BACKGROUND: During the natural history, the incidence HTLV-1 related diseases were 0.5% until 10% after decades of infection. Despite relative low lethality, previous study observed that HTLV-1 infection is associated with significantly increased mortality. For example, the incidence of ATLL and HAM/TSP, co-infections with HIV and HCV, parasitic co-infection with Strongyloides stercoralis may increase morbidity and mortality. OBJECTIVE: Determine the mortality rate and its major variables as possible risk factors, analyzing the HTLV Clinic at Emilio Ribas Institute, a continuous open cohort of HTLV patients since 1997. METHODS: This cohort open cohort possesses new patients added at a rate of approximately 50 patients/year. There were 1100 HTLV-infected subjects identified by September 30th 2018. All clinical data including clinical and laboratory data, which have been updated on a regular basis over the last 22 years, were entered into a specific REDCap database. The Ethical Board of the IIER approved the protocol. RESULTS: Along 22 years of clinical care in the HTLV-out clinic, 727 HTLV-1-infected subjects and 248 HAM/TSP cases. Four-hundred sixty-eight patients of whom remaining under active follow up. The mean follow-up time of the cohort was 12 years. Twenty-seven patients died (median age of 51,5 years old). From this total, 13 was asymptomatic carriers and 14 HAM/TSP subjects, 12 of asymptomatic and seven HAM/TSP possess co-infected with HIV or/and HCV. Other seven presented HAM/TSP without co-infection, and all was female, and sepsis was the majority cases the majority of cases of sepsis were related to infection of the urinary tract (p=0.058) and to ulcers of decubitus (p=0.021), and it was associated with risk factors for mortality. CONCLUSIONS: Overall, the mortality rate for HAM-TSP patients was six percent. The mean life expectancy in Brazil is about 78 years in 2018, twenty-two years higher than HAM/TSP patients without any other coinfection. This study highlights the possibility of higher death risk among HTLV-1-infected patients and HAM/TSP subjects in Brazil, and identified some risk factors for this outcome. Also, these patients may possess higher risk for morbidity, usually urinary tract infections and decubitus scars, which could increase risk for death.

No doubt pollution is a global problem which must be holistically tackled. In doing this, adequate knowledge of the sources of pollution is important, therefore the aim of this paper is to review source apportionment with reference to top-down and bottom-up methods. In this paper, dispersion modeling, emissions inventory, and sampling methods were discussed. Also, analytical methods involved in top-down source apportionment were mentioned. The two techniques are needed to evaluate pollutants and their sources. Based on these two approaches, pollution control strategy would be developed and decisions can be made in deciding the right approach to solve or reduce the pollution problems.

Transseptal puncture is an established technique for achieving left atrium access during cardiac procedures. It is associated with low overall complication rate and high success rates. Although being almost a century old technique, recent years brought a substantial development in the field, allowing for faster and safer left atrium catheterization. In this paper we discuss its history, complications, available techniques and current state of the art.

Human T-lymphotropic virus type 1 (HTLV-1)–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a slowly progressive spinal cord disorder with no effective treatment. There is much of interest in developing potential biomarkers for predicting the pathogenesis of HAM/TSP disorder. This study used Illumina massive parallel sequencing (MPS) technology to assess the cellular global noncoding RNAome expression profile in HAM/TSP patients (n = 10), asymptomatic HTLV-1 infected carriers (ASP, n = 8), and a second group of healthy controls (n = 5). Using various bioinformatics tools, the sRNA MPS reads were aligned, annotated, and profiled. There were 251 known and 50 potential novel sRNAs among the 402 detected sRNAs in the HAM and ASP groups versus the HC group. Sixty-eight known sRNAs were found to be significantly different between the ASP and HAM groups. In HAM vs ASP subjects, 88 mature miRNAs were downregulated. Three of these miRs (hsa-miR-185-5p, 32-5p, and 192-5p) have the potential to be used as biomarkers for predicting the pathogenesis of HAM/TSP. The top seven deregulated miRS target genes were linked to a variety of biological processes and molecular functions. Relevant reactome pathways to our findings provide a rich source of data and an opportunity to further understand sRNA regulation and function in HTLV-1 pathophysiology.

This work focuses on expressing the TSP with Time Windows (TSPTW for short) as a quadratic unconstrained binary optimization (QUBO) problem. The time windows impose time constraints that a feasible solution must satisfy. These take the form of inequality constraints, which are known to be particularly difficult to articulate within the QUBO framework. This is, we believe, the first time this major obstacle is overcome and the TSPTW is cast in the QUBO formulation. We have every reason to anticipate that this development will lead to the actual execution of small scale TSPTW instances on the D-Wave platform.

We propose a new binary formulation of the Travelling Salesman Problem (TSP), with which we overcame the best formulation of the Vehicle Routing Problem (VRP) in terms of the minimum number of necessary variables. Furthermore, we present a detailed study of the constraints used and compare our model (GPS) with other frequent formulations (MTZ and native formulation). Finally, we have carried out a coherence and efficiency check of the proposed formulation by running it on a quantum annealing computer, D-Wave\_2000Q6.

The Kolkata Paise Restaurant Problem is a very challenging game, where n agents have to decide where they will have lunch on a busy day during their lunch break. The game is very interesting because there are exactly n restaurants and each restaurant can accommodate only one agent. If two or more agents happen to choose the same restaurants, only one gets served and the others have to return back to work hungry. In this paper, we tackle this problem from an entirely new angle. We abolish certain implicit assumptions, which allows us to propose a novel strategy with greater utilization of the restaurants and overall efficiency. We emphasize the spatially distributed nature of our approach, which, for the first time, perceives the locations of the restaurants as uniformly distributed in the entire city area. This critical change in perspective has profound ramifications in the topological layout of the restaurants, which now makes it completely realistic to assume that every agent has a second chance. Every agent now may visit, in case of failure, more than one restaurants, within the predefined time constraints. From the point of view of each agent, the situation now resembles more that of the iconic travelling salesman, who must compute an optimal route through n cities. Following this shift in paradigm, we advocate the use of metaheuristics, as exacts solution of the TSP are prohibitively expensive, because they can produce near-optimal solutions in a very short amount of time. The use of metaheuristics enables each agent to compute her own personalized solution, incorporating her preferences, and providing alternative destinations in case of successive failures. We analyze rigorously the resulting situation, proving probabilistic formulas that confirm the advantages of this policy and the increase in utilization. The detailed mathematical analysis of our scheme demonstrates that it can achieve utilization ranging from .85 to 0.95 from the first day, while rapidly attaining steady state utilization 1.0. Moreover, the equations we have developed generalize previously presented formulas in the literature, which can be shown to be special cases of our results.

General Variable Neighborhood Search (GVNS) is a well known and widely used metaheuristic for efficiently solving many NP-hard combinatorial optimization problems. Quantum General Variable Neighborhood Search (qGVNS) is a novel, quantum inspired extension of the conventional GVNS. Its quantum nature derives from the fact that it takes advantage and incorporates tools and techniques from the field of quantum computation. Travelling Salesman Problem (TSP) is a well known NP-Hard problem which has broadly been used for modelling many real life routing cases. As a consequence, TSP can be used as a basis for modelling and finding routes for Geographical Systems (GPS). In this paper, we examine the potential use of this method for the GPS system of garbage trucks. Specifically, we provide a thorough presentation of our method accompanied with extensive computational results. The experimental data accumulated on a plethora of symmetric TSP instances (symmetric in order to faithfully simulate GPS problems), which are shown in a series of figures and tables, allow us to conclude that the novel qGVNS algorithm can provide an efficient solution for this type of geographical problems.