ABSTRACT
A culture collection of 50 Neisseria gonorrhoeae isolates is available from the CDC & FDA Antibiotic Resistance Isolate Bank. Associated data include antibiotic susceptibility information for azithromycin, cefixime, cefpodoxime, ceftriaxone, tetracycline, ciprofloxacin, penicillin, and spectinomycin and linked whole-genome sequences.
ABSTRACT
BACKGROUND: Tuberculosis is the leading infectious cause of death. Steep reductions in tuberculosis-related mortality are required to realize the World Health Organization's "End Tuberculosis Strategy." However, accurate mortality estimates are lacking in many countries, particularly following discharge from care. This study aimed to establish the mortality rate among patients with pulmonary tuberculosis in Vietnam and to quantify the excess mortality in this population. METHODS: We conducted a prospective cohort study among adult patients treated for smear-positive pulmonary tuberculosis in 70 clinics across Vietnam. People living in the same households were recruited as controls. Participants were re-interviewed and their survival was established at least 2 years after their treatment with an 8-month standardized regimen. The presence of relapse was established by linking identifying data on patients and controls to clinic registries. Verbal autopsies were performed. The cumulative mortality among patients was compared to that among a control population, adjusting for age and gender. RESULTS: We enrolled 10964 patients and 25707 household controls. Among enrolled tuberculosis patients, 9% of patients died within a median follow-up period of 2.9 years: 342 (3.1%) during treatment and 637 (5.8%) after discharge. The standardized mortality ratio was 4.0 (95% confidence interval 3.7-4.2) among patients with tuberculosis, compared to the control population. Tuberculosis was the likely cause of death for 44.7% of these deceased patients. CONCLUSIONS: Patients treated for tuberculosis had a markedly elevated risk of death, particularly in the post-treatment period. Interventions to reduce tuberculosis mortality must enhance the early detection of drug-resistance, improve treatment effectiveness, and address non-communicable diseases.
Subject(s)
Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/mortality , Adult , Antitubercular Agents/therapeutic use , Autopsy , Female , Humans , Male , Middle Aged , Prospective Studies , Recurrence , Tuberculosis, Pulmonary/drug therapy , Vietnam/epidemiology , Young AdultABSTRACT
A large number of silicon (Si) patterns consisting of nanopillars of varying diameter and pitch have been fabricated and further coated with diamond-like carbon (DLC) and perfluoropolyether (Z-DOL) films. The wetting behavior and nano-adhesion/friction of the patterns are investigated experimentally in relation to the nanostructures and the hydrophobicity of the materials. Measurements of water contact angle illustrate that the patterning-enhanced wettability of the Si flat surface, along with two distinct wettings which are in good agreement with the Wenzel and hemi-wicking states, depended on the value of the pitch-over-diameter ratio. In the case of the coated patterns, three wetting states are observed: the Cassie-Baxter, the Wenzel, and a transition from the Cassie-Baxter into the Wenzel, which varies with regard to the hydrophobic properties of the DLC and Z-DOL. In terms of tribological properties, it is demonstrated that a combination of the nanopatterns and the films is effective in reducing adhesive and frictional forces. In addition, the pitch and diameter of the patterns are found to significantly influence their adhesion/friction behaviors.
Subject(s)
Carbon/chemistry , Ethers/chemistry , Fluorocarbons/chemistry , Nanostructures/chemistry , Silicon/chemistry , Wettability , Nanostructures/ultrastructureABSTRACT
Our objective was to determine if protons allow for the expansion of treatment volumes to cover high-risk nodes in patients with regionally advanced non-small-cell lung cancer. In this study, 5 consecutive patients underwent external-beam radiotherapy treatment planning. Four treatment plans were generated for each patient: 1) photons (x-rays) to treat positron emission tomography (PET)-positive gross disease only to 74 Gy (XG); 2) photons (x-rays) to treat high-risk nodes to 44 Gy and PET-positive gross disease to 74 Gy (XNG); 3) protons to treat PET-positive gross disease only to 74 cobalt gray equivalent (PG); and 4) protons to treat high-risk nodes to 44 CGE and PET-positive gross disease to 74 CGE (PNG). We defined high-risk nodes as mediastinal, hilar, and supraclavicular lymph nodal stations anatomically adjacent to the foci of PET-positive gross disease. Four-dimensional computed tomography was utilized for all patients to account for tumor motion. Standard normal-tissue constraints were utilized. Our results showed that proton plans for all patients were isoeffective with the corresponding photon (x-ray) plans in that they achieved the desired target doses while respecting normal-tissue constraints. In spite of the larger volumes covered, median volume of normal lung receiving 10 CGE or greater (V10Gy/CGE), median V20Gy/CGE, and mean lung dose were lower in the proton plans (PNG) targeting gross disease and nodes when compared with the photon (x-ray) plans (XG) treating gross disease alone. In conclusion, proton plans demonstrated the potential to safely include high-risk nodes without increasing the volume of normal lung irradiated when compared to photon (x-ray) plans, which only targeted gross disease.
Subject(s)
Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Proton Therapy , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy, Intensity-Modulated/methods , Carcinoma, Non-Small-Cell Lung/pathology , Esophagus/radiation effects , Four-Dimensional Computed Tomography , Heart/radiation effects , Humans , Lung Neoplasms/pathology , Lymph Nodes , Neoplasm Staging , Positron-Emission Tomography , Radiotherapy Dosage , Spinal Cord/radiation effects , Tomography, X-Ray ComputedABSTRACT
The size effect obtained when studying the effective properties of plates is investigated by producing a third-order correlation approximation and Hashin-Shtrikman bounds for the effective in-plane conductivity of heterogeneous plates. The boundary condition of the plates is taken into account by obtaining the exact Green operator for the boundary problem. Results are obtained for a two-dimensional (2D) random distribution of disks and a 3D distribution of spheres. All results recover those obtained for an infinite medium when the heterogeneity size becomes small compared to plate thickness. They show that the size effect is more significant in the case of a 2D distribution of heterogeneities than for a 3D distribution.
ABSTRACT
We derive exact expressions for so-called "void" bounds on the trapping constant gamma and fluid permeability k for coated-sphere and coated-cylinder models of porous media. We find that in some cases the bounds are optimal. In these instances, exact expressions are obtained for the relevant length scale that arises in the void bounds, which depends on a two-point correlation function that characterizes the porous medium. This is the first time that model microstructures have been found that exactly realize bounds on either the trapping constant or fluid permeability.