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Electrical vehicles (EVs) are among the fastest-growing electrical loads that change both temporally and spatially on distribution networks. The large-scale integration of EVs equipped with power electronic-based chargers into distribution networks, to meet new electrical load demands, can cause instability and power quality issues. Moreover, the absence of control strategies for the smart charging and discharging of EVs at their plug-in intervals poses serious challenges to them. Accordingly, the implementation of controlled charging/discharging scheduling of EV batteries along with the use of charger capabilities, such as reactive power support, is a must. Against this background, this paper introduces an integrated model to solve the problem of simultaneous active and reactive power management in distribution networks subject to network operation constraints imposed by EV batteries and chargers. To this end, this problem is modeled as an optimization problem. In this respect, minimization of the costs associated with power generation and losses and improvement of the total harmonic distortion of voltage (THDv) on network buses are two terms of the objective function. The problem is solved by a hybrid technique named the “ PSO-GA algorithm” that takes advantage of both the genetic algorithm (GA) and the particle swarm optimization (PSO) method. Accordingly, the effectiveness of the proposed model is examined in a standard IEEE 33-bus distribution network populated with EVs and nonlinear devices (NLDs). The results obtained show that the maximum possible penetration rate of EVs into the network is facilitated, while technical and financial goals of the network and parking lots are ensured.

Background. Diabetes mellitus is recognized as one of the most common, serious, and costly chronic diseases. Opium addiction is also a common health problem in Iran. Given the high prevalence of opium use in South Khorasan Province and the increasing prevalence of opioid abuse in the community, this study was performed to investigate the effect of opioid abuse on the extent of disease in diabetic patients undergoing coronary angiography in the cardiology department of Vali-e-Asr Hospital in Birjand city, South Khorasan Province, Iran. Methods. This study recruited a total of 1051 diabetic patients who underwent coronary angiography in the cardiology department of Vali-e-Asr Hospital of Birjand city from 2011 to 2015. The collected data were analyzed using SPSS version 22.0 with the chi-square test and univariate regression analysis. P value Results. Among opiate-addicted diabetics, the risk of coronary artery disease was 0.44 times higher than among nonaddicted diabetics (range 0.24–0.77, P=0.004). The extent of coronary vessel involvement, when present, was not different between the two groups. Conclusion. Opiate-addicted diabetics appear to be more susceptible to CAD than their nonaddicted counterparts. The determinants and correlates of this interaction must be the subject of further study.

Purpose. To assess quantitative stenosis grading by color-coded fluoroscopy using an in vitro pulsatile flow phantom. Methods. Three different stenotic tubes (80%, 60%, and 40% diameter restriction) and a nonstenotic reference tube were compared regarding their different flow behavior by using contrast-enhanced fluoroscopy with a flat-detector system for visualisation purposes. Time-density curves (TDC), area under the curve (AUC), time-to-peak (TTP), and different ROI sizes were analyzed in three independent measurements using two different postprocessing software solutions. In addition, exemplary TDCs of a patient with a high-grade stenosis before and after stent angioplasty were acquired. Results. Color-coded fluoroscopy enabled depiction of differences in AUC and TDC between high-grade (80%), middle (60%), low-grade (40%), and nonstenotic tubes. The best correlation between high-, middle-, and low-grade stenosis was appreciated in ROIs behind the stenosis. This effect was enhanced by using longer integration times (5s, 7s) and a maximum frame rate of image acquisition for analysis (correlation coefficient rho=0.9284 at 5s). TTP showed no significant differences between high- and low-grade stenosis. Conclusions. Various clinical studies in the literature already demonstrated reproducible and reliable stenosis grading by analyzing TDCs acquired with color-coded fluoroscopy. In contrast to TTP, AUC values derived in ROIs behind the stenosis proved to be reliable parameters for stenosis grading. However, our results also demonstrate that several factors are able to significantly impact the evaluation of AUC values. More precisely, accuracy of acquired AUC values can be improved by choosing longer integration times, a large ROI size adapted to the vessel diameter, and a higher frame rate of image acquisition.

Multiple observational studies have demonstrated that psoriasis is associated with nephropathy; however, the renal involvement in psoriasis remains largely a matter of debate. The current study was designed to investigate if psoriatic patients are at increased risk of renal abnormalities, in absence of any other comorbidities. Forty patients (11 women, 29 men, mean age 44.9 ± 15.45 years) with moderate to severe chronic plaque type psoriasis who were not under systemic therapy and 40 age- and gender-matched control subjects were enrolled in the study. Patients and controls with history of diabetes, hypertension, and chronic renal disease were excluded. Urinalysis by dipstick and microscopic evaluation and 24 h proteinuria and albuminuria were measured in all patients and controls. Patients with psoriasis and controls were not significantly different with respect to the prevalence of abnormal urinalysis (7.5% versus 5%, P = 1.0), mean 24 h proteinuria (70.40 ± 24.38 mg/24 h versus 89.40 ± 26.78 mg/24 h, P = 0.30), and albuminuria (14.15 ± 8.12 mg/24 h versus 16.62 ± 8.21 mg/24 h, P = 0.18). The presence of abnormal urinalysis was not more common in patients with psoriasis than in controls. Our study demonstrated that psoriatic patients without any other comorbidities are not at increased risk of kidney disease.

In this study, the chemical and microbiological properties of Siahmazgi cheese, an Iranian artisanal cheese made of unheated ewe and goat milk without addition of starter culture, were evaluated. The pH of the samples ranged from 4.76 to 5.18. The average numbers of total viable count and lactic acid bacteria (LAB) in cheese samples were 3.7 × 106 and 6.9 × 106 cfu/g, respectively. Coliforms and Enterobacteriaceae were absent in all the samples. A total of 125 LAB isolates were selected according to their Gram-positive and catalase-negative characteristics, out of which 23 strains were cocci and 102 were lactobacilli. Identification of the selected isolates was done through biochemical tests and 16s rDNA sequencing. Isolated strains were identified as Lactobacillus plantarum group (41.6%), Lactobacillus brevis (39.2), Lactobacillus parabuchneri (0.8%), Enterococcus faecium (13.6%), Enterococcus durans (3.2%) and Pediococcus parvulus (1.6%). The results of this study showed the microbiological diversity of traditional Siahmazgi cheese. Practical Applications Exploring the microbiological diversity of traditional dairy products is required for selection of appropriate strains to manufacture the products with consistent quality and original taste on industrial scale.

In this study, the effect of Cuminum cyminum L. essential oil (EO) and Lactobacillus acidophilus (a probiotic) on growth of Staphylococcus aureus in white brined cheese was evaluated. The experiment included different levels of EO (0, 7.5, 15 and 30 µL/100 mL milk) and L. acidophilus (0 and 0.5%) to assess their effects on S. aureus count during the manufacture, ripening and storage of Iranian white brined cheese for up to 75 days. The significant (P

BACKGROUND/AIM: The use of infliximab in severe ulcerative colitis (UC) is established; however, its role in severe acute UC requires clarification. The present multicentre case series evaluated infliximab in hospitalized patients with steroid-refractory severe UC.METHODS: Patients from six hospitals were retrospectively evaluated. Data collection included demographics, duration of disease and previous treatments. The primary end point was response to in-hospital infliximab; defined as discharge without colectomy.RESULTS: Twenty-one patients (median age 26 years) were admitted between May 2006 and May 2008 with severe UC requiring intravenous steroids and given infliximab (median time to infusion eight days). Sixteen (76%) patients were discharged home without colectomy; three of these underwent colectomy at a later date. Of the remaining 13 patients (62%), all but two did not require further courses of steroids; six patients had infliximab as a bridge to azathioprine and seven patients were maintained on regular infliximab. Five patients required in-hospital colectomy after the initial infliximab.CONCLUSIONS: In this real-life experience of infliximab in patients with steroid-refractory severe UC, infliximab appears to be a viable rescue therapy. The majority of patients were discharged without surgery and 62% maintained response either as a bridge to azathioprine or maintenance infliximab.

BACKGROUND: The pp65 cytomegalovirus (CMV) antigenemia assay has been used as a means of guiding the pre-emptive therapy of CMV disease in solid organ transplant (SOT) recipients. Recently, concerns have been raised regarding the utility of the test to accurately and precisely detect viral activity early enough to reduce the morbidity and mortality associated with CMV.OBJECTIVE: To determine the performance characteristics of the method of antigenemia testing of SOT recipients used at Vancouver General Hospital, Vancouver, British Columbia.METHODS: All SOT recipients between January 1, 1999, and June 30, 2000, were retrospectively reviewed for six months following transplantation. Physical examination results, laboratory parameters, antigenemia results and treatment information were reviewed.RESULTS: A total of 134 kidney, liver, lung and kidney-pancreas transplant recipients were included in the analysis. The overall performance characteristics of the antigenemia assay in predicting CMV disease included a sensitivity of 64%, a specificity of 81%, a positive predictive value of 76% and a negative predictive value of 71%. A mean of 18 days passed between the onset of signs and symptoms of CMV disease/syndrome and the first recorded positive antigenemia result, and only 26% of patients had a positive test result before the onset of symptoms. It was found that an antigenemia test breakpoint of at least one positive cell for defining a positive test provided the most sensitive and specific prediction, with increased odds of developing CMV disease.CONCLUSIONS: Based on performance characteristics, the Vancouver General Hospital's current method of antigenemia testing to guide pre-emptive ganciclovir therapy in SOT patients is not optimal for the early detection of disease. Further study is needed on new molecular testing methods to determine if our ability to predict CMV disease can be improved.

To study the effect of immunosuppressive reduction on the incidence and consequence of late acute rejection (LAR) in liver allograft recipients, mean daily prednisone dose, mean cyclosporine A (CsA) trough and nadir levels were retrospectively reviewed for the nearest 12-week period preceding six episodes of LAR in five liver allograft recipients (group 1). Results were compared with those from a cohort of 12 liver allograft recipients who did not develop LAR (group 2). LAR was defined as acute rejection occurring more than 365 days post-transplantation. Median follow-up for both groups was similar (504 days, range 367 to 1050, versus 511 days, range 365 to 666, not significant). Mean trough CsA levels were lower in patients with LAR compared with those without (224 +/- 66 ng/mL versus 233 +/- 49 ng/mL) but the difference was not statistically significant. In contrast, mean daily prednisone dose (2.5 +/- 1.6 mg/day versus 6.5 +/- 2.9 mg/day, P = 0.007) and CsA nadir values (129 +/- 60 ng/mL versus 186 +/- 40 ng/mL, P = 0.03) were significantly lower in patients who developed LAR compared with those who did not. Five of six episodes (83%) of LAR occurred in patients receiving less than 5 mg/day of prednisone, versus a single LAR episode in only one of 12 patients (8%) receiving prednisone 5 mg/day or more (P = 0.004). In all but one instance, LAR responded to pulse methylprednisolone without discernible affect on long term graft function. The authors conclude that liver allograft recipients remain vulnerable to acute rejection beyond the first post-transplant year; and reduction of immunosuppressive therapy, particularly prednisone, below a critical, albeit low dose, threshold increases the risk of LAR.

For most of the decade, the commercial availability of peginterferon (pegIFN) and ribavirin (RBV) combination therapy for the treatment of chronic hepatitis C virus (HCV) has allowed both patients and health care professionals alike to expect a reasonable likelihood of long-term viral clearance. Both pegIFN and RBV combination products (ie, pegIFN α-2a and RBV, [Pegasys RBV, Hoffman-La Roche Ltd, Canada], and pegIFN α-2b and RBV, [Pegetron, Schering Canada Inc]) are associated with sustained virological response (SVR) probabilities of approximately 40% to 50% for genotype 1 and approaching 80% for genotypes 2 and 3 (1-3). Moreover, the impressive results reported in randomized clinical trials have also been reported in a retrospective analysis of clinical practice (4), going against the common wisdom that results obtained in a ‘real world’ clinical setting cannot match those obtained in the ‘ideal world’ of controlled trials. Despite this great optimism regarding HCV treatment, the cold hard reality is that pegIFN and RBV combination therapy is lengthy, taking approximately 24 to 48 weeks depending on the genotype; has many adverse effects, such that it is an unpleasant experience for many and punishing for some; and is very expensive, with an associated drug acquisition cost of $10,000 to $20,000 for 24 and 48 weeks of therapy, respectively. Although it would appear intuitive for any treatment regimen, that to maximize the likelihood of success one must take as much of the drug as possible, for pegIFN and RBV therapy, given the mentioned problems associated with therapy, the stakes are even higher.