<p>Eligibility for antiretroviral therapy (ART) in HIV-infected patients is defined either by a cluster of differentiation antigen 4 (CD4) count of less than 200cells/mm3 or clinical diagnosis of WHO stage III and IV. Therefore, the decision to start ART becomes difficult when CD4 cell count is not available. With limited laboratory infrastructure, the decision to start ART is usually made based on clinical symptoms leading to late commencement of ART. This calls for alternative criteria to see if nail discoloration (ND) correlates with low CD4 count among untreated HIV infected patients. This will serve as a complementary screening tool for identifying asymptomatic ARV naive HIV patients with a CD4 cell count of less than 200cells/mm3 which signifies&nbsp / severe immunosuppression. Study Design and Setting: This was a quantitative cross-sectional descriptive and analytical study involving adult ART na&iuml / ve HIV infected patients in WHO stage I and II. Systematic sampling was used to select the participants from all adult ART na&iuml / ve HIV infected patients attending APIN clinic, located at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Data Collection: Face-to-face interviews, physical examination and relevant laboratory investigations with selected participants were conducted using a questionnaire guide. Questions on socio-demographic characteristics, clinical data, general physical examinations including finger nail examination and photographing with subsequent laboratory investigations including CD4 count and western blot were employed. Data Analysis: Variables were categorized and data analyzed using descriptive statistics including the frequency, percentage frequency / mean and standard deviation of continuous variables. Association between CD4 count of &le / 200cells/mm3 and ND was tested using the chisquare test with an alpha level of 0.05. Prevalence of ND, sensitivity, specificity, positive predictive and negative predictive values and accuracy of the screening test of ND was calculated. Results: 394 patients had their fingernails photographed and assessed. It was shown that distal banded and grey nails were the common types of ND seen with a prevalence of 38%. There was an association between CD4 count &le / 200cells/mm3 and ND (p&lt / 0.0001). CD4 count &le / 200cells/mm3 was a risk factor for developing ND (RR=2.3[1.8-3.6]). The association has a sensitivity of 78%, specificity of 55%, positive predictive value of 50%, and negative predictive value of 80% and accuracy of test 63%. Conclusion: With a significant association (p&lt / 0.0001) and a sensitivity of 78%, ND can be a useful clinical indicator of immune dysfunction mediated by HIV among patients in WHO stage I or II. ND can either be a clinical sign or a symptom in HIV patients with a CD4 of &le / 200cells/mm3 as seen in the study as the specificity and sensitivity of ND compared favourably with other WHO stage III diagnosis. Recommendations: Nail discoloration should complement CD4 count as an additional staging sign to help identify patients likely to benefit from ART especially in resource-limited settings. Finally, all patients with grey or distal banded should be on co-trimoxaxole prophylaxis in line with WHO /national guideline on the use of co-trimoxaxole for all HIV positive patients with a CD4 cell count of &le / 350cells/mm3.</p>

In this thesis, the problem of multiple access interference (MAI) suppression for the multi-carrier (MC) code division multiple access (CDMA) system, based on the multi-carrier modulation with modified Gaussian wavelet, associated with the combining process is investigated for Rayleigh fading channel. The main concern of this thesis is to derive a new scheme, based on the linearly constrained constant modulus (LCCM) criterion with the robust inverse QR decomposition (IQRD) recursive least squares (RLS) algorithm to improve the performance of the wavelet-based MC-CDMA system with combining process. To verify the merits of the new algorithm, the effect due to imperfect channel parameters estimation and near-far effect are investigated. We show that the proposed robust LCCM IQRD-RLS algorithm outperforms the conventional LCCM-gradient algorithm, in terms of output SINR, for MAI suppression under channel mismatch environment. Also, the performance of the modified Gaussian wavelet-based MC-CDMA system is superior to the one with wavelet-based MC-CDMA system. It is more robust to the channel mismatch and near-far effect. Moreover, the modified Gaussian wavelet-based MC-CDMA system with robust LCCM IQRD-RLS algorithm does have better performance over other conventional approaches, such as the LCCM-gradient algorithm, maximum ratio combining (MRC), and blind adaptation algorithm, in terms of the capability of MAI suppression and bit error rate (BER).

<p>Eligibility for antiretroviral therapy (ART) in HIV-infected patients is defined either by a cluster of differentiation antigen 4 (CD4) count of less than 200cells/mm3 or clinical diagnosis of WHO stage III and IV. Therefore, the decision to start ART becomes difficult when CD4 cell count is not available. With limited laboratory infrastructure, the decision to start ART is usually made based on clinical symptoms leading to late commencement of ART. This calls for alternative criteria to see if nail discoloration (ND) correlates with low CD4 count among untreated HIV infected patients. This will serve as a complementary screening tool for identifying asymptomatic ARV naive HIV patients with a CD4 cell count of less than 200cells/mm3 which signifies&nbsp / severe immunosuppression. Study Design and Setting: This was a quantitative cross-sectional descriptive and analytical study involving adult ART na&iuml / ve HIV infected patients in WHO stage I and II. Systematic sampling was used to select the participants from all adult ART na&iuml / ve HIV infected patients attending APIN clinic, located at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Data Collection: Face-to-face interviews, physical examination and relevant laboratory investigations with selected participants were conducted using a questionnaire guide. Questions on socio-demographic characteristics, clinical data, general physical examinations including finger nail examination and photographing with subsequent laboratory investigations including CD4 count and western blot were employed. Data Analysis: Variables were categorized and data analyzed using descriptive statistics including the frequency, percentage frequency / mean and standard deviation of continuous variables. Association between CD4 count of &le / 200cells/mm3 and ND was tested using the chisquare test with an alpha level of 0.05. Prevalence of ND, sensitivity, specificity, positive predictive and negative predictive values and accuracy of the screening test of ND was calculated. Results: 394 patients had their fingernails photographed and assessed. It was shown that distal banded and grey nails were the common types of ND seen with a prevalence of 38%. There was an association between CD4 count &le / 200cells/mm3 and ND (p&lt / 0.0001). CD4 count &le / 200cells/mm3 was a risk factor for developing ND (RR=2.3[1.8-3.6]). The association has a sensitivity of 78%, specificity of 55%, positive predictive value of 50%, and negative predictive value of 80% and accuracy of test 63%. Conclusion: With a significant association (p&lt / 0.0001) and a sensitivity of 78%, ND can be a useful clinical indicator of immune dysfunction mediated by HIV among patients in WHO stage I or II. ND can either be a clinical sign or a symptom in HIV patients with a CD4 of &le / 200cells/mm3 as seen in the study as the specificity and sensitivity of ND compared favourably with other WHO stage III diagnosis. Recommendations: Nail discoloration should complement CD4 count as an additional staging sign to help identify patients likely to benefit from ART especially in resource-limited settings. Finally, all patients with grey or distal banded should be on co-trimoxaxole prophylaxis in line with WHO /national guideline on the use of co-trimoxaxole for all HIV positive patients with a CD4 cell count of &le / 350cells/mm3.</p>

Dentro del marco de los sistemas de comunicaciones de banda ancha podemos encontrar canales modelados como sistemas MIMO (Multiple Input Multiple Output) en el que se utilizan varias antenas en el transmisor (entradas) y varias antenas en el receptor (salidas), o bien sistemas de un solo canal que puede ser modelado como los anteriores (sistemas multi-portadora o multicanal con interferencia entre ellas, sistemas multi-usuario con una o varias antenas por terminal móvil y sistemas de comunicaciones ópticas sobre fibra multimodo). Estos sistemas pretenden alcanzar valores de capacidad de transmisión relativa al ancho de banda muy superiores al de un único canal SISO (Single Input Single Output). Hoy en dÍa, existe, desde un punto de vista de implementación del sistema, una gran actividad investigadora dedicada al desarrollo de algoritmos de codificación, ecualización y detección, muchos de ellos de gran complejidad, que ayuden a aproximarse a las capacidades prometidas. En el aspecto relativo a la detección, las soluciones actuales se pueden clasificar en tres tipos: soluciones subóptimas, ML (Maximum Likelihood) o cuasi-ML e iterativas. En estas ultimas, se hace uso explicito de técnicas de control de errores empleando intercambio de información soft o indecisa entre el detector y el decodificador; en las soluciones ML o cuasi-ML se lleva a cabo una búsqueda en árbol que puede ser optimizada llegando a alcanzar complejidades polinómicas en cierto margen de relación señal-ruido; por ultimo dentro de las soluciones subóptimas destacan las técnicas de forzado de ceros, error cuadrático medio y cancelación sucesiva de interferencias SIC (Succesive Interference Cancellation), esta última con una versión ordenada -OSIC-. Las soluciones subóptimas, aunque no llegan al rendimiento de las ML o cuasi-ML son capaces de proporcionar la solución en tiempo polinómico de manera determinista. En la presente tesis doctoral, hemos implementado un método basado en la literatura para l / Martínez Zaldívar, FJ. (2007). Algoritmos paralelos segmentados para los problemas de mínimos cuadrados recursivos (RLS) y de detección por cancelación ordenada y sucesiva de interferencia (OSIC) [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/1873 / Palancia

Background: Stroke is a leading cause of significant physical, cognitive, and psychiatric morbidity. One risk factor for stroke is paradoxical embolization through a patent foramen ovale (PFO). In cardiac clinical practice, power M-mode Transcranial Doppler (TCD) evaluation is the gold standard for diagnosis of PFO, or right-to-left cardiac shunt (RLS). Brain micro-embolization due to diagnostic bubble contrast echocardiography may cause neurological symptoms in patients with PFO. However, the neurocognitive effects of TCD have not been studied. Objective: The purpose of this study was to evaluate cognitive outcomes in patients who undergo routine diagnostic bubble contrast TCD. The aims of the study were (1) to determine if cognitive function declines pre- to post-TCD evaluation and, (2) to assess the relationship between cognitive function and severity of the RLS measured using the Spencer Grading System. Methods: One hundred and four participants referred to Sorensen Cardiovascular Group for diagnosis of RLS were evaluated for changes in cognitive functioning at three time points. A dual baseline (pre-test and baseline test) was administered to mitigate practice effects between the first and second administrations. All pre and post-TCD comparisons were analyzed using the baseline test and post-TCD test, controlling for the effects of practice, if present. Results: Practice effects were observed for the working memory task, with significant improvement in working memory scores occurring between the first (pre-test) and second (baseline) administrations. The main effect for shunt group (no shunt vs. moderate-to-severe shunt) and the shunt group by time interactions were not significant for processing speed, attention, or working memory, adjusting for practice effects, age, and education. Migraine did not predict group status for mood or shunt variables. Conclusion: Cardiac patients with both small and large RLS did not experience a decline in processing speed, attention, or working memory ability following TCD, suggesting that TCD-induced microemboli do not result in immediate cognitive deficits in these domains. These findings support the use of TCD for routine evaluation of PFO, even in patients with severe RLS, although findings are limited to young (30s), medically healthy, predominately Caucasian individuals assessed immediately following TCD. Results do not exclude the possibility of cognitive impairment at follow-up, on other cognitive tests, or in other cognitive domains.

No description available.

<div> <div> <div> <p>Speech quality is a demand in voice commanded systems and in telephony. The voice communication system in real time often suffers from audible echoes. In order to cancel echoes, an acoustic echo cancellation system is designed and applied to increase speech quality both subjectively and objectively. </p> <p>In this research we develop various nonlinear adaptive filters wielding the new channel sparsity-aware recursive least squares (RLS) algorithms using a sequential update. The developed nonlinear adaptive filters using the sparse sequential RLS (S-SEQ-RLS) algorithm apply a discard function to disregard the coefficients which are not significant or close to zero in the weight vector for each channel in order to reduce the computational load and improve the algorithm convergence rate. The channel sparsity-aware algorithm is first derived for nonlinear system modeling or system identification, and then modified for application of echo cancellation. Simulation results demonstrate that by selecting a proper threshold value in the discard function, the proposed nonlinear adaptive filters using the RLS (S-SEQ-RLS) algorithm can achieve the similar performance as the nonlinear filters using the sequential RLS (SEQ-RLS) algorithm in which the channel weight vectors are sequentially updated. Furthermore, the proposed channel sparsity-aware RLS algorithms require a lower computational load in comparison with the non-sequential and non-sparsity algorithms. The computational load for the sparse algorithms can further be reduced by using data-selective strategies. </p> </div> </div> </div>

No description available.

Το αντικείμενο της διδακτορικής διατριβής αφορά στην ανάπτυξη μιας ευέλικτης και επεκτάσιμης αρχιτεκτονικής που θα αξιοποιηθεί στον σχεδιασμό συστημάτων για την διεξαγωγή πειραμάτων από απόσταση. Τα συστήματα αυτά αναφέρονται ως RLs (Remote Laboratories) και επιτρέπουν στους χρήστες να χειρίζονται απομακρυσμένα τον διαθέσιμο εργαστηριακό εξοπλισμό με σκοπό την διεξαγωγή πειραμάτων. Στην διεθνή βιβλιογραφία έχουν καταγραφεί σημαντικές ερευνητικές προσπάθειες που σχετίζονται με την ανάπτυξη RLs σε διάφορα γνωστικά αντικείμενα. Όμως ακόμη και σήμερα δεν έχει υιοθετηθεί από την επιστημονική κοινότητα κάποια κοινά αποδεκτή αρχιτεκτονική για την ανάπτυξη RLs. Αρχικά προτείνεται μια αρχιτεκτονική για την ανάπτυξη RLs η οποία ονομάζεται ARIAL (Architecture of Internet Accessible Laboratories) η οποία είναι ανεξάρτητη από το γνωστικό αντικείμενο των υποστηριζόμενων από απόσταση πειραμάτων. Η συγκεκριμένη αρχιτεκτονική είναι επίσης ανεξάρτητη τόσο από το υλικό (hardware) όσο και από το λογισμικό (software) που θα αξιοποιηθεί για την ανάπτυξη ενός RL. Η ARIAL αποτελείται από δύο δομικά στοιχεία, τον MWS (Main Web Server) και το WS (WorkStation). Ο MWS αναλαμβάνει κυρίως την διαχείριση των χρηστών και των διαθέσιμων WSs. Ενώ τα WSs που συνήθως βρίσκονται σε πολλαπλότητα, αναλαμβάνουν αποκλειστικά την διεξαγωγή των υποστηριζόμενων από απόσταση πειραμάτων. Η επικοινωνία μεταξύ του MWS και των WSs επιτυγχάνεται μέσω μιας βάσης δεδομένων που επιτρέπει την πρόσβαση μέσω διαδικτύου. Επομένως, τα WSs μπορούν να εγκατασταθούν σε οποιαδήποτε γεωγραφική τοποθεσία επιτρέποντας την ανάπτυξη ομοσπονδιακών RLs. Όμως το σημαντικότερο χαρακτηριστικό της προτεινόμενης αρχιτεκτονικής το οποίο συμβάλει αποφασιστικά στην βιωσιμότητα ενός RL, είναι η υποστήριξη από απόσταση πειραμάτων που έχουν σχεδιαστεί και υλοποιηθεί από τους χρήστες. Με στόχο την επιβεβαίωση της ARIAL προτείνεται ένα RL στην ψηφιακή επεξεργασία σήματος με DSPs που ονομάζεται R-DSP Lab (Remote Digital Signal Processors Laboratory). Το R-DSP Lab παρέχει στους χρήστες την δυνατότητα είτε να διεξάγουν ένα από τα προκαθορισμένα από απόσταση πειράματα είτε να επιβεβαιώσουν την ορθή λειτουργία μιας DSP εφαρμογής που ανέπτυξαν οι ίδιοι. Το συγκεκριμένο RL επιτρέπει επίσης την ανάπτυξη από απόσταση πειραμάτων από τους χρήστες. Στην περίπτωση αυτή οι χρήστες εκτός από την DSP εφαρμογή που επιθυμούν, θα πρέπει να υλοποιήσουν και το GUI (Graphical User Interface) που αναλαμβάνει τον απομακρυσμένο έλεγχο της παραπάνω DSP εφαρμογής. Κατά την διεξαγωγή οποιουδήποτε από τα παραπάνω απόσταση πειράματα οι χρήστες μέσω μιας κατάλληλα σχεδιασμένης ιστοσελίδας έχουν την δυνατότητα να ελέγχουν απομακρυσμένα τα διαθέσιμα εργαστηριακά όργανα. Στην συνέχεια προτείνεται ένα RL στην ψηφιακή επεξεργασία εικόνας με DSPs που ονομάζεται R-DImPr Lab (Remote Digital Image Processing Laboratory). Το συγκεκριμένο RL επιτρέπει την επιβεβαίωση μιας DSP εφαρμογής που αναπτύχθηκε από τον χρήστη αξιοποιώντας το API (Application Program Interface) του R-DImPr Lab. Η DSP εφαρμογή αναλαμβάνει την ψηφιακή επεξεργασία εικόνων που λαμβάνονται από τον διαθέσιμο αισθητήρα εικόνας. Κατά την διεξαγωγή του από απόσταση πειράματος ο χρήστης μέσω της ιστοσελίδας του RL αφού επιλέξει τις ρυθμίσεις του αισθητήρα εικόνας, έχει την δυνατότητα να παρατηρήσει τόσο στην αρχική όσο και στην επεξεργασμένη εικόνα. Με σκοπό την διεύρυνση των δυνατοτήτων του R-DimPr Lab σχεδιάστηκε και αναπτύχθηκε ένα σύστημα επεξεργασίας εικόνας με DSPs το οποίο παρέχει στους χρήστες την δυνατότητα να διεξάγουν από απόσταση πειράματα ελέγχοντας απομακρυσμένα, τόσο την λειτουργία της αντίστοιχης DSP εφαρμογής όσο και την θέση του αισθητήρα εικόνας. Ο έλεγχος της θέσης του αισθητήρα εικόνας επιτυγχάνεται μέσω ενός μηχανισμού κίνησης που βασίζεται σε δύο βηματικούς κινητήρες και επιτρέπει την περιστροφή του αισθητήρα εικόνας σε δύο άξονες. Επιπρόσθετα, διερευνείται η δυνατότητα ανάπτυξης από απόσταση πειραμάτων στην ψηφιακή επεξεργασία εικόνας με DSPs από τους χρήστες αξιοποιώντας το R-DSP Lab. Τέλος, προτείνεται ένα RL στην αρχιτεκτονική των υπολογιστών που επιτρέπει στους χρήστες να προγραμματίσουν σε assembly μια από τις δύο διαθέσιμες CPUs (Central Processing Units). Κατά την διαδικασία επιβεβαίωσης, αρχικά φορτώνεται στο FPGA (Field Programmable Gate Array) της διαθέσιμης αναπτυξιακής πλατφόρμας η υλοποίηση του συστήματος που βασίζεται στην επιλεγμένη CPU. Στην συνέχεια μέσω του GUI της ιστοσελίδας του προτεινόμενου RL, οι χρήστες έχουν την δυνατότητα να παρατηρήσουν βήμα προς βήμα τις μικρο-λειτουργίες που λαμβάνουν χώρα στην επιλεγμένη CPU κατά την εκτέλεση του προγράμματος. / The subject of this Ph.D. dissertation deals with the development of a flexible and expandable architecture which will be exploited in the design of systems for the conduction of remote experiments. These systems are referred as RLs (Remote Laboratories) and allow the users to handle remotely the available laboratory equipment in order to perform remote experiments. Significant scientific efforts which deal with the development of RLs in several cognitive fields, have been documented in the international literature. However, even today a commonly accepted architecture for the development of RLs has not been adopted by the scientific community. At the beginning, an architecture for the development of RLs which is called ARIAL (ARchitecture of Internet Accessible Laboratories) and is independent of the cognitive field of the supported remote experiments, is proposed. This architecture is also independent of both the hardware and the software which will be utilized for the development of the corresponding RL. The ARIAL consists of two structural elements, the MWS (Main Web Server) and the WS (WorkStation). The MWS undertakes the management of the users and the available WSs. Each one of the multiple WSs is exclusively responsible for the conduction of the supported remote experiments. The communication between the MWS and the WSs is achieved through an internet accessible database. Therefore, the WSs can be installed in any geographic location allowing the development of federal RLs. However, the most important feature of the proposed architecture which contributes decisively to the sustainability of a RL, is the support of remote experiments designed and implemented by the users. In order to confirm the ARIAL, this Ph.D. dissertation also proposes a RL in digital signal processing with DSPs which is called R-DSP Lab (Remote Digital Signal Processors Laboratory). The R-DSP Lab provides the users with the ability either to perform one of the predefined remote experiments or to confirm the operation of a DSP application which is developed by them. In addition, the proposed RL allows the development of remote experiments by the users. In this case, the users implement offline both the desired DSP application and the GUI (Graphical User Interface) which undertakes the remote control of the above DSP application. During the conduction of the above remote experiments, the users are able to remote control the available laboratory instruments through a carefully designed web page. Subsequently, a RL in digital image processing with DSPs which is called R-DImPr Lab (Remote Digital Image Processing Laboratory), is also proposed. This RL allows the verification of a DSP application developed by the user utilizing the API (Application Program Interface) of R-DImPr Lab. The DSP application undertakes the digital process of images which are captured by the available image sensor. During the conduction of the remote experiment, the user through the web page of the proposed RL, selects the parameters of the image sensor and observes both the original and the processed image. In order to expand the features of the R-DImPr Lab, a digital image processing system based on DSPs was designed and developed. This system allows the users to perform remote experiments by controlling remotely both the DSP application and the position of the image sensor. The control of the image sensor’s position is achieved through a motion actuator which is based on two stepper motors and allows the rotation of the image sensor in two axes. In addition, this Ph.D. dissertation explores the possibility of the development of remote experiments in digital image processing with DSPs by the users utilizing the features of the R-DSP Lab. Finally, a RL in computer architecture which allows the users to program in assembly language one of the two available CPUs (Central Processing Units), is proposed. During the verification process, the implementation of the system which is based on the selected CPU, is loaded into the FPGA (Field Programmable Gate Array) of the available development platform. The users through the GUI of the proposed RL’s web page, are able to observe the micro-operations which take place in the selected CPU during the step by step program execution.

La sécrétion de mélatonine chez des patients atteints du syndrome d’impatience musculaire de l’éveil (SIME) débute approximativement 2 heures avant l’aggravation des symptômes en soirée (Michaud et al., 2004). Le but de ce projet était de préciser le rôle de la mélatonine dans l’augmentation de la sévérité des symptômes en soirée. Huit sujets atteints de SIME primaire ont été étudiés dans trois conditions : contrôle, avec administration de mélatonine, avec exposition à la lumière vive. La sévérité des symptômes a été évaluée par l’administration de tests d’immobilisation suggérée (TIS). Les résultats ont démontré une augmentation significative des mouvements périodiques des jambes durant l’éveil (MPJE) lorsque de la mélatonine avait été administrée comparativement à la condition contrôle et celle où les sujets étaient exposés à la lumière vive. La lumière vive n’a pas eu d’effet significatif sur les symptômes moteurs comparativement à la condition contrôle mais elle a amélioré significativement les symptômes sensoriels comparativement à la condition contrôle. Ainsi, bien que la mélatonine exogène ait un effet aggravant sur les symptômes moteurs du SIME, l’augmentation de la sécrétion endogène au cours de la soirée ne saurait expliquer à elle seule les variations de la sévérité des symptômes du SIME. / A close temporal relationship was shown between the onset of melatonin secretion at night and the worsening of restless legs syndrome (RLS) symptoms, suggesting that melatonin may play a role in the genesis of this phenomenon. Thus, we studied the effects of the administration of exogenous melatonin and the suppression of endogenous melatonin secretion by bright light exposure on the severity of RLS symptoms. Eight RLS subjects were studied in three conditions: at baseline, after administration of melatonin and during bright light exposure. The severity of RLS symptoms was assessed by the Suggested Immobilization Test (SIT), which allows quantification of both sensory and motor manifestations (SIT-PLM – periodic leg movements) of RLS. Analyses showed a significant increase of SIT-PLM index when subjects received exogenous melatonin compared to both baseline and bright light conditions, but bright light exposure had no effect on leg movements compared to the baseline condition. Analyses also revealed a small but significant decrease in sensory symptoms with bright light exposure compared to baseline. Although that exogenous melatonin may have a detrimental effect on motor symptoms, the augmentation of endogenous secretion during the evening is insufficient to explain the variations of the severity of the RLS symptoms.