Exploring Identity Issues in Development Areas of Vernacular Rural Settlements: A Case Study of Behramkale, Türkiye

Sustainable rural development is a challenging issue, considering the pressure of change brought by the demands of globalisation and intensified tourism activities in rural vernacular settlements. While studies in this field often focus on historical centres, research on the distinctive urban and architectural identity of “village development areas” in rural vernacular settlements remains scarce. To address this gap in the literature, a field study was conducted in the vernacular rural settlement of Behramkale, located in the Northern Aegean region of Türkiye. The study explored the continuity of architectural and urban identity and its significance. The research involved a qualitative assessment of primary data obtained through architectural surveys and archival documents collected in 2017 and 2021. Data analysis not only focused on static features of place identity but included dynamic and perceptual features of place identity. Planning policy inadequacies and the implications of top-down decisions on vernacular rural Türkiye are discussed. The key finding from the study highlights the necessity for a more participatory and site-specific approach to preserving vernacular rural heritage’s urban and architectural identity for sustainable development. In this regard, the paper proposes that an identity-based and people-centred approach should be integrated into the policies for the development areas of vernacular rural settlements. This integration aims to preserve the local architectural identity and promote a belongingness community among residents

Shoulder problems and related conditions in patients with implantable cardioverter defibrillators

Aim: Shoulder pain and disability is a complication that can be seen frequently after implantable cardioverter defibrillator (ICD) implantation. The aims of this study were to determine the causes of shoulder problems and related factors in patients with ICD implantation and to investigate the effects of shoulder problems on quality of life and psychological status. Material and Methods: A total of ninety-four consecutive patients (average age 59.38±10.75 years) who admitted to ICD follow up clinic were included in the study. Patients who had shoulder problems were referred to our physical therapy and rehabilitation outpatient clinic for further evaluation. The Shoulder Pain and Disability Index (SPADI), Short Form-36 (SF-36) and The Hospital Anxiety and Depression Scale (HADS) were used as the clinical assessment scales. Results: Thirty-nine (41.5%) patients had shoulder complaints. The patients were divided into two groups according to presence of shoulder problem. The statistical analysis revealed no significant differences between the groups in terms of the socio-demographic and clinical characteristics. None of these characteristics was demonstrated as a risk factor for the development of shoulder problem (p>0.05). There were significantly lower SF-36 subgroup scores and higher HADS depression and anxiety scores in patients with shoulder complaints. The SPADI scores also showed significant correlations with shoulder pain VAS score, several subgroups of SF-36 and HADS scores (p<0.05). Conclusion: Our study revealed that patients with shoulder complications had decreased quality of life and deteriorated psychological status. In patients with ICD, awareness should be increased in terms of shoulder problems and appropriate management strategies should be determined

Oral antibiotic prophylaxis in elective cesarean deliveries: pilot analysis in tertiary Care Hospital

Introduction: Puerperal infection remains a significant cause of maternal morbidity and mortal ity. Those infections occur more likely after cesarean delivery (CD). Prophylactic antibiotics are administered at the time of CD to prevent complications. In addition to intraoperative prophy laxis; prescription of antibiotics during hospital discharge to prevent surgical site infections (SSI) is quite common. Purpose of this study is to determine the utility of prophylactic oral antibiotic prescription in a cohort of low-risk women undergoing CD. Materials and methods: A prospective observational study was conducted between 2014 and 2018 at Ufuk University School of Medicine, Department of Obstetrics and Gynaecology. Total of 389 low risk elective cesarean deliveries were selected. All cases received intraoperative prophy laxis. In group I (157 subjects), no further antibiotics were given and in group II (232 cases), oral cephuroxime 500 mg was given during hospital discharge. Primary outcome was SSI. Secondary outcomes were endometritis and other infectious conditions. Results: Overall SSI rate was 2.5%. Only 2 SSIs were noted in group 1 (1.2%) compared to eight in group II (3.4%). There was no statistical difference in SSI rate between two groups. Secondary outcomes were also comparable. Conclusion: In this study, we failed to reveal any beneficial effect of oral antibiotic prescription during hospital discharge in low risk elective CDs. Therefore, use of oral antibiotics in addition to intraoperative prophylaxis should be questioned in terms of increased costs, emergence of bacterial resistance and long term effects on new born as a consequence of changes in gut microbiom

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

The Definition and Cancellation Conditions of Protected Geographical Indications and Protected Designations of Origin According to the Regulation (EU) No 1151/2012 of the European Parliament of the Council of 21 November 2012 on Quality Schemes for Agricultural Products and Foodstuffs

Geographical indications and designations of origin on agricultural products and foodstuffs are protected according to the Regulation (EU) No 1151/2012 (Regulation). The definitions of geographical indications, designations of origin and the cancellation conditions of protected geographical indications and protected designations of origin are one of the controversial issues of the recent regulation. The aim of the paper is to analyze the definition of geographical indications and designations of origin and the cancellation conditions of protected geographical indications and protected designations of origin. The conclusion is composed of ideas and recommendations about the definition and cancellation of protected designations of origin and protected geographical indications

Protection of geographical indications: The legal framework in European Union and practice in Turkey

Bu çalışma uluslararası sözleşmelerde, Avrupa Birliği ve Türk Hukukunda coğrafi işaretlerin korunması ile ilgilidir. Dünyada yıllık yaklaşık 3 milyar Dolar değerinde coğrafi işaret tescilli ürünün ticaretinin yapıldığı dikkate alınırsa coğrafi işaretlerin korunmasının ne kadar önemli olduğu anlaşılmaktadır.Ülkeler çoğunlukla ekonomik çıkarları doğrultusunda coğrafi işaretlerin korunması ile ilgili farklı tutumlara sahiptir. Avrupa Birliği coğrafi işaretlerin korunmasını desteklerken Amerika Birleşik Devletleri gibi tarım sektörüne kültürel bağı az olan ülkeler coğrafi işaret konseptine kuşku ile yaklaşmaktadır. Coğrafi işaretlerle ilgili birçok tartışma yapılmaktadır. Her ne kadar TRIPs Sözleşmesi terimi tanımlayarak ve bazı ortak standartlar oluşturarak bazı sorunları çözse de konuyla ilgili yapılması gereken çok çalışma bulunmaktadır. Bu çalışma ile dünyada uzun yıllardan beri üzerinde tartışılmakta olan bu konuya dikkat çekmek ve Avrupa Birliği üyeliğine aday olan ülkemizin mevzuatı ile Avrupa Birliği Mevzuatını karşılaştırıp Türkiye'de mevzuat ve uygulama anlamında yapılanları, yapılması gerekenleri belirleyip eksiklikler hususunda öneriler geliştirmek amaçlanmaktadırThis thesis addresses the legal protection of geographical indications in international conventions, European Union Law and Turkish Law.When we consider the annual 3 billion Dolar amount of trade of geographical indication products in the world the importance of the protection of geographical indications can be understood. Countries have different attitudes towards the protection of geographical indications depending to a large degree on their economic interests. The European Union supports the protection of geographical indications where as countries with less strong cultural traditions in the agricultural sector are sceptical to the concept of geographical indications like The United States. A great deal of controversy surrounds geographical indications. Although the TRIPs Agreement has solved some issues by defining the concept and trying to establish some common standards, there is much to do. The aim of the thesis is to attract attention to this hotly debated topic and to compare the Turkish law and European Union Law about geographical indications to determine the negatif and positif aspects of Turkish legislation about geographical indications and to provide suggestions about the defects of Turkish practice and legislation about geographical indications

European Union’s solutions to domain names on the internet

İnternetin gelişmesiyle birlikte alan isimleri teknik özelliklerinden daha çok tanıtıcı fonksiyonlarıyla gündeme gelmişlerdir.Bu çalışmanın amacı marka hukuku ve alan isimleri arasında yaşanan problemleri araştırmaktı.Marka sahipleri markalarını daha önceleri geleneksel marka hukuku kuralları,haksız rekabet kurallarıyla koruyabilmekteydiler.İnternetin ve teknolojinin gelişmesiyle birlikte bu konudaki hukuki çalışmalar yetersiz ve statik kalmıştır.Marka sahiplerinin siber ortamda haklarını koruyabilmek için bir çok ulusal ve uluslararası çalışmalar yapılmıştır.Yeknesak Uyuşmazlık Çözüm Mekanizması bu çalışmaların başında gelmektedir.Diğer taraftan her ülke kendi ulusal mevzuatını internet alan isimleri ve markalar arasında yaşanan problemleri çözmek için değiştirmeye ve uyumlaştırmaya başlamıştır.Bu çalışmalar marka sahiplerinin haklarını belli bir dereceye kadar koruyabilmektedir.Devletler, her ne kadar İnternet ortamında kanun yapmak zor olsa da yaşanan bu problemleri çözmek için toplanmalı ve yeni uluslararası kurallar oluşturmalıdır.Yapılan bu reformlar markalar konusunda yaşanan problemleri azaltsa da yakın zamanda markalar ve alan isimleri arasında yaşanan sorunların tamamen ortadan kalkacağı sanılmamaktadır.İnternet eğer bu düzeyde ticarileşmeye devam ederse "alan isimleri hukuku"markalar hukukunun özel bir alanı olarak gelecekte önemini koruyacaktır. As the Internet has been developed domain names have become more important for their technical functions but also for their identification functions.The purpose of this study is to examinetrademark and domain name problems seen in the newly devoloping Internet law.In the past trademark owners protected their trademarks using traditional trademark legislations or unfair competition rules.However as the Internet and technology started to grow faster,legal arrangements about these issues remained static and insufficient.Many national and international improvements have been made to protect trademark owners' rights in the cyberspace.Uniform Dispute Resolution Mechanism is on of the leading improvements about this matter.On the other side each country started to implement its own national legislation to solve these problems.These applications protect trademark owners' rights to some extent.The International Community must gather to solve their problems and diffrences about Internet domain names by creating new international norms,however,regulation is very difficult in the cyberspace.Although the intended reforms might help in minimizing some of the trademark issues,it can still not be assumed that in the near future most of the conflict situations between trademarks and domain names will fade into insignificance.If the commercialization of the Internet continues of the current pace "the law of domain names" as a specific sector of trademark law will play an important role in the future legal practice