A robust variable-structure LQI controller for under-Actuated systems via flexible online adaptation of performance-index weights

This article presents flexible online adaptation strategies for the performance-index weights to constitute a variable structure Linear-Quadratic-Integral (LQI) controller for an underactuated rotary pendulum system. The proposed control procedure undertakes to improve the controller s adaptability, allowing it to flexibly manipulate the control stiffness which aids in efficiently rejecting the bounded exogenous disturbances while preserving the system s closed-loop stability and economizing the overall control energy expenditure. The proposed scheme is realized by augmenting the ubiquitous LQI controller with an innovative online weight adaptation law that adaptively modulates the state-weighting factors of the internal performance index. The weight adaptation law is formulated as a pre-calibrated function of dissipative terms, anti-dissipative terms, and model-reference tracking terms to achieve the desired flexibility in the controller design. The adjusted state weighting factors are used by the Riccati equation to yield the time-varying state-compensator gains

Evaluation of the in vitro antioxidant and antitumor activity of hydroalcoholic extract from Jatropha mollissima leaves in Wistar rats

Introduction: Despite modern sciences and advancements in new drugs or chemicals, the new era now rushes natural remedies for various illnesses and diseases that lead to end organ damage. In this study, we investigated Jatropha mollissima ethanolic extract’s effect against doxorubicin-induced cardiotoxicity and renal toxicity.Methods: To determine phytochemicals, a phytochemical screening was conducted. Various assays were used to measure the antioxidant activity, including the DPPH (2,2-diphenylpicrylhydrazyl), SOD (superoxide dismutase), NO (nitric oxide), and others. The antiproliferative effect of Jm was assessed by MTT assay; morphological analysis was performed using an inverted and phase contrast microscope, ultra morphological analysis of apoptosis with acridine orange (AO)/propidium iodide (PI) staining.Results: It was seen that doxorubicin caused elevated serum markers and abnormal changes in histological patterns. The significant reduction in cardiac and renal marker levels seen in groups given either 400 or 600 mg/kg of crude extract demonstrates that Jm has a protective effect against doxorubicin-induced cardiotoxicity due to the presence of active phytoconstituents having antioxidant potential. There is a dose-dependent decrease in cell viability when using J. mollissima. Apoptosis was observed in the treated cells.Conclusion: In conclusion, our research lends credence to the idea that J. mollissima could be used for cancer management and have cardioprotective and nephroprotective effects

Neuromyelitis optica spectrum disorder: a case Report from Rehman Medical institute, Peshawar.

Devic\u27s disease or Neuromyelitis Optica is a serious, rare idiopathic neurological disorder which affects the optic nerve and the spinal cord. A 15-year-old girl was admitted in the neurology was with a previous history of 4 episodes of weakness in both the lower limbs and urinary retention. The patient gradually lost her eyesight in both eyes at the age of 8. Initially, she was diagnosed as a case of Multiple Sclerosis at the age of 11 when she presented with first episode of lower limb weakness. Later, Seropositivity for Aquaporin 4 IgG and clear MRI scan of the brain confirmed the diagnosis of Neuromyelitis Optica

Cross-sectional study of knowledge of stroke Management amongst doctors of a tertiary Care Hospital; Peshawar, Pakistan

Stroke is one of the leading causes of mortality and neurological disability worldwide. ‘Time is brain’ and prompt management of stroke is vital to improve the outcomes. Knowledge of stroke management is important for clinicians working in various specialties and this study focused on evaluation of this vital aspect

Eradication of Stage IV Gastric Cancer: Case Report

Background. Gastric cancer has a low overall survival rate worldwide, and surgery still remains the intent to cure option on early stages of disease. HER-2 positive cancers may have a survival advantage. We present a patient with stage IV gastric cancer HER-2 positive responsive to Herceptin, free of detectable disease two years after surgery. Patient Presentation. 70 years old Caucasian male complained of left-sided chest pain. Upon evaluation, he was diagnosed with HER-2 positive adenocarcinoma of the stomach at the pylorus with two liver metastases. Near complete response was observed with Herceptin and Cis-platinum based chemotherapy followed by 80% distal gastrectomy and liver resection with uneventful recovery. Two years follow up reported a patient living normal life with undetectable disease. Conclusion. Multimodality targeted therapy may accomplish 24months cure of advanced malignant gastric disease

Assessment of ameliorative effect of Aab-e-Shifa polyherbal formulation in experimentally-induced wound in rabbits

Purpose: The aim of the current study is to evaluate the wound healing potential of a polyherbal formulation (PHF) Aab-e-Shifa in normal and diabetic albino rabbits. Methods: The activity of PHF application was evaluated in comparison to tetrachlorodecaoxide (TCDO) on experimentally-induced excision wound in the thigh of normal and diabetic rabbits under ketamine anesthesia. Preliminary phytochemical analysis, total phenolic contents, wound contraction, as well as toxicological and histopathological studies were also investigated. Results: PHF exhibited parallel (p < 0.05) activity for initial wound healing in both normal (48.07 %) and diabetic groups (36.32 %), when compared to their respective control groups. Phytochemical analysis showed the presence of high levels of total phenolic contents in Allilum sativum L. (54.25 ± 0.15 GAE mg/g), Curcuma longa L. (25.45 ± 0.48 GAE mg/g), Zingiber officinale Rosc. (29.08 ± 0.35 GAE mg/g) and some phytochemicals such as flavonoids, couramins, terpenoids in these plants. No adverse sign of PHF was observed when applied at a dose of 2000 - 3000 g on rabbit skin. Conclusion: Aab-e-Shifa has great potential in wound healing and may be used as an alternative treatment for the healing of wounds in animals. The phytochemicals present in PHF might play a role in the wound healing activity possibly due to their antioxidant potential. However, further detailed studies are required to buttress this

Green inspired synthesis of zinc oxide nanoparticles using Silybum marianum (milk thistle) extract and evaluation of their potential pesticidal and phytopathogens activities

Background The green approaches for the synthesis of nanoparticles are gaining significant importance because of their high productivity, purity, low cost, biocompatibility, and environmental friendliness. Methods The aim of the current study is the green synthesis of zinc oxide nanoparticles (ZnO-NPs) using seed extracts of Silybum marianum, which acts as a reducing and stabilizing agent. central composite design (CCD) of response surface methodology (RSM) optimized synthesis parameters (temperature, pH, reaction time, plant extract, and salt concentration) for controlled size, stability, and maximum yields of ZnO-NPs. Green synthesized ZnO-NPs was characterized using UV-visible spectroscopy and Zetasizer analyses. Results The Zetasizer confirmed that green synthesized ZnO-NPs were 51.80 nm in size and monodispersed in nature. The UV-visible results revealed a large band gap energy in the visible region at 360.5 nm wavelength. The bioactivities of green synthesized ZnO-NPs, including antifungal, antibacterial, and pesticidal, were also evaluated. Data analysis confirmed that these activities were concentration dependent. Bio-synthesized ZnO-NPs showed higher mortality towards Tribolium castaneum of about 78 ± 0.57% after 72 h observation as compared to Sitophilus oryzae, which only displayed 74 ± 0.57% at the same concentration and time intervals. Plant-mediated ZnO-NPs also showed high potential against pathogenic gram-positive bacteria (Clavibacter michiganensis), gram-negative bacteria (Pseudomonas syringae), and two fungal strains such as Fusarium oxysporum, and Aspergillums niger with inhibition zones of 18 ± 0.4, 25 ± 0.4, 21 ± 0.57, and 19 ± 0.4 mm, respectively. Conclusion The results of this study showed that Silybum marianum-based ZnO-NPs are cost-effective and efficient against crop pests

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial