Quantification of water requirement of some major crops under semi-arid climate in Turkey.

The Southeastern Anatolian Region of Turkey is located in semi arid climate zone and therefore requires an efficient water use. Well-planned irrigation with optimum water required by the crops is essential for the limited water resources of the region. The numerical tool CROPWAT of the Food and Agriculture Organization (FAO) was used for modelling efficient irrigation of local crops pistachio, olive, almond and grape without reducing the yield. Local climatic, soil, plant and rainfall information were used as inputs to CROPWAT model to predict the reference evapotranspiration (ETo) values. The crop water requirement (CWR) for pistachio, olive, almond, and grape was calculated as 1,294.0 mm, 659.4 mm, 790.2 mm, and 752.0 mm, respectively, The number of irrigation needed during growth stages was determined as eight for pistachio, three for olive, six for almond and five for grape.

Assessing of evapotranspiration models using limited climatic data in Southeast Anatolian Project Region of Turkey.

Evapotranspiration carries vital importance in areas with arid and semi-arid climate properties for many issues, including the planning of irrigation water as a scarce resource, the establishment of irrigation programs and conducting project design for drainage. The empirical equations used for determining plant water consumption are classified subject to the diversity of the utilized data. The Penman-Monteith method used frequently in many parts of the world as a standard method needs more climate data. Models that yield results that are similar to those of the standard method with less climate parameters are preferred due to their ease of use and wide impact. Temperature, relative humidity and radiation data for the years 2008-2017 were utilized to analyze the usability of the Hargreaves-Samani and Turc-1961 equations with regard to the estimation of reference evapotranspiration in four provinces located in Southeastern Anatolia Region. Results obtained via models were compared in pairs by way of the standard method in order to define the performance of the models. While the best performances were obtained from the comparison with the standard method and Hargreaves-Samani value pair, the comparison of the standard model with Turc displayed the lowest performance. Based on the study data, ETo-Turc values were higher in the provinces analyzed, thus displaying a lower performance. While maximum long term annual monthly average ETo-HS value was identified as 7.6 mm at Diyarbakir in July, whereas the lowest value was determined at Kilis with 5.8 mm; the highest and lowest ETo-Turc values were obtained in the same month at Diyarbakir and Kilis with 13.3 and 10.3 mm respectively. It was calculated based on the long term average annual total ETo values that while highest ETo-HS was calculated at Diyarbakir with 1,500 mm, whereas the lowest value was calculated at Batman with 1,183 mm. The highest value for ETo-Turc was obtained at Diyarbakir with 2,365 mm while Mardin had the lowest ETo value with 1,920 mm. Accordingly, based on the ETo values calculated at both cities studies based on both models, Diyarbakir had the highest values, whereas Kilis had the lowest ETo values. According to the standard method known as PM, lowest daily ETo values were calculated in all provinces, which displayed the highest performance among the models. As a result of this study, it is possible to use the Hargreaves-Samani model instead of the standard model in the absence of reliable climatic data.

Adaptive Human Force Scaling via Admittance Control for Physical Human-Robot Interaction.

The goal of this article is to design an admittance controller for a robot to adaptively change its contribution to a collaborative manipulation task executed with a human partner to improve the task performance. This has been achieved by adaptive scaling of human force based on her/his movement intention while paying attention to the requirements of different task phases. In our approach, movement intentions of human are estimated from measured human force and velocity of manipulated object, and converted to a quantitative value using a fuzzy logic scheme. This value is then utilized as a variable gain in an admittance controller to adaptively adjust the contribution of robot to the task without changing the admittance time constant. We demonstrate the benefits of the proposed approach by a pHRI experiment utilizing Fitts' reaching movement task. The results of the experiment show that there is a) an optimum admittance time constant maximizing the human force amplification and b) a desirable admittance gain profile which leads to a more effective co-manipulation in terms of overall task performance.

Does electrocardiogram help in identifying the culprit artery when angiogram shows both right and circumflex artery disease in inferior myocardial infarction?

OBJECTIVE: In a subgroup of patients with inferior myocardial infarction (MI), both the right coronary artery (RCA) and circumflex coronary artery (Cx) show potentially culprit lesions, and angiography may be insufficient to determine which artery is responsible for the clinical presentation. Although many electrocardiographic (ECG) algorithms have been proposed for identifying the infarct-related artery in patients with inferior MI, it is unclear whether the current algorithms have the discriminative power to identify the real culprit artery in these patients. METHODS: The patients with the diagnosis of acute inferior MI and underwent coronary angiography were enrolled in the study. The prediction of the infarct-related artery was attempted from the admission ECG using published algorithms and criteria. For the angiographic definition of the infarct-related artery, multiple criteria were used. RESULTS: Total 417 inferior MI cases were enrolled during the study period; the final patient population comprised of 318 patients. Forty-five patients (14.2%) had both RCA and Cx lesions on coronary angiography. Although several criteria and algorithms are able to identify the infarct-related artery in the general inferior MI population, they lose their strength in patients with both RCA and Cx lesions. Only the Aslanger-Bozbeyoglu criterion emerges as a more powerful diagnostic test with a sensitivity, specificity, and c-statistic of 80%, 48%, and 0.650, respectively for the whole population (p<0.001) and 81%, 58%, and 0.709, respectively, for patients with both RCA and Cx lesions (p=0.019). CONCLUSION: The Aslanger-Bozbeyoglu criterion is not only helpful in differentiating the infarct territory in combined inferior and anterior ST-segment elevation as previously shown, but also valuable in identifying the infarct-related artery in patients with inferior STEMI with critical lesions in both the RCA and the Cx. (Anatol J Cardiol 2020; 23: 318-23).

Stable Physical Human-Robot Interaction Using Fractional Order Admittance Control.

In the near future, humans and robots are expected to perform collaborative tasks involving physical interaction in various environments, such as homes, hospitals, and factories. Robots are good at precision, strength, and repetition, while humans are better at cognitive tasks. The concept, known as physical human-robot interaction (pHRI), takes advantage of these abilities and is highly beneficial by bringing speed, flexibility, and ergonomics to the execution of complex tasks. Current research in pHRI focuses on designing controllers and developing new methods which offer a better tradeoff between robust stability and high interaction performance. In this paper, we propose a new controller, fractional order admittance controller, for pHRI systems. The stability and transparency analyses of the new control system are performed computationally with human-in-the-loop. Impedance matching is proposed to map fractional order control parameters to integer order ones, and then the stability robustness of the system is studied analytically. Furthermore, the interaction performance is investigated experimentally through two human subject studies involving continuous contact with linear and nonlinear viscoelastic environments. The results indicate that the fractional order admittance controller can be made more robust and transparent than the integer order admittance controller and the use of fractional order term can reduce the human effort during tasks involving contact interactions with environment.

Relationship between metabolic syndrome and nodular thyroid diseases.

Nodular thyroid diseases are common in Turkey. Insulin resistance (IR) is considered as the most important component of metabolic syndrome (MetS), and it is thought to directly affect thyroid diseases, together with other components of MetS. The aim of this study was to evaluate potential factors associated with thyroid nodularity. This study was part of the prospective MELEN study. In total, randomly selected 2233 subjects were evaluated. A euthyroid subgroup of participants (n = 1432) was selected and 421 of them had MetS. Both goitres and multinodular goitres (MNGs) were significantly more common in the MetS (+) group (p < .001). Older age was the only factor that significantly affected the presence of a nodular goitre (NG) (p < .001). The presence of a MNG was associated with older age (p < .001), systolic blood pressure level (p < .008) and MetS (p < .001). There was no difference in the thyroid volume or presence of nodular thyroid diseases between the IR (+) and (-) groups. Both the thyroid volume and the presence of MNGs were significantly associated with MetS, independent of thyroid-stimulating hormone (TSH) and IR. We suggest that the individual components of MetS may influence thyroid nodularity to some degree and that together they exert a cumulative effect on the thyroid gland. As a result, in the absence of MetS, we further suggest that IR alone does not explain the increase in thyroid volume and thyroid nodule formation.

Is there a relationship between blood lipids and lumbar disc herniation in young Turkish adults?

INTRODUCTION: Atherosclerosis might diminish the nutrient supply to intervertebral discs (IVD), leading to disc herniation. Therefore, there is interest in determining the possible association between the blood lipid profile and lumbar disc herniation (LDH). We aimed to evaluate the association between blood lipids and LDH in a homogeneous group of patients, controlling for age- and sex-specific effects. MATERIAL AND METHODS: This is a case-control study which consisted of 100 individuals (mean age: 41.25 ±9.09; 50 men and 50 women), classified into two groups, as follows. Group I (G-I) consisted of 50 patients who underwent surgery for symptomatic LDH, while group II (G-II) consisted of 50 patients with nonspecific complaints of a headache, but with no previous history of back and/or leg pain, recruited among patients admitted to the outpatient clinic at the time of the study, and whose age and sex were matched to the study group. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose, and hemoglobin A1c levels were measured. The TC/HDL-C ratio was calculated. Blood pressure, waist circumference, body mass index, and the history of smoking were included in the analysis. RESULTS: The mean values of the TC, TG, LDL-C, HDL-C levels and TC/HDL-C ratio were 198.38, 132.76, 131.9, 40.38 mg/dl and 5.09, respectively. No statistically significant relationship between the blood lipid profile and LDH was identified in this population. CONCLUSIONS: Blood lipid levels in this young adult Turkish population did not predict LDH, and may not be a leading cause of IVD ischemia and IVD degeneration.

The effect of radioactive iodine treatment on 14C urea breath test results in patients with hyperthyroidism.

PURPOSE: Radioactive Iodine therapy (RAIT) plays a major role in the treatment of hyperthyroidism. In addition to the thyroid gland, significant amounts of radioactive iodine are maintained in the stomach. The aim of this study was to determine if RAIT has any effect on Helicobacter pylori infection, based on the C urea breath test (UBT). MATERIALS AND METHODS: The study included 85 patients with hyperthyroidism scheduled to undergo RAIT and 69 hyperthyroid subjects in whom methimazole treatment was planned. All subjects had pretreatment-positive UBT results, and the test was repeated on the first and third months after RAIT and methimazole treatment. RESULTS: After a mean RAIT dose of 15 mCi (range, 10-20 mCi), UBT became negative in 13 (15.3%) of 85 patients on the first month and 18 (21.2%) of 85 patients on the third month. All subjects treated with methimazole remained UBT positive on the first and third months of methimazole treatment (100%). Reduction in the number of UBT-positive patients on both the first and the third months after RAIT was statistically significant (P < 0.001). Distribution of hyperthyroidism etiologies and thyroid autoantibody levels in subjects with UBT that became negative and in subjects with UBT that remained positive were similar in the RAIT group (P > 0.05). Urea breath test negativity rates did not differ according to the radioiodine dose. CONCLUSIONS: Our findings indirectly showed that RAIT might have an antimicrobial effect on H. pylori. Clinical applications of this beneficial effect of RAIT on H. pylori should be further evaluated.

Spectrum and prevalence of nodular thyroid diseases detected by ultrasonography in the Western Black Sea region of Turkey.

OBJECTIVE: The aim of the study was to investigate thyroid diseases and the prevalence of goiter by ultrasonography (US) in a moderately iodine deficient area. MATERIAL-METHODS: The MELEN Study is a prospective cohort study on the prevalence of thyroid diseases in Turkish adults. A total of 2233 subjects with a mean age of 50 (age range 18 to 92) were submitted to study. Thyroid US was performed and interpreted by the same experienced physician. Goiter prevalence was defined according to Gutekunst's criteria. RESULTS: The most common thyroid disease was multinodular goiter (MNG) (42%), followed by nodular goiter (NG) (14.6%). The crude prevalence of nodular disease in the region was 56.6%. In the study cohort, thyrotoxicosis (TSH <0.35 µIU/ml) prevalence was 12 % and subclinical and overt hypothyroidism (TSH > 4.5 µIU/ml) prevalence was 6.5 %. CONCLUSION: We found that thyrotoxicosis and nodular thyroidal diseases are more important public health issues in moderate iodine deficient geographical areas. We recommend the increased rates of US screening especially in the endemic regions in order to detect thyroidal nodules earlier.

Carotid artery intima-media thickness and erectile dysfunction in patients with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MS) has become a pandemic in Turkey, as is the case globally. Increase in carotid artery intima-media thickness (CIMT) and erectile dysfunction (ED) may be evident before the clinical signs of cardiovascular disease appear. We aimed to investigate the prevalence of increased CIMT and ED as markers of atherosclerotic disease in patients with MS. MATERIAL AND METHODS: Thirty-two patients with MS and 29 healthy controls were included. Anthropometric and biochemical parameters, along with total testosterone (TT), high sensitive C-reactive protein (hs-CRP), were recorded. Carotid artery intima-media thickness was measured. Erectile dysfunction was assessed with International Index of Erectile Function. RESULTS: Patients with MS had higher BMI, fasting plasma glucose, post-prandial plasma glucose, insulin, HOMA-IR, total cholesterol, triglycerides, hs-CRP, and CIMT, whereas TT levels were lower (p<0.0001). The prevalence and severity of erectile dysfunction were higher in patients with MS (p<0.0001). Erectile dysfunction scores correlated inversely with CIMT. MS patients with ED were older and had higher CIMT compared to those without ED. Increase in age and HOMA and decrease in TT increased the risk of ED. When KIMT exceeding the 95th percentile of healthy controls was accepted as a risk factor for CVD, presence of ED was the only determinant for this increase. CONCLUSIONS: Erectile dysfunction was more prevalent and severe in patients with MS and correlated with subclinical endothelial dysfunction. Total testosterone deficiency was prominent among MS patients. Presence of ED points to an increased risk of cardiovascular disease when MS is present.

The frequency of malignancy and the relationship between malignancy and ultrasonographic features of thyroid nodules with indeterminate cytology.

Various approaches are available for the management of nodules that are evaluated to be indeterminate according to the results of thyroid fine needle aspiration biopsy. The present study aimed to determine the rate of malignancy and the ultrasonographic features that could be used as predictor of malignant pathologies at the nodules with indeterminate cytology. A total of 201 patients who underwent total thyroidectomy and whose fine needle aspiration biopsy results were evaluated to be Hurthle cell lesion (n = 99), follicular neoplasm (n = 61) and [corrected] suspicious for malignancy (n = 41) were enrolled in this study. Of these patients, 178 were females (88.6 %) and 23 were males (11.4 %). The rates of malignancy were found to be 33.3 % in the Hurthle cell lesion group, 23.0 % in the follicular neoplasm group and 53.7 % in the suspicious for malignancy group (p = 0.006). The comparison of the ultrasonographic characteristics of the malignant and benign nodules revealed hypoechogenicity and microcalcification to be more common in malignant nodules (34.3 vs. 16.9 %, p = 0.005; 27.1 vs. 13.1 %, p = 0.014; respectively). While 92.3 % of the malignant nodules were ≥1 cm, 82.9 % of the benign nodules were ≥1 cm (p = 0.042). We believe that as the patients at Hurthle cell lesion group have higher risk of malignancy than the patients with Follicular Neoplasia so total thyroidectomy will be suitable for these patients. [corrected]. In addition, microcalcification and hypoechoic nodules at patients with indeterminate cytology can be related with increased risk of malignancy. [corrected].

Osteoblastic metastasis from signet ring cell gastric cancer in a young male.

Bone metastasis is common in patients with lung, prostate, and breast cancers but it isn't common in stomach cancer. Gastric carcinoma infrequently metastasizes to the bone and rarely in an osteoblastic form. Herein we presented a rare case of signet ring cell gastric adenocarcinoma in early stage with osteoblastic metastasis. To our knowledge our case was the youngest signet cell gastric cancer patient with osteoblastic bone metastasis reported in literature.

Evaluation of outer hair cell function and medial olivocochlear efferent system in patients with type II diabetes mellitus.

AIM: This study was designed to investigate the function of outer hair cells and medial olivocochlear efferents in type II diabetes mellitus (DM). MATERIALS AND METHODS: There were 50 patients with type II DM and 51 age- and sex-matched healthy controls included in the study. Both groups were compared in terms of transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and contralateral suppression of TEOAE. RESULTS: Pure tone thresholds of the patients with type II DM were significantly higher than in the controls (P < 0.05). The TEOAE amplitudes at 1 kHz and at 1.5, 2, 3, 4, and 6 kHz signal-to-noise ratio amplitudes on DPOAE testing were significantly lower in the patients than controls (P < 0.05). There was no significant difference between the type II DM and control groups regarding contralateral suppression test results of TEOAEs. CONCLUSION: Type II DM seems to impact the auditory system at the cochlear level by affecting the functions of outer hair cells, and it results in elevation of the thresholds on audiometry and a decrease in the amplitudes of otoacoustic emissions.

Comparison of efficiencies of michigan neuropathy screening instrument, neurothesiometer, and electromyography for diagnosis of diabetic neuropathy.

Aim. This study compares the effectiveness of Michigan Neuropathy Screening Instrument (MNSI), neurothesiometer, and electromyography (EMG) in detecting diabetic peripheral neuropathy in patients with diabetes type 2. Materials and Methods. 106 patients with diabetes type 2 treated at the outpatient clinic of Ankara Numune Education and Research Hospital Department of Endocrinology between September 2008 and May 2009 were included in this study. Patients were evaluated by glycemic regulation tests, MNSI (questionnaire and physical examination), EMG (for detecting sensorial and motor defects in right median, ulnar, posterior tibial, and bilateral sural nerves), and neurothesiometer (for detecting alterations in cold and warm sensations as well as vibratory sensations). Results. According to the MNSI score, there was diabetic peripheral neuropathy in 34 (32.1%) patients (score ≥2.5). However, when the patients were evaluated by EMG and neurothesiometer, neurological impairments were detected in 49 (46.2%) and 79 (74.5%) patients, respectively. Conclusion. According to our findings, questionnaires and physical examination often present lower diabetic peripheral neuropathy prevalence. Hence, we recommend that in the evaluation of diabetic patients neurological tests should be used for more accurate results and thus early treatment options to prevent neuropathic complications.

Heart rate variability and heart rate recovery in patients with type 1 diabetes mellitus.

OBJECTIVE: Patients with diabetes mellitus (DM) are at an increased risk of sudden cardiac death (SCD) partly explained by cardiac autonomic neuropathy (CAN). There have been fewer studies to evaluate CAN using heart rate variability (HRV) and heart rate recovery (HRR) in patients with type 2 DM.To our knowledge, there has been no study to investigate the association between HRR, HRV and type 1 DM. The purpose of this study was to examine the changes in HRR and HRV measurements in type 1 diabetic patients. METHODS: The study population consisted of 35 consecutive patients with type 1 diabetes and 35 sex- and age-matched non-diabetic controls. We performed electrocardiography, echocardiography, Holter analysis, exercise stress test, routine biochemical tests including haemoglobin Ale, high-sensitivity C-reactive protein and evaluated the clinical characteristics. HRR was calculated by subtracting the heart rate values at the first minute of the recovery phase from the peak heart rate. Abnormal HRR was defined as HRR < or = 18 beats.The HRV analysis was performed in both time domain and frequency domain. RESULTS: In HRV analysis, type 1 diabetic patients had significantly lower time domain [SDNN (P=0.041), SDANN (P=0.016), r-MSSD (P<0.001), pNN50 (P<0.001)] and frequency domain [total power (P=0.002), VLF (P<0.001), LF (P<0.001), HF (P=0.001), LF/HF (P=0.034)] HRV parameters as compared to controls. In logistic regression analysis, the HRR (OR 0.927, 95% CI 0.872 to 0.985, P= 0.014), METs (OR 0.562, 95% CI 0.355 to 0.890, P= 0.014), pNN50 (OR 0.729, 95% CI 0.566 to 0.941, P= 0.015) and HF (OR 0.952, 95% CI 0.911 to 0.994, P= 0.027) were independently associated with type 1 DM. CONCLUSION: The results of this study showed that HRV parameters and HRR were significantly reduced in patients with type 1 versus healthy controls. We found that HRV parameters correlated with HRR in type 1 diabetic patients. There is a relationship between CAN and inflammation and also, there may be a relationship between CAN and intensive glycaemic control according to this study.

The investigation of effects of fluorosis on thyroid volume in school-age children.

AIM: To compare the urine iodine, fluoride, and to measure thyroid volumes in 10-15-year-old children using ultrasonography, a gold standard in evaluating thyroid volume. METHODS: A total of 261 children were enrolled into the study group from the 4-8th grades of 3 different primary schools, which were in the zone with high fluoride levels. The control group was formed by enrolling 298 children from the 4-8th grades of only one primary school. Age, gender, height, and weight values were recorded for the children. The urine iodine, fluoride, and thyroid volumes were measured with ultrasonography in 10-15-year-old children with fluorosis and controls and compared between two groups. RESULTS: The mean urine fluoride level was 0.48±0.24 mg/L in the study group and 0.22±0.17 mg/L in the control group (p < 0.001). The mean urine iodine level did not differ between two groups. The mean total thyroid volume was 8.60±3.11 mL and 8.73± 2.75 mL in the study and control group, respectively. The groups were also compared according to the echobody index, and the score was 6.94±2.14 ml/m² in the study group and 6.48±1.53 ml/m² in the control group (p=0.003). Mean thyroid volumes did not differ between two groups. However, the echobody index in the study group was higher than in the control group. CONCLUSION: A relation between fluoride concentration and thyroid gland with ultrasonographic examination was firstly evaluated, and it was concluded that fluoride affected thyroid gland although it was weakly significant. After puberty, echobody index in subjects with fluorosis was markedly high. Based on our results, we thought that fluorosis increases thyroid volume in children with fluorosis after puberty.

Suicidal ingestion of potassium permanganate.

BACKGROUND: Potassium permanganate is used clinically as an antiseptic and antifungal agent. Ingestion of potassium permanganate may result in damage to the upper gastrointestinal tract. Burns and ulceration of the mouth, esophagus and stomach occur due to its action. Emergency endoscopy is useful to assess the severity of damage and also to guide management. METHODS: We reported a patient presenting to the emergency department after suicidal ingestion of potassium permanganate. RESULTS: After treatment, the patient was discharged home on the 7th day after admission. CONCLUSION: Early emergency endoscopy should be considered to determine the extent of upper gastrointestinal damage in the emergency department.