Determining the best therapy for HIV-associated cryptococcal meningitis in resource-poor settings is controversial. In this trial in Vietnam, initial therapy with amphotericin B with flucytosine had ...better outcomes than amphotericin B alone or with fluconazole.
There are approximately 1 million cases of cryptococcal meningitis annually and 625,000 deaths.
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Treatment guidelines recommend induction therapy with amphotericin B deoxycholate (0.7 to 1 mg per kilogram of body weight per day) and flucytosine (100 mg per kilogram per day).
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However, this treatment has not been shown to reduce mortality, as compared with amphotericin B monotherapy.
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,
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Flucytosine is frequently unavailable where the disease burden is greatest, and concerns about cost and side effects have limited its use in resource-poor settings.
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Fluconazole is readily available, is associated with low rates of adverse events, and has good penetration into cerebrospinal . . .
Epileptic seizure is a neurological condition caused by short and unexpectedly occurring electrical disruptions in the brain. It is estimated that roughly 60 million individuals worldwide have had an ...epileptic seizure. Experiencing an epileptic seizure can have serious consequences for the patient. Automatic seizure detection on electroencephalogram (EEG) recordings is essential due to the irregular and unpredictable nature of seizures. By thoroughly analyzing EEG records, neurophysiologists can discover important information and patterns, and proper and timely treatments can be provided for the patients. This research presents a novel machine learning-based approach for detecting epileptic seizures in EEG signals. A public EEG dataset from the University of Bonn was used to validate the approach. Meaningful statistical features were extracted from the original data using discrete wavelet transform analysis, then the relevant features were selected using feature selection based on the binary particle swarm optimizer. This facilitated the reduction of 75% data dimensionality and 47% computational time, which eventually sped up the classification process. After having been selected, relevant features were used to train different machine learning models, then hyperparameter optimization was utilized to further enhance the models' performance. The results achieved up to 98.4% accuracy and showed that the proposed method was very effective and practical in detecting seizure presence in EEG signals. In clinical applications, this method could help relieve the suffering of epilepsy patients and alleviate the workload of neurologists.
The use of low-resolution analog-to-digital converters (ADCs) is considered to be an effective technique to reduce the power consumption and hardware complexity of wireless transceivers. However, in ...systems with low-resolution ADCs, obtaining channel state information (CSI) is difficult due to significant distortions in the received signals. The primary motivation of this paper is to show that learning techniques can mitigate the impact of CSI unavailability. We study the blind detection problem in multiple-input-multiple-output (MIMO) systems with low-resolution ADCs using learning approaches. Two methods, which employ a sequence of pilot symbol vectors as the initial training data, are proposed. The first method exploits the use of a cyclic redundancy check (CRC) to obtain more training data, which helps improve the detection accuracy. The second method is based on the perspective that the to-be-decoded data can itself assist the learning process, so no further training information is required except the pilot sequence. For the case of 1-bit ADCs, we provide a performance analysis of the vector error rate for the proposed methods. Based on the analytical results, a criterion for designing transmitted signals is also presented. Simulation results show that the proposed methods outperform existing techniques and are also more robust.
Adjunctive dexamethasone reduces mortality from tuberculous meningitis, but how it produces this effect is not known. Matrix metalloproteinases (MMPs) are important in the immunopathology of many ...inflammatory CNS diseases thus we hypothesized that that their secretion is important in TBM and might be influenced by dexamethasone.
The kinetics of cerebrospinal fluid (CSF) MMP and tissue inhibitors of MMPs (TIMPs) concentrations were studied in a subset of HIV uninfected adults (n = 37) with TBM recruited to a randomized, placebo-controlled trial of adjuvant dexamethasone. Analysis followed a pre-defined plan. Dexamethasone significantly reduced CSF MMP-9 concentrations in early follow up samples (median 5 days (range 3-8) of treatment), but had no significant influence on other MMPs/TIMPs. Additionally CSF MMP-9 concentration was strongly correlated to concomitant CSF neutrophil count.
Dexamethasone decreased CSF MMP-9 concentrations early in treatment and this may represent one mechanism by which corticosteroids improve outcome in TBM. The strong correlation between CSF MMP-9 and neutrophil count suggests that polymorphonuclear leukocytes may play a central role in the early pathogenesis of TBM.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Massive multiple-input multiple-output (MIMO) is a key technology for emerging next-generation wireless systems. Utilizing large antenna arrays at base-stations, massive MIMO enables substantial ...spatial multiplexing gains by simultaneously serving a large number of users. However, the complexity in massive MIMO signal processing (e.g., data detection) increases rapidly with the number of users, making conventional hand-engineered algorithms less computationally efficient. Low-complexity massive MIMO detection algorithms, especially those inspired or aided by deep learning, have emerged as a promising solution. While there exist many MIMO detection algorithms, the aim of this magazine article is to provide insight into how to leverage deep neural networks (DNN) for massive MIMO detection. We review recent developments in DNN-based MIMO detection that incorporate the domain knowledge of established MIMO detection algorithms with the learning capability of DNNs. We then present a comparison of the key numerical performance metrics of these works. We conclude by describing future research areas and applications of DNNs in massive MIMO receivers.
Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood. We describe a cohort of ...HIV uninfected Vietnamese patients with cryptococcal meningitis in whom underlying disease is uncommon, and relate presenting features of patients and the characteristics of the infecting species to outcome.
A prospective descriptive study of HIV negative patients with cryptococcal meningitis based at the Hospital for Tropical Diseases, Ho Chi Minh City. All patients had comprehensive clinical assessment at baseline, were cared for by a dedicated study team, and were followed up for 2 years. Clinical presentation was compared by infecting isolate and outcome.
57 patients were studied. Cryptococcus neoformans var grubii molecular type VN1 caused 70% of infections; C. gattii accounted for the rest. Most patients did not have underlying disease (81%), and the rate of underlying disease did not differ by infecting species. 11 patients died while in-patients (19.3%). Independent predictors of death were age > or = 60 years and a history of convulsions (odds ratios and 95% confidence intervals 8.7 (1 - 76), and 16.1 (1.6 - 161) respectively). Residual visual impairment was common, affecting 25 of 46 survivors (54.3%). Infecting species did not influence clinical phenotype or outcome. The minimum inhibitory concentrations of flucytosine and amphotericin B were significantly higher for C. neoformans var grubii compared with C. gattii (p < 0.001 and p = 0.01 respectively).
In HIV uninfected individuals in Vietnam, cryptococcal meningitis occurs predominantly in people with no clear predisposing factor and is most commonly due to C. neoformans var grubii. The rates of mortality and visual loss are high and independent of infecting species. There are detectable differences in susceptibility to commonly used antifungal drugs between species, but the clinical significance of this is not clear.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Parkinson’s Disease (PD) is a brain disorder that causes uncontrollable movements. According to estimation, roughly ten million individuals worldwide have had or are developing PD. This disorder can ...have severe consequences that affect the patient’s daily life. Therefore, several previous works have worked on PD detection. Automatic Parkinson’s Disease detection in voice recordings can be an innovation compared to other costly methods of ruling out examinations since the nature of this disease is unpredictable and non-curable. Analyzing the collected vocal records will detect essential patterns, and timely recommendations on appropriate treatments will be extremely helpful. This research proposed a machine learning-based approach for classifying healthy people from people with the disease utilizing Grey Wolf Optimization (GWO) for feature selection, along with Light Gradient Boosted Machine (LGBM) to optimize the model performance. The proposed method shows highly competitive results and has the ability to be developed further and implemented in a real-world setting.
The proper orthogonal decomposition (POD) technique (or the Karhunan Loève procedure) has been used to obtain low-dimensional dynamical models of many applications in engineering and science. In ...principle, the idea is to start with an ensemble of data, called
snapshots, collected from an experiment or a numerical procedure of a physical system. The POD technique is then used to produce a set of basis functions which spans the snapshot collection. When these basis functions are used in a Galerkin procedure, they yield a finite-dimensional dynamical system with the smallest possible degrees of freedom. In this context, it is assumed that the physical system has a mathematical model, which may not be available for many physical and/or industrial applications. In this paper, we consider the steady-state Rayleigh-Bénard convection whose mathematical model is assumed to be unknown, but numerical data are available. The aim of the paper is to show that, using the obtained ensemble of data, POD can be used to model accurately the natural convection. Furthermore, this approach is very efficient in the sense that it uses the smallest possible number of parameters, and thus, is suited for process control. Particularly, we consider two boundary control problems
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(a) tracking problem, and
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(b) avoiding hot spot in a certain region of the domain.
Both artemether and artesunate have been shown to be superior to quinine for the treatment of severe falciparum malaria in Southeast Asian adults, although the magnitude of the superiority has been ...greater for artesunate than artemether. These two artemisinin derivatives had not been compared in a randomized trial.
A randomized double blind trial in 370 adults with severe falciparum malaria; 186 received intramuscular artesunate (2.4 mg/kg immediately followed by 1.2 mg/kg at 12 hours then 24 hours then daily) and 184 received intramuscular artemether (3.6 mg per kilogram immediately followed by 1.8 mg per kilogram daily) was conducted in Viet Nam. Both drugs were given for a minimum of 72 hours.
There were 13 deaths in the artesunate group (7 percent) and 24 in the artemether group (13 percent); P = 0.052; relative risk of death in the patients given artesunate, 0.54; (95 percent confidence interval 0.28-1.02). Parasitaemia declined more rapidly in the artesunate group. Both drugs were very well tolerated.
Intramuscular artesunate may be superior to intramuscular artemether for the treatment of severe malaria in adults.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study involves a research conducted in hatcheries concerning the impact of feed reduction on the survival, productivity and growth of the larvae and postlarvae (PL) of freshwater prawn ...(Macrobrachium rosenbergii). The experiment included cohorts with different daily feeding schedules, i.e., (i) Artemia twice + artificial feed thrice (control); (ii) Artemia twice + artificial feed twice; (iii) Artemia twice + artificial feed once; (iv) Artemia once + artificial feed thrice; (v) Artemia once + artificial feed twice; (vi) Artemia once + artificial feed once. Refined sugar was supplied as a carbon source to create biofloc from larval stage-4, and the C/N ratio was maintained at 17.5. A 250-L tank was used for larval rearing, stocking density was 60 ind L-1, and salinity of 12%o. The results obtained imply that environmental factors, bacterial factors, and biofloc parameters were in a suitable range for PL to develop; the greatest PL15 length (10.03±0.51 mm) followed treatment (i), with significant differences (p < 0.05) observed for treatments (v) and (vi) but no significant differences (p > 0.05) observed for any of the remaining treatments. The highest survival rate and productivity were observed for PL15 under treatment (i) (56.8% and 27±1.05 ind L-1 respectively); although no significant differences (p > 0.05) were observed for treatment (ii), significant differences (p < 0.05) were observed for the remaining treatments. Towards the end of the experiment, the feeding regime was modified by removing one artificial feed instance; this did not negatively impact growth, survival, or productivity compared to the conventional feeding regime.
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