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To determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length.
The study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the ‘X’ line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured.
Cochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line.
Using the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.
A layer of silver nanoparticles created by thermal annealing of evaporated silver films can increase the photocurrents in silicon-on-insulator (SOI) devices by fivefold or more, but significant enhancements have been restricted to wavelengths greater than 800 nm. Here we report a significant enhancement of photoconductance at shorter wavelengths (500-750 nm) by using a monolayer of silver nanoparticles transferred from a colloidal suspension. Photocurrents on SOI increased in the 500-750 nm spectral range with the addition of silver nanoparticles, with enhancements more than two times; enhancements at longer wavelengths were small, in contrast to results with annealed silver films. We prepared similar colloidal silver nanoparticle monolayers layers on nanocrystalline silicon solar cells with conducting oxide top layers. There is an overall decrease in the quantum efficiency of these cells with the deposition of silver nanoparticles. We attribute these effects to the substantial substrate-mediated changes in the localized surface plasmon resonance frequencies of the differing nanoparticle configurations.
Climate and tectonics effect the fluvial evolution of the Mediterranean Mut basin. The basin contains a river terrace staircase of 16 levels (T16–T1) ranging from 365 to 10 m above the current Göksu River in its middle and lower sections. These river terraces records tectonic uplift in the Mut basin. Optically stimulated luminescence (OSL) dating of the fluvial sediments of the youngest terrace (T16) provides a chronology for the assessment of the important impacts of climatic changes. The ages from the youngest river terrace deposits in T16 may be subdivided into two intervals: (1) 239–194.7 ka during the later part of Marine Oxygen Isotope Stage (MIS) 7, implying that the aggradation of T16 started in (the final phase of) this warm period; and (2) 187.9–171 ka during much of MIS 6. Thus, it appears that the Göksu River continued depositing sediment from an interglacial into a glacial time. The differences in climate-driven fluvial evolution between this Mediterranean fluvial system and the classical, well-studied temperate–periglacial river systems in Europe may be the result of different vegetation cover and greater thaw of more intense snowfalls.
To evaluate dysphagia and manometric changes in the upper oesophageal sphincter in patients with unilateral vocal fold paralysis.
Thirty patients with unilateral vocal fold paralysis due to vagal nerve paralysis scheduled for evaluation were enrolled in the study group; 24 healthy subjects were included in the control group. Upper oesophageal sphincter basal and residual pressure, relaxation time, and pharyngeal pressure values were evaluated by manometry. All patients completed the Turkish Eating Assessment Tool 10 questionnaire, the MD Anderson dysphagia questionnaire and the reflux symptom index form.
Swallowing assessment questionnaires and reflux symptom index results were significantly higher in the study group. Upper oesophageal sphincter basal and relaxation pressures were lower in the study group. Upper oesophageal sphincter relaxation time was shorter in the study group, but pressure values recorded from the pharynx were higher.
Upper oesophageal sphincter manometric pressure was lower in patients with unilateral vocal fold paralysis. A hypotonic sphincter likely contributes to dysphagia and aspiration.
A massive die-off of benthic suspension feeders (BSF) covered by large amounts of sediments was observed along Prince Islands coasts (north-eastern Sea of Marmara) in August 2015. Alcyonarians, pennatulaceans, bivalves and sponges were severely affected. Many BSF probably died from burial and clogging of their feeding and respiratory apparatus. Of the gorgonian colonies, 66 ± 34% (mean ± SD) were dead, while 15 ± 16% (mean ± SD) displayed recent necrosis on the colony surface. In addition, histopathological and microbial examinations of the affected gorgonians and gold corals (Savalia savaglia) suggest that stress caused by sedimentation made them vulnerable to exploitation by consistently isolated opportunistic microorganisms. We isolated Vibrio splendidus and Vibrio neptunius from diseased gold coral colonies, but the bacterial isolates obtained from gorgonians could only be identified to genus Vibrio level. The presumably artificially introduced fungus Mucor circinelloides was common on both gold coral and gorgonians. This mould and opportunistic bacteria may have colonized BSF by taking advantage of low oxygen levels leading to impaired coral immune responses and thereby exacerbated the BSF mortality. Construction and landfill operations at Yassıada seem to be the greatest contributor to the observed sedimentation, as shown by silicate concentrations in nearby waters. These observations imply that preventive measures are necessary when construction operations take place in the vicinity of sensitive marine habitats.
The Istanbul Strait is an important cetacean habitat that is intensely used by humans. Yet little is known about their spatial-temporal distribution. To understand the encounter rates and residency patterns of bottlenose dolphins, photo-identification data were collected between 2011 and 2016 in the Istanbul Strait. The study showed that bottlenose dolphins are a regular, year-round component of the strait. The encounter rate was estimated to be four groups (22 individuals) per 10 km. The adjacent waters of Marmara Sea and Black Sea, that host relatively less marine traffic, had the highest number of encounters in the area. Conversely, the middle sections had the lowest number of encounters but the highest marine vessel density. Further, the encounter rates dropped to zero in the fishing zones, where the number of purse seines reached up to 100 per day. Additionally, dolphins showed varying degrees of residency patterns, with multi-year re-sightings. Maximum re-sighting distance was up to 35 km, which is more than the total length of the strait. This movement pattern should be investigated as it might reveal possible migration between local populations. This study finds that the Istanbul Strait serves as a critical habitat for the regional bottlenose dolphin populations and they are likely to be a part of a resident local population with a home range extending the length of the strait. Dedicated surveys with inter-regional collaborations are needed to evaluate the home range and population status of this endangered species for their effective conservation in one of the busiest waterways of the world.
How does Turkey's Presidency of Religious Affairs (Diyanet) act as an instrument of foreign policy (FP)? What are the factors that allow such an instrumentalization of Islam in Turkish FP? In addressing these questions, this paper uses semi-structured expert interviews from Bulgaria and the Netherlands. Although both countries host a sizeable Muslim minority, these populations differ in their characteristics and historical ties with Turkey. Comparing Diyanet’s role in the Netherlands with its recent Turkish-Muslim diaspora, and in Bulgaria with its centuries-old Muslim minority allows us to reveal variation in the practical engagement strategies that Diyanet adopts in different country contexts. Thus, this paper advances two main claims; first, Diyanet serves as a primary FP tool of Turkey in countries with a significant Turkish-Muslim minority. Secondly, this instrumentalization destabilizes secularization projects both at home and abroad.
Trace elements are essential micronutrients for the human body. In this study, we evaluated the alterations in copper, chromium, manganese, selenium, magnesium, zinc, iron, arsenic, boron, and silicon levels in children with cyanotic and acyanotic CHD who underwent cardiac surgery with cardiopulmonary bypass. Participants were divided into the following three groups: patients acyanotic CHDs (n=34), patients with cyanotic CHDs (n=30), and healthy controls (n=30). Blood samples were collected before the surgery and 1 hour after the sternum was closed. Serum trace elements were determined by Inductively Coupled Plasma Optical Emission Spectrometer-ICAP 6000. The baseline serum arsenic, manganese, and zinc levels of both patient groups were lower compared with controls, but there was no significant difference between baseline serum trace element levels of cyanotic and acyanotic patients. In both the patient groups, there was a significant decrease in postoperative serum arsenic, boron, copper, and zinc levels, and a significant increase in postoperative serum iron and magnesium levels. Silicon levels increased in cyanotic patients. Alterations in trace element levels were in the same direction in cyanotic and acyanotic patients. Copper, zinc, and manganase replacement may be needed after on-pump cardiac surgery.
The temporal change in soil organic carbon (SOC) was analysed over an 80-year period based on climate change predictions of four regional circulation models under the International Panel on Climate Change (IPCC) A1B emission scenario in the 21st century. A 20-year (1991–2010) set of observed climate data was used to form the baseline, and generate synthetic data for future scenario analyses. With increasing carbon dioxide (CO2) levels, and under continuous winter wheat production with conventional tillage at different nitrogen (N) input rates, three crop-soil models were used to study the temporal changes of SOC. Results indicated that soil carbon (C) generally decreased over the simulation period. In addition, increased N losses through leaching and denitrification were estimated. Decline in soil C under continuous mono-cropping systems indicated increased focus on N fertilization strategies. The results also suggested significant interactive effect of N input rate and climate variables on soil C and denitrification in response to climate change. The uncertainty was addressed by including the crop-soil models in a mixed-effect analysis so that the contribution of the models to the total variance of random variation was quantified. Statistical analysis showed that the crop-soil models are the main source for uncertainty in analysing soil C and N responses to climate change.
Re-stenosis and a consequent need for revision surgery are the most common problems in the follow-up period following endoscopic modification of the Lothrop procedure.
This paper reports a new technique for reconstructing and resurfacing of the posterior frontal recess bone for prevention of re-stenosis.
A 46-year-old man presented with a frontal sinus osteoma, and treatment featured an endoscopic modification of the Lothrop procedure. A vascularised, posteriorly based, septal mucosal flap was used in reconstruction. There have been no reported issues over 24 months of follow up.
The use of a nasoseptal flap seems feasible to reduce scarring and recurrence of (common) frontal recess stenosis after a Draf III operation.
Background: In April of 2014, the Turkish Ministry of Health held the First Annual Health Technology Assessment (HTA) Meeting in Antalya.
Objectives: The objectives were to understand the perceptions of stakeholders regarding the current status of HTA and document their recommendations and strategies for promoting systematic use of HTA in Turkey.
Methods: The study was conducted using a qualitative written survey assessing current compliance with the fifteen HTA principles suggested by Drummond et al. (Key principles for the improved conduct of health technology assessments for resource allocation decision. Int J Technol Assess Health Care. 2008;24:244–258) and a qualitative method referred to as the Collective Intelligence Platform®.
Results: A total of 216 stakeholders representing academic, public, and the private health sector attended the annual meeting; 178 completed the survey and 183 participated in the Platform. Quantitative Results: Survey participants reported that, although Turkey does not currently fully comply with any of the fifteen HTA principles, there is some compliance with all of them. The overall average score for all fifteen principles was 3.04. Quantitivate Results: Participants recommended a more transparent, independent, and evidence-based policy decision-making system through better coordination of HTA activities, data aggregation, capacity development, and a national HTA core model and framework.
Conclusions: Platform participants described the current HTA environment as disjointed and lacking in resources and support from policy-making leaders. Despite the persisting challenges, awareness of the strengths and weaknesses of the current system combined with increasing interaction among Turkish stakeholders and the international HTA community can meaningfully contribute to the continued development and promotion of HTA in Turkey.
Development of winter wheat (Triticum aestivum) synthetics started at CIMMYT-Mexico in 2004, when winter durum wheat (Triticum turgidum) germplasm from Ukraine and Romania was crossed with Aegilops tauschii accessions from the Caspian Sea region. Chromosomes were doubled after pollination and embryo rescue, but chromosome number and cytological validation was not performed. F2 populations were grown in Mexico and were shipped to Turkey in 2008. During 2009–2015, these populations were subjected to rigorous pedigree selection under dry, cold, disease-affected environments of the Central Anatolian Plateau. The wide segregation and partial sterility observed in 2009 gradually decreased and, by 2016, most of the F8 single spike progenies demonstrated good fertility and agronomic performance. Since 2013, lines have been selected from synthetic populations and evaluated at multiple sites. Superior lines were characterized for resistance to leaf, stripe and stem rust, plant height, and reaction to common bunt and soil-borne pathogens. Thousand kernel weight of many lines exceeded 50 g, compared with the check varieties that barely reached 40 g. Threshability of synthetic lines varied from 0 to 95%, demonstrating genetic variation for this important domestication trait. Screening against Hessian fly, sunny pest and Russian wheat aphid identified several resistant genotypes. Both durum and Aegilops parents affected synthetic wheat traits. Several studies are underway to reveal the genetic diversity of synthetic lines and the basis of resistance to diseases and insects. This synthetic germplasm represents a new winter bread wheat parental pool. It is available upon request to interested breeding/research programmes.
Until recently, there were two popular misconceptions in the academic community related to Byzantine Cappadocia, the region in central Turkey: (1) that Cappadocia was a Byzantine monastic centre; and (2) that the history of Byzantine Cappadocia came to an end with the arrival of the Seljuks in the last quarter of the eleventh century. Accordingly, convinced of the inordinately generalised monastic identity of the region, scholars had initially categorised the settlement of Acıksaray in Cappadocia as a monastic site that dates back to the tenth and eleventh centuries, although literary and physical evidence is absent. At the other extreme, while advocating a secular purpose, Thomas Mathews and Anna-Christine Daskalakis-Mathews suggest that the inverted T-plan scheme and decorative elements of the rock-cut facades of those in Acıksaray and similar complexes in the region are secular Islamic in origin. The dual character of the settlement of Acıksaray, which apparently bears both Christian and Islamic features, is also strengthened by legends that put the settlement in connection with Hacı Bektaş Veli, the founder of the Bektaşi Sufi order in the thirteenth century, who was settled in Sulucakarahoyuk (today Hacıbektaş), just 30 km north of Acıksaray.
Acıksaray's diverse architectural vocabulary and entangled identities can be directly linked with its location between the Christian and Islamic worlds. Paying particular attention to this, and to the impact of prior scholarship on the formation of these identities, this chapter will discuss the invention of a ‘sacred’ Christian image of a secular Byzantine site that emerged on a medieval border, as well as the adaptability and transmission of this image of a non-Muslim site in an Islamic land up to the present day, through Acıksaray.
Cappadocia is the name commonly given to a particular area in central Anatolia with boundaries that have been drawn and redrawn on many occasions throughout its history. Cappadocia can be defined as an area of unique geological formations that have been subjected over time to intensive rock-cut architectural activity (Plate 7). The boundaries of this idiosyncratic volcanic landscape can be marked by the contemporary cities of Aksaray, Nevşehir, Kayseri and Nicde in present-day Turkey (Figure 6.1).
The invasive alien mytilid species, Brachidontes pharaonis, forms a biogenic habitat in the mediolittoral and upper-infralittoral zones of the Levantine Sea, hosting a number of alien and native species. Examinations of samples taken from dense, continuous mussel beds at seven stations along the coast of northern Levantine Sea yielded 187 macro-benthic invertebrate species belonging to 11 taxonomic groups. Polychaeta accounted for 46% and 37% of the total number of species and individuals, respectively. The top three dominant species in the mussel beds were Stenothoe gallensis, Spirobranchus kraussi and Mytilaster minimus. The species with the highest frequency values on the mussel beds were Pseudonereis anomala, Phascolosoma stephensoni and Elasmopus pocillimanus. The highest density and biomass of the associated fauna were estimated as 42,550 ind m−2 and 1503 wwt g m−2, respectively. The species number in samples varied between 14 and 47 species. The environmental variables best explaining variations in zoobenthic community structures were salinity, dissolved oxygen and total inorganic nitrogen in the water column. The biotic indices, TUBI and ALEX, classified the ecological status of one or two stations as moderate or poor, based on the relative abundances of ecological and zoogeographic groups, respectively. A total of 21 alien species were found to be associated with the mussel bed, of which Syllis ergeni is being newly considered as a new established alien species for the Mediterranean Sea. The maximum density of associated alien species was calculated as 30,300 ind m−2. The alien species assemblages were greatly affected by salinity and total inorganic nitrogen.
The response of grain yield, grain nitrogen (N), phenological development and evapotranspiration of winter wheat to climate change was analysed over an 80-year period based on climate change predictions of four regional circulation models (RCMs) under the IPCC (International Panel on Climate Change) A1B emission scenario for the 21st century using three process-based models; A 20-year set (1991–2010) of observed daily climate data from Aarslev, Denmark was used to form the baseline, from which the RCM data were generated. The simulation of crop growth was performed with increasing carbon dioxide (CO2) levels and under continuous mono-cropping system at different N input rates. Results indicated that grain yield and grain N will be reduced in the future despite increased CO2 concentration in the atmosphere. While the increased N input may increase yield, it will not increase grain N. The present study suggested that in Denmark, alternative strategies for organic N acquisition of plants must be developed. Statistical analyses showed that while the crop models were the main source of uncertainty in estimating crop performance indicators in response to climate change, the choice of RCM was the main source of uncertainty in relation to baseline estimations.
Oxidative stress refers to an imbalance between reactive oxidative species and antioxidants. In this case-controlled, prospective, observational study, we investigated the total oxidant status, total antioxidant status, oxidative stress index, and albumin and C-reactive protein levels of children with cyanotic and acyanotic congenital heart diseases who had undergone on-pump cardiac surgery.
The study groups consisted of 60 patients with congenital heart disease, who were operated under cardiopulmonary bypass, and a control group of 30 healthy individuals. The patients were classified into two groups. Among them, one was a patient group that consisted of 30 patients with acyanotic congenital heart disease and the other group consisted of 30 patients with cyanotic congenital heart disease. In the patient groups, blood samples were collected before surgery and at one and 24 hours following surgery. In control groups, blood samples were collected once during hospital admission.
No statistically significant differences were found between the groups in terms of baseline total oxidant status, total antioxidant status, and oxidative stress index values. Regarding the postoperative first-hour and 24-hour total oxidant status and total antioxidant status levels as well as oxidative stress index values, there were no significant differences between the groups, except for an increase in total antioxidant status levels (p=0.002) 24 hours after surgery in cyanotic patients.
There was no difference between oxidative stress status of cyanotic and acyanotic congenital heart disease patients and healthy individuals. Oxidative stress status of cyanotic and acyanotic patients does not change after cardiac surgery under cardiopulmonary bypass.