Mersin City-Lab: Co-creative and participatory design approach for a circular neighbourhood

While environmental, economical and social challenges that the world has been facing recently are increasing dramatically; cities have played critical role in generation many of these problems like negative impacts on environment and overconsumption of resources. Most of the cities today face severe sustainability challenges including sanitation, air pollution, environmental degradation, over population and lack of livability. However, cities may also raise answers to find solutions against many of such complex urban problems, since they are assumed as creative and innovative platforms for social ecosystem of ideas. In this sense, there is increasing interest in ‘City Laboratories’ or ‘Urban Living Labs’, which are established to provide creative experimental platforms with participation of city actors to discuss urban sustainability issues before implementation of deep and structural urban changes for citizens. They provide participatory, co-creative and experimental platforms for self-organizing cities. The aim of this paper is to discuss a collaborative City Laboratory approach -Mersin City Lab- to achieve sustainability principles during urban regeneration process for the selected case-study area located in Mersin. Mersin City Lab focuses on two aspects: Firstly, ‘City Lab’ approach, involves citizens and stakeholders into decision-making process. Secondly, it  focuses on urban transformation process with circularity principles including water, mobility, energy, waste management, food and circular economy to achieve sustainable neighborhood development. The paper starts with introduction of ‘city-gaming’ methodology which has been adopted as the main structure of participation of multi-stakeholders. It continues with discussions on stages of the case-study project through implementation of workshops and game sessions by participation of multi stake-holders. Following, the results gathered from overall evaluations of participants’ proposals regarding land-use, mobility and urban water management, local economy, urban development, urban agriculture and food strategies in neighborhood level are discussed. Finally, the paper concludes with impacts of City Labs approach and city-gaming methodology on decision-making process for real urban problems and urban settings

Pulmonary echinococcosis mimicking multipl lung metastasis of breast cancer: The role of fluoro-deoxy-glucose positron emission tomography

<p>Abstract</p> <p>Background</p> <p>Echinococcosis is still a serious problem particularly in endemic areas such as South and Central America, Mediterranean countries, and Russia. Furthermore, hydatid cysts of the lung are often indistinguishable from a variety of other pulmonary lesions such as lung tumors</p> <p>Case presentation</p> <p>We herein present a 56 year old woman with breast cancer who presented with bilateral pulmonary nodules due to echinococcosis granulosis that mimicked metastatic breast cancer to the lung.</p> <p>Conclusion</p> <p>During the evaluation of the malignancies which could metastasize to the lung, it must be kept in mind that the appearance of bilateral multiple pulmonary masses can also be the sign of a pulmonary echinococcosis especially in endemic areas. FDG-PET with its known high negative predictive value in characterizing indeterminate pulmonary nodules >1 cm is very helpful to characterize this kind of lesions.</p

Effect of Pterygium Surgery on Tear Osmolarity

Purpose. To investigate changes of dry eye test results in patients who underwent pterygium surgery. Methods. Seventy-four patients who underwent primary pterygium surgery were enrolled in this study. At the baseline, 3-, 12-, and 18-month visits, measurements of tear osmolarity, BUT, and Schirmer test were performed. The patients were divided into 2 groups: Group 1, which consisted of patients in whom pterygium did not recur, and Group 2, which consisted of patients in whom pterygium recurred after surgery. Results. The patients in Group 1 had lower tear osmolarity levels after surgery than those at baseline (all P0.05). Conclusions. Anormal tear film function associated with pterygium. Pterygium excision improved tear osmolarity and tear film function. However, tear osmolarity deteriorated again with the recurrence of pterygium

Investigation of the Pathogenesis and Treatment Efficiency of Bevacizumab-Induced Hypertension in the Rat Model

Bevacizumab is known to reduce Vascular Endothelial Growth Factor (VEGF) to undetectable levels when used in conjunction with chemotherapy. Hypertension is a frequent adverse effect of bevacizumab, although its mechanism(s) remain unclear. In this study, our aim was to examine the pathogenesis of bevacizumab-induced hypertension and to investigate the treatment efficacy of valsartan. A total of 24 Wistar Albino female rats were included in the study. Rats were divided into three groups with 8 rats in each, as follows: The control group, bevacizumab group and bevacizumab + valsartan group. Blood pressure, blood urea nitrogen and serum creatinine levels were measured, urine samples were collected for 24 hours statistical analyses were performed using IBM SPSS 20 software pack. Nephrectomy specimens in bevacizumab and bevacizumab + valsartan groups exhibited varying degrees of renal injury. Although valsartan was able to reduce the bevacizumab-induced rise in blood pressure, it could not prevent the development of nephropathy. Conclusions these findings suggest that hypertension occurring secondary to bevacizumab treatment in rats may be associated with mechanisms involving renal injury

Persistent High Postoperative Carcinoembryonic Antigen in Colorectal Cancer Patients- Is it Important?

INTRODUCTION: Evaluation of pre- and postoperative serum CEA levels together has seldom been assessed for the prognosis of colorectal cancer (CRC). OBJECTIVE: To concurrently evaluate pre- and postoperative CEA as factors of relapse and survival. METHODS: The study consisted of 114 patients who had undergone surgery from February 2002 to June 2006 for CRC. All patients were classified into four groups according to their pre- and postoperative CEA levels. Data obtained for clinicopathologic parameters, lymph node metastasis, stage, recurrence, and CEA levels were analyzed to determine their association with survival. Multivariate analysis by the Cox proportional hazard regression model was performed to identify the independent prognostic factors associated with survival. RESULTS: Postoperative serum CEA levels remained high in Group 3 (n = 32). Nineteen patients (59.3%) demonstrated a detectable cause for persistent high CEA levels, while the reasons for those in the other thirteen patients (40.6%) remained obscure. Abnormal preoperative CEA levels significantly correlated with the depth of tumor invasion, lymph node metastasis, TNM stage, and recurrence (p < 0.05). Abnormal postoperative CEA levels were significantly related to the depth of tumor invasion, TNM stage, and postoperative relapse (p<0.05). Patients in Group 3 demonstrated the worst survival rate. Abnormal postoperative CEA levels, lymph node metastasis, and location of the tumor were independent prognostic factors for survival. CONCLUSION: The survival of patients with high postoperative CEA levels due to unknown reasons may be extended if they are exhaustively tested with sensitive diagnostic methods and treated at an early stage

The effects of intrauterine device on cervico-vaginal smears with liquid-based cytology technique: A North-Eastern Anatolia region study in Turkey

Intrauterine device (IUD), is one of the most efficient methods of contraception. The aim of study to investigate the effects of intrauterine device in cervicovaginal smears with liquid based cytology technique in our patient population. Cervicovaginal smears of 5492 patients who sought the services of the pathology department in a sixmonth period were reviewed retrospectively. Samples were prepared with liquid based cytology technique. The patients using IUD as contraceptive method (n= 562 cases) were included in the study. The samples taken with the conventional method were excluded from the study. The results were categorized according to the Bethesda system. The age range of the patients was 18-61 years (mean age: 34.6). The most common diagnosis was “negative for intraepithelial lesion or malignancy” (97.2%). In 307 patients (54.6%) there were infection and only in 93 out of them (30.2%) a specific agent was detected. Actinomyces (11%) were recorded as the most common infectious agent, followed by Gardnerella vaginalis (2.8%) and Candida species (2.4%). There were reactive changes in 134 cases (23.8%). In 13 cases (2.3%) epithelial cell abnormalities were detected. The most common cytopathologic diagnosis was ASC-US (atypical squamous cells of undetermined significance) in patients who had epithelial cell abnormalities (2.1%). In conclusion, IUDs increase the frequency of genital infection by disrupting the genital flora. In our study the most frequent agent was Actinomyces, and this rate was higher than some studies. This high rate for Actinomyces may be associated with IUDs that are frequently used for contraception in Erzurum province with long term uses

Increased mean platelet volume associated with extent of slow coronary flow

Background: Slow coronary flow (SCF) is characterized by delayed opacification of epicardial coronary vessels. SCF can cause ischemia and sudden cardiac death. We investigated the association between presence and extent of SCF, and cardiovascular risk factors and hematologic indices. Methods: In this study, 2467 patients who received coronary angiography for suspected or known ischemic heart disease were retrospectively evaluated between April 2009 and November 2010. Following the application of exclusion criteria, our study population consisted of 57 SCF patients (experimental group) and 90 patients with age- and gender-matched subjects who proved to have normal coronary angiograms (control group). Baseline hematologic indices were measured by the automated complete blood count (CBC) analysis. The groups were evaluated for cardiovascular risk factors and medications. Patients were categorized based on the angiographic findings of vessels with or without SCF. Moreover, patients with SCF were divided into subgroups relative to the extent of SCF. Results: Among the 147 patients (mean age 52.7 &#177; 10.0, 53.7% male), mean platelet volume (MPV) ranged from 6.5 fL to 11.7 fL (median 7.9 fL, mean 8.1 &#177; 0.8 fL). Diabetes (OR = 3.64, 95% CI 1.15&#8211;10.43, p = 0.03), hypercholesterolemia (OR = 4.94, 95% CI 1.99&#8211;12.21, p = 0.001), smoking (OR = 3.54, 95% CI 1.43&#8211;8.72, p = 0.006), hemoglobin (OR = 1.69, 95% CI 1.22&#8211;2.36, p = 0.002), and MPV (OR = 2.52, 95% CI 1.43&#8211;4.44, p = 0.001) were found to be the independent correlates of SCF presence. Only MPV (OR = 2.13, 95% CI 1.05&#8211;4.33, p = 0.03) was identified as an independent correlate of extent of SCF. Conclusions: Elevated baseline MPV value was found to be an independent predictor of the presence and extent of SCF

Navigating exodus: understanding the migration dynamics of health care professionals from Turkey

Objectives: We aimed to determine the reasons for the emigration of health workers who left Turkey and the difficulties experienced before and after the migration. Methods: This is an exploratory qualitative study of open-text fields focusing on migrant health workers from Turkey. Answers given to five open-ended questions directed to the participants in our survey, with 513 participants between April and June 2022, were used. Data were analyzed following content analysis. Results: A total of 506 responses were analyzed. The mean age of the participants was 39.9 ± 8.8 years (54.2% men, 77.5% medical doctors). Almost all participants reported that the political atmosphere in Turkey forced them to migrate. Some participants were unable to do their jobs due to the increasing violence in the health system in recent years. Most participants saw migration as the only way out, as they did not feel free and safe. Comparatively, they were in a better economic situation in Turkey and had a higher standard of living. Conclusion: Migration creates a sense of security while at the same time accepting a lower standard of living. To organize the sustainable migration of professionals, it is beneficial to ask what framework conditions need to be created and to access the labor market in particular

The epidemiology, Clinical Manifestations, radiology, microbiology, treatment, and prognosis of echinococcosis: Results of NENEHATUN study

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 +/- 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important

Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever - a randomized controlled noninferiority trial

Background: In this study, we examined the efficacy and safety of a once-daily dosage schema of colchicine compared with a twice-daily dosage schema in pediatric patients with familial Mediterranean fever (FMF). Methods: In this 24-week, multicenter, randomized controlled noninferiority trial, pediatric patients newly diagnosed with FMF carrying a homozygous or compound heterozygous mutation and not receiving any treatment were included. Patients were randomly assigned using a block randomization method to receive treatment with a once- or twice-daily dosage. Clinical and laboratory characteristics and medication side effects were recorded and compared between groups. The study was carried out in compliance with Good Clinical Practice and the Consolidated Standards for Reporting of Trials (CONSORT) statement. Results: A total of 92 patients were selected, and 79 patients completed the study. There were 42 patients in the once-daily dosage group and 37 in the twice-daily dosage group. The results indicated that the once-daily dosage was not inferior to the twice-daily dosage regarding decrease in attack frequency and duration as well as improvement in clinical findings and Mor severity scores. Alterations in laboratory findings indicating inflammation, such as erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A, were similar in both groups. The rates of drug side effects were similar between the once- and twice-daily dosage groups, implying comparable safety of colchicine, with the exception of diarrhea, which was slightly higher in the once-daily dosage group. Conclusions: Using colchicine with either a once- or twice-daily dosage provides similar clinical and laboratory improvements. Considering both efficacy and safety, colchicine can be prescribed with a once-daily dosage. Trial Registration ID: ClinicalTrials.gov identifier NCT02602028. Registered 5 November 2015