Panel 10. Paper 10.3: A Multi-layered Rural Settlement Resisting to Sustain the Rural Habitat: Gaziköy, Turkey

The most important features of rural settlements are the fertile agricultural lands satisfying needs of people, the connections with the regional transportation network and proximity to natural resources such as water and fresh air. These features are important for the continuation of rural life and Gazikoy, which is known as Ganos in ancient period, has always been a rural settlement since antiquity because of them. Throughout time, Gaziköy (Ganos) in Thrace was inhabited by different cultures. The inhabitation in the village continued all through the Hellenistic, Roman, Byzantine and Ottoman periods. The Gaziköy (Ganos) which had a Rum (Ottoman-Greek) population in Ottoman period was subject to population exchange at the beginning of Turkish Republic; as a result of which the Turks living in Greece and Bulgaria were replaced with the Greeks living in Anatolia with the agreement between Turkey and Greece. Despite the change of population in early republican period, the rural life has always continued in Gaziköy, due to the fact that the land is very fertile. However, as there are archaeological remains in the area as a result of continuous inhabitancy, there are restrictions for new interventions. Villagers who deal with agricultural activities are not allowed to make any interventions to adapt the traditional houses and infrastructure. As a result of the lack of maintenance and repair, traditional buildings are being damaged in Gaziköy day by day. Although this situation forces the villagers to leave the village, the villagers resist to stay in the area due to continuity of agricultural activities. The problem of conservation in Gaziköy (Ganos) is to protect all layers of the multi-layered rural landscape while providing the continuity of the rural life. The responses provided to solve these problems focus on the preservation of both of archaeological remains and traditional buildings dating back to late 19th century, the continuation of rural life and agricultural production contrary to strict conservation policies emphasising only the preservation archaeological layer

The Significance of Serum C-Reactive Protein and Neutrophil–Lymphocyte Ratio in Predicting the Diagnostic Outcomes of Renal Mass Biopsy Procedure

This study aimed to investigate the predictive role of serum C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) on renal mass biopsy outcomes. A total of 71 patients with suspected kidney masses who underwent renal mass biopsy procedure between January 2017 and January 2021 were retrospectively evaluated. Pathological results after the procedure were obtained and pre-procedural serum CRP and NLR levels were extracted from the patients’ data. The patients were grouped into benign and malignant pathology groups according to the histopathology results. The parameters were compared between the groups. Diagnostic role of the parameters in terms of sensitivity, specificity, and positive and negative predictive values was also determined. Additionally, Pearson correlation analysis, and univariate and multivariate cox proportional hazard regression analyses were also performed to investigate the above association with tumor diameter and pathology results, respectively. At the end of the analyses, a total of 60 patients had malignant pathology on histopathological investigations of the mass biopsy specimens, whereas the remaining 11 patients had a benign pathological diagnosis. Significantly higher CRP and NLR levels were detected in the malignant pathology group. The parameters positively correlated with the malignant mass diameter, as well. Serum CRP and NLR determined the malignant masses before the biopsy with sensitivity and specificity of 76.6 and 81.8%, and 88.3 and 45.4%, respectively. Moreover, univariate and multivariate analyses showed that serum CRP level had a significant predictive value for malignant pathology (HR: 0.998, 95% CI: 0.940–0.967, P < 0.001 and HR: 0.951, 95% CI: 0.936–0.966, P < 0.001, respectively). In conclusion, serum CRP and NLR levels were significantly different in patients with malignant pathology after renal mass biopsy compared to the patients with benign pathology. Serum CRP level, in particular, diagnosed malignant pathologies with acceptable sensitivity and specificity values. Additionally, it had a substantial predictive role in determining the malign masses prior the biopsy. Therefore, pre-biopsy serum CRP and NLR levels may be used to predict the diagnostic outcomes of renal mass biopsy in clinical practice. Further studies with larger cohorts can prove our findings in the future

Why Rudolph's nose is red: Observational study

Objective: To characterise the functional morphology of the nasal microcirculation in humans in comparison with reindeer as a means of testing the hypothesis that the luminous red nose of Rudolph, one of the most well known reindeer pulling Santa Claus's sleigh, is due to the presence of a highly dense and rich nasal microcirculation. Design: Observational study. Setting: Tromsø, Norway (near the North Pole), and Amsterdam, the Netherlands. Participants: Five healthy human volunteers, two adult reindeer, and a patient with grade 3 nasal polyposis. Main outcome measures: Architecture of the microvasculature of the nasal septal mucosa and head of the inferior turbinates, kinetics of red blood cells, and real time reactivity of the microcirculation to topical medicines. Results: Similarities between human and reindeer nasal microcirculation were uncovered. Hairpin-like capillaries in the reindeers' nasal septal mucosa were rich in red blood cells, with a perfused vessel density of 20 (SD 0.7) mm/mm2. Scattered crypt or gland-like structures surrounded by capillaries containing flowing red blood cells were found in human and reindeer noses. In a healthy volunteer, nasal microvascular reactivity was demonstrated by the application of a local anaesthetic with vasoconstrictor activity, which resulted in direct cessation of capillary blood flow. Abnormal microvasculature was observed in the patient with nasal polyposis. Conclusions: The nasal microcirculation of reindeer is richly vascularised, with a vascular density 25% higher than that in humans. These results highlight the intrinsic physiological properties of Rudolph's legendary luminous red nose, which help to protect it from freezing during sleigh rides and to regulate the temperature of the reindeer's brain, factors essential for flying reindeer pulling Santa Claus's sleigh under extreme temperatures

A multidisciplinary approach to address climate-resilience, conservation and comfort in traditional architecture: The PROT3CT example

Traditional dwellings despite their environmental credentials, due to age, previous damage, and residents unable to afford even the limited maintenance allowed by restrictive legal framework, may offer poor thermal performance, which is expected to be further exacerbated by changing climate. More than 70% of Turkey’s built heritage stock is composed of traditional dwellings, which makes this stock able to create a major impact nationally on the building-related energy use, carbon emissions and population wellbeing. This research aims to develop an evidence-based multidisciplinary methodology for cost-effective retrofit of the traditional dwellings in Turkey, to improve energy performance, satisfy user expectations of comfort, and protect heritage value

Collecting system percutaneous access using real-time tracking sensors : first pig model in vivo experience

PURPOSE: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. MATERIALS AND METHODS: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. RESULTS: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p=0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p=0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. CONCLUSIONS: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques.Supported by the Foundation for Science and Technology-Portugal Fellowships SFRH/BD/ 74276/2010 and SFRH/BPD/46851/2008, and Foundation for Science and Technology-Portugal Research and Development Projects PTDC/SAUBEB/ 103368/2008 and PTDC/SAU-OSM/105578/2008 FCOMP-01-0124-FEDER-011363

Changes in labial capillary density on ascent to and descent from high altitude

Present knowledge of how the microcirculation is altered by prolonged exposure to hypoxia at high altitude is incomplete and modification of existing analytical techniques may improve our knowledge considerably. We set out to use a novel simplified method of measuring in vivo capillary density during an expedition to high altitude using a CytoCam incident dark field imaging video-microscope. The simplified method of data capture involved recording one-second images of the mucosal surface of the inner lip to reveal data about microvasculature density in ten individuals. This was done on ascent to, and descent from, high altitude. Analysis was conducted offline by two independent investigators blinded to the participant identity, testing conditions and the imaging site. Additionally we monitored haemoglobin concentration and haematocrit data to see if we could support or refute mechanisms of altered density relating to vessel recruitment. Repeated sets of paired values were compared using Kruskall Wallis Analysis of Variance tests, whilst comparisons of values between sites was by related samples Wilcoxon Signed Rank Test. Correlation between different variables was performed using Spearman’s rank correlation coefficient, and concordance between analysing investigators using intra-class correlation coefficient. There was a significant increase in capillary density from London on ascent to high altitude; median capillaries per field of view area increased from 22.8 to 25.3 (p=0.021). There was a further increase in vessel density during the six weeks spent at altitude (25.3 to 32.5, p=0.017). Moreover, vessel density remained high on descent to Kathmandu (31.0 capillaries per field of view area), despite a significant decrease in haemoglobin concentration and haematocrit. Using a simplified technique, we have demonstrated an increase in capillary density on early and sustained exposure to hypobaric hypoxia at thigh altitude, and that this remains elevated on descent to normoxia. The technique is simple, reliable and reproducible

Monitoring of the Sublingual Microcirculation During Cardiac Surgery:Current Knowledge and Future Directions

Handheld vital microscopes allow for direct observation of the sublingual microcirculatory perfusion during cardiac surgery. Through the use of handheld vital microscopes, it has been shown that cardiac surgery with cardiopulmonary bypass is associated with reduced and heterogenous microcirculatory perfusion. Microcirculatory impairment can result in inadequate tissue perfusion, leading to perioperative complications and poor outcome. Because microcirculatory impairment can occur despite stable or improved global hemodynamics, there is a yet unmet need for specific monitoring of the microcirculation. Technological advancements may facilitate point-of-care monitoring of microcirculatory perfusion using automated real-time analysis of microcirculatory measurements. Thus, microcirculatory monitoring may create new opportunities for specific microcirculatory treatment as part of hemodynamic management. The implementation of microcirculatory variables into personalized treatment concepts has the potential to improve hemodynamic management during cardiac surgery and thereby improve patient outcomes. Therefore, specific treatment strategies need to be developed to prevent or treat alterations of the microcirculatory perfusion. In the future, the use of handheld vital microscopes for microcirculatory monitoring may help to improve hemodynamic management and outcomes for patients undergoing cardiac surgical procedures