Game theory and fuzzy programming approaches for bi-objective optimization of reservoir watershed management: a case study in Namazgah reservoir.

In this study, game theory and fuzzy programming approaches were used to balance economic and environmental impacts in the Namazgah reservoir, Turkey. The main goals identified were to maximize economic benefits of land use and to protect water quality of reservoir and land resources. Total phosphorous load (kg ha(-1) year(-1)) and economic income (USD ha(-1) year(-1)) from land use were determined as environmental value and economic value, respectively. The surface area of existing land use types, which are grouped under 10 headings according to the investigations on the watershed area, and the constraint values for the watershed were calculated using aerial photos, master plans, and basin slope map. The results of fuzzy programming approach were found to be very close to the results of the game theory model. It was concluded that the amount of fertilizer used in the current situation presents a danger to the reservoir and, therefore, unnecessary fertilizer use should be prevented. Additionally, nuts, fruit, and vegetable cultivation, instead of wheat and corn cultivation, was found to be more suitable due to their high economic income and low total phosphorus (TP) load. Apart from agricultural activities, livestock farming should also be considered in the area as a second source of income. It is believed that the results obtained in this study will help decision makers to identify possible problems of the watershed.

Diagnosis of central nervous system infection by CSF sampling of the myelomeningocele sac as an alternative to ventricular tap.

BACKGROUND: Infection significantly affects mortality and morbidity in myelomeningocele cases. Ventricular tap is the most common method performed to diagnose central nervous system (CNS) infection in myelomeningocele patients. However, the ventricular tap can cause serious trauma to the baby and to the family. Here we discuss the technique of taking a cerebrospinal fluid (CSF) sample from the sac in myelomeningocele cases. METHODS: The study comprised 24 myelomeningocele patients undergoing sac repair; 7 patients in the early period and 17 in the late period (after the first 24 hours). CSF samples were taken from the sac and via ventricular tap. In all patients' samples, cell count and cultures were compared. RESULTS: In patients who underwent early meningomyelocele repair there was no significant difference between sac and ventricular CSF. There were also no positive cultures in samples taken from both areas. In comparison, in the group submitted to late repair, the number of cells in the sac and ventricle CSF samples was over 10 in 4 of the 17 patients. The cultures from CSF samples taken from both areas were positive for E. coli. In 13 of 17 patients who were admitted to our clinic for late repair, there was no significant difference between the number of cells in the sac and in ventricular samples. Cultures taken from these patients were negative. CONCLUSION: Puncture of the sac represents a quicker and more convenient way to obtain CSF in myelomeningocele cases. In addition, there was no increase in pain to a level that would cause stress for the baby. A CSF sample can be taken from the sac for diagnosis of CNS infection in myelomeningocele patients. This method, therefore, represents a safer and more comfortable option for both the patient and doctor.

Diagnosis of central nervous system infection by CSF sampling of the myelomeningocelesac as an alternative to ventricular tap

Background. Infection significantly affects mortalityand morbidity in myelomeningocele cases. Ventriculartap is the most common method performed to diagnosecentral nervous system (CNS) infection in myelomeningocelepatients. However, the ventricular tap can causeserious trauma to the baby and to the family. Here wediscuss the technique of taking a cerebrospinal fluid(CSF) sample from the sac in myelomeningocele cases.Methods. The study comprised 24 myelomeningocelepatients undergoing sac repair; 7 patients in theearly period and 17 in the late period (after the first 24hours). CSF samples were taken from the sac and viaventricular tap. In all patients’ samples, cell count andcultures were compared.Results. In patients who underwent early meningomyelocelerepair there was no significant differencebetween sac and ventricular CSF. There were also nopositive cultures in samples taken from both areas. Incomparison, in the group submitted to late repair, thenumber of cells in the sac and ventricle CSF sampleswas over 10 in 4 of the 17 patients. The cultures fromCSF samples taken from both areas were positive for E.coli. In 13 of 17 patients who were admitted to our clinicfor late repair, there was no significant difference betweenthe number of cells in the sac and in ventricularsamples. Cultures taken from these patients were negative.Conclusion. Puncture of the sac represents a quickerand more convenient way to obtain CSF in myelomeningocelecases. In addition, there was no increase inpain to a level that would cause stress for the baby. ACSF sample can be taken from the sac for diagnosisof CNS infection in myelomeningocele patients. Thismethod, therefore, represents a safer and more comfortableoption for both the patient and doctor (AU)

Fundamentos. La infección de LCR afecta significativamentela mortalidad y morbilidad en pacientes conmielomeningocele. La punción ventricular es la técnicamás frecuentemente utilizada para detectar infección delSNC en los casos de mielomeningocele. Sin embargo, lapunción ventricular puede causar un grave estrés tantopara el niño como para la familia. En nuestro estudio,presentamos la técnica y resultados del examen de LCRobtenido a partir del saco del mielomeningocele.Pacientes y métodos. El estudio comprende 24 pacientescon mielomeningocele sometidos a cierre quirúrgicode la malformación, 7 pacientes con reparaciónprecoz y 17 con cirugía tardía (después de las primeras24 horas). Las muestras de LCR fueron obtenidas delsaco de la malformación y de los ventrículos mediantepunción ventricular. Se compararon los resultados delrecuento de células y los cultivos realizados a todos lospacientes.Resultados. En los pacientes operados precozmente,no se encontraron diferencias significativas entre elLCR lumbar y ventricular. Tampoco se obtuvieroncultivos positivos en las muestras tomadas de ambasáreas. En los operados después de las primeras 24horas, el recuento de células del LCR del saco y delventrículo fue alrededor de 10 en 4 de los 17 pacientes.Se obtuvieron cultivos positivos (E. coli) de las muestrasde LCR tomadas de ambas áreas. En 13 de 17 pacientesque fueron admitidos a nuestra clínica para reparacióntardía, no hubo una diferencia significativa entre elnúmero de células del saco y del LCR ventricular. Loscultivos de LCR obtenidos en estos pacientes fueron (..) (AU)