An improved MOPSO algorithm for multi-objective optimization of reservoir operation under climate change.

Gradually, the previously proposed water resource management schemes and reservoir operating policies adjusted to the historically experienced climatic conditions are losing their validity and efficacy, urging building up the models compatible with the likely climatic change conditions at the future. This paper aims at optimizing the reservoir operation under climate change conditions targeting the objectives including (1) minimizing the shortages in meeting the reservoir downstream water demands and (2) maximizing the sustainability of the reservoir storage. For evaluating the effects of the climate change, six general circulation models (GCMs) built up under the representative concentration pathway (RCP4.5) emission scenario are adopted and utilized to predict the climate variables over a 30-year planning period. To solve this problem, an improved version of our recently proposed fuzzy multi-objective particle swarm optimization (f-MOPSO) algorithm, named f-MOPSO-II, is proposed. The f-MOPSO takes a novel approach to handle multi-objective nature of the optimization problems. In this approach, the common concept of "diversity" is replaced with "extremity," to choose the better guides of the search agents in the algorithm. The f-MOPSO-II is based on the f-MOPSO. However, it is aimed at simultaneously mitigating the f-MOPSO computational complexity and enhancing the quality of the final results presented by this algorithm. The results obtained by the f-MOPSO-II were then compared with those yielded by the popular non-dominated sorting genetic algorithm-II (NSGA-II). As the results suggest, the f-MOPSO-II is capable of simultaneously meeting the water demands and holding the reservoir storage sustainable, much better than the NSGA-II.

Dental Management of a Patient with Pulmonary Atresia and Ventricular Septal Defect.

Pulmonary atresia with ventricular septal defect (PA/VSD) is one of the congenital heart diseases that results in cyanosis, susceptibility to bacterial endocarditis, and increased risk of complications during general anesthesia. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited genetic disorder affecting the red blood cells. We aimed to elaborate the potential dental management for patients with this serious condition. This report presents the single-visit dental treatment of a three-year-old female with PA/VSD, G6PD deficiency and rampant caries. The complexity of dental treatments, high incidence of dental caries, lack of cooperation, and the systemic condition limit treatment options to providing service under general anesthesia and hospitalization. Careful monitoring of oxygen saturation during general anesthesia and antibiotic prophylaxis are essential due to the invasive nature of dental treatments. It appears that single-visit dental management under general anesthesia minimizes the risk of treatment of patients at high risk of bacterial endocarditis.

Characteristics and Outcomes of Liver Transplantation for Primary Biliary Cholangitis in Young Patients: Analysis of the United Network for Organ Sharing Database.

BACKGROUND: Primary biliary cholangitis (PBC) in younger patients has been suggested to require liver transplantation (LT) in early adulthood, but data is limited on its outcomes. We aimed to evaluate the characteristics and outcome of LT in young patients with PBC in comparison with older adults. METHODS: The United Network for Organ Sharing database was analyzed for all patients with PBC who underwent LT between 2000 and 2012. Based on age at the time of LT, subjects were divided into 2 groups: young patients (≤40 y) and older adults (≥41 y). Baseline demographics, clinical parameters, and outcomes of LT were then compared between the 2 groups. Univariable and multivariable analyses were performed to assess the factors associated with outcomes of LT. RESULTS: A total of 2084 patients with PBC were included in the analysis with 158 young patients. Compared with older adults, younger patients were more likely to be male (27.2% versus 15.4%) and nonwhite (43.7% versus 21.5%), but they were less likely to have obesity, diabetes, or hypertension (P < 0.05) and had a lower mortality (8.2% versus 15.1%) but higher retransplantation rate (14.6% versus 4.7%) (P < 0.001). On multivariable analysis, older age, dialysis or ventilator use, and lower albumin were associated with high post-LT mortality. CONCLUSIONS: Compared with older adults, early-onset PBC in younger patients requiring LT had higher percentage of males and nonwhites and had a lower prevalence of metabolic comorbidities but higher retransplantation rates. Further studies are warranted to confirm these findings.

Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran.

In this article which was published in Int J Fertil Steril, Vol 11, No 4, Jan-Mar 2018, on pages 293-297, the "Duration of tducation (male)" was misspelled in Table 1. The corrected one is "Duration of education (male)". In the sentence "These differences might be related to the use of a fertility-specific instrument (FertiQoL) in the study by Huppelschoten et al. (23) and the current study compared to the general QoL assessment instrument by Chachamovich et al. (24) and Rashidi et al. (15)." Which was at the page of 296 in the discussion section, the word "generic" was corrected in to "general".

Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran.

BACKGROUND: Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples. MATERIALS AND METHODS: In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran. We used an additional questionnaire to assess participants' demographic and clinical characteristics. The relationship between the scores of QoL to the sociodemographic and treatment data was analysed. RESULTS: The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and environmental domains were significantly more desirable when the infertility problem was related to a male factor. CONCLUSION: Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic education, lower income levels, or prior unsuccessful treatments are associated with lower QoL.

Treatment of Morbidly Adherent Placentation Utilizing a Standardized Multidisciplinary Approach in the Community Hospital-Private Practice Setting.

Objective Morbidly adherent placentation is associated with increased maternal morbidity and mortality. Recently, there has been mounting evidence supporting the benefits of a standardized multidisciplinary approach at tertiary teaching hospitals. Our objective was to estimate the impact of the implementation of a similar program at a high-volume private community hospital. Study Design In this retrospective cohort study, we evaluated maternal outcomes in all cases of histopathologically confirmed morbidly adherent placentation since the initiation of our multidisciplinary program (2012-2016). Our data were compared with the previously published outcomes of two large cohorts from tertiary teaching hospitals in Utah and Texas. Results In the 28 cases included for evaluation, our group's median estimated blood loss, median packed red blood cells transfused, median anesthesia time, median length of stay, or rates of maternal morbidity did not statistically differ from the published data in Utah or Texas. Conclusion Our data demonstrate the feasibility and utility of a multidisciplinary morbidly adherent placentation program in the private practice/community hospital setting with outcomes similar to those at tertiary teaching hospitals. Implementation of such program may prove beneficial in remote centers, where various factors may prohibit patient travel to a larger center.

Missense Mutation in Fam83H Gene in Iranian Patients with Amelogenesis Imperfecta.

BACKGROUND: Amelogenesis Imperfecta (AI) is a disorder of tooth development where there is an abnormal formation of enamel or the external layer of teeth. The aim of this study was to screen mutations in the four most important candidate genes, ENAM, KLK4, MMP20 and FAM83H responsible for amelogenesis imperfect. METHODS: Geneomic DNA was isolated from five Iranian families with 22 members affected with enamel malformations. The PCR amplifications were typically carried out for amplification the coding regions for AI patients and unaffected family members. The PCR products were subjected to direct sequencing. The pedigree analysis was performed using Cyrillic software. RESULTS: One family had four affected members with autosomal dominant hypocalcified amelogenesis imperfecta (ADHPCAI); pedigree analysis revealed four consanguineous families with 18 patients with autosomal recessive hypoplastic amelogenesis imperfecta (ARHPAI). One non-synonymous single-nucleotide substitution, c.1150T>A, p. Ser 342Thr was identified in the FAM83H, which resulted in ADHCAI. Furthermore, different polymorphisms or unclassified variants were detected in MMP20, ENAM and KLK4. CONCLUSION: Our results are consistent with other studies and provide further evidence for pathogenic mutations of FAM83H gene. These findings suggest different loci and genes could be implicated in the pathogenesis of AI.