High order sliding mode control for restoration of a population of predators in a Lotka-Volterra system.

Human-induced extinction and rapid ecological changes require the development of techniques that can help avoid extinction of endangered species. The most used strategy to avoid extinction is reintroduction of the endangered species, but only 31% of these attempts are successful and they require up to 15 years for their results to be evaluated. In this research, we propose a novel strategy that improves the chances of survival of endangered predators, like lynx, by controlling only the availability of prey. To simulate the prey-predator relationship we used a Lotka-Volterra model to analyze the effects of varying prey availability on the size of the predator population. We calculate the number of prey necessary to support the predator population using a high-order sliding mode control (HOSMC) that maintains the predator population at the desired level. In the wild, nature introduces significant and complex uncertainties that affect species' survival. This complexity suggests that HOSMC is a good choice of controller because it is robust to variability and does not require prior knowledge of system parameters. These parameters can also be time varying. The output measurement required by the HOSMC is the number of predators. It can be obtained using continuous monitoring of environmental DNA that measures the number of lynxes and prey in a specific geographic area. The controller efficiency in the presence of these parametric uncertainties was demonstrated with a numerical simulation, where random perturbations were forced in all four model parameters at each simulation step, and the controller provides the specific prey input that will maintain the predator population. The simulation demonstrates how HOSMC can increase and maintain an endangered population (lynx) in just 21-26 months by regulating the food supply (hares), with an acceptable maximal steady-state error of 3%.

Thermally Rearranged Mixed Matrix Membranes from Copoly(o-hydroxyamide)s and Copoly(o-hydroxyamide-amide)s with a Porous Polymer Network as a Filler-A Comparison of Their Gas Separation Performances.

Copoly(o-hydroxyamide)s (HPA) and copoly(o-hydroxyamide-amide)s (PAA) have been synthesized to be used as continuous phases in mixed matrix membranes (MMMs). These polymeric matrices were blended with different loads (15 and 30 wt.%) of a relatively highly microporous porous polymer network (PPN). SEM images of the manufactured MMMs exhibited good compatibility between the two phases for all the membranes studied, and their mechanical properties have been shown to be good enough even after thermal treatment. The WAX results show that the addition of PPN as a filler up to 30% does not substantially change the intersegmental distance and the polymer packing. It seems that, for all the membranes studied, the free volume that determines gas transport is in the high end of the possible range. This means that gas flow occurs mainly between the microvoids in the polymer matrix around the filler. In general, both HPA- and PAA-based MMMs exhibited a notable improvement in gas permeability, due to the presence of PPN, for all gases tested, with an almost constant selectivity. In summary, although the thermal stability of the PAA is limited by the thermal stability of the polyamide side chain, their mechanical properties were better. The permeability was higher for the PAA membranes before their thermal rearrangement, and these values increased after the addition of moderate amounts of PPN.

Accurate diagnosis of sepsis using a neural network: Pilot study using routine clinical variables.

BACKGROUND AND OBJECTIVES: Sepsis is a severe infection that increases mortality risk and is one if the main causes of death in intensive care units. Accurate detection is key to successful interventions, but diagnosis of sepsis is complicated because the initial signs and symptoms are not specific. Biomarkers that have been proposed have low specificity and sensitivity, are expensive, and not available in every hospital. In this study, we propose the use of artificial intelligence in the form of a neural network to diagnose sepsis using only common laboratory tests and vital signs that are routine and widely available. METHODS: A retrospective, cross sectional cohort of 113 patients from an intensive care unit, each with 48 routinely evaluated vital signs and biochemical parameters was used to train, validate and test a neural network with 48 inputs, 10 neurons in a single hidden layer and one output. The sensitivity and specificity of the neural network as a point sampled diagnostic test was calculated. RESULTS: All but one case were correctly diagnosed by the neural network, with 91% sensitivity and 100% specificity in the validation data set, and 100% sensitivity and specificity in the test data set. CONCLUSIONS: The designed neural network system can identify patients with sepsis, with minimal resources using standard laboratory tests widely available in most health care facilities. This should reduce the burden on the medical staff of a difficult diagnosis and should improve outcomes for patients with sepsis.

Effects of watermelon supplementation on arterial stiffness and wave reflection amplitude in postmenopausal women.

OBJECTIVE: Postmenopausal women have increased arterial stiffness (brachial-ankle pulse wave velocity [baPWV]) and wave reflection. L-Citrulline supplementation reduces baPWV but not brachial blood pressure. Peripheral vasodilators decrease wave reflection amplitude or second systolic peak (SBP2) in radial artery and aorta, which are related to aortic systolic blood pressure (SBP). We examined the effects of L-citrulline-rich watermelon supplementation on baPWV, wave reflection characteristics, and aortic SBP in postmenopausal women. METHODS: In a randomized cross-over study, 12 postmenopausal women (mean [SE] age, 57 [1] y; mean [SE] body mass index, 38.1 [2.1] kg/m; mean [SE] SBP, 153 [4] mm Hg) were assigned to watermelon supplementation (L-citrulline/L-arginine 6 g/d) or placebo supplementation for 6 weeks. Before and after each intervention, baPWV, aortic SBP, aortic diastolic blood pressure, aortic SBP2, radial SBP2, and aortic and radial augmentation indices were measured using applanation tonometry. RESULTS: baPWV (-1.2 [0.3] m/s, P < 0.001), aortic SBP (-10 [3] mm Hg, P < 0.01), and aortic diastolic blood pressure (-7 [1] mm Hg, P < 0.001) decreased after watermelon supplementation compared with placebo. Although radial and aortic augmentation indices were unaffected, radial and aortic SBP2 decreased (-10 [3] mm Hg, P < 0.01) after watermelon supplementation compared with placebo. The reduction in aortic SBP was correlated with reductions in radial SBP2 (r = 0.99, P < 0.001) and aortic SBP2 (r = 0.98, P < 0.001). The decreases in baPWV correlated with reductions in radial SBP2 (r = 0.57, P < 0.01) and aortic SBP2 (r = 0.64, P < 0.01). CONCLUSIONS: Watermelon supplementation reduces arterial stiffness and aortic SBP by reducing pressure wave reflection amplitude in obese postmenopausal women with hypertension.

The effects of short term L-citrulline supplementation on wave reflection responses to cold exposure with concurrent isometric exercise.

BACKGROUND: Supplementation with L-citrulline (L-cit) has shown attenuating effects on blood pressure (BP) and pulse-wave-reflection responses (augmentation index (AIx)) to local exposure to cold, but the potential cardioprotective effects of L-cit during whole-body cold exposure with concurrent exercise are poorly understood. We hypothesized that L-cit would attenuate the BP and AIx responses to cold exposure and isometric handgrip (IHG) exercise. METHODS: Sixteen healthy males with a mean age of 23±3 years volunteered for a study of the effect of L-cit on the BP and AIx responses to cold exposure and IHG exercise. Experiments were conducted inside an environmental chamber in cold conditions (4 ºC). Radial waveforms were obtained in duplicates and averaged through applanation tonometry. After 5 minutes of measurements made at rest in the supine position (RES), after the finalization of the exercise about the subjects were evaluated in non exercise condition that were basically the same as the RES. After initial measurements in cold conditions, subjects were randomized to receive either a placebo (Maltodextrin, PL) or L-cit (100mg/kg) for 14 days, followed by a 14-day washout period and then a 14-day regimen of the other agent. Subjects were re-evaluated after each treatment period. RESULTS: At RES, there was a significant treatment-by-time interaction for brachial systolic BP (BSBP; P < 0.01), aortic systolic BP (ASBP; P < 0.01), and AIx (P < 0.05), such that L-cit decreased BSBP (-11±2mm Hg; P < 0.01), ASBP (-10±2mm Hg; P < 0.05), and AIx (-2±2%; P < 0.05) as compared with their respective values before the intervention. During IHG, BSBP, ASBP, and AIx were increased (P < 0.05) as compared with their values at RES, but these responses were unaffected by either of the study treatments. CONCLUSIONS: L-citrulline may be a feasible adjuvant treatment for decrease the BP and AIx responses induced by cold. Further research is warranted to evaluate the impact of cold exposure and exercise on cardiovascular risk in clinical populations.

Effects of hypocaloric diet, low-intensity resistance exercise with slow movement, or both on aortic hemodynamics and muscle mass in obese postmenopausal women.

OBJECTIVE: This study aims to examine the independent and combined impact of hypocaloric diet and low-intensity resistance exercise training (LIRET) on aortic hemodynamics and appendicular skeletal muscle mass (ASM) in obese postmenopausal women. METHODS: Forty-one obese postmenopausal women (mean [SD] age, 54 [1] y) were randomly assigned to LIRET (n = 13), diet (n = 14), or diet + LIRET (n = 14). Body weight, waist circumference, aortic systolic blood pressure, aortic pulse pressure, augmentation index, subendocardial viability ratio (SEVR; myocardial perfusion), and heart rate (HR) were measured before and after 12 weeks. ASM was assessed by dual-energy x-ray absorptiometry. RESULTS: Body weight (P < 0.001) and waist circumference (P < 0.01) decreased similarly after diet and diet + LIRET compared with no changes after LIRET. ASM did not change after diet + LIRET, and the decrease observed after diet (P < 0.001) was significant compared with LIRET. Aortic systolic blood pressure decreased similarly after LIRET (P < 0.05), diet (P < 0.01), and diet + LIRET (P < 0.01). Aortic pulse pressure (P < 0.05) decreased similarly after diet and diet + LIRET, but not after LIRET. SEVR (P < 0.01) increased similarly in both diet groups, whereas HR (P < 0.01) decreased only after diet. Changes in SEVR (P < 0.05) and HR (P< 0.01) with diet were different compared with LIRET. The augmentation index did not change in any group. CONCLUSIONS: Our findings suggest that diet-induced weight loss may reduce cardiovascular risk by improving SEVR via HR and aortic pulse pressure reductions in obese postmenopausal women. LIRET prevents ASM loss associated with hypocaloric diet but has no additive effects on aortic hemodynamics.

Effects of diet and/or low-intensity resistance exercise training on arterial stiffness, adiposity, and lean mass in obese postmenopausal women.

BACKGROUND: Obesity and aging are associated with increased arterial stiffness as indicated by an increased pulse-wave velocity (PWV). We evaluated the independent and combined effects on PWV and body composition of a hypocaloric diet and low-intensity resistance exercise training (LIRET) with slow movement. METHODS: Forty-one postmenopausal women (mean age, 54±6 years; body mass index (BMI), 33.8±0.5kg/m(2)) were randomly assigned to LIRET (n = 14), diet (n = 13), or diet + LIRET (n = 14) for 12 weeks. The women's PWV, mean arterial pressure (MAP), body composition by dual-en ergy x-ray absorptiometry (DXA), and plasma adipokine and insulin levels were measured before and after the interventions. RESULTS: Body weight (P = 0.0001), trunk-fat mass (FM, P = 0.0001), and the serum concentration of leptin (P = 0.02 and P = 0.004) decreased similarly with diet and diet + LIRET, but not with LIRET alone. Leg lean mass (LM) decreased (P = 0.02) with diet, but did not change with diet + LIRET or with LIRET alone. Leg muscle strength increased similarly with LIRET (P = 0.001) and diet + LIRET (P = 0.0001), but did not change with diet alone. Brachial-ankle PWV (baPWV) decreased with diet (P = 0.04) and diet + LIRET (P = 0.01), whereas femoral-ankle PWV (legPWV) decreased only with diet (P = 0.01). Mean arterial pressure (MAP) decreased after LIRET (P = 0.03), diet (P = 0.04), and diet + LIRET (P = 0.004). Carotid-femoral PWV, serum adiponectin concentration, and insulin were not significantly affected by the interventions examined in the study. The reductions in baPWV and legPWV were correlated with one another (r = 0.73, P = 0.0001), and the reductions in legPWV and trunk FM were also correlated with one another (r = 0.36, P = 0.03). CONCLUSIONS: A hypocaloric diet decreases baPWV mainly by reducing legPWV, and this reduction is related to the loss of truncal fat. Although LIRET alone does not affect PWV or body composition, LIRET combined with diet improves baPWV and muscle strength while preventing loss of lean body mass in obese postmenopausal women.

Eficacia y seguridad de la terapia tópica con capsaicina 0,075 por ciento versus mentol 1 por ciento, en el tratamiento del prurito de la foliculitis eosinofílica asociada al virus de la inmudeficiencia adquirida / Topical capsaicin 0, 075 per cent versus menthol 1 per cent efficacy and safety in HIV associated eosinofilic folliculitis

Objetivo: Determinar la eficacia y seguridad de la terapia tópica con capsaicina 0,075 por ciento versus mentol 1 por ciento en el tratamiento del prurito de la foliculitis eosinofílica asociada al virus de la inmunodeficiencia adquirida (VIH). Diseño: Estudio clínico aleatorizado y doble ciego. Lugar: Servicios de Enfermedades Infecciosas y Tropicales (SEIT) y Dermatología, Hospital Nacional Dos de Mayo, Lima, Perú. Participantes: Pacientes con foliculitis eosinofílica asociada al VIH. Intervenciones: La muestra estuvo constituida por 40 pacientes con foliculitis eosinofílica asociada al VIH, quienes fueron distribuidos mediante muestreo aleatorio sistemático en dos grupos: el grupo 1 conformado por 20 pacientes que recibieron la terapia 1; y el grupo 2, conformado por 20 pacientes que recibieron la terapia 2. Los pacientes recibieron tratamiento con capsaicina al 0,075 por ciento y mentol 1 por ciento; la aplicación se realizó en el área afectada, cada 6 horas, durante 45 días. Se implementó un sistema de visitas (domiciliarias u hospitalarias), se evaluó la eficacia en la reducción del prurito (escala de Likert) y se registró los eventos. Principales medidas de resultados: Respuesta clínica a la administración de capsaicina y mentol. Resultados: La respuesta fue buena en 90 por ciento de los pacientes que recibieron capsaicina 0,075 por ciento, en comparación con 40 por ciento en el grupo que recibió mentol al 1 por ciento (p = 0,001), con OR = 0,074 (IC 95 por ciento: 0,013 - 0,411). La eficacia de las terapias tópicas fue modificada por el recuento de linfocitos CD4 (p menor que 0,001). La presencia de enfermedades oportunistas (p = 0,252) no afectó la eficacia de las terapias. Se presentaron efectos adversos locales (eritema y ardor) en 3 pacientes (15 por ciento) que recibieron...

Objetive: To determine efficacy and safety of capsaicin 0,075 per cent topical therapy in the treatment of pruritus due to eosinophilic folliculitis in HIV patients with lymphocyte count CD4 (+) minor 250 x mm3. Design: Randomized clinical trial, double blind study. Setting: Infectious and Tropical Diseases Service and Dermatology Service, Hospital Nacional Dos de Mayo, Lima, Peru. Participants: Patients with VIH-associated eosinophilic folliculitis. Interventions: Forty patients with HIV-associated eosinophilic folliculitis were randomly distributed in two groups: group 1 included 20 patients that received sample 1 and group 2, 20 patients that received sample 2. Patients received capsaicin 0,075 per cent and menthol 1 per cent treatments (marked as sample 1 and sample 2). Instructions on topical use each 6 hours were given to patients. Visits were programmed to evaluate efficacy and monitor adverse events by study drugs. Main outcome measures: Capsaicin and menthol administration clinical outcome. Results: We found good response in 90 per cent of patients receiving capsaicin 0,075 per cent (18/20) versus 40 per cent of the group treated with menthol 1 per cent (88/20), with significant statistical difference (p= 0,001), OR = 0,074 per cent (IC 95 per cent: 0,013 - 0,411). Topical therapy efficacy was altered by CD4 lymphocyte count (p minor 0,001); otherwise the occurrence of opportunistic diseases (p= 0,252) did not affect therapy efficacy. There were local adverse events (erithema and heat) in 3 patients (15 per cent) who received capsaicin 0,075 per cent and only in one patient (5 per cent) of group 2 (menthol) who presented erithema (5%), with no significant statistical difference (p major 0,05). Conclusions: Capsaicin topical therapy is effective and safe in the treatment of pruritus in HIV-associated eosinophilic folliculitis.

Linfangitis esclerosante no venérea del pene: presentación de un caso clínico / Nonvenereal sclerosing lymphangitis of the penis: presentation of a clinical case

La linfangitis esclerosante no venérea del pene es un proceso infrecuente que afecta a los linfáticos distales de este órgano. Se caracteriza por la aparición súbita de un cordón translúcido e indurado en el surco coronal. Su etiología es desconocida, aunque se ha relacionado con microtraumatismos en la zona después de una actividad sexual intensa. Es un proceso benigno y autorresolutivo por lo que no es necesaria la realización de biopsia en etapas iniciales y el tratamiento inicial debe ser conservador. Se presenta un nuevo caso de esta enfermedad y se comentan sus características etiopatogénicas, clínicas, diagnósticas y terapéuticas

Nonvenereal sclerosing lymphangitis of the penis is an infrequent process that affects the distal lymphatics of this organ. It is characterized by the sudden appearance of a translucent and indurated cord on the coronal sulcus. Its etiology is unknown, although it has been related to microtraumas in the area after intense sexual activity. It is a benign, self-resolving process, so it is not necessary to perform a biopsy in early stages, and initial treatment should be conservative. We present a new case of this disease and discuss its etiopathogenic, clinical, diagnostic and therapeutic characteristics

[Nonvenereal sclerosing lymphangitis of the penis: presentation of a clinical case]. / Linfangitis esclerosante no venérea del pene: presentación de un caso clínico.

Nonvenereal sclerosing lymphangitis of the penis is an infrequent process that affects the distal lymphatics of this organ. It is characterized by the sudden appearance of a translucent and indurated cord on the coronal sulcus. Its etiology is unknown, although it has been related to microtraumas in the area after intense sexual activity. It is a benign, self-resolving process, so it is not necessary to perform a biopsy in early stages, and initial treatment should be conservative. We present a new case of this disease and discuss its etiopathogenic, clinical, diagnostic and therapeutic characteristics.

Criptococcosis esplénica: a propósito de un caso en un paciente con VIH / Consumption of alcoholic drinks in teenagers of Puno's city

El objetivo es conocer la edad, causa de inicio y la frecuencia de consumo de bebidas alcohólicas en adolescentes de Puno. Se realiza un estudio descriptivo - tansversal en 109 estudiantes de 5° año de secundaria (15 - 16 años) en 4 diferentes colegios de la ciudad, elegidos por conveniencia. Se realizó una encuesta con 7 preguntas cerradas, la cual fue validad previamente en 25 estudiantes ajenos a la muestra. Encontramos, que más del 50 por ciento (64) de encuestados, ha consumido alcohol por lo menos una vez en su vida; la edad media de inicio es, 13,9 años (2,4 D.E) y 15 años (1 D. E.) en varones y mujeres respectivamente; la causa de inicio frecuente, es curioosidad (18,2 por ciento); el 89,1 por ciento es bebedor social; el 1,6 por ciento lo hace frecuentemente (fines de semana). El 82,6 por ciento indica que se les expande alcohol sin que previamente estos acrediten su mayoría de edad.