Philosophiae Doctor - PhD (Chemistry) / Tuberculosis (TB) is an airborne disease caused by Mycobacterium tuberculosis (MTB) that usually affects the lungs leading to severe coughing, fever and chest pains. It was estimated that over 9.6 million people worldwide developed TB and 1.5 million died from the infectious disease of which 12 % were co-infected with human immunodeficiency virus (HIV) in the year 2015. In 2016 the statistics increased to a total of 1.7 million people reportedly died from TB with an estimated 10.4 million new cases of TB diagnosed worldwide. The development of the efficient point-of-care systems that are ultra-sensitive, cheap and readily available is essential in order to address and control the spread of the tuberculosis (TB) disease and multidrugresistant tuberculosis.

The purpose of the study was to investigate the knowledge of TB patients receiving TB treatment at a clinic in Tshwane regarding the condition and their treatment. A descriptive cross-sectional survey was conducted. Data was collected using a self-designed structured questionnaire administered by the researcher and nurses. The population consisted of diagnosed TB patients. The total sample consisted of 74 respondents. The respondents were described in terms of inter alia their demographics, aspects of their health and TB and aspects related to clinic visits. For the knowledge about TB a competency indicator was set at 70% which means that those that achieved this were regarded as knowledgeable. Those that were found to be not knowledgeable were 41.9% of the sample. The mean score achieved by the group was 61% with a standard deviation of 25. Recommendations were made to amend knowledge deficits of TB patients and for further research / Health Studies / M.A. (Public Health)

The purpose of the study was to investigate and describe the experiences of a mobile injection team for multi drug resistant-tuberculosis outpatients, and to design and recommend a mobile injection team guideline based on the experiences of the team members in Ugu District, KwaZulu-Natal and to indicate the support that the MIT require. Phenomenological research was conducted. Convenient census sampling was used as all the seven members of the Ugu District mobile injection team were included. The inclusion criteria was at least six months’ working experience with MDR-TB patients in a mobile injection team at Ugu District, be an enrolled nurse registered with the South African Nursing Council as an enrolled nurse and must have an annual practicing certificate, or be a TB assistant, be willing to participate in the study and be located at the decentralised and satellite site. Data were collected through individual in-depth interviews with the participants. Data were analysed using Giorgi’s method of data analysis. The research findings revealed four broad themes (the perceptions held by the team, challenges, available support and needs to promote the service) and 73 sub-themes. The findings of the study indicate that the MDR-TB outreach injection teams experience many challenges in the community and need to be supported by their management in order to provide quality care to the patients. This study contributes to the development of guidelines to assist the mobile injection teams to provide quality patient care and effective service delivery. Based on the findings, the recommendation is that an intervention study be performed to compare the utilisation of the mobile MDR-TB injection team after implementing the recommendations made and the guidelines developed in this study / Health Studies / D. Litt. et Phil. (Health Studies)

Tuberkulos (tbc) är en luftburen droppsmitta orsakad av mykobakterium tuberkulosis. Tbc är den sjukdom som efter AIDS orsakar flest dödsfall, trots att botande behandling finns. Behandlingen är krävande för den tbc-smittade att genomgå och bygger på en kombination av en rad antibiotika som måste intas under minst sex månader. Ett avvikande i behandlingen kan resultera i att mykobakterium tuberkulosis blir resistent mot de ordinerade antibiotika. Följsamhet av långtidsbehandlingar som tbc-behandling graderas till 50 %. Syftet med litteraturstudien var att ur ett globalt perspektiv beskriva hur sjuksköterskan kan påverka följsamhet vid tbc-behandling i syfte att minska resistensutvecklingen av mykobakterium tuberkulosis. Studien genomfördes som en litteraturstudie där 12 vetenskapliga artiklar granskades och analyserades. Resultatet visar tydligt att specifika faktorer påverkar följsamhet och därigenom resistensutvecklingen. Faktorerna innefattar patientundervisning, behandlingsstrategier, omgivningens påverkan och stöd.  Undervisningen resulterar i att patienten får ökad förståelse för behandlingen. För att minska stigmatiseringen och det lidande den innebär för den tbc-smittade är även omgivningen i behov av ökad kunskap och information om tbc. Ett flertal studier visar att DOTS-strategin är betydelsefull för ökad följsamhet vid antituberkulos behandling. Litteraturstudien medför ett förslag om att sjuksköterskeprogrammet ska öka fokuseringen på följsamhet vid läkemedelsanvändning. Sjuksköterskan är i behov av att redan under grundutbildningen få kunskap om ansvarsfull antibiotikahantering som leder till en följsamhetsomtanke. / Tuberculosis (TB) is an airborne droplet infection caused by mycobacterium tuberculosis. TB is the disease after AIDS that is most deadly, even though curative treatment exists. The treatment is demanding for the TB-infected to undergo and consists of a combination of a number of antibiotics that must be administered for at least six months. A dissenting in anti-tuberculosis treatment might result in mycobacterium tuberculosis strains that are resistant to antibiotics. As adherence to long-term treatment is graded at a low percentage (50 %) the aim of the literature study was from a global perspective to develop a working-strategy for nurses that promote compliance in TB-treatment in order to reduce resistance development of mycobacterium tuberculosis. The study was conducted as a literature study where 12 research articles were reviewed and analyzed. The results describe specific factors that are essential to compliance. These factors comprise patient education, treatment strategies, social influences and support. As knowledge gives the patient a better understanding for the treatment it provokes compliance. The social environment of the TB-infected patient demands increased knowledge in order to reduce stigma. Several studies show that the DOTS strategy is important for increasing compliance in anti-tuberculosis treatment. The literature study results in a proposal for the nursing program to focus more on compliance in taking medication. The nursing program’s attendants need to gain knowledge about prudent antibiotic treatment that leads to a compliance concern.

Mycobacterium tuberculosis, the etiological agent of tuberculosis, has adapted with the host environment and evolved to survive in harsh conditions in the host. The pathogen has successfully evolved strategies not only to evade the host immune system but also to thrive within the host cells. Upon infection, the pathogen is either cleared due to the host immune response, or it survives and causes active tuberculosis (TB) infection. In a number of cases however, the pathogen is neither killed nor does it actively proliferate, but it remains dormant in the host until the environment becomes favorable. This dormant state of pathogen is responsible for latent TB infection (LTBI). WHO reports indicated that as much as a third of the whole world’s population is exposed to the pathogen, of which a significant proportion could be latently infected (WHO report, 2015). These individuals do not show symptoms of active TB infection and hence are difficult to detect. The latent TB infected (LTBI) individuals serve as a reservoir for the pathogen, which can lead to epidemics when the conditions change. Hence, it is necessary to understand the host -pathogen interactions during LTBI, as this might provide clues to developing new strategies to detect and curb a latent infection. Host-pathogen interactions are multifaceted, in which both species attempt to recognize and respond to each other, all of these through specific molecules making distinct interactions with the other species. The outcome of the infection is thus decided by a complex set of host-pathogen interactions. The complexity arises since a large number of molecular components are involved, also multiplicity of interactions among these components and due to several feedback, feed forwards or other regulatory or influential loops within the system. The complexity of biological systems makes modeling and simulation an essential and critical part of systems– level studies. Systems biology studies provide an integrated framework to analyze and understand the function of biological systems. This work addresses some of these issues with an unbiased systems-level analysis so as to identify and understand the important global changes both in the host and in the pathogen during LTBI. The broad objectives of the work was to identify the key processes that vary in the host during latent infection, the set of metabolic reactions in the host which can be modulated to control the reactivation of infection, global adaptation in Mycobacterium tuberculosis (Mtb) and then to utilize this knowledge to identify strategies for tackling latent infection. A review of literature of the current understanding of latency from the pathogen and the host perspective is described in chapter 1. From this, it is clear that most available studies have focused on the role of individual molecules and individual biological processes such as granuloma formation, toll-like receptor signaling, T cell responses as well as cytokine signaling, in either initiating or maintaining a latent infection, but there is no report till date about whether and how these processes are connected with each other. While transcriptome based studies have identified lists of differentially expressed genes in LTBI as compared to healthy controls, no further understanding is currently available for many of them, regarding the processes they may be involved in and what interactions they make, which may be important for understanding LTBI. The first part of the work is a systematic meta-analysis of genome-scale protein interaction networks rendered condition-specific with transcriptome data of patients with LTBI, which has provided a global unbiased picture of the transcriptional and metabolic variations in the host and in the pathogen during the latent infection. To start with, publicly available gene expression data related to LTBI, active TB and healthy controls were considered. In all, 183 datasets summing up to 105 LTBI, 41 active TB and 37 healthy control samples were analyzed. (Chapter 2). Standard analysis of the transcriptome profiles of these datasets indicated that there was zero overlap among them and that not a single gene was seen in common among all datasets for the same condition. An extensive human protein-protein interaction network was constructed using information available from multiple resources that comprehensively contained structural or physical interactions and genetic interactions or functional influences. Nodes in this network represented individual proteins and edges represented interactions between pairs of nodes. The identity of each node and the nature of interaction of each edge along with the type of evidence that was used as the basis for drawing the edge, was collated for the network. The gene expression data was integrated into the human protein-protein interaction (PPI) network for each condition, which essentially had weighted nodes and directed edges, specific to that condition, from which specific comparative networks were derived. The highest ranked perturbations in LTBI were identified through a network mining protocol previously established in the laboratory. This involved computing all versus all shortest paths on the comparative network, scoring the paths based on connectedness and various centrality measures of the nodes and the edges and finally ranking the paths based on the cumulative path scores. Intriguingly, the top-ranked set of perturbations were found to form a connected sub-network by themselves, referred to as a top perturbed sub-network (top-net), indicating that they were functionally linked or perhaps even orchestrated in some sense. Th17 signaling appears to be dominant. About 40 genes were identified in the unique set of LTBI condition as compared to the active TB condition, and these genes showed enrichment for processes such as apoptosis, cell cycle as well as natural killer cell mediated toxicity. Construction and analysis of a miRNA network indicated that 32 of these have strong associations with miRNA explaining the role of the latter in controlling LTBI. 3 other genes from the top-net are already established drug targets for different diseases with known drugs associated with them, which are BCL2, HSP90AA1 and NR3C1. These 3 proteins can be explored further as drug targets in LTBI whose manipulation using existing drugs may result in inhibiting the underlying biological process and thereby result in disturbing the state of latency. As a second objective, global variations in the host transcriptome were identified during ascorbic acid induced dormancy (Chapter 3). Ascorbic acid or Vitamin C is a nutrient supplement required in the diet. This organic compound has a known antioxidant property, as it is known to scavenge the free radicals. In a recent study, Taneja et al, demonstrated that Vitamin C could induce dormancy in Mtb. On similar lines, experiments were done in THP-1 cells infected with Mtb to determine the host responses during ascorbic acid (AA) induced dormancy. The raw gene expression data was provided by our collaborator Prof. Jaya Tyagi that included 0 hour, 4 days and 6 days time points with infection and vitamin C versus infection alone or vitamin C alone as controls. The transcriptome data was normalized and integrated into the human PPI network as described for the meta-analyses. It was experimentally determined that ascorbic acid induces dormancy in 4 days post infection. The top-ranked paths of perturbation were analyzed and compared for three different conditions: (i) uninfected condition, (ii) AA treated and infected condition, and (iii) AA, isoniazid and infected condition. The dormant pathogen is known to be drug-tolerant and thus as a marker for the state of dormancy, the lack of effect of isoniazid is also monitored in the infected host cells. The analysis revealed that there were some broad similarities as compared to LTBI from patient samples but AA induced dormancy in cell lines stood out a separate group indicating that there were significant differences such as involving Interferon Induced Transmembrane Proteins (IFITMs), vacuolar ATPase as well as GDF15, which belongs to TGF-beta signaling pathway. The highest ranked perturbed paths contained genes involved in innate immune responses of which ISG15, IFITMs, HLAs and ATPases emerge as the most altered in the dormant condition. CCR7 emerges as a key discriminator, which is subdued in the latent samples but highly induced in infection conditions. Pathway-based analysis of different conditions showed that oxidative stress, glutathione metabolism, proteasome degradation as well as type II interferon signaling are significantly up-regulated in AA induced dormancy. The dormant bacteria reside in the host cells and are known to modulate the host metabolism for their own benefit. So, the third objective was to understand the metabolic variations in the host during LTBI (Chapter 4). A genome-scale metabolic (GSM) model of alveolar macrophage was used in this study. The metabolic model contains information of the reactions, metabolites and the genes encoding enzymes that catalyze a particular reaction. Flux balance analysis (FBA), a constraint-based metabolic modeling method, is used for analyzing the alterations in the metabolism under different infection conditions. In order to mimic the physiological condition, gene expression data was used for constraining the bounds of the reactions in the model. Two different expression studies were used for analysis: GSE25534 (from Chapter 2) and ascorbic acid induced dormancy (Chapter 3). The analysis was carried out for latent TB versus healthy control and latent TB versus active TB to identify the most altered metabolic processes in LTBI. Differences in fluxes between the two conditions were calculated. A new classification scheme was devised to categorize the reactions on the basis of flux differences. In this chapter, higher fluxes in LTBI condition were identified for reactions involved in transport of small metabolites as well as amino acids. Solute carrier proteins responsible for the transport of the metabolites were identified and their biological significance is discussed. Reduced glutathione (GSH), arachidonic acid, prostaglandins, pantothenate were identified as important metabolites in LTBI condition and their physiological role has been described. Sub-system analysis for different conditions shows differential regulation for arachidonic acid metabolism, fatty acid metabolism, folate metabolism, pyruvate metabolism, glutathione metabolism, ROS detoxification, triacylglycerol synthesis and transport as well as tryptophan metabolism. From the study, transporter proteins and reactions altered during LTBI were identified, which again provide clues for understanding the molecular basis of establishing a latent infection. Mycoabcterium tuberculosis is known to undergo dormancy during stress conditions. In this chapter, the main objective was to identify the global variations in the dormant Mtb (Chapter 5). To carry out the analysis, the Mtb PPI network was constructed using information from available resources. Gene expression data of two different dormancy models, Wayne growth model and multiple-stress model, were used for the study. To identify the key players involved in reversal of dormancy, the transcriptome data of reaeration condition was also used. In this study, the Max-flow algorithm was implemented to identify the feasible paths or flows in different condition. The flows with higher scores indicate that more information is traversed by the path, and hence is important for the study. From the analysis of Wayne growth model (hypoxia model), important transcriptional regulators such as SigB, SigE, SigH, regulators in the two-component system such as MprA, MtrA, PhoP, RegX3 and TrcR were identified in stress condition. Multiple-stress model studied the growth of bacteria in low oxygen concentration, high carbon dioxide levels, low pH and nutrient starvation. The gene expression data was integrated in the Mtb PPI network and implementation of Max-flow algorithm showed that MprA, part of the MprA-MprB two-component system, is involved in the regulation of persistent condition. WhiB1 also features in the paths of dormant condition and its role in persistence can be explored. In reaeration model, WhiB1 and WhiB4 are present in the top flows of this condition indicating that the redox state is perturbed in the pathogen and the interactions of these proteins are important to understand the reversal of dormant condition. From the study, Rv2034, Rv2035, HigA, Rv1989, Rv1990 and Rv0837 proteins belonging to toxin-antitoxin systems were also identified in the dormant bacteria, indicating their role in adaptation during stress condition. The role of Rv2034 has been studied in persistence, but the function of other proteins can be analyzed to provide new testable hypotheses about the role of these proteins in dormancy. Thus, the flows or paths perturbed during dormancy were identified in this study. To get a better understanding of the metabolic network active in mycobacteria under different conditions, experiments were performed in Mycobacterium smegmatis MC2 155. The non-pathogenic strain of genus Mycobacteria, Mycobacterium smegmatis, is used as a surrogate to carry out molecular biology studies of Mtb. Mycobacterium smegmatis MC2 155 (Msm) is the commonly used laboratory strain for experimental purpose. In order to obtain a clear understanding of how comparable are the metabolic networks between the virulent M. tuberculosis H37Rv and the model system Msm, the latter model is first studied systematically. In Chapter 6, first the functional annotation of the Msm genome was carried out and the genes were categorized into different Tuberculist classes based on homology with the Mtb genome. A high-throughput growth characterization was carried out to characterize the strain systematically in terms of different carbon, nitrogen or other sources that promoted growth and thus served as nutrients and those that did not, together yielding a genome-phenome correlation in Msm. Gene expression was measured and used for explaining the observed phenotypic behavior of the organism. Together with the genome sequence, the transcriptome and phenome analysis, a set of about 257 different metabolic pathways were identified to be feasible in wild-type Msm. About 284 different carbon, nitrogen source and nutrient supplements were tested in this experiment and 167 of them supported growth of Msm. This indicates that the compounds enter the cells and are metabolized efficiently, thus yielding similar phenotypes. The expressed genes and metabolites supporting growth were mapped to the metabolic network of Msm, thus helping in the identification of feasible metabolic routes in Msm. A comparative study between Msm and Mtb revealed that these organisms share similarity in the nutrient sources that are utilized for growth. The study provides experimental proof to identify the feasible metabolic routes in Msm, and this can be used for understanding the metabolic capability in the two organisms under different conditions providing a basis to understand adaptations during dormancy. In the last part of the work presented in this thesis, the metabolic shift in the pathogen was studied using a genome-scale metabolic model of Mtb (Chapter 7). The model contains information of the reactions, metabolites and genes involved in the reactions. Flux balance analysis (FBA) was carried out by integrating normalized gene expression data (Wayne model and multiple-stress model transcriptome considered in Chapter 5) to identify the set of reactions, which have a higher flux in the dormant condition as compared to the control replicating condition. Glutamate metabolism along with propionyl CoA metabolism emerge as major up-regulated processes in dormant Mtb. Next, with an objective of identifying essential genes in dormant Mtb, a systematic in silico single gene knock-out analysis was carried out where each gene and it's associated reaction was knocked out of the model, one at a time and the ability of the model to reach its objective function assessed. About 168 common genes in Wayne model and multiple-stress model were identified as important in Mtb after the knockout analysis. Essentiality is in essence a systems property and requires to be probed through multiple angles. Towards this, essential genes were identified in Mtb using a multi-level multi-scale systems biology approach. About 283 genes were identified as essential on the basis of combined analysis of transcriptome data, FBA, network analysis and phyletic retention studies in Mtb. 168 genes identified as important in dormant Mtb were compared with 283 essential genes and about 91 genes were found to be essential. Finally, among the set of essential genes, those that satisfy other criteria for a drug target were analyzed using the list of high-confidence drug targets of Mtb available in the laboratory along with their associated drug or drug-like molecules. 38 out of the 168 important genes in Mtb were found to have one or more drugs associated with them from the DrugBank database. Colchicin-Rv1655, Raloxifene-Rv1653, Bexarotene-Rv3804, Rosiglitazone-Rv3804 are top-scoring drug-target pairs that can be explored for killing dormant bacilli. The study has thus been useful in identifying important proteins, reactions and drug targets in dormant Mtb. In summary, the thesis presents a comprehensive systems-level understanding of various aspects of host responses and pathogen adaptation during latent TB infection. Key host and pathogen factors involved in LTBI are identified that serve as useful pointers for deriving strategies for tackling a latent infection.

[EN] The first generation of Terrestrial Digital Television(DTV) has been in service for over a decade. In 2013, several countries have already completed the transition from Analog to Digital TV Broadcasting, most of which in Europe. In South America, after several studies and trials, Brazil adopted the Japanese standard with some innovations. Japan and Brazil started Digital Terrestrial Television Broadcasting (DTTB) services in December 2003 and December 2007 respectively, using Integrated Services Digital Broadcasting - Terrestrial (ISDB-T), also known as ARIB STD-B31. In June 2005 the Committee for the Information Technology Area (CATI) of Brazilian Ministry of Science and Technology and Innovation MCTI approved the incorporation of the IC-Brazil Program, in the National Program for Microelectronics (PNM) . The main goals of IC-Brazil are the formal qualification of IC designers, support to the creation of semiconductors companies focused on projects of ICs within Brazil, and the attraction of semiconductors companies focused on the design and development of ICs in Brazil. The work presented in this thesis originated from the unique momentum created by the combination of the birth of Digital Television in Brazil and the creation of the IC-Brazil Program by the Brazilian government. Without this combination it would not have been possible to make these kind of projects in Brazil. These projects have been a long and costly journey, albeit scientifically and technologically worthy, towards a Brazilian DTV state-of-the-art low complexity Integrated Circuit, with good economy scale perspectives, due to the fact that at the beginning of this project ISDB-T standard was not adopted by several countries like DVB-T. During the development of the ISDB-T receiver proposed in this thesis, it was realized that due to the continental dimensions of Brazil, the DTTB would not be enough to cover the entire country with open DTV signal, specially for the case of remote localizations far from the high urban density regions. Then, Eldorado Research Institute and Idea! Electronic Systems, foresaw that, in a near future, there would be an open distribution system for high definition DTV over satellite, in Brazil. Based on that, it was decided by Eldorado Research Institute, that would be necessary to create a new ASIC for broadcast satellite reception. At that time DVB-S2 standard was the strongest candidate for that, and this assumption still stands nowadays. Therefore, it was decided to apply to a new round of resources funding from the MCTI - that was granted - in order to start the new project. This thesis discusses in details the Architecture and Algorithms proposed for the implementation of a low complexity Intermediate Frequency(IF) ISDB-T Receiver on Application Specific Integrated Circuit (ASIC) CMOS. The Architecture proposed here is highly based on the COordinate Rotation Digital Computer (CORDIC) Algorithm, that is a simple and efficient algorithm suitable for VLSI implementations. The receiver copes with the impairments inherent to wireless channels transmission and the receiver crystals. The thesis also discusses the Methodology adopted and presents the implementation results. The receiver performance is presented and compared to those obtained by means of simulations. Furthermore, the thesis also presents the Architecture and Algorithms for a DVB-S2 receiver targeting its ASIC implementation. However, unlike the ISDB-T receiver, only preliminary ASIC implementation results are introduced. This was mainly done in order to have an early estimation of die area to prove that the project in ASIC is economically viable, as well as to verify possible bugs in early stage. As in the case of ISDB-T receiver, this receiver is highly based on CORDIC algorithm and it was prototyped in FPGA. The Methodology used for the second receiver is derived from that used for the ISDB-T receiver, with minor additions given the project characteristics. / [ES] La primera generación de Televisión Digital Terrestre(DTV) ha estado en servicio por más de una década. En 2013, varios países completaron la transición de transmisión analógica a televisión digital, la mayoría de ellas en Europa. En América del Sur, después de varios estudios y ensayos, Brasil adoptó el estándar japonés con algunas innovaciones. Japón y Brasil comenzaron a prestar el servicio de Difusión de Televisión Digital Terrestre (DTTB) en diciembre de 2003 y diciembre de 2007 respectivamente, utilizando Radiodifusión Digital de Servicios Integrados Terrestres (ISDB-T), también conocida como ARIB STD-B31. En junio de 2005, el Comité del Área de Tecnología de la Información (CATI) del Ministerio de Ciencia, Tecnología e Innovación de Brasil - MCTI aprobó la incorporación del Programa CI-Brasil, en el Programa Nacional de Microelectrónica (PNM). Los principales objetivos de la CI-Brasil son la formación de diseñadores de CIs, apoyar la creación de empresas de semiconductores enfocadas en proyectos de circuitos integrados dentro de Brasil, y la atracción de empresas de semiconductores interesadas en el diseño y desarrollo de circuitos integrados. El trabajo presentado en esta tesis se originó en el impulso único creado por la combinación del nacimiento de la televisión digital en Brasil y la creación del Programa de CI-Brasil por el gobierno brasileño. Sin esta combinación no hubiera sido posible realizar este tipo de proyectos en Brasil. Estos proyectos han sido un trayecto largo y costoso, aunque meritorio desde el punto de vista científico y tecnológico, hacia un Circuito Integrado brasileño de punta y de baja complejidad para DTV, con buenas perspectivas de economía de escala debido al hecho que al inicio de este proyecto, el estándar ISDB-T no fue adoptado por varios países como DVB-T. Durante el desarrollo del receptor ISDB-T propuesto en esta tesis, se observó que debido a las dimensiones continentales de Brasil, la DTTB no sería suficiente para cubrir todo el país con la señal de televisión digital abierta, especialmente para el caso de localizaciones remotas, apartadas de las regiones de alta densidad urbana. En ese momento, el Instituto de Investigación Eldorado e Idea! Sistemas Electrónicos, previeron que en un futuro cercano habría un sistema de distribución abierto para DTV de alta definición por satélite en Brasil. Con base en eso, el Instituto de Investigación Eldorado decidió que sería necesario crear un nuevo ASIC para la recepción de radiodifusión por satélite, basada el estándar DVB-S2. En esta tesis se analiza en detalle la Arquitectura y algoritmos propuestos para la implementación de un receptor ISDB-T de baja complejidad y frecuencia intermedia (IF) en un Circuito Integrado de Aplicación Específica (ASIC) CMOS. La arquitectura aquí propuesta se basa fuertemente en el algoritmo Computadora Digital para Rotación de Coordenadas (CORDIC), el cual es un algoritmo simple, eficiente y adecuado para implementaciones VLSI. El receptor hace frente a las deficiencias inherentes a las transmisiones por canales inalámbricos y los cristales del receptor. La tesis también analiza la metodología adoptada y presenta los resultados de la implementación. Por otro lado, la tesis también presenta la arquitectura y los algoritmos para un receptor DVB-S2 dirigido a la implementación en ASIC. Sin embargo, a diferencia del receptor ISDB-T, se introducen sólo los resultados preliminares de implementación en ASIC. Esto se hizo principalmente con el fin de tener una estimación temprana del área del die para demostrar que el proyecto en ASIC es económicamente viable, así como para verificar posibles errores en etapa temprana. Como en el caso de receptor ISDB-T, este receptor se basa fuertemente en el algoritmo CORDIC y fue un prototipado en FPGA. La metodología utilizada para el segundo receptor se deriva de la utilizada para el re / [CAT] La primera generació de Televisió Digital Terrestre (TDT) ha estat en servici durant més d'una dècada. En 2013, diversos països ja van completar la transició de la radiodifusió de televisió analògica a la digital, i la majoria van ser a Europa. A Amèrica del Sud, després de diversos estudis i assajos, Brasil va adoptar l'estàndard japonés amb algunes innovacions. Japó i Brasil van començar els servicis de Radiodifusió de Televisió Terrestre Digital (DTTB) al desembre de 2003 i al desembre de 2007, respectivament, utilitzant la Radiodifusió Digital amb Servicis Integrats de (ISDB-T), coneguda com a ARIB STD-B31. Al juny de 2005, el Comité de l'Àrea de Tecnologia de la Informació (CATI) del Ministeri de Ciència i Tecnologia i Innovació del Brasil (MCTI) va aprovar la incorporació del programa CI Brasil al Programa Nacional de Microelectrònica (PNM). Els principals objectius de CI Brasil són la qualificació formal dels dissenyadors de circuits integrats, el suport a la creació d'empreses de semiconductors centrades en projectes de circuits integrats dins del Brasil i l'atracció d'empreses de semiconductors centrades en el disseny i desenvolupament de circuits integrats. El treball presentat en esta tesi es va originar en l'impuls únic creat per la combinació del naixement de la televisió digital al Brasil i la creació del programa Brasil CI pel govern brasiler. Sense esta combinació no hauria estat possible realitzar este tipus de projectes a Brasil. Estos projectes han suposat un viatge llarg i costós, tot i que digne científicament i tecnològica, cap a un circuit integrat punter de baixa complexitat per a la TDT brasilera, amb bones perspectives d'economia d'escala perquè a l'inici d'este projecte l'estàndard ISDB-T no va ser adoptat per diversos països, com el DVB-T. Durant el desenvolupament del receptor de ISDB-T proposat en esta tesi, va resultar que, a causa de les dimensions continentals de Brasil, la DTTB no seria suficient per cobrir tot el país amb el senyal de TDT oberta, especialment pel que fa a les localitzacions remotes allunyades de les regions d'alta densitat urbana.. En este moment, l'Institut de Recerca Eldorado i Idea! Sistemes Electrònics van preveure que, en un futur pròxim, no hi hauria a Brasil un sistema de distribució oberta de TDT d'alta definició a través de satèl¿lit. D'acord amb això, l'Institut de Recerca Eldorado va decidir que seria necessari crear un nou ASIC per a la recepció de radiodifusió per satèl¿lit. basat en l'estàndard DVB-S2. En esta tesi s'analitza en detall l'arquitectura i els algorismes proposats per l'execució d'un receptor ISDB-T de Freqüència Intermèdia (FI) de baixa complexitat sobre CMOS de Circuit Integrat d'Aplicacions Específiques (ASIC). L'arquitectura ací proposada es basa molt en l'algorisme de l'Ordinador Digital de Rotació de Coordenades (CORDIC), que és un algorisme simple i eficient adequat per implementacions VLSI. El receptor fa front a les deficiències inherents a la transmissió de canals sense fil i els cristalls del receptor. Esta tesi també analitza la metodologia adoptada i presenta els resultats de l'execució. Es presenta el rendiment del receptor i es compara amb els obtinguts per mitjà de simulacions. D'altra banda, esta tesi també presenta l'arquitectura i els algorismes d'un receptor de DVB-S2 de cara a la seua implementació en ASIC. No obstant això, a diferència del receptor ISDB-T, només s'introdueixen resultats preliminars d'implementació en ASIC. Això es va fer principalment amb la finalitat de tenir una estimació primerenca de la zona de dau per demostrar que el projecte en ASIC és econòmicament viable, així com per verificar possibles errors en l'etapa primerenca. Com en el cas del receptor ISDB-T, este receptor es basa molt en l'algorisme CORDIC i va ser un prototip de FPGA. La metodologia utilitzada per al segon receptor es deriva de la utilitzada per al receptor I / Rodrigues De Lima, E. (2016). Architecture and algorithms for the implementation of digital wireless receivers in FPGA and ASIC: ISDB-T and DVB-S2 cases [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/61967 / TESIS

MCur / Department of Advanced Nursing Science

Purpose: The purpose of this study is to assess risk factors associated with TB co-infection in HIV/AIDS patients taking antiretroviral therapy (ART). Methodology: An observational, analytic, case-control and quantitative study was conducted on a randomly selected 367 HIV and AIDS patients of whom 92 of them were TB co-infected. Data collection was done by using self-structured questionnaire. Result: In this study, educational status, waste disposal system, monthly income, contact history with a patient of active tuberculosis or presence of a family member with active tuberculosis, drug adherence, knowledge on tuberculosis prevention and history of exposure to substance were factors independently associated with the occurrence of active tuberculosis among HIV and Aids patients taking ART. Conclusion: The findings highlight the need for on-going educational, informational and other interventions to address the risk factors of tuberculosis in HIV and Aids patients in order to decrease the rate of TB co-infection / Health Studies / M.A. Public Health

No description available.

Thesis (Ph.D. (Nursing Science)) -- University of Limpopo, 2017 / The aim of this study was to develop a model to ensure the integration of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) services in the Primary Health Care (PHC) facilities of Limpopo Province. An explanatory sequential mixed method was used in this study to develop a model for ensuring the integration of TB and HIV services in the PHC facilities of the Limpopo Province. The researcher collected quantitative data followed by qualitative data. Quantitative data was collected through administration of questionnaires to 450 PHC nurses in the five districts of Limpopo Province. The qualitative data was collected by conducting focus group discussions to five groups of Community Home Based Carers (CHBCs) and five groups of TB/HIV co-infected patients in the five districts of Limpopo Province. Audiotape and field notes were used to capture verbal and non-verbal cues. The Statistical Package for Social Sciences (SPSS) computer programme version 22.0 was used for capturing and analysis of the quantitative data. Content analysis was used to analyse the qualitative data from the CHBCs and the TB and HIV co-infected patients’ focus group discussions. The study revealed lack of knowledge and skills on TB and HIV management due to insufficient training of PHC nurses about TB and HIV management. Staff shortage of PHC nurses in the facilities was also indicated by PHC nurses. Furthermore, TB and HIV coinfected patients are faced with challenges in the PHC facilities and in the community. Challenges that are faced by CHBCs and the TB and HIV co-infected patients include negative attitudes of some clinic staff members towards them. The patients’ families also have some negative attitudes towards the CHBCs as they leave the patients to them without assisting them in the caring duties. The community members also has negative attitudes as they do not accept the CHBCs in their homes to support the patients. Based on the results, a model was developed to ensure the integration of TB and HIV services. The model was validated by PHC nurses and the experts in research and model development. The validation results showed that the model was clear and simple to be used in the PHC facilities for integration of TB and HIV services. The study recommends that the model should be used by PHC facilities for integration of TB and HIV services. The PHC nurses should attend TB and HIV capacity-building courses.