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.
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.
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).
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.).
Deep Learning-Based Detector for OFDM-IM Luong, Thien Van; Ko, Youngwook; Vien, Ngo Anh ...
IEEE wireless communications letters,
08/2019, Volume:
8, Issue:
4
Journal Article
Peer reviewed
Open access
This letter presents the first attempt of exploiting deep learning (DL) in the signal detection of orthogonal frequency division multiplexing with index modulation (OFDM-IM) systems. Particularly, we ...propose a novel DL-based detector termed as DeepIM, which employs a deep neural network with fully connected layers to recover data bits in an OFDM-IM system. To enhance the performance of DeepIM, the received signal and channel vectors are pre-processed based on the domain knowledge before entering the network. Using datasets collected by simulations, DeepIM is first trained offline to minimize the bit error rate (BER) and then the trained model is deployed for the online signal detection of OFDM-IM. Simulation results show that DeepIM can achieve a near-optimal BER with a lower runtime than existing hand-crafted detectors.
Global myocardial work (GMW) is an emerging method to characterize left ventricle (LV) function with potential advantages over both ejection fraction and global longitudinal strain (GLS). We aimed to ...determine the feasibility and reproducibility for echocardiographic-derived GMW in a healthy pediatric population; establish normal reference values; and investigate the influence of age, gender, and other clinical factor on normal reference ranges. We prospectively enrolled 212 individuals (median age of 9 years; interquartile range, 6 to 12 years, 112 female). Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were measured from LV pressure–strain loops. Quantification of GMW was performed using a GE Vivid E95 system and available software package (Echopac V.203, GE). The mean LV EF was 64 ± 3% with GLS of -21.3 ± 1.5%. GWI was 1688 ± 219 mmHg% with mean GWE of 96.5 ± 1.4%. The GCW was 1959 ± 207 mmHg%, and the mean GWW of 61.1 ± 30.9 mmHg%. No significant difference was found in MW indices across age group and gender (
p
> 0.05 for all). There were significant correlations between both GWI and GCW with GLS and systolic blood pressure (
p
< 0.001), but not with GWE and GWW. Linear regression model revealed that GWI and GCW were more closely correlated with systolic blood pressure than GLS. LV MW indices had good intra-observer and inter-observer reproducibility. This study establishes both the feasibility and reference ranges for non-invasive echocardiographic indices of GMW in healthy children. Myocardial work appears to be a complementary modality to assess LV performance in children.
Recent in vitro evidence suggests a link between vitamin D status and the risk of tuberculosis (TB). This study sought to examine the association between vitamin D status, parathyroid hormone (PTH) ...and the risk of TB in a Vietnamese population.
The study was designed as a matched case-control study, which involved 166 TB patients (113 men and 53 women), who were age-and-sex matched with 219 controls (113 men and 106 women). The average age of men and women was 49 and 50, respectively. TB was diagnosed by the presence of acid-fast bacilli on smears from sputum, and the isolation of M. tuberculosis. All patients were hospitalized for treatment in a TB specialist hospital. Controls were randomly drawn from the general community within the Ho Chi Minh, Vietnam. 25-hydroxyvitamin D 25(OH)D and PTH was measured prior to treatment by an electrochemiluminescence immunoassay (ECLIA) on a Roche Elecsys. A serum level of 25(OH)D below 30 ng/mL was deemed to be vitamin D insufficient.
The prevalence of vitamin D insufficiency was 35.4% in men with TB and 19.5% in controls (P = 0.01). In women, there were no significant differences in serum 25(OH)D and serum PTH levels between TB patients and controls. The prevalence of vitamin D insufficiency in women with TB (45.3%) was not significantly different from those without TB (47.6%; P = 0.91). However, in both genders, serum calcium levels in TB patients were significantly lower than in non-TB individuals. Smoking (odds ratio OR 1.25; 95% confidence interval CI 1.10 - 14.7), reduced 25(OH)D (OR per standard deviation SD: 1.14; 95% CI 1.07 - 10.7) and increased PTH (OR per SD 1.13; 95% CI 1.05 - 10.4) were independently associated with increased risk of TB in men.
These results suggest that vitamin D insufficiency was a risk factor for tuberculosis in men, but not in women. However, it remains to be established whether the association is a causal relationship.
Extended-spectrum, β-lactamase-producing Escherichia coli (ESBL-E) harboring the bla
-encoding plasmid (ESBL-E55) has been reported to be associated with urinary tract infection (UTI). The aims of ...this study were to clarify the prevalence of ESBL-E55 in pork meats and workers from the same wholesale market, as well as patients with UTI from a nearby hospital in Vietnam; we also investigated the plasmids encoding bla
. Sequencing analysis showed that 66.6% of the ESBL-E isolated from pork meats contained bla
, whereas the gene was present in 25.0% of workers and 12.5% of patients with UTI. Plasmid analysis showed that several sizes of plasmid encoded bla
in ESBL-E55 isolated from pork meats, whereas ESBL-E55 isolated from workers and patients with UTI contained only 104-139 kbp of bla
-encoding plasmids. This indicates that the 104-139 kbp sizes of bla
-encoding plasmids were commonly disseminated in pork meats, wholesale market workers, and patients with UTI.
The original version of this article unfortunately contained a mistake. The legends of Tables 2 and 3, Fig. 1 are incorrect. The corrected legends are given below,
For future high-speed transmission systems, increasing the symbol rate and modulation format orders have been considered as a main direction to reduce the cost per bit. On the other hand, increasing ...the symbol rate and modulation format order leads to increase of fiber nonlinear impairments which limit the system performance and reach. Digital back-propagation (DBP) has been considered as one of the most effective techniques for combating the fiber nonlinearity. However, conventional DBP scheme employing standard split-step Fourier method (S-SSFM) requires high hardware computational complexity which is difficult to meet in practice. In this paper, we study the effectiveness of the DBP technique for high-baudrate single-channel transmission systems and propose an advanced DBP technique based on the optimization of a general case of logarithmic step-size and Kerr nonlinearity coefficient. We show that the proposed method improves performance significantly in comparison with S-SSFM and the conventional natural logarithmic step-size technique. In particular, for 40 Gbaud DP-16QAM transmission over 2400 km, the proposed method with 6 steps/span shows 1.3 dB performance advantage over conventional logarithmic step-size with the same complexity. For large data rate (i.e. 160 Gbaud) transmission system, an improvement by 1 dB can be achieved by the proposed technique with 6 steps/span with respect to logarithmic step-size over 2400 km.
Due to its simplicity, low-cost and small footprint, intensity modulation and direct detection (IM/DD) using directly modulated lasers (DMLs) remains the most widely-adopted optical transmission ...scheme for short-reach applications. However, when the data rate increases to 100 Gb/s and beyond, the DML nonlinearity and fibre chromatic dispersion become major factors that limit system performance. In this paper, we show that artificial neural networks (ANNs) are an effective nonlinear equaliser for enhancing the transmission performance of high-speed IM/DD systems using DML. More specifically, for 56 Gbaud PAM-4 transmission system, a low-complexity ANN equaliser with only 1 hidden layer and 10 neurons can increase the receiver sensitivity at KP-4 FEC limit in comparison with FFE-15 by approximately 1 dB at dispersion of −60 ps/nm and ＋20 ps/nm. In addition, we also show that ANN equaliser outperforms the commonly used Volterra equaliser for 56 Gbaud PAM-4 transmissions.
•Low-complexity ANN equaliser for 56 Gbaud PAM4 DML-based fiber transmissions is reported.•ANN equaliser having up to 20 neurons is compared with second order Volterra equaliser with up to 15 taps.•10-neuron ANN equaliser increases sensitivity at KP-4 FEC by ∼1 dB at 20 ps/nm and −60 ps/nm of dispersion.•Once ANN has been trained, complexity of ANN equaliser is much lower than that of Volterra’s equaliser.
A field experiment was conducted to study the effects on yield and soil properties of the continuous application of rice straw compost to an alluvial soil in the Mekong Delta, Vietnam. Fourteen rice ...crops, two crops per year, were grown by direct seeding of the crop. There were seven treatments: F0C− (no fertilizer and compost), F0C+ (compost with no fertilizer), F20C+, F40C+, F60C+, F80C+ (20, 40, 60 and 80% of the fertilizer application rate with compost, respectively), F100C− (full strength fertilizer application as N:P
2
O
5
:K
2
O at 100:30:30 kg ha
−1
in the dry season and 80:30:30 kg ha
−1
in the wet season without compost). Compost prepared from the rice straw was applied at 6 Mg ha
−1
(fresh weight) at the cultivation of each crop. The F0C+ treatment showed higher yield than the F0C− treatment by 0.68 Mg ha
−1
on average in the wet season, but not in the dry season. The rice yield in F0C− declined at a rate of 0.163 Mg ha
−1
year
−1
in the wet season, but there was no decline in rice yield in F0C+. In treatments with compost, the yield reached its plateau at F40, suggesting that compost could replace part of the fertilizer. Although there were no significant differences in the total C concentrations in the soil among the treatments, even after 12 consecutive crops, soil penetration resistance appeared to be lower with compost than without compost. This long-term field trial showed that the continuous application of rice straw compost has some positive effects on rice yield as well as on soil physical properties.
The original version of this article unfortunately contained a mistake. The legends of Tables 2 and 3, Fig. 1 are incorrect. The corrected legends are given below.
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