:95. Epub 2018 Jun 5.

University Mohammed V, Ibn Sina, Hospital University, Rabat, Morocco.

Ecthyma gangrenosum (EG) is a severe potentially lethal cutaneous infection that progresses sequentially from maculopapular rash to haemorrhagic bulla and then to necrotic ulceration with surrounding erythema. It usually occurs in immunocompromised patients (aplasia secondary to chemotherapy, HIV infection, neutropenia or functional deficit of neutrophils, agammaglobulinemia). It rarely affects healthy people. Read More

Acta Haematol 2018 9;140(3):166-168. Epub 2018 Oct 9.

Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain.

Infection 2018 Sep 5. Epub 2018 Sep 5.

Department of Haematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.

Virusdisease 2018 Sep 28;29(3):405-410. Epub 2018 Jul 28.

1Division of Veterinary Microbiology and Immunology, Faculty of Veterinary Sciences and Animal Husbandry (FVSc & AH), Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir (SKUAST-K), Srinagar, 190006 India.

Orf virus (ORFV) is a zoonotic pathogen that primarily infects sheep and goats, and is responsible for significant economic losses. ORFV is endemic in all the major sheep and goat rearing areas of the world including Indian subcontinent. However, the nature of ORFV circulating among sheep and goat in Kashmir Himalayas has not yet been characterized. Read More

J Virol Methods 2018 11 24;261:112-120. Epub 2018 Aug 24.

ICAR- National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, 560064, Karnataka, India.

Orf or contagious ecthyma, is a highly contagious transboundary disease of sheep and goats. For sero-diagnosis of orf, recombinant antigen based assays are considered as alternatives to conventional approaches such as serum neutralization test (SNT) and counter-immuno-electrophoresis (CIE). A major envelope protein of orf virus (ORFV), F1L, is highly immunogenic and is a candidate for use in these assays. Read More

Cutis 2018 Jul;102(1):E13-E15

Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, USA.

Skin Res Technol 2018 Jul 18. Epub 2018 Jul 18.

Dermatology Division, Department of Medical, Surgical and NeuroSciences, University of Siena, Siena, Italy.

Front Vet Sci 2018 19;5:134. Epub 2018 Jun 19.

Instituto de Biotecnología, Centro Nacional de Investigaciones Agropecuarias, Instituto Nacional de Tecnología Agropecuaria, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.

Orf virus (ORFV) is the etiological agent of Contagious Ecthyma (CE) disease that mainly affects sheep, goats, wild ruminants, and humans with a worldwide distribution. To date, only two strains from Argentinian sheep have been characterized at the molecular level and there is little information on ORFV strains circulating in Argentina. Here we describe and analyze five outbreaks of CE in goats in three geographic regions of the country: Northwest, Center, and Southwest. Read More

Virusdisease 2018 Jun 22;29(2):216-220. Epub 2018 Mar 22.

1Division of Virology, ICAR-Indian Veterinary Research Institute, Mukteswar, Nainital District, Uttarakhand 263 138 India.

This study describes the first confirmed report of contagious ecthyma in Black Bengal goats from Tripura state, a North-Eastern state of India situated at the Indo-Bangladesh border. Outbreaks were characterized by the high rates of morbidity (58-67%), low mortality (8-10%) and case fatality (11-15%). The etiology of the outbreaks was confirmed as orf virus (ORFV) by standard virological/serological and molecular techniques including sequence analysis of B2L, a major envelop protein gene of genus . Read More

J Pediatr Adolesc Gynecol 2018 Dec 6;31(6):625-628. Epub 2018 Jun 6.

Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Gynecology, Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. Electronic address:

Background: An 18-month-old female toddler presented with severe vulvar ulcers and pancytopenia with investigations revealing Pseudomonas aeruginosa bacteremia.

Case: A previously healthy 18-month-old female toddler presented with 6 days of fevers, vulvar rash, and ulcers. Vulvar cultures showed Staphylococcus aureus and P aeruginosa. Read More

Cureus 2018 Apr 6;10(4):e2441. Epub 2018 Apr 6.

Department of Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, PAK.

Ecthyma gangrenosum is a skin lesion consequent to bacteremia, mostly due to Pseudomonas aeruginosa, although it may develop secondary to other organisms as well. The disease is often witnessed in patients with leukemia; however, a few cases of ecthyma gangrenosum in adults were reported to be associated with myelofibrosis. We report a case of ecthyma gangrenosum due to Escherichia coli (E. Read More

Vet Microbiol 2018 Jun 13;219:178-182. Epub 2018 Apr 13.

Veterinary Immunology Laboratory, College of Veterinary Medicine, Northwest Agriculture and Forestry University, Yangling 712100, Shaanxi Province, China. Electronic address:

Contagious pustular dermatitis is an exanthematous zoonotic disease caused by the orf virus. Pandemic outbreaks of this disease cause great economic losses, while the pathogenesis of this disease still remains obscure. In this study, blood samples were collected from 628 asymptomatic goats across China for PCR-based virus detection. Read More

Pediatr Dermatol 2018 Jul 15;35(4):e237-e238. Epub 2018 May 15.

Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

The case of a 6-year-old boy with multiple, target-shaped lesions and a crusted nodule on his right index finger is presented. Based on clinical findings and the patient's recent contact with sheep and goats, a diagnosis of orf disease associated with erythema multiforme was suspected. Microscopy studies confirmed the presence of parapoxvirus in the primary lesion. Read More

Microb Pathog 2018 Jul 28;120:55-63. Epub 2018 Apr 28.

Virology Unit, Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University Putra Malaysia, Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia. Electronic address:

Orf disease is known to be enzootic among small ruminants in Asia, Africa, and some other parts of the world. The disease caused by orf virus is highly contagious among small ruminant species. Unfortunately, it has been neglected for decades because of the general belief that it only causes a self-limiting disease. Read More

Am J Dermatopathol 2018 Sep;40(9):e126-e129

Department of Dermatology, Bahçeşehir University Medical Faculty, Istanbul, Turkey.

The orf virus, a member of poxvirus family, is a zoonotic parapoxvirus endemic in many countries, mostly seen among sheep, goats, oxen, and may be transmitted to humans. Orf virus infections may induce ulceration, papulonodular, pustular, or ecthyma lesions in the skin. Rarely, orf virus provokes extensive vasculoendothelial proliferation by encoding an apparent homolog of the mammalian vascular endothelial growth factor family of molecules. Read More

Rev Chilena Infectol 2017 Dec;34(6):607-609

Facultad de Ciencias, Universidad Mayor, Santiago, Chile.

Infection with the orf virus, also known as contagious ecthyma, is recognized as an occupational zoonosis worldwide. It is diagnosed by cutaneous lesions that progress rapidly from macules to papules, vesicles and pustules. The clinical case of a student of veterinary medicine who had had contact with goats, clinically healthy and without apparent lesions, which occured 19 days ago, is reported. Read More

Acta Vet Scand 2018 Feb 21;60(1):12. Epub 2018 Feb 21.

Department of Nursing and Health Sciences-Vestfold, Faculty of Health and Social Sciences, University College of Southeast Norway, 3603, Kongsberg, Norway.

Background: The zoonotic Orf virus (ORFV; genus Parapoxvirus, Poxviridae family) occurs worldwide and is transmitted between sheep and goats, wildlife and man. Archived tissue samples from 16 Alaskan wildlife cases, representing mountain goat (Oreamnos americanus, n = 8), Dall's sheep (Ovis dalli dalli, n = 3), muskox (Ovibos moschatus, n = 3), Sitka black-tailed deer (Odocoileus hemionus sitkensis, n = 1) and caribou (Rangifer tarandus granti, n = 1), were analyzed.

Results: Clinical signs and pathology were most severe in mountain goats, affecting most mucocutaneous regions, including palpebrae, nares, lips, anus, prepuce or vulva, as well as coronary bands. Read More

J Dtsch Dermatol Ges 2018 Feb;16(2):139-148

Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen und Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg.

Nukleinsäure-Amplifikations-Techniken (NAT), wie die PCR, sind hochsensitiv sowie selektiv und stellen in der mikrobiologischen Diagnostik wertvolle Ergänzungen zur kulturellen Anzucht und Serologie dar. Sie bergen aber gerade bei formalinfixiertem und in Paraffin eingebettetem Gewebe ein Risiko für sowohl falsch negative als auch falsch positive Resultate, welches nicht immer richtig eingeschätzt wird. Daher haben Vertreter der Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM) und der Deutschen Dermatologischen Gesellschaft (DDG) einen Konsensus in Form einer Übersichtsarbeit erarbeitet, wann eine NAT am Paraffinschnitt angezeigt und sinnvoll ist und welche Punkte dabei in der Präanalytik und Befundinterpretation beachtet werden müssen. Read More

J Dtsch Dermatol Ges 2018 Feb;16(2):139-147

Institute of Microbiology - Clinical Microbiology, Immunology, and Hygiene, University Medical Center and Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Nucleic acid amplification techniques (NATs), such as PCR, are highly sensitive and specific methods that have become valuable supplements to culture and serology in the diagnosis of infectious disorders. However, especially when using formalin-fixed and paraffin-embedded tissue, these techniques are associated with both false-negative and false-positive results, a pitfall that is frequently misjudged. Representatives of the German Society of Hygiene and Microbiology (DGHM) and the German Society of Dermatology (DDG) therefore set out to develop a consensus - in the form of a review article - on the appropriate indications for NATs using paraffin-embedded tissue, its contraindications, and the key points to be considered in the pre- and post-analytical phase. Read More

Am J Med 2018 May 31;131(5):510-511. Epub 2018 Jan 31.

Chief of Infectious Diseases, Veterans Affairs Medical Center, Northport, NY; Stony Brook University School of Medicine, NY. Electronic address:

Arch Virol 2018 May 24;163(5):1285-1291. Epub 2018 Jan 24.

Sección Virología, Facultad de Ciencias, UdelaR, Iguá 4225, 11400, Montevideo, Uruguay.

Orf virus (ORFV) is the etiological agent of contagious ecthyma, a disease widely spread in the world that occasionally causes zoonotic infections. This work is the first molecular characterization of ORFV in Uruguay, where we analyzed twenty-one sheep samples, eighteen of which were recovered from thirteen ORFV outbreaks that occurred during 2004 to 2011 as well as three strains from a national vaccine. Phylogenetic analysis and the derived amino acid sequences from the B2L gene suggest that the Uruguayan virus do not form a unique cluster, with most of them displaying similarities with worldwide ORFV isolates as well as our vaccine strains. Read More

J Dermatol Case Rep 2017 Dec 1;11(2):32-34. Epub 2017 Dec 1.

Micology Department, General Hospital "Dr. Manuel Gea González", Mexico City, Mexico.

Mucormycosis of the scalp is a rare cutaneous presentation of the disease. It is also an unusual infection in children. We present the case of a 4-year-old girl with acute lymphoblastic leukemia, who presented with atypical cutaneous mucormycosis simulating an lesion. Read More

BMC Res Notes 2018 Jan 15;11(1):29. Epub 2018 Jan 15.

Department of Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, The University of Gondar, P.O. Box: 196, Gondar, Ethiopia.

Objective: This study was performed with the objective of identifying the proportion of emerging and endemic livestock diseases using cross sectional survey.

Result: A total of 285 clinically diseased animals were presented to a veterinary clinic and diagnosed tentatively based on history, clinical sign, and simple laboratory diagnostics and from the study, actinomycosis (15.83%), mastitis (15%), tick infestation (10%), respiratory diseases (9. Read More

BMC Vet Res 2018 Jan 15;14(1):13. Epub 2018 Jan 15.

Department of Clinical Studies, University of Gondar, College of Veterinary Medicine and Animal Sciences, P.O. Box: 196, Gondar, Ethiopia.

Background: Orf virus, the prototype of parapoxvirus, is the main causative agent of contagious ecthyma. Little is known about the status of the disease in Ethiopia and this study was aimed at determining its status using PCR as a confirmatory tool.

Methods: a total of 400 randomly selected sheep and goat was screened for the identification of the virus using amplification of B2L gene and transfection of mammalian cells (VERO cells). Read More

Lancet Infect Dis 2018 Jan 20;18(1):122. Epub 2017 Dec 20.

Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany. Electronic address:

Infect Chemother 2017 Dec;49(4):301-325

Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.

Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. Read More

PLoS Pathog 2017 12 15;13(12):e1006779. Epub 2017 Dec 15.

Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana- Champaign, Urbana, IL, United States of America.

Poxviruses have evolved multiple strategies to subvert signaling by Nuclear Factor κB (NF-κB), a crucial regulator of host innate immune responses. Here, we describe an orf virus (ORFV) virion-associated protein, ORFV119, which inhibits NF-κB signaling very early in infection (≤ 30 min post infection). ORFV119 NF-κB inhibitory activity was found unimpaired upon translation inhibition, suggesting that virion ORFV119 alone is responsible for early interference in signaling. Read More

Acta Derm Venereol 2018 Apr;98(4):469-470

Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, DE-80802 Munich, Germany.

Hautarzt 2018 Jun;69(6):484-486

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.

This article presents the case of a patient with newly developed skin erosions and ulcerations following an exanthematous drug eruption due to sultamicillin therapy. The skin lesions were treated topically with clobetasol and prednicarbate and orally with methylprednisolone. A skin smear revealed massive growth of Escherichia coli bacteria. Read More

N Engl J Med 2017 Dec;377(23):e32

Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands

An Bras Dermatol 2017 Sep-Oct;92(5):698-700

Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León - Monterrey, México.

Ecthyma gangrenosum is a rare skin infection classically associated with Pseudomonas aeruginosa. We performed a retrospective study of all cases diagnosed with ecthyma gangrenosum from 2004-2010 in a university hospital in Mexico (8 cases, 5 female patients and 3 male patients, ages between 4 months and 2 years). The most common risk factor for ecthyma gangrenosum is neutropenia in immunocompromised patients. Read More

Arch Pediatr 2017 Dec 16;24(12):1241-1243. Epub 2017 Nov 16.

Service d'accueil des urgences, American Memorial Hospital, CHU de Reims, 47, rue Cognacq-Jay, 51100 Reims, France.

Ecthyma contagiosum, or Orf, is a specific infection of small ruminants accidentally reaching humans. Few cases have been reported in the literature to date. We report here a case of ecthyma contagiosum occurred in a 9-year-old girl after contact with a flock of ecthyma sheep. Read More

Cutis 2017 Sep;100(3):148;158;166

Cooper Medical School, Rowan University, Camden, New Jersey, USA.

J Craniofac Surg 2018 03;29(2):531-532

Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain Department of Pathology, Virgen del Rocio University Hospital, Seville, Spain Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.

PLoS One 2017 26;12(10):e0186681. Epub 2017 Oct 26.

State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Ministry of Agriculture, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu, China.

Contagious ecthyma is a highly contagious disease with worldwide distribution, which is caused by the Orf virus (ORFV) belonging to the Parapoxvirus. To study the alteration of host gene expression in response to ORFV infection at the transcriptional level, several young small-tailed Han sheep were inoculated with ORFV, and their oral mucosa tissue samples (T0, T3, T7 and T15) were collected on day 0, 3, 7 and 15 after ORFV infection respectively. RNA-seq transcriptome comparisons were performed, showing that 1928, 3219 and 2646 differentially expressed genes (DEGs) were identified among T3 vs. Read More

Clin Exp Dermatol 2018 Jan 23;43(1):67-69. Epub 2017 Oct 23.

Dermatology Department, Kingston Hospital NHS Foundation Trust, Galsworthy Road, Kingston upon Thames, London, UK.

Int J Dermatol 2018 01 23;57(1):115-116. Epub 2017 Oct 23.

Department of Pathology, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.