Tip 1 diabetes mellitus hastalarında tanı mevsimi değişiyor mu?

Objective: By the effect of global warming, climate model of Turkey is suggested to evolve through semi-arid seasons and to the tropical climate. This study aimed to determine the seasonability for clinical onset of Type 1 diabetes mellitus (T1DM). Method: T1DM patients newly diagnosed between 2014 and 2019 in our pediatric endocrinology department located in Istanbul were included in this study. Clinical onset date and age of diagnosis of diabetes were recorded for each patient. Using the worldwheatheronline.com website, regional average rainy days, cloudy days, sunny days, temperature, and ultraviolet index (UVI) were calculated per month for the past 6 years. Results: A total of 659 patients with the new onset T1DM included in this study. A number of new diagnosed patients were 29.1% (192) in winter, 22.8% (150) in spring, 17.6% (116) in summer, and 30.5% (201) in autumn, respectively. No significant effect of the rainy day, cloudy day, sunny day, temperature, and UVI average of the month of diagnosis could be detected on this seasonal shift. Similar results were obtained when 132 patients whose under 4 years of age at the time of diagnosis were excluded from the study data. Conclusion: Although weather conditions seemed to have no considerable effect on this seasonal shift, the T1DM onset in the autumn season was seen to be shifted to the spring season, partially. Further studies including large number of participants are needed for a better understanding of the seasonality of T1DM worldwide.Amaç: Küresel ısınma ile birlikte Türkiye’de mevsimlerin yarı kurak ve tropik iklim özelliklerine doğru evrildiği, son yıllarda sonbahar ve ilkbahar hava koşullarının yarısının kışa, yarısının da yaza benzer seyrettiği düşünülmektedir. Bu çalışmada, tip 1 diabetes mellitus klinik tanı zamanında mevsim değişikliğinin ve bu duruma hava koşullarının olası etkisinin incelenmesi amaçlandı. Yöntem: Çalışmaya İstanbul’daki çocuk endokrinoloji kliniğimizde 2014 ile 2019 yılları arasında yeni tanı almış 18 yaş altı tip 1 diabetes mellitus hastaları dahil edildi. Her hasta için klinik belirti başlangıç tarihi ve diyabet tanı mevsimi ile demografik veriler kaydedildi. Worldwheatheronline.com web sitesi kullanılarak İstanbul ilinin son beş yılındaki tip 1 diabetes mellitus tanı ayına ait aylık ortalama yağışlı gün, bulutlu gün, güneşli gün sayısı, sıcaklık ve ultraviyole indeks ortalaması saptandı. Hastaların tanı yaşı ile tanı mevsimi ve hava koşulları arasındaki ilişki istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya 659 yeni tanı almış tip 1 diabetes mellitus hastası alındı. Çalışmaya alınan hastaların %50,4’ü kız (n=332), %49,6’sı (n=327) erkek idi. Mevsimlere göre yeni tanı konulan hasta sayısı sırasıyla kışın %29,1 (n=192), ilkbaharda %22,8 (n=150), yazın %17,6 (n=116) ve sonbaharda %30,5 (n=201) idi. Çalışma süresince tip 1 diabetes mellitus klinik başlangıcının kış ve sonbahar aylarında yüksek ilkbahar ve yaz aylarında düşük olduğu görülmekle beraber istatistiksel anlamı olacak şekilde 2016 yılı ve sonrasında sonbahar mevsimindeki diyabet başlangıç ağırlığının bir kısmının ilkbahar mevsiminekaymış olduğu izlendi. Ancak mevsimsel bu kayma üzerinde tanı ayına ait yağışlı gün, bulutlu gün, güneşli gün, sıcaklık ve ultraviyole indeks ortalamasının anlamlı bir etkisi saptanmadı. Tanı sırasında dört yaşın altında olan 132 hasta çalışma verilerinden çıkarılarak yapılan istatistiksel değerlendirmede sonuçların değişmediği görüldü. Sonuç: Çalışmamız ile sonbahar mevsimindeki diyabet başlangıç ağırlığının bir kısmının ilkbahar mevsimine kaymış olduğu tespit edilmiş olup bu mevsimsel kaymaya hava koşullarının etkisinin olmadığı görüldü. T1DM tanısında mevsimsel özelliklerin etkisini daha iyi değerlendirebilmek için daha çok sayıda hasta içeren geniş kapsamlı çalışmalara gereksinim duyulmaktadır

Scrotal Tissue Necrosis in a Patient with Urethral Stricture Treated with Internal Urethrotomy and Mitomycin-C Injection

An 89-year-old male patient was admitted with open scrotal tissue wound. Approximately 4x4 cm scrotal necrotic tissue extending to the anal region was observed. It was learned that the patient underwent radical prostatectomy 9 years ago and then, internal urethrotomy was performed due to urethral stricture. Urethroscopy showed an anterior urethral stricture 2 cm in length. After internal urethrotomy, 20 mg of mitomycin-C (MMC) was diluted with 50 cc saline and injected as an intralesional injection (10 cc) and instillation (40 cc). In previous applications, our patients have tolerated this treatment during the process. In this case report, we present the case of scrotal tissue necrosis and treatment in a patient in whom internal urethrotomy and intralesional MMC application were performed

Assessment of Serotonin Metabolite 5-hydroxyindoleacetic Acid Levels in Urine Sample for Diagnosis and Treatment Efficacy in Children with Dysfunctional Voiding and Their Interaction with Biofeedback Therapy

Objective:Dysfunctional voiding (DV), which is explained as an incoordination between the external urethral sphincter and the bladder, is a situation developing in neurologically normal children. Serotonin has some effects on the lower urinary tract which cannot be fully explained. The selective 5-hydroxyindoleacetic acid (5-HIAA) agonist improves voiding efficacy in the rat model with voiding dysfunction as serotonin. Serotonin decomposes to 5-HIAA which excreted from urine. We considered that a problem in neuromodulator levels can lead to DV and evaluated the levels of 5-HIAA in urine.Materials and Methods:Our study included 130 children aged 5-15 years who were diagnosed with DV and 48 children with no urological complaints as controls. Urine samples were taken only once in control group, and 3 times [before and after the biofeedback treatment (sixth month and twelfth month)] in the study group to determine the difference and the interaction between 5-HIAA and biofeedback therapy.Results:Biofeedback therapy was found to be an effective method in the treatment of DV. However, there was no significant difference in the level of mean urine 5-HIAA/creatinine (u5-HIAA/Cr) between study (6.139±3.652) and control groups (6.374±4.329) (p=0.751). The mean u5-HIAA/Cr levels in the DV group at baseline and at the end of biofeedback therapy (6th month) were 6.249±4.132 and 6.19±4.715, respectively (p=0.951). The mean u5-HIAA/Cr levels in the DV group at baseline and at 12 months were 5.901±3.291 and 6.644±4.206, respectively (p=0.557). There was no significant difference in u5-HIAA/Cr levels between pre-treatment and post-treatment in the DV group.Conclusion:We still do not know if a problem at the level of neurotransmitter metabolite in the central nervous system plays a role in the etiology of DV. We evaluated this relationship, but we could not find a significant result. New studies are needed to get more information about the role of neuromodulators in the etiology and treatment of DV

Hyperspectral Image Classification Based on Multilayer Perceptron Trained with Eigenvalue Decay

Hyperspectral Images (HSI) require sufficient labeled samples and a complex classifier to identify an area. Support Vector Machine (SVM) is one of the most competent algorithms in this field. Neural Networks (NN) is another approach used for classification problems, and both have been widely proposed in the literature. The Convolutional Neural Network (CNN) method has also received significant attention in the deep learning field recently. Nevertheless, during NN training, the overfitting problem may cause continuous dragging of the algorithm toward larger error. In this case, a regularization technique is needed to constitute the most useful decision boundary. The Eigenvalue Decay method is one of the regularization techniques that may be applied for HSI. This study investigates the performance of Multilayer Perceptron trained with an Eigenvalue Decay (MLP-ED) algorithm for HSI classification. The SVM, CNN with Pixel-Pair and CNN-Ensemble methods are used as comparison algorithms for MLP-ED performance assessment. All methods were tested with 3 different high-resolution HSI datasets. While SVM is one of the classic classifiers, and the 2 new CNN algorithms show high performance, the proposed MLP-ED method has more computational efficiency and achieves higher success than the others do

Hyperspectral Image Classification Based on Multilayer Perceptron Trained with Eigenvalue Decay

Hyperspectral Images (HSI) require sufficient labeled samples and a complex classifier to identify an area. Support Vector Machine (SVM) is one of the most competent algorithms in this field. Neural Networks (NN) is another approach used for classification problems, and both have been widely proposed in the literature. The Convolutional Neural Network (CNN) method has also received significant attention in the deep learning field recently. Nevertheless, during NN training, the overfitting problem may cause continuous dragging of the algorithm toward larger error. In this case, a regularization technique is needed to constitute the most useful decision boundary. The Eigenvalue Decay method is one of the regularization techniques that may be applied for HSI. This study investigates the performance of Multilayer Perceptron trained with an Eigenvalue Decay (MLP-ED) algorithm for HSI classification. The SVM, CNN with Pixel-Pair and CNN-Ensemble methods are used as comparison algorithms for MLP-ED performance assessment. All methods were tested with 3 different high-resolution HSI datasets. While SVM is one of the classic classifiers, and the 2 new CNN algorithms show high performance, the proposed MLP-ED method has more computational efficiency and achieves higher success than the others do

Investigation of thermo-mechanical characteristics of borax reinforced polyester composites

The aim of this study is to investigate the effect of borax added as reinforcement on the mechanical properties, flame retardancy, and thermal conductivity of polyester-based composites. The polyester-based composites were prepared by adding 5, 10, 20, and 40 wt% of borax powder into an unsaturated polyester resin. The composite samples were subjected to different types of mechanical tests such as tensile strength, flexural strength, and hardness to evaluate their performance, limiting oxygen index (LOI) test to determine flame retardancy properties. Tensile and flexural strength values of composite samples were observed to increase until the borax content of 20 wt% into polyester resin. It slightly improved the hardness values of the borax reinforced composite. The distribution of borax particles in the polyester matrix was observed by scanning electron microscopy (SEM). The thermal conductivity of the composite samples was measured experimentally using a portable thermal conductivity meter. Increasing borax content increased the thermal conductivity coefficient of composite samples. Also, the most suitable model for the effective thermal conductivity coefficient was determined by statistical analysis. © 2021 Elsevier Lt

Optimization of PID Controllers Using Ant Colony and Genetic Algorithms

XX, 88 p.online resource

FIRST REPORT ON THE OCCURRENCE AND SYMPTOMATOLOGY OF PHYLLODY DISEASE IN JUTE (Corchorus olitorius L.) AND ITS PLANT CHARACTERISTICS IN TURKEY

Although jute (Corchorus olitorius L.) is treated as a weed in Turkey, it is cultivated and harvested for its fiber, tender shoots, and leaves in Africa and Asia. We report the occurrence and symptomatology of phyllody disease in jute observed for the first time in 2010 during our studies focusing on sesame phyllody in an experimental field at the Akdeniz University Campus, Antalya, Turkey. The disease was also observed in the following two years, 2011 and 2012. In the top of the infected jute plant, the internodes were shortened which resulted a cluster of leaves in smaller size than the normal ones, and the leaves were crinkled as well as turned to yellowing and leathery-looking. Additionally, the large leaves accumulated more anthocyanin in their margins. The floral organs abnormally developed into leafy structures; and ovaries at the symptomatic part enlarged but stamens and filaments did not show any symptoms. There was neither proliferation of the branches nor needle-like shape of the leaves in our case. Jute and sesame seeds started germination synchronously, and looked similar at the cotyledonary stage. Wild plants or weeds deserve a particular attention for disease development or inoculum build-up in cultivated crops. Considering the voluntary nature, jute may be an alternative for biofuel production. Also, the similarity in developmental stages of jute and sesame suggests that they might be affected by the same phytoplasma. To verify this, molecular analyses have been started