Optimal and sub-optimal control in Dengue epidemics

This work concerns the application of the optimal control theory to Dengue epidemics. The dynamics of this insect-borne disease is modelled as a set of non-linear ordinary differential equations including the effect of educational campaigns organized to motivate the population to break the reproduction cycle of the mosquitoes by avoiding the accumulation of still water in open-air recipients. The cost functional is such that it reflects a compromise between actual financial spending (in insecticides and educational campaigns) and the population health (which can be objectively measured in terms of, for instance, treatment costs and loss of productivity). The optimal control problem is solved numerically using a multiple shooting method. However, the optimal control policy is difficult to implement by the health authorities because it is not practical to adjust the investment rate continuously in time. Therefore, a suboptimal control policy is computed assuming, as the admissible set, only those controls which are piecewise constant. The performance achieved by the optimal control and the sub-optimal control policies are compared with the cases of control using only insecticides when Breteau Index is greater or equal to 5 and the case of no-control. The results show that the sub-optimal policy yields a substantial reduction in the cost, in terms of the proposed functional, and is only slightly inferior to the optimal control policy. Copyright (C) 2001 John Wiley & Sons, Ltd.

Hematological parameters in Nile Tilápia, Oreochromis niloticus exposed to sub-letal concentrations of mercury

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antiretroviral resistance mutations in human immunodeficiency virus type 1 infected patients enrolled in genotype testing at the Central Public Health Laboratory, São Paulo, Brazil: preliminary results

Antiretroviral resistance mutations (ARM) are one of the major obstacles for pharmacological human immunodeficiency virus (HIV) suppression. Plasma HIV-1 RNA from 306 patients on antiretroviral therapy with virological failure was analyzed, most of them (60%) exposed to three or more regimens, and 28% of them have started therapy before 1997. The most common regimens in use at the time of genotype testing were AZT/3TC/nelfinavir, 3TC/D4T/nelfinavir and AZT/3TC/efavirenz. The majority of ARM occurred at protease (PR) gene at residue L90 (41%) and V82 (25%); at reverse transcriptase (RT) gene, mutations at residue M184 (V/I) were observed in 64%. One or more thymidine analogue mutations were detected in 73%. The number of ARM at PR gene increased from a mean of four mutations per patient who showed virological failure at the first ARV regimens to six mutations per patient exposed to six or more regimens; similar trend in RT was also observed. No differences in ARM at principal codon to the three drug classes for HIV-1 clades B or F were observed, but some polymorphisms in secondary codons showed significant differences. Strategies to improve the cost effectiveness of drug therapy and to optimize the sequencing and the rescue therapy are the major health priorities.

Fenologia de Rubiaceae do sub-bosque em floresta Atlântica no sudeste do Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sementes recalcitrantes: intolerantes a baixas temperaturas? Embriões recalcitrantes de Inga vera Willd. subsp. affinis (DC.) T. D. Penn. toleram temperatura sub-zero

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Description of an injury in a human caused by a false tocandira (Dinoponera gigantea, Perty, 1833) with a revision on folkloric, pharmacological and clinical aspects of the giant ants of the genera Paraponera and Dinoponera (sub-family Ponerinae)

A partir de um acidente causado pela picada de uma formiga falsa tocandira na mão de um pescador amador, os autores descrevem os achados clínicos locais observados, tais como edema, eritema e dor excruciante e a evolução do envenenamento, que cursou com fenômenos sistêmicos imediatos, como sudorese fria, náuseas, vômitos, mal estar, taquicardia e linfadenopatia axilar à esquerda. Após três horas, a dor intensa persistia e o paciente apresentou um episódio de hematoquesia, sem história anterior de enfermidades do trato digestivo, hematológicas ou vasculares. O uso de analgésicos (Tramal® 300 mg/dia), água quente e gelo não melhorou a dor, que arrefeceu em oito horas, tendo permanecido por cerca de 24 horas. São apresentados ainda os aspectos folclóricos, farmacológicos e clínicos relacionados às picadas de tocandiras.

Influence of genotype on the quality of sheep leather

The objective of this study was to evaluate the influence of crossings between sheep breeds on the intrinsic quality of leather. It was used the skins of 36 lambs (18 females and 18 males), resulting from crosses between ewes of a native breed from the Brazilian state of Mato Grosso do Sul and rams of the same native breed as well as the Texel and Santa Inês genetic groups. The animals were raised in confinement until slaughter weight, from 28 to 32 kg. After slaughter, samples were taken from the skins for histological analysis. The skins were tanned with chromium, retanned and greased. It was taken from the leather samples for electromicrographs and for tests for tensile and tear strength (intrinsic quality). Morphological aspects from the skin as well as from the leather help to understand the results found and they evidence that breeds or crossings among breeds interfere in the intrinsic quality of leather and skin of sheep.

Compostagem dos dejetos da bovinocultura de corte: influência do período, do genótipo e da dieta

O objetivo neste estudo foi identificar possíveis alterações na composição e no processo de compostagem dos dejetos produzidos por bovinos Canchim e Nelore em diferentes períodos do confinamento alimentados com diferentes proporções de volumoso e concentrado. O experimento foi conduzido em delineamento inteiramente casualizado em esquema fatorial com parcelas subdivididas no tempo. As parcelas foram compostas por quatro tratamentos: dejetos provenientes de duas dietas (40% de volumoso e 60% de concentrado e 60% de volumoso e 40% de concentrado) e dois genótipos (Canchim e Nelore) e as subparcelas pelos três períodos de coleta dos resíduos (início, meio e final). A eficiência do processo de compostagem foi avaliada pelas reduções de volume, sólidos totais, sólidos voláteis, frações fibrosas, carbono orgânico e temperatura, além do número mais provável de coliformes totais e termotolerantes e teores de nitrogênio e macro e microminerais. Não houve efeito do genótipo nem do período de coleta dos resíduos sobre a composição dos dejetos, no entanto o aumento da proporção de volumoso na dieta levou a menor eficiência do processo de compostagem dos dejetos. Também foram observadas reduções de 100% no número mais provável de coliformes totais e termotolerantes e aumento no teor dos nutrientes no composto final.

Avaliação das Sub-Frações dos Carboidratos e das Proteinas, Usando as Metodologias do Cncps e In situ com Bovinos da Raça Nelore. 1. Silagem de Milho

To validate the use of the Cornell Net Carbohydrate and Protein System (CNCPS) under Brazilian conditions, the chemical composition, the potential and the effective degradabilities of the carbohydrate and protein subfractions, and the solid phase passage rate were determined for corn silage in diets with forage:concentrate ratios of 80:20 (DI) and 60:40 (D2) using Nellore cattle. The chromium mordant technique was used to determine the particulate passage rate of solids. For diet 2, there was a reduction in the potentially degradable dry matter (DM), and however not significant, a reduction in the degradation rates of neutral detergent Fiber (NDF, 49%) and neutral detergent insoluble nitrogen (NDIN, 32%), and an increase in the degradation rare of starch (ST, 25%). The use of lag time increased the effective DM degradation (EDDM) of corn silage in both diets (23% and 53% for D1 and D2, respectively). The concentrate ratios did not influence the particulate passage rate of the diets. The higher values related ro the availability of the protein subfractions may indicate a underestimation by CNCPS, Rnd(or) could be attributed to the Zebu animals used in this study.

Expression of p53, Ki-67, and CD31 in the vaginal margins of radical hysterectomy in patients with stage IB carcinoma of the cervix

Objectives. This study was undertaken to evaluate the expression of p53, Ki-67, and CD31 both in the tumor and in the vaginal margins of radical hysterectomy in patients with stage IB squamous cell carcinoma of the cervix, as an attempt to use these proteins as possible markers for residual tumor in cervical cancer.Methods. Thirty patients with stage IB squamous cell carcinoma of the cervix were submitted to radical hysterectomy (study group), and thirty patients with uterine myoma were submitted to vaginal hysterectomy (control group) and were prospectively studied from November 2001 to September 2002. Tissue samples were taken from the tumor or cervix, anterior vaginal margin (AVM), and posterior vaginal margin (PVM) and were immunohistochemically evaluated by monoclonal antibodies for p53, Ki-67, and CD31. Vaginal samples in which the histological examination showed tumor involvement were excluded from the study.Results. Patient's mean age was 48.7 +/- 10.4 years (27-73 years). The clinical stage was IB1 in 22 patients (73.3%) and IB2 in eight patients (26.7%). The expressions of p53, Ki-67, and CD31 were significantly higher in the tumor than in the benign cervix (P < 0.001). Higher expressions of these markers were noted in the vaginal margins of radical hysterectomy in patients with cervical carcinoma compared to the vaginal margins of control patients. This association was demonstrated for p53 in the AVM proximal (P = 0.045), for Ki-67 in AVM proximal (P < 0.001), AVM distal (P < 0.001), PVM proximal (P = 0.009), and PVM distal (P < 0.001), and for CD31 in AVM proximal (P = 0.003) and AVM distal (P = 0.018). There was no difference in p53, Ki-67, and CD31 expression between the proximal and distal regions of the vaginal margins in patients with carcinoma of the cervix.Conclusion. The expressions of p53, Ki-67, and CD31 were significantly higher in both the histologically positive (cervical tumor) and negative (vaginal margins) tissues of patients who had undergone radical hysterectomy for cervical cancer compared to the benign control tissues. (C) 2004 Elsevier B.V. All rights reserved.

Using pegylated interferon alfa-2b and ribavirin to treat chronic hepatitis patients infected with hepatitis C virus genotype 1: Are nonresponders and relapsers different populations?

The combination of pegylated interferon (PEG-INF) and ribavirin is currently the best treatment for chronic hepatitis C, providing a sustained virological response (SVR) in 54%-63% of patients. In patients infected with hepatitis C virus (HCV) genotype 1, the SVR rate is 42%-52%. To evaluate the treatment efficacy of this drug combination, we conducted an open, prospective study of 58 consecutive treatment-naive patients infected with HCV genotype 1 and treated at a university hospital, comparing those presenting an SVR (SVRs), nonresponders (NRs), and relapsers (RELs). Among the intent-to-treat patients, an end-of-treatment virological response was achieved in 69 % of the sample as a whole and in 52 % of the SVRs. We found that being an SVR was significantly associated with mild fibrosis (p = 0.04) and with undetectable HCV RNA at weeks 12 and 24 of treatment (p < 0.0001). Comparing the SVR and REL groups, we observed that being older than 40 was significantly associated with being a REL (p = 0.04). Being an NR was found to be associated with severe fibrosis and moderate inflammatory infiltrates (portal or periportal). In the polytomous logistic regression, no independent factors were associated with the REL group when compared with the SVR group. We conclude that RELs and NRs differ in comparison with SVRs. The RELs accounted for 17% of the sample. The HCV RNA test results at weeks 12 and 24 of treatment, although independent predictors of non-response (OR: 4.8 and 8.2, respectively), did not differ between SVRs and RELs.

A single intraoperative sub-Tenon's capsule triamcinolone acetonide injection for the treatment of post-cataract surgery inflammation

Purpose: To compare a single intraoperative sub-Tenon's capsule triamcinolone acetonicle injection with steroid drops in the treatment of ocular inflammation after cataract surgery.Design: Randomized, double-masked controlled trial.Participants: A total of 100 patients were randomized prospectively into 2 groups: 50 patients treated with 1% prednisolone eyedrops (control group A) and 50 patients treated with sub-Tenon's capsule triamcinolone (treatment group B).Methods: All patients underwent phacoemulsification and intraocular posterior lens implantation. After surgery, patients were randomized to receive either (group B) an intraoperative 40 mg triamcinolone acetonicle sub-Tenon's capsule injection or (group A) 1% prednisolone acetate eyedrops, according to the following schedule: 1 drop 4 times daily (week 1), 3 times daily (week 2), 2 times daily (week 3), once daily (week 4). To mask the study, group B received vehicle drops administered on a similar schedule, and group A received an intraoperative sub-Tenon's capsule injection of a 1 ml balanced salt solution.Main Outcome Measures: the main outcome measures included inflammation (cell, flare, ciliary flush), intraocular pressure, and lack of response.Results: Triamcinolone was shown to have anti-inflammatory efficacy clinically equivalent to conventional 1% prednisolone eyedrops in reducing intraocular inflammation, as measured by clinical methods. Triamcinolone was found to be as safe as the prednisolone in terms of adverse effects, changes in visual acuity, intraocular pressure, and biomicroscopic and ophthalmoscopic variables. on the third, seventh, fourteenth, and twenty-eighth postoperative days, a significantly lower intraocular pressure (P<0.01) was noted in the triamcinolone group than in the prednisolone group.Conclusions: A single intraoperative 40-mg triamcinolone acetonide sub-Tenon's capsule injection demonstrated a clinically equivalent therapeutic response and ocular tolerance compared with 1% prednisolone drops in controlling postoperative inflammation after uncomplicated cataract surgery and merits further investigation. (C) 2004 by the American Academy of Ophthalmology.

Seed size and genotype effects on maize (Zea mays L.) yield under different technology levels

Final plant population in maize crop was used as a basis to identify the technology level of a given farmer. Final population of 50,000 plants/hectare was considered as an indication of a high technology level farmer; 35,000 of a medium, and 20,000 of a low technology level farmer. These populations were artificially obtained for the hybrids HT-2X, BR-201, and BR-205 from small, medium and large seeds. The results showed the triple cross hybrid HT-2X to be the most indicated for low technology level regions, due to its lesser sensitivity to variations in seed size and also to its significant outyielding of the other two hybrids. The double cross hybrids BR-201 and BR-205 exhibited much higher sensitivity to variations in seed size so that if they have to be used in a low technology region, the most recommended procedure would be to make use of the largest possible seeds. In conclusion, genotype and seed size seem to be factors capable of compensating for plant population reductions in maize crops. The more prolific hybrids and the largess seeds are more indicated for low technology level regions.