A Nonsmooth Maximum Principle for Optimal Control Problems with State and Mixed Constraints-Convex Case

Here we derive a nonsmooth maximum principle for optimal control problems with both state and mixed constraints. Crucial to our development is a convexity assumption on the "velocity set". The approach consists of applying known penalization techniques for state constraints together with recent results for mixed constrained problems.Comment: Published in 'Discrete and Continuous Dynamical Systems, Vol. 2011, pp. 174-18

INTRA-DUODENAL RELEASE OF A BITTER COMPOUND DECREASES CALORIC INTAKE IN HEALTHY VOLUNTEERS

Background and aim: α-gustducin and bitter taste receptors (T2R) are expressed both in the oral cavity and in the gastrointestinal (GI) tract. Experimental data showed that bitter tastants induce the release of gut hormones from enteroendocrine cells in the gut, suggesting a possible role of bitter taste receptors in the control of food intake and GI functions. We aimed to test the effects of a bitter taste receptor agonist on food intake and GI feelings. Material and methods: We enrolled 19 healthy subjects (9 males, age 27±7, BMI 24±6) in a double-blind placebo controlled study. Each subject randomly received an acid-resistant capsule containing placebo or 18 mg of quinine HCl. 60 minutes after capsule administration, the subjects underwent to an ad libitum test, until the maximum satiation. Meal test was composed by white bread, cheese and meat cream (89 kcal/portion: 50% carbohydrate, 31% fat, 19% protein). Caloric intake, meal duration and satiation levels, scored on a Visual Analogue Scale (VAS) were calculated at the end of the meal test. A questionnaire assessing GI sensations (bloating, fullness, nausea, epigastric discomfort and hunger) was administered before and at the end of the test. Data (mean ± SD) were compared by using paired t test. Results: No oral bitter sensation or side effects was observed both with quinine HCland placebo. No significant differences in terms of GI sensations and hunger feelings were observed between the two sessions of the study. The amount of calories ingested was significantly lower when subjects received quinine HCl than placebo (564±262 vs 667±278 kcal; p=0.02). Conversely, quinine HCl did not affect the meal duration (14.4±4.2 vs 16.6±4.6 min; p=NS) and the satiationintensity (82 vs 82 mm; p=NS). Conclusions: The intra-duodenal release of a bitter compound significantly decreases caloric intake in an ad libitum test meal without affecting GI sensations and hunger feeling. As the bitter compound does not influence meal duration, we hypothesize that quinine HCl decreases the caloric intake by affecting the rate of meal portions consumption. Evaluation of gut hormones kinetics and studies with other bitter taste receptor agonist are needed to establish the role of gastrointestinal bitter taste receptor in the control of food intak

CHRONIC CONSTIPATION IS A RISK FACTOR FOR METABOLIC SYNDROME

Background and aim: A recent epidemiologic survey in the U.S. provides indirect evidence that constipation is a risk factor for cardiovascular disease in postmenopausal females. To characterize the related factors involved in and to further analyse if this assumption also applies to an Italian population, we studied the impact of chronic constipation on ischemic cardiopathy and predisposing risk factors in a large population of female patients in a primary care setting. Material and methods: We retrospectively evaluated 754 female patients (mean age 46±20 years) on data file of a primary care setting. All subjects requiring medical referral for constipation were screened and presence of chronic constipation was confirmed by standardized questionnaires. The presence of clinical and/or instrumental diagnosis of ischemic cardiopathy, metabolic syndrome, diabetes and blood hypertension was scored in patients with and without chronic constipation. In all patients the consumption of drugs potentially delaying colonic transit (calcium channel blockers and beta blockers) was recorded. Patients on opioid or analgesic treatment were excluded. Results: The overall prevalence of chronic constipation was 9.4% (71/754) with the age being similar in patients with and without constipation (46±19 vs. 51±22, p=NS). The prevalence of metabolic syndrome was significantly higher in subjects with chronic constipation (5/66 vs 16/667, OR=3.1, 95% CI 1.1–8.9, p=0.03). Conversely, prevalence of diabetes, blood hypertension, ischemic cardiopathy was similar in patients with and without constipation (59/624 vs 10/61; 204/478 vs 28/43; 46/637 vs 6/65, respectively p= all NS). No significant difference was also observed as far as calcium channel blockers (64/619 vs 9/62) and beta blockers (81/602 vs 9/62) consumption in patients with or without constipation respectively. Conclusions: We showed that chronic constipation is a risk factor for metabolic syndrome in female patients. Although we did not find any significant association between chronic constipation and ischemic cardiopathy, our findings support the hypothesis that constipation may act as cardiovascular risk factor. Whether this association is dependent on dietary or hormonal factors deserves further investigation

Evaluation of rK39 rapid diagnostic tests for canine visceral leishmaniasis : longitudinal study and meta-analysis

Canine visceral leishmaniasis is a vector-borne disease caused by the intracellular parasite Leishmania infantum. It is an important veterinary disease, and dogs are also the main animal reservoir for human infection. The disease is widespread in the Mediterranean area, and parts of Asia and South and Central America, and is potentially fatal in both dogs and humans unless treated. Diagnosis of canine infections requires serological or molecular tests. Detection of infection in dogs is important prior to treatment, and in epidemiological studies and control programmes, and a sensitive and specific rapid diagnostic test would be very useful. Rapid diagnostic tests (RDTs) have been developed, but their diagnostic performance has been reported to be variable. We evaluated the sensitivity of a RDT based on serological detection of the rK39 antigen in a cohort of naturally infected Brazilian dogs. The sensitivity of the test to detect infection was relatively low, but increased with time since infection and the severity of infection. We then carried out a meta-analysis of published studies of rK39 RDTs, evaluating the sensitivity to detect disease and infection. The results suggest that rK39 RDTs may be useful in a veterinary clinical setting, but the sensitivity to detect infection is too low for operational control programmes

Paclitaxel loading in PLGA nanospheres affected the in vitro drug cell accumulation and antiproliferative activity

<p>Abstract</p> <p>Background</p> <p>PTX is one of the most widely used drug in oncology due to its high efficacy against solid tumors and several hematological cancers. PTX is administered in a formulation containing 1:1 Cremophor^®EL (polyethoxylated castor oil) and ethanol, often responsible for toxic effects. Its encapsulation in colloidal delivery systems would gain an improved targeting to cancer cells, reducing the dose and frequency of administration.</p> <p>Methods</p> <p>In this paper PTX was loaded in PLGA NS. The activity of PTX-NS was assessed in vitro against thyroid, breast and bladder cancer cell lines in cultures. Cell growth was evaluated by MTS assay, intracellular NS uptake was performed using coumarin-6 labelled NS and the amount of intracellular PTX was measured by HPLC.</p> <p>Results</p> <p>NS loaded with 3% PTX (w/w) had a mean size < 250 nm and a polydispersity index of 0.4 after freeze-drying with 0.5% HP-Cyd as cryoprotector. PTX encapsulation efficiency was 30% and NS showed a prolonged drug release in vitro. An increase of the cytotoxic effect of PTX-NS was observed with respect to free PTX in all cell lines tested.</p> <p>Conclusion</p> <p>These findings suggest that the greater biological effect of PTX-NS could be due to higher uptake of the drug inside the cells as shown by intracellular NS uptake and cell accumulation studies.</p

The use of medicinal plants in health care practices by Rohingya refugees in a degraded forest and conservation area of Bangladesh

People in developing countries traditionally rely on plants for their primary healthcare. This dependence is relatively higher in forests in remote areas due to the lack of access to modern health facilities and easy availability of the plant products.We carried out an ethno-medicinal survey in Teknaf Game Reserve (TGR), a heavily degraded forest and conservation area in southern Bangladesh, to explore the diversity of plants used by Rohingya refugees for treating various ailments. The study also documented the traditional utilization, collection and perceptions of medicinal plants by the Rohingyas residing on the edges of this conservation area. We collected primary information through direct observation and by interviewing older respondents using a semi-structured questionnaire. A total of 34 plant species in 28 families were frequently used by the Rohingyas to treat 45 ailments, ranging from simple headaches to highly complex eye and heart diseases. For medicinal preparations and treating various ailments, aboveground plant parts were used more than belowground parts. The collection of medicinal plants was mostly from the TGR. © 2009 Taylor & Francis

Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: A systematic review

Background Our understanding of effective perioperative supportive interventions for patients undergoing cystectomy procedures and how these may affect short and long-term health outcomes is limited. Methods Randomised controlled trials involving any non-surgical, perioperative interventions designed to support or improve the patient experience for patients undergoing cystectomy procedures were reviewed. Comparison groups included those exposed to usual clinical care or standard procedure. Studies were excluded if they involved surgical procedure only, involved bowel preparation only or involved an alternative therapy such as aromatherapy. Any short and long-term outcomes reflecting the patient experience or related urological health outcomes were considered. Results 19 articles (representing 15 individual studies) were included for review. Heterogeneity in interventions and outcomes across studies meant meta-analyses were not possible. Participants were all patients with bladder cancer and interventions were delivered over different stages of the perioperative period. The overall quality of evidence and reporting was low and outcomes were predominantly measured in the short-term. However, the findings show potential for exercise therapy, pharmaceuticals, ERAS protocols, psychological/educational programmes, chewing gum and nutrition to benefit a broad range of physiological and psychological health outcomes. Conclusions Supportive interventions to date have taken many different forms with a range of potentially meaningful physiological and psychological health outcomes for cystectomy patients. Questions remain as to what magnitude of short-term health improvements would lead to clinically relevant changes in the overall patient experience of surgery and long-term recovery

Interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review

Background: To systematically review the effects of interventions to improve exercise behaviour in sedentary people living with and beyond cancer. Methods: Only randomised controlled trials (RCTs) that compared an exercise intervention to a usual care comparison in sedentary people with a homogeneous primary cancer diagnosis, over the age of 18 years were eligible. The following electronic databases were searched: Cochrane Central Register of Controlled Trials MEDLINE; EMBASE; AMED; CINAHL; PsycINFO; SportDiscus; PEDro from inception to August 2012. Results: Fourteen trials were included in this review, involving a total of 648 participants. Just six trials incorporated prescriptions that would meet current recommendations for aerobic exercise. However, none of the trials included in this review reported intervention adherence of 75% or more for a set prescription that would meet current aerobic exercise guidelines. Despite uncertainty around adherence in many of the included trials, the interventions caused improvements in aerobic exercise tolerance at 8–12 weeks (SMD=0.73, 95% CI=0.51–0.95) in intervention participants compared with controls. At 6 months, aerobic exercise tolerance is also improved (SMD=0.70, 95% CI=0.45–0.94), although four of the five trials had a high risk of bias; hence, caution is warranted in its interpretation. Conclusion: Expecting the majority of sedentary survivors to achieve the current exercise guidelines is likely to be unrealistic. As with all well-designed exercise programmes, prescriptions should be designed around individual capabilities and frequency, duration and intensity or sets, repetitions, intensity of resistance training should be generated on this basis