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Davranışsal Coğrafyada Değişen Kentsel Mekan Algısı: Deprem Kentleri Örneği
No full textBu çalışmanın amacı, Şubat 2023 depremleri nedeniyle yıkımların en fazla yaşandığı Adıyaman, Kahramanmaraş, Malatya ve Antakya’da kentsel mekân algısını ortaya koymaktır. Nitel araştırma yönteminin kullanıldığı çalışmada bu dört kentin sakinlerinin sosyal medyada yaptıkları toplam 346 yorum içerik yönünden incelenmiştir. Yorumların sistematik olarak analiz edilmesi için literatürde geçen kent imgesi tipolojileri doküman analizine tabi tutulmuştur. Çalışmada, akademik çevrelerce yaygın bir şekilde kabul gören Lynch (1960)’ın tipolojisi kullanılmıştır. Elde edilen bulgulara göre; kesimler ve nirengi noktalarının kentsel mekân algısında daha fazla ön plana çıktığı, kenarlar ve kavşakların ise aynı öneme sahip olmadığı görülmüştür. Araştırmalar neticesinde Lynch tipolojisini kullanan akademik çalışmalarda kent imgeleri üzerinden ortaya konulan literatür bulgularının bu çalışmanın bulgularıyla genel olarak uyumlu olduğu anlaşılmıştır. Daha da önemlisi, araştırmadan elde edilen başlıca çıkarımların Lynch'in teorisinin dijital çağdaki geçerliliğini de desteklediği söylenebilir. Çalışmanın son bölümünde, özellikle depremlerle yıkılmış kentlerin dirençli ve sürdürülebilir olabilmeleri için kentsel hafızanın özenle korunması gerektiği vurgulanmıştır.</p
Association Between Major Bleeding and In-Hospital Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention in Acute Coronary Syndromes
No full textBackground Major bleeding (MB) is a serious complication in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Although its association with long-term adverse outcomes is well documented, the impact of in-hospital MB on early cardiovascular prognosis remains incompletely characterized. Objective To investigate the association between in-hospital MB and major adverse cardiovascular events (MACE) in patients with ACS treated with PCI. Methods We conducted a retrospective cohort study on 829 consecutive ACS patients who underwent successful PCI between January 2021 and December 2023. MB was defined as Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding events. MACE was defined as a composite of all-cause mortality, recurrent myocardial infarction, ischemic stroke, urgent target vessel revascularization, or new-onset/decompensated heart failure with left ventricular ejection fraction (LVEF) <30%. Clinical data and outcomes were extracted from hospital records and independently adjudicated. Results MB occurred in 4.5% of patients (n = 37). The incidence of in-hospital MACE was significantly higher among patients with MB compared to those without (40.5% vs. 8.1%, p < 0.001). In multivariate logistic regression, MB was the strongest independent predictor of in-hospital MACE (OR: 12.43, 95% CI: 3.43-44.98, p < 0.001), followed by reduced LVEF (OR per % increase: 0.794, 95% CI: 0.747-0.843, p < 0.001), age, and white blood cell count. Conclusions In-hospital MB is a potent and independent predictor of early MACE in patients with ACS undergoing PCI. These findings emphasize the need for careful risk stratification, bleeding prevention strategies, and individualized antithrombotic management in this high-risk population
Evaluation of Clinical and Laboratory Findings at Admission in Diabetic Patients with Acute Invasive Fungal Rhinosinusitis
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Analyzing emergency department presentations linked to secondary earthquake effects
No full textObjective: The earthquakes that struck Türkiye on February 6, 2023, significantly impacted the province of Hatay. A portion of the patients presenting to emergency departments (ED) following the earthquake were exposed to secondary effects without experiencing direct physical trauma. This study aims to evaluate the demographic, clinical, and psychosocial characteristics of patients presenting to the ED during the early post-earthquake period due to secondary effects, as well as to examine the challenges encountered during this process. Methods: This cross-sectional case study was conducted at the only tertiary healthcare center in Hatay that continued patient care after the earthquake. Data were collected between February 6, 2023, and February 27, 2023. Patients aged 18 and older who did not experience direct physical trauma during the earthquake were included in the study. Results: A total of 1257 patients were included in the study. The median age was 41 (IQR 29–58), with 52.7 % male and 47.3 % female. Most patients were Turkish (62.5 %) and 37.5 % were Syrian. Chronic diseases worsened or a new symptom emerged in 30.5 % of the patients, medication loss (24.8 %), and psychosocial complaints (25.1 %) were the leading reasons for ED visits. The majority were triaged as green (83.1 %), followed by yellow (11.1 %) and red (5.8 %). Most patients presented on the 2nd day (252 patients) and 1st day (198 patients), with a gradual decrease in visits over the following weeks. Among the discharged patients (89.4 %), the median length of stay was 45 min (IQR 20–90). A significant shift in triage levels was observed between 2022 and 2023 (p < 0.001), with a higher proportion of green triage patients in 2023. Conclusion: Patients affected by secondary health impacts began presenting to the ED shortly after the earthquake, with many requiring medical treatment, hospitalization, or referral. The most common reasons for ED visits were disruptions in access to medical supplies and the exacerbation of chronic diseases
Water kefir-assisted fermentation improved quality of plant-based cheese alternative comparable with cow's milk cheese by reducing plant-origin odor and enhancing cheese-like flavours
No full textThe growing human population in the world has led to a global food shortage and the environmental impact of animal food production is declared in various platforms. The challenges for animal breeding and the limited availability of dairy products have increased the search for alternatives to traditional cheese and other dairy products. In addition, the rising popularity of vegan diets has increased interest in plant-based food alternatives. However, these plant-based products have some limitations, especially having some difficulties to achieving the texture and flavours of dairy counterparts. This study aims to improve the cheese-like flavour of a plant-based cheese alternative (PCA) by incorporating water kefir into the product. The microbiota presents in the water kefir induced biochemical changes and altered the composition of volatiles in PCA. The addition of water kefir led to an increased level of organic acids in the PCA. Significant changes in key organic acids, relevant to cheese production, such as lactic and propionic acids, were observed during storage. In water kefir-free PCA, all free amino acids (FAAs) steadily decreased throughout storage, whereas in the water kefir-treated sample, many FAAs initially decreased and then increased at 60 days. Plant-origin compounds like benzaldehyde, responsible for apricot kernel odor, and green aldehydes associated with off-flavours, declined after 60 days. Meanwhile, compounds important for cheese flavour-e.g., ethanol, acetaldehyde, 3-methylbutanol, and ethyl acetate-increased. These findings suggest that water kefir can effectively improve the flavour of PCA
