Control of The Spread of TB-HIV/AIDS Coinfection Using Optimal Control

The condition in which an individual is affected by TB and HIV/AIDS in his body is called a TB-HIV/AIDS coinfection. This research aims to minimize the populations of TB-HIV/AIDS coinfection with a minimum expenditure on medical expenses, that means minimizing the objective’s function ( ) or purpose function. In this research, modification of the model was carried out by adding the treatment population for HIV patients with ARV ( ). The population used was 11 classes with the use of three controls including treatment for individuals with latent TB ( ), active TB ( ), and HIV ( ). After performing numerical simulation using the forward backward fourth order Runge-Kutta, the results show that scenario 7 is the best scenario in controlling the spread of TB-HIV/AIDS coinfection because it resulted a minimum value of 1401,44. This means that providing the treatment for individuals with latent TB, active TB, and HIV in tandem can reduce the populations of TB-HIV/AIDS coinfection in the minimum treatment cost.

Effect of Antimicrobial Treatment on the Dynamics of Ceftiofur Resistance in Enterobacteriaceae from Adult California Dairy Cows

Dairy farm use of antimicrobial drugs (AMD) is a risk for the selection of antimicrobial resistance (AMR); however, these resistance dynamics are not fully understood. A cohort study on two dairy farms enrolled 96 cows with their fecal samples collected three times weekly, for the first 60 days in milk. Enterobacteriaceae were enumerated by spiral plating samples onto MacConkey agar impregnated with 0, 1, 8, 16 and 30 µg/mL ceftiofur. Negative binomial regression analyzed AMR over time. The continuum of ceftiofur concentrations permitted estimation of the minimum inhibitory concentration (MIC) and analysis using interval regression. The most common systemic AMD was ceftiofur, administered in 94% of treatments (15/16 cows). Enterobacteriaceae did not grow in 88% of samples collected from non-AMD treated cows at 8 µg/mL ceftiofur. Samples from AMD treated cows had peak counts of resistant Enterobacteriaceae during AMD treatment and returned to baseline counts by 3–4 days post-treatment at 8 µg/mL. Sensitive Enterobacteriaceae (0–1 µg/mL ceftiofur) were reduced below pre-treated levels for 29–35 days post-AMD treatment. Population MIC peaked during AMD treatment and returned to baseline levels by 7–8 days. We conclude that the effect of systemic ceftiofur on the resistance of Enterobacteriaceae in early lactation dairy cows was limited in duration.

A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Background Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences.

The Beneficial Effect of Traditional Chinese Exercises on the Management of Obesity

This paper systematically reviewed the clinical update of traditional Chinese exercises in the treatment of simple obesity in recent years and discussed their specific advantages in this aspect. This review focused on several typical traditional Chinese exercises, namely, Tai Chi, Ba Duan Jin, Yi Jin Jing, Wu Qin Xi, Shaolin Neigong, and Liu Zi Jue, which all showed clinical beneficial effect on the treatment of simple obesity with their own characteristics. To optimize the clinical therapeutic effect of these traditional Chinese exercises, we need to seek the most appropriate exercise or the combo exercise based on the characteristics of different obese population, to improve the efficiency of weight loss, reduce sports injury, and consolidate the therapeutic effect. In the future, we need to further evaluate the efficacy of sitting exercise, lying exercise, and static training in the treatment of simple obesity, subdivide the treatment population, and explore the working mechanism of these traditional Chinese exercises.

Assessment, Treatment, and Management of Paraphilic Disorders

Many books, chapters, and articles concerning the assessment and treatment of the paraphilias have been published. Most are limited due to a lack of clarity about what is being treated and a failure to fully recognize the heterogeneity of the treatment population(s). This chapter provides a review of the assessment methods and treatments that have been recommended for paraphilic disorders in general. They are presented together because assessments and treatments can be generalized across different paraphilic disorders and many assessment and treatment approaches are complementary. Treatment approaches specific to individual paraphilias are discussed in the chapters dealing with the specific paraphilias.

Analisis Kestabilan dan Kontrol Optimal Model Matematika Penyebaran Penyakit Ebola dengan Penanganan Medis

Ebola disease is one of an infectious disease caused by a virus. Ebola disease can be transmitted through direct contact with Ebola’s patient, infected medical equipment, and contact with the deceased individual. The purpose of this paper is to analyze the stability of equilibriums and to apply the optimal control of treatment on the mathematical model of the spread of Ebola with medical treatment. Model without control has two equilibria, namely non-endemic equilibrium (E0) and endemic equilibrium (E1) The existence of endemic equilibrium and local stability depends on the basic reproduction number (R0). The non-endemic equilibrium is locally asymptotically stable if R0 < 1 and endemic equilibrium tend to asymptotically stable if R0 >1 . The problem of optimal control is then solved by Pontryagin’s Maximum Principle. From the numerical simulation result, it is found that the control is effective to minimize the number of the infected human population and the number of the infected human with medical treatment population compare without control.