Some kinds of the controllable problems for fuzzy control dynamic systems

In this work, we have discussed the fuzzy solutions for fuzzy controllable problem, fuzzy feedback problem, and fuzzy global controllable (GC) problems. We use the method of successive approximations under the generalized Lipschitz condition for the local existence and furthermore, we have described the contraction principle under suitable conditions for global existence and uniqueness of fuzzy solutions. We have too the GC results for fuzzy systems. Some examples and computer simulation illustrating our approach are also given for these controllable problems

Preparation and Foliar Application of Oligochitosan - Nanosilica on the Enhancement of Soybean Seed Yield

Oligochitosan with weight average molecu-lar weight (Mw) of 5000 g/mol was prepared by gamma Co-60 radiation degradation of 4% chitosan solution containing 0.5% H2O2 at 21 kGy. Nanosilica with size of 10 – 30 nm was synthesized by calcination of acid treated rice husk at 700o C for 2 h. The mixture of 2% oligo-chitosan-2% nanosilica was prepared by dispersion of nanosilica in oligochitosan solution. Oligochitosan, nanosilica and their mixture were characterized by gel permeation chromatography (GPC), transmission electr-on microscopy (TEM), X-ray diffraction (XRD), energy dispersive x-ray spectroscopy (EDX), Ultraviolet-visible spectroscopy (UV-Vis), and Furrier transform infrared spectroscopy (FT-IR). Effect of foliar application of oli-gochitosan and oligochitosan-nanosilica on soybean seed yield was conducted in experimental field. Results indi-cated that soybean seed yield increased 10.5 and 17.0% for oligochitosan and oligochitosan-nanosilica, respect-tively for the control. Radiation degraded oligo-chitosan and its mixture with nanosilica can be potentially used for cultivation of soybean with enhanced seed yield

Chemical composition, antimicrobial and larvicidal activities of essential oils of two Syzygium species from Vietnam

Abstract The present study is the first to investigate the chemical composition, antimicrobial and larvicidal activities of the essential oils from the leaves of Syzygium attopeuense (Gagnep.) Merr. & L.M.Perry and Syzygium tonkinense (Gagnep.) Merr. & L.M.Perry collected in Vietnam. The essential oils were extracted by hydrodistillation and analyzed by GC and GC–MS. The study indicated the presence of a high percentage of sesquiterpenes in both investigated essential oils. The major components of S. attopeuense essential oil were bicyclogermacrene (24.26%), (E)-caryophyllene (11.72%), and (E)-β-ocimene (6.75%), whereas S. tonkinense essential oil was dominated by (E)-caryophyllene (80.80%). The antimicrobial activity of essential oils was evaluated by broth microdilution assay to determine the minimum inhibitory concentration (MIC) and median inhibitory concentration (IC50). Both essential oils exhibited remarkable inhibitory activity against all tested Gram-positive bacteria and yeast than Gram-negative bacteria. Among them, essential oils of S. attopeuense and S. tonkinense possessed the strongest activity against Enterococcus faecalis (MIC = 4.00 μg/mL; IC50 = 1.69 μg/mL) and Candida albicans (MIC = 16.00 μg/mL; IC50 = 8.67 μg/mL), respectively. Furthermore, the larvicidal activity of essential oils was tested using fourth-instar larvae of Aedes aegypti. Results from the larvicidal test revealed that both essential oils had an excellent inhibitory effect against A. aegypti larvae with LC50 values from 25.55 to 30.18 μg/mL and LC90 values from 33.00 to 39.01 μg/mL. Our findings demonstrate that the essential oil extracted from S. attopeuense and S. tonkinense are potential sources of natural antimicrobials and can act as inexpensive mosquito larvicidal agents

The management of tetanus in adults in an intensive care unit in Southern Vietnam

Background: Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere. Methods: We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria. Results: Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients. Conclusion: We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common

Adjunctive dexamethasone for tuberculous meningitis in HIV-positive adult

BACKGROUND Adjunctive glucocorticoids are widely used to treat human immunodeficiency virus (HIV)–associated tuberculous meningitis despite limited data supporting their safety and efficacy. METHODS We conducted a double-blind, randomized, placebo-controlled trial involving HIV-positive adults (≥18 years of age) with tuberculous meningitis in Vietnam and Indonesia. Participants were randomly assigned to receive a 6-to-8-week tapering course of either dexamethasone or placebo in addition to 12 months of antituberculosis chemotherapy. The primary end point was death from any cause during the 12 months after randomization. RESULTS A total of 520 adults were randomly assigned to receive either dexamethasone (263 participants) or placebo (257 participants). The median age was 36 years; 255 of 520 participants (49.0%) had never received antiretroviral therapy, and 251 of 484 participants (51.9%) with available data had a baseline CD4 count of 50 cells per cubic millimeter or less. Six participants withdrew from the trial, and five were lost to follow-up. During the 12 months of follow-up, death occurred in 116 of 263 participants (44.1%) in the dexamethasone group and in 126 of 257 participants (49.0%) in the placebo group (hazard ratio, 0.85; 95% confidence interval, 0.66 to 1.10; P=0.22). Prespecified analyses did not reveal a subgroup that clearly benefited from dexamethasone. The incidence of secondary end-point events, including cases of immune reconstitution inflammatory syndrome during the first 6 months, was similar in the two trial groups. The numbers of participants with at least one serious adverse event were similar in the dexamethasone group (192 of 263 participants [73.0%]) and the placebo group (194 of 257 participants [75.5%]) (P=0.52). CONCLUSIONS Among HIV-positive adults with tuberculous meningitis, adjunctive dexamethasone, as compared with placebo, did not confer a benefit with respect to survival or any secondary end point. (Funded by the Wellcome Trust; ACT HIV ClinicalTrials.gov number, NCT03092817. opens in new tab.

Combination Antifungal Therapy for Cryptococcal Meningitis

Background Combination antifungal therapy (amphotericin B deoxycholate and flucytosine) is the recommended treatment for cryptococcal meningitis but has not been shown to reduce mortality, as compared with amphotericin B alone. We performed a randomized, controlled trial to determine whether combining flucytosine or high-dose fluconazole with high-dose amphotericin B improved survival at 14 and 70 days. Methods We conducted a randomized, three-group, open-label trial of induction therapy for cryptococcal meningitis in patients with human immunodeficiency virus infection. All patients received amphotericin B at a dose of 1 mg per kilogram of body weight per day; patients in group 1 were treated for 4 weeks, and those in groups 2 and 3 for 2 weeks. Patients in group 2 concurrently received flucytosine at a dose of 100 mg per kilogram per day for 2 weeks, and those in group 3 concurrently received fluconazole at a dose of 400 mg twice daily for 2 weeks. Results A total of 299 patients were enrolled. Fewer deaths occurred by days 14 and 70 among patients receiving amphotericin B and flucytosine than among those receiving amphotericin B alone (15 vs. 25 deaths by day 14; hazard ratio, 0.57; 95% confidence interval [CI], 0.30 to 1.08; unadjusted P=0.08; and 30 vs. 44 deaths by day 70; hazard ratio, 0.61; 95% CI, 0.39 to 0.97; unadjusted P=0.04). Combination therapy with fluconazole had no significant effect on survival, as compared with monotherapy (hazard ratio for death by 14 days, 0.78; 95% CI, 0.44 to 1.41; P=0.42; hazard ratio for death by 70 days, 0.71; 95% CI, 0.45 to 1.11; P=0.13). Amphotericin B plus flucytosine was associated with significantly increased rates of yeast clearance from cerebrospinal fluid (−0.42 log10 colony-forming units [CFU] per milliliter per day vs. −0.31 and −0.32 log10 CFU per milliliter per day in groups 1 and 3, respectively; P<0.001 for both comparisons). Rates of adverse events were similar in all groups, although neutropenia was more frequent in patients receiving a combination therapy. Conclusions Amphotericin B plus flucytosine, as compared with amphotericin B alone, is associated with improved survival among patients with cryptococcal meningitis. A survival benefit of amphotericin B plus fluconazole was not found

Intensified Antituberculosis Therapy in Adults with Tuberculous Meningitis

BACKGROUND Tuberculous meningitis is often lethal. Early antituberculosis treatment and adjunctive treatment with glucocorticoids improve survival, but nearly one third of patients with the condition still die. We hypothesized that intensified antituberculosis treatment would enhance the killing of intracerebral Mycobacterium tuberculosis organisms and decrease the rate of death among patients. METHODS We performed a randomized, double-blind, placebo-controlled trial involving human immunodeficiency virus (HIV)-infected adults and HIV-uninfected adults with a clinical diagnosis of tuberculous meningitis who were admitted to one of two Vietnamese hospitals. We compared a standard, 9-month antituberculosis regimen (which included 10 mg of rifampin per kilogram of body weight per day) with an intensified regimen that included higher-dose rifampin (15 mg per kilogram per day) and levofloxacin (20 mg per kilogram per day) for the first 8 weeks of treatment. The primary outcome was death by 9 months after randomization. RESULTS A total of 817 patients (349 of whom were HIV-infected) were enrolled; 409 were randomly assigned to receive the standard regimen, and 408 were assigned to receive intensified treatment. During the 9 months of follow-up, 113 patients in the intensified-treatment group and 114 patients in the standard-treatment group died (hazard ratio, 0.94; 95% confidence interval, 0.73 to 1.22; P=0.66). There was no evidence of a significant differential effect of intensified treatment in the overall population or in any of the subgroups, with the possible exception of patients infected with isoniazid-resistant M. tuberculosis. There were also no significant differences in secondary outcomes between the treatment groups. The overall number of adverse events leading to treatment interruption did not differ significantly between the treatment groups (64 events in the standard-treatment group and 95 events in the intensified-treatment group, P=0.08). CONCLUSIONS Intensified antituberculosis treatment was not associated with a higher rate of survival among patients with tuberculous meningitis than standard treatment. (Funded by the Wellcome Trust and the Li Ka Shing Foundation; Current Controlled Trials number, ISRCTN61649292.)

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types