HIV associated neurocognitive dysfunction and its association with CD4 count in HIV positive patients-a hospital based study

Background: The main objective of the present work was to study the neurocognitive dysfunction in HIV positive patients and to determine its relation with CD4 count. Further, an attempt has also been made to study the relationship of neurocognitive dysfunction with cART regimen.Methods: The study was a prospective observational study, conducted over a period of one year (from July 2012 to June 2013) in the Department of Medicine in collaboration with the Department of Psychiatry at Indira Gandhi Medical College and Hospital, Shimla.Results: HIV associated neurocognitive dysfunction (HAND) was found in 39.04% patients. Mean duration from diagnosis of HIV to detection of HAND was 3.77 ± 1.7 years. Mean nadir CD4 cell count was 126.1/mm3. 39.04% patients (n=41) were found to have HIV associated neurocognitive disorder out of 105 screened patients. 95.1% patients (n=39) had asymptomatic neurocognitive impairement, 4.9% patients (n=2) had mild cognitive impairment and 2.08% patients (n=1) had HIV associated dementia. Out of 41 patients having HIV associated neurocognitive disorder, 68.3% patients (n=28) were having CD4 count less than 150. Those having CD4 count less than 150/mm3 had scored less on dementia scales indicating severe disease. 31.7% patients (n=13) were having HIV associated neurocognitive disorder (HAND) and CD4 count was more than 150/mm3.Conclusions: The conclusion of the study is that HIV associated neurocognitive disorder is common and asymptomatic neurocognitive impairement is the commonest type of HIV associated neurocognitive disorder in HIV positive patients. It can be detected while patient is asymptomatic with help of simple neurocognitive tests. Although few studies reported higher prevalence of HIV associated neurocognitive disorder among patients on certain combined antiretroviral therapy (cART) regimen but our study didn’t indicate any such association

E-Mail Data Analysis by Considering Auxiliary Information

The immense evolution of the technologies is directly proportional to the rise of mails in our email boxes. Emails are always considered as the best source of communication. To utilize the true potential of these emails (unstructured data) transformation should be done on it in order to extract needed information from it thus saving time. Data mining fulfills this need. Also the main information is carried by the documents attached to these mails, so extraction of this auxiliary data is very necessary. To access these emails effectively with the auxiliary data present in them as per user’s sentiments, this paper propose text analytics method to cluster the mails into different groups on the basis of emotions using various scalable machine learning techniques

Multilevel Scalable Solvers for Stochastic Linear and Nonlinear Problems

This article discusses the uncertainty quantification (UQ) for time-independent linear and nonlinear partial differential equation (PDE)-based systems with random model parameters carried out using sampling-free intrusive stochastic Galerkin method leveraging multilevel scalable solvers constructed combining two-grid Schwarz method and AMG. High-resolution spatial meshes along with a large number of stochastic expansion terms increase the system size leading to significant memory consumption and computational costs. Domain decomposition (DD)-based parallel scalable solvers are developed to this end for linear and nonlinear stochastic PDEs. A generalized minimum residual (GMRES) iterative solver equipped with a multilevel preconditioner consisting of restricted additive Schwarz (RAS) for the fine grid and algebraic multigrid (AMG) for the coarse grid is constructed to improve scalability. Numerical experiments illustrate the scalabilities of the proposed solver for stochastic linear and nonlinear Poisson problems

Scalable computational algorithms for geospatial COVID-19 spread using high performance computing

A nonlinear partial differential equation (PDE) based compartmental model of COVID-19 provides a continuous trace of infection over space and time. Finer resolutions in the spatial discretization, the inclusion of additional model compartments and model stratifications based on clinically relevant categories contribute to an increase in the number of unknowns to the order of millions. We adopt a parallel scalable solver that permits faster solutions for these high fidelity models. The solver combines domain decomposition and algebraic multigrid preconditioners at multiple levels to achieve the desired strong and weak scalabilities. As a numerical illustration of this general methodology, a five-compartment susceptible-exposed-infected-recovered-deceased (SEIRD) model of COVID-19 is used to demonstrate the scalability and effectiveness of the proposed solver for a large geographical domain (Southern Ontario). It is possible to predict the infections for a period of three months for a system size of 186 million (using 3200 processes) within 12 hours saving months of computational effort needed for the conventional solvers

Correlation of donor-acceptor pair emission on the performance of GaN-based UV photodetector

High responsivity UV photodetector has been realized by fabricating single crystalline epitaxial GaN-based devices grown on silicon substrate by using molecular beam epitaxy system. The influence of trap states existing within the forbidden gap on GaN-based optoelectronic devices has been investigated. The quality and performance of the fabricated GaN based UV photodetector with distinct AlN buffer layer grown at low and high substrate temperature are substantiated. A detailed analysis reveals that high temperature buffer can yield improved crystalline quality of GaN with similar morphological properties as compared to buffer layer grown at low temperature. However, the distinct buffer layer influence the optical properties as the photoluminescence analysis explains that both the films possess superior band-to-band edge emission where GaN grown with high temperature AlN buffer consists of dominant acceptor defect states in comparison to GaN with low temperature AlN buffer layer. The existence of acceptor states has been accredited by the presence of Ga vacancy related states in the band gap. The fabricated devices yield high photoresponsivity of 2.1 and 1.5 A/W at 1 V from GaN films bearing low and high accepter defect states which explain a clear correlation of device performance with trap states within the band-gap region

Active case finding among marginalised and vulnerable populations reduces catastrophic costs due to tuberculosis diagnosis

Background: There is limited evidence on whether active case finding (ACF) among marginalised and vulnerable populations mitigates the financial burden during tuberculosis (TB) diagnosis. Objectives: To determine the effect of ACF among marginalised and vulnerable populations on prevalence and inequity of catastrophic costs due to TB diagnosis among TB-affected households when compared with passive case finding (PCF). Methods: In 18 randomly sampled ACF districts in India, during March 2016 to February 2017, we enrolled all new sputum-smear-positive TB patients detected through ACF and an equal number of randomly selected patients detected through PCF. Direct (medical and non-medical) and indirect costs due to TB diagnosis were collected through patient interviews at their residence. We defined costs due to TB diagnosis as ‘catastrophic’ if the total costs (direct and indirect) due to TB diagnosis exceeded 20% of annual pre-TB household income. We used concentration curves and indices to assess the extent of inequity. Results: When compared with patients detected through PCF (n = 231), ACF patients (n = 234) incurred lower median total costs (US$ 4.6 and 20.4, p < 0.001). The prevalence of catastrophic costs in ACF and PCF was 10.3 and 11.5% respectively. Adjusted analysis showed that patients detected through ACF had a 32% lower prevalence of catastrophic costs relative to PCF [adjusted prevalence ratio (95% CI): 0.68 (0.69, 0.97)]. The concentration indices (95% CI) for total costs in both ACF [−0.15 (−0.32, 0.11)] and PCF [−0.06 (−0.20, 0.08)] were not significantly different from the line of equality and each other. The concentration indices (95% CI) for catastrophic costs in both ACF [−0.60 (−0.81, –0.39)] and PCF [−0.58 (−0.78, –0.38)] were not significantly different from each other: however, both the curves had a significant distribution among the poorest quintiles. Conclusion: ACF among marginalised and vulnerable populations reduced total costs and prevalence of catastrophic costs due to TB diagnosis, but could not address inequity

Patient characteristics, health seeking and delays among new sputum smear positive TB patients identified through active case finding when compared to passive case finding in India.

BackgroundAxshya SAMVAD is an active tuberculosis (TB) case finding (ACF) strategy under project Axshya (Axshya meaning 'free of TB' and SAMVAD meaning 'conversation') among marginalized and vulnerable populations in 285 districts of India.ObjectivesTo compare patient characteristics, health seeking, delays in diagnosis and treatment initiation among new sputum smear positive TB patients detected through ACF and passive case finding (PCF) under the national TB programme in marginalized and vulnerable populations between March 2016 and February 2017.MethodsThis observational analytic study was conducted in 18 randomly sampled Axshya districts. We enrolled all TB patients detected through ACF and an equal number of randomly selected patients detected through PCF in the same settings. Data on patient characteristics, health seeking and delays were collected through record review and patient interviews (at their residence). Delays included patient level delay (from eligibility for sputum examination to first contact with any health care provider (HCP)), health system level diagnosis delay (from contact with first HCP to TB diagnosis) and treatment initiation delays (from diagnosis to treatment initiation). Total delay was the sum of patient level, health system level diagnosis delay and treatment initiation delays.ResultsWe included 234 ACF-diagnosed and 231 PCF-diagnosed patients. When compared to PCF, ACF patients were relatively older (≥65 years, 14% versus 8%, p = 0.041), had no formal education (57% versus 36%, pConclusionAxshya SAMVAD linked the most impoverished communities to TB care and resulted in reduction of health system level diagnosis delay