Individualization of exosuit assistance based on measured muscle dynamics during versatile walking.

Variability in human walking depends on individual physiology, environment, and walking task. Consequently, in the field of wearable robotics, there is a clear need for customizing assistance to the user and task. Here, we developed a muscle-based assistance (MBA) strategy wherein exosuit assistance was derived from direct measurements of individuals' muscle dynamics during specific tasks. We recorded individuals' soleus muscle dynamics using ultrasonographic imaging during multiple walking speeds and inclines. From these prerecorded images, we estimated the force produced by the soleus through inefficient concentric contraction and designed the exosuit assistance profile to be proportional to that estimated force. We evaluated this approach with a bilateral ankle exosuit at each measured walking task. Compared with not wearing a device, the MBA ankle exosuit significantly reduced metabolic demand by an average of 15.9, 9.7, and 8.9% for level walking at 1.25, 1.5, and 1.75 meters second−1, respectively, and 7.8% at 1.25 meters second−1 at 5.71° incline while applying lower assistance levels than in existing literature. In an additional study (n = 2), we showed for multiple walking tasks that the MBA profile outperforms other bioinspired strategies and the average profile from a previous optimization study. Last, we show the feasibility of online assistance generation in a mobile version for overground outdoor walking. This muscle-based approach enables relatively rapid (~10 seconds) generation of individualized low-force assistance profiles that provide metabolic benefit. This approach may help support the adoption of wearable robotics in real-world, dynamic locomotor tasks by enabling comfortable, tailored, and adaptive assistance.

Occult Hepatitis B virus infection among HIV negative and positive isolated anti-HBc individuals in eastern Ethiopia.

The absence of hepatitis B surface antigen (HBsAg) and the presence of antibody to hepatitis B core antigen (anti-HBc) in the blood of apparently healthy individuals may not indicate the absence of circulating hepatitis B virus (HBV) and might be infectious. Despite the risk of HBV transmission, there has been no report from Ethiopia examining this issue; therefore, this study determined occult HBV infection (OBI) among isolated anti-HBc (IAHBc) HIV negative and HIV positive individuals on ART in eastern Ethiopia. A total of 306 IAHBc individuals were included in this study. DNA was extracted, amplified, and detected from plasma using a commercially available RealTime PCR platform (Abbott m2000rt) following the manufacturer's instructions. Data were entered into EPI Data version 3.1, cleaned, and analyzed using Stata version 13. Descriptive analysis was used to calculate prevalence, summarize sociodemographic data and other factors. From the 306 IAHBc individuals (184 HIV positive and 122 HIV negative) included in the study, 183 (59.8%) were female of which 142 (77.6%) were within the reproductive age group. DNA extraction, amplified and detection was conducted in 224 individuals. The overall OBI prevalence was 5.8% (5.6% in HIV negative and 6% in HIV positive) among the IAHBc individuals. The HBV DNA concentration among the occult hepatitis B individuals was < 200 IU/mL, indicating a true occult. This study reported the burden of OBI, which pauses a significant public health problem due to the high burden of HBV infection in the country. OBI may cause substantial risk of HBV transmission from blood transfusion, organ transplantation as well as vertical transmission as screening is solely dependent on HBsAg testing.

Impact of rapid microbial identification on clinical outcomes in bloodstream infection: the RAPIDO randomized trial.

OBJECTIVES: Bloodstream infection has a high mortality rate. It is not clear whether laboratory-based rapid identification of the organisms involved would improve outcome. METHODS: The RAPIDO trial was an open parallel-group multicentre randomized controlled trial. We tested all positive blood cultures from hospitalized adults by conventional methods of microbial identification and those from patients randomized (1:1) to rapid diagnosis in addition to matrix-assisted desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) performed directly on positive blood cultures. The only primary outcome was 28-day mortality. Clinical advice on patient management was provided to members of both groups by infection specialists. RESULTS: First positive blood culture samples from 8628 patients were randomized, 4312 into rapid diagnosis and 4136 into conventional diagnosis. After prespecified postrandomization exclusions, 2740 in the rapid diagnosis arm and 2810 in the conventional arm were included in the mortality analysis. There was no significant difference in 28-day survival (81.5% 2233/2740 rapid vs. 82.3% 2313/2810 conventional; hazard ratio 1.05, 95% confidence interval 0.93-1.19, p 0.42). Microbial identification was quicker in the rapid diagnosis group (median (interquartile range) 38.5 (26.7-50.3) hours after blood sampling vs. 50.3 (47.1-72.9) hours after blood sampling, p < 0.01), but times to effective antimicrobial therapy were no shorter (respectively median (interquartile range) 24 (2-78) hours vs. 13 (2-69) hours). There were no significant differences in 7-day mortality or total antibiotic consumption; times to resolution of fever, discharge from hospital or de-escalation of broad-spectrum therapy or 28-day Clostridioides difficile incidence. CONCLUSIONS: Rapid identification of bloodstream pathogens by MALDI-TOF MS in this trial did not reduce patient mortality despite delivering laboratory data to clinicians sooner.

Repeated evolution of drag reduction at the air-water interface in diving kingfishers.

Piscivorous birds have a unique suite of adaptations to forage under the water. One method aerial birds use to catch fish is the plunge dive, wherein birds dive from a height to overcome drag and buoyancy in the water. The kingfishers are a well-known clade that contains both terrestrially foraging and plunge-diving species, allowing us to test for morphological and performance differences between foraging guilds in an evolutionary context. Diving species have narrower bills in the dorsoventral and sagittal plane and longer bills (size-corrected data, n = 71 species, p < 0.01 for all). Although these differences are confounded by phylogeny (phylogenetically corrected ANOVA for dorsoventral p = 0.26 and length p = 0.14), beak width in the sagittal plane remains statistically different ( p < 0.001). We examined the effects of beak morphology on plunge performance by physically simulating dives with three-dimensional printed models of beaks coupled with an accelerometer, and through computational fluid dynamics (CFD). From physically simulated dives of bill models, diving species have lower peak decelerations, and thus enter the water more quickly, than terrestrial and mixed-foraging species (ANOVA p = 0.002), and this result remains unaffected by phylogeny (phylogenetically corrected ANOVA p = 0.05). CFD analyses confirm these trends in three representative species and indicate that the morphology between the beak and head is a key site for reducing drag in aquatic species.

Genetic & virulence profiling of ESBL-positive E. coli from nosocomial & veterinary sources.

CTX-M genes are the most prevalent ESBL globally, infiltrating nosocomial, community and environmental settings. Wild and domesticated animals may act as effective vectors for the dissemination of CTX-producing Enterobacteriaceae. This study aimed to contextualise blaCTX-M-14-positive, cephalosporin-resistant Enterobacteriaceae human infections and compared resistance and pathogenicity markers with veterinary isolates. Epidemiologically related human (n=18) and veterinary (n=4) blaCTX-M-14-positive E. coli were fully characterised. All were typed by XbaI pulsed field gel electrophoresis and ST. Chromosomal/plasmidic locations of blaCTX-M-14 were deduced by S1-nuclease digestion, and association with ISEcp1 was investigated by sequencing. Conjugation experiments assessed transmissibility of plasmids carrying blaCTX-M-14. Presence of virulence determinants was screened by PCR assay and pathogenicity potential was determined by in vitro Galleria mellonella infection models. 84% of clinical E. coli originated from community patients. blaCTX-M-14 was found ubiquitously downstream of ISEcp1 upon conjugative plasmids (25-150 kb). blaCTX-M-14 was also found upon the chromosome of eight E. coli isolates. CTX-M-14-producing E. coli were found at multiple hospital sites. Clonal commonality between patient, hospitals and livestock microbial populations was found. In vivo model survival rates from clinical isolates (30%) and veterinary isolates (0%) were significantly different (p<0.05). Co-transfer of blaCTX-M-14 and virulence determinants was demonstrated. There is evidence of clonal spread of blaCTX-M-14-positive E. coli involving community patients and farm livestock. blaCTX-M-14 positive human clinical isolates carry a lower intrinsic pathogenic potential than veterinary E. coli highlighting the need for greater veterinary practices in preventing dissemination of MDR E. coli among livestock.

CMOS integration of inkjet-printed graphene for humidity sensing.

We report on the integration of inkjet-printed graphene with a CMOS micro-electro-mechanical-system (MEMS) microhotplate for humidity sensing. The graphene ink is produced via ultrasonic assisted liquid phase exfoliation in isopropyl alcohol (IPA) using polyvinyl pyrrolidone (PVP) polymer as the stabilizer. We formulate inks with different graphene concentrations, which are then deposited through inkjet printing over predefined interdigitated gold electrodes on a CMOS microhotplate. The graphene flakes form a percolating network to render the resultant graphene-PVP thin film conductive, which varies in presence of humidity due to swelling of the hygroscopic PVP host. When the sensors are exposed to relative humidity ranging from 10-80%, we observe significant changes in resistance with increasing sensitivity from the amount of graphene in the inks. Our sensors show excellent repeatability and stability, over a period of several weeks. The location specific deposition of functional graphene ink onto a low cost CMOS platform has the potential for high volume, economic manufacturing and application as a new generation of miniature, low power humidity sensors for the internet of things.

Yb- and Er-doped fiber laser Q-switched with an optically uniform, broadband WS2 saturable absorber.

We demonstrate a ytterbium (Yb) and an erbium (Er)-doped fiber laser Q-switched by a solution processed, optically uniform, few-layer tungsten disulfide saturable absorber (WS2-SA). Nonlinear optical absorption of the WS2-SA in the sub-bandgap region, attributed to the edge-induced states, is characterized by 3.1% and 4.9% modulation depths with 1.38 and 3.83 MW/cm(2) saturation intensities at 1030 and 1558 nm, respectively. By integrating the optically uniform WS2-SA in the Yb- and Er-doped laser cavities, we obtain self-starting Q-switched pulses with microsecond duration and kilohertz repetition rates at 1030 and 1558 nm. Our work demonstrates broadband sub-bandgap saturable absorption of a single, solution processed WS2-SA, providing new potential efficacy for WS2 in ultrafast photonic applications.

Wideband saturable absorption in few-layer molybdenum diselenide (MoSe2) for Q-switching Yb-, Er- and Tm-doped fiber lasers.

We fabricate a free-standing molybdenum diselenide (MoSe2) saturable absorber by embedding liquid-phase exfoliated few-layer MoSe2 flakes into a polymer film. The MoSe2-polymer composite is used to Q-switch fiber lasers based on ytterbium (Yb), erbium (Er) and thulium (Tm) gain fiber, producing trains of microsecond-duration pulses with kilohertz repetition rates at 1060 nm, 1566 nm and 1924 nm, respectively. Such operating wavelengths correspond to sub-bandgap saturable absorption in MoSe2, which is explained in the context of edge-states, building upon studies of other semiconducting transition metal dichalcogenide (TMD)-based saturable absorbers. Our work adds few-layer MoSe2 to the growing catalog of TMDs with remarkable optical properties, which offer new opportunities for photonic devices.

Analytic laboratory performance of a point of care urine culture kit for diagnosis and antibiotic susceptibility testing.

Currently available point-of-care (POC) diagnostic tests for managing urinary tract infections (UTIs) in general practice are limited by poor performance characteristics, and laboratory culture generally provides results only after a few days. This laboratory evaluation compared the analytic performance of the POC UK Flexicult(™) (Statens Serum Institut) (SSI) urinary kit for quantification, identification and antibiotic susceptibility testing and routine UK National Health Service (NHS) urine processing to an advanced urine culture method. Two hundred urine samples routinely submitted to the Public Health Wales Microbiology Laboratory were divided and: (1) analysed by routine NHS microbiological tests as per local laboratory standard operating procedures, (2) inoculated onto the UK Flexicult(™) SSI urinary kit and (3) spiral plated onto Colorex Orientation UTI medium (E&O Laboratories Ltd). The results were evaluated between the NHS and Flexicult(™ )methods, and discordant results were compared to the spiral plating method. The UK Flexicult(™) SSI urinary kit was compared to routine NHS culture for identification of a pure or predominant uropathogen at ≥ 10(5) cfu/mL, with a positive discordancy rate of 13.5% and a negative discordancy rate of 3%. The sensitivity and specificity were 86.7% [95% confidence interval (CI) 73.8-93.7] and 82.6% (95% CI 75.8-87.7), respectively. The UK Flexicult(™) SSI urinary kit was comparable to routine NHS urine processing in identifying microbiologically positive UTIs in this laboratory evaluation. However, the number of false-positive samples could lead to over-prescribing of antibiotics in clinical practice. The Flexicult(™) SSI kit could be useful as a POC test for UTIs in primary care but further pragmatic evaluations are necessary.

Application of a decision analytic framework for adoption of clinical trial results: are the data regarding TARGIT-A IORT ready for prime time?

The results from randomized clinical trials are often adopted slowly. This practice potentially prevents many people from benefiting from more effective care. Provide a framework for analyzing clinical trial results to determine whether and when early adoption of novel interventions is appropriate. The framework includes the evaluation of three components: confidence in trial results, impact of early, and late adoption if trial results are reversed or sustained. The adverse impact of early adoption, and the opportunity cost of late adoption are determined using Markov modeling to simulate the impact of early and late adoption in terms of quality of life years and resources gained or lost. We applied the framework to the TARGIT-A randomized clinical trial comparing intraoperative radiation (IORT) to standard external beam radiation (EBRT) and considered these results in the context of trials comparing endocrine therapy with and without radiation therapy in postmenopausal women. Confidence in the TARGIT-A trial 4 year results is high because the peak hazard for local recurrence in the trial is between 2 and 3 years. This is consistent with most trials, and no second peak has been observed in similar patient populations, suggesting that the TARGIT-A trial results are stable. The interventions offer approximately equivalent life expectancy. If IORT local recurrences rate were as high as 10 % at 10 years (which is higher than expected), we would project only 0.002 fewer expected life years (less than 1 day) compared to EBRT if IORT is adopted early. However, there is a $1.7 billion opportunity cost of waiting an additional 5 years to adopt IORT in low risk, hormone-receptor-positive, postmenopausal women. EBRT costs an additional $1467 in indirect costs per patient. Applying an evaluative framework for the adoption of clinical trial results to the TARGIT-A IORT therapy trial results in the assessment that the trial results are stable, early adoption would lead to minimal adverse impact, and substantially less resource use. Both IORT and no radiation are reasonable strategies to adopt.

Cycloserine as an alternative urinary tract infection therapy: susceptibilities of 500 urinary pathogens to standard and alternative therapy antimicrobials.

PURPOSE: Cycloserine has been used previously in some areas of the world for the treatment of urinary tract infections. The emergence of multi-resistant strains of Enterobacteriaceae and the lack of new agents in the development pipeline has prompted a need to review the activity of older agents. Susceptibility testing of cycloserine has traditionally been problematic owing to testing in standard media, containing competitive alanine, thus presenting falsely elevated minimum inhibitory concentrations (MICs). This study tests urinary coliforms against cycloserine in both standard and minimal media. METHODS: Susceptibilities were performed on 500 "wild type" UTI coliforms using Mueller-Hinton broth in the range 0.008-128 µg/ml in accordance with ISO guidelines. Cycloserine was also tested in Minimal Salts medium + 2 % 1 M glucose + 0.2 % 1 M magnesium sulphate. MICs were recorded after 18 h of incubation at 35 °C and interpreted with EUCAST breakpoints (where available). RESULTS: Cycloserine MIC50 for the "wild type" coliforms was 32 µg/ml in Mueller-Hinton broth compared with 2 µg/ml in Minimal Salts. Eighty-seven per cent of "wild type" UTI coliforms show cycloserine MICs < = 8 µg/ml in Minimal Salts. The epidemiological cut-off values for cycloserine for E. coli in this study were 64 µg/ml using Mueller-Hinton broth and 8 µg/ml using Minimal Salts medium. Ninety-four per cent of trimethoprim-resistant and 82 % of third generation cephalosporin-resistant E. coli had MICs in Minimal Salts ≤ 8 µg/ml. CONCLUSION: Cycloserine is still licensed in some countries for the treatment of urinary infections and the data presented here suggest that it may play a role in the management of infections resistant to trimethoprim and third generation cephalosporins.

Differential gene expression of activating Fcγ receptor classifies active tuberculosis regardless of human immunodeficiency virus status or ethnicity.

New diagnostics and vaccines for tuberculosis (TB) are urgently needed, but require an understanding of the requirements for protection from/susceptibility to TB. Previous studies have used unbiased approaches to determine gene signatures in single-site populations. The present study utilized a targeted approach, reverse transcriptase multiplex ligation-dependent probe amplification (RT-MLPA), to validate these genes in a multisite study. We analysed ex vivo whole blood RNA from a total of 523 participants across four sub-Saharan countries (Ethiopia, Malawi, South Africa, and The Gambia) with differences in TB and human immunodeficiency virus (HIV) status. We found a number of genes that were expressed at significantly lower levels in participants with active disease than in those with latent TB infection (LTBI), with restoration following successful TB treatment. The most consistent classifier of active disease was FCGR1A (high-affinity IgG Fc receptor 1 (CD64)), which was the only marker expressed at significantly higher levels in participants with active TB than in those with LTBI before treatment regardless of HIV status or genetic background. This is the first study to identify a biomarker for TB that is not affected by HIV status or geo-genetic differences. These data provide valuable clues for understanding TB pathogenesis, and also provide a proof-of-concept for the use of RT-MLPA in rapid and inexpensive validation of unbiased gene expression findings.

Documentation and treatment outcomes of smear-negative and extra-pulmonary tuberculosis in Ethiopia.

BACKGROUND: Smear-negative and extra-pulmonary tuberculosis (TB) comprise two thirds of TB cases reported in Ethiopia. Neither treatment outcomes nor underlying associated factors are routinely reported for these cases. OBJECTIVE: To assess treatment outcomes and associated risk factors of smear-negative and extra-pulmonary TB in comparison with smear-positive cases. DESIGN: Record review of all TB cases registered in 14 randomly selected public and private health facilities in Addis Ababa, Ethiopia, over a 1-year period. RESULTS: Percentages of smear-negative and extra-pulmonary TB were independent of human immunodeficiency virus (HIV) status, and were not evenly distributed among health facilities. Extra-pulmonary TB was overrepresented in the private sector, and smear-negative TB was more frequent in health clinics than in hospitals. Outcomes reported by clinics were more favourable than those of the hospitals; no differences were observed when comparing public and private health facilities. Only 54% of the TB registers were complete; missing information correlated with unfavourable outcomes. Younger age, but not sex or HIV status, was associated with favourable outcomes. CONCLUSION: The uneven distribution of smear-negative and extra-pulmonary TB among different health facilities requires further study and may provide important insight into diagnosis and care of these patients. Incomplete TB register information may be an underappreciated factor contributing to unfavourable outcomes.

Cadre : La tuberculose (TB) extra-pulmonaire et la TB à frottis négatif constituent deux tiers des cas déclarés en Ethiopie, mais les rapports de routine ne précisent pas les résultats du traitement ni les facteurs sous-jacents associés.Objectif : Evaluer les résultats du traitement et les facteurs de risque associés à la TB extra-pulmonaire et à frottis négatif par comparaison avec les cas à frottis positif.Schéma : Revue des dossiers de tous les cas enregistrés dans 14 structures de santé publiques et privées sélectionnées au hasard à Addis Abeba pendant une période d'une année.Résultats : Les proportions de TB à frottis négatif et extra-pulmonaire étaient indépendantes du statut à l'égard du virus de l'immunodéficience humaine (VIH) et n'étaient pas distribuées de façon égale dans les différentes structures. La TB extra-pulmonaire était surreprésentée dans le secteur privé et la TB à frottis négatif se trouvait plutôt dans les centres de santé que dans les hôpitaux. Les résultats rapportés par les centres de santé étaient plus favorables que ceux des hôpitaux ; aucune différence n'a été observée entre les structures publiques et privées. Seulement 54% des dossiers de TB étaient complets ; il y avait une corrélation entre le manque d'informations et des résultats défavorables. Un âge plus jeune était associé à un résultat favorable, mais le sexe et le statut VIH ne l'étaient pas.Conclusion : La distribution inégale de la TB à frottis négatif et extra-pulmonaire dans les différentes institutions justifie une nouvelle étude et pourrait révéler d'importantes perspectives en matière de diagnostic et de soins de ces patients. Le caractère incomplet des dossiers des patients tuberculeux pourrait être un facteur sous-estimé contribuant aux résultats défavorables.

Marco de referencia: La tuberculosis (TB) con baciloscopia negativa y la TB extrapulmonar (EPTB) representan dos tercios de los casos notificados en Etiopía. Estas notificaciones no comportan sistemáticamente datos sobre los desenlaces terapéuticos ni los factores subyacentes.Objetivo: Evaluar los desenlaces clínicos de los casos de TB con baciloscopia negativa y EPTB, determinar los factores de riesgo que se asocian con su aparición y compararlos con los casos de TB con baciloscopia positiva.Método: Se examinaron las historias clínicas de todos los casos de TB atendidos durante un período de un año en 14 establecimientos sanitarios públicos y privados de Addis Abeba, escogidos de manera aleatoria.Resultados: Los porcentajes de casos de TB con baciloscopia negativa y EPTB fueron independientes de la situación frente el virus de la inmunodeficiencia humana (VIH). La distribución de estos casos no fue homogénea en las diferentes instituciones. La EPTB se encontró sobrerrepresentada en el sector privado y la TB con baciloscopia negativa fue más frecuente en los consultorios que en los hospitales. Los desenlaces terapéuticos notificados por los consultorios fueron más favorables que los comunicados por los hospitales y no se observaron diferencias entre las instituciones del sector público y el sector privado. Solo el 54% de los registros de TB estaba completo y la información incompleta se correlacionó con los desenlaces desfavorables. La menor edad se asoció con los desenlaces favorables, pero no el sexo ni la situación frente al VIH.Conclusión: La distribución heterogénea de los casos de TB con baciloscopia negativa y EPTB en las diferentes instituciones de salud justifica futuras investigaciones que podrían revelar aspectos importantes sobre el diagnóstico y la atención de estos pacientes. La información incompleta en los registros de TB puede ser un factor que contribuye a los desenlaces clínicos desfavorables y que no se ha valorado hasta el momento.

Depletion of cells and abundant proteins from biological samples by enhanced dielectrophoresis.

Platforms that are sensitive and specific enough to assay low-abundance protein biomarkers, in a high throughput multiplex format, within a complex biological fluid specimen, are necessary to enable protein biomarker based diagnostics for diseases such as cancer. The signal from an assay for a low-abundance protein biomarker in a biological fluid sample like blood is typically buried in a background that arises from the presence of blood cells and from high-abundance proteins that make up 90% of the assayed protein mass. We present an automated on-chip platform for the depletion of cells and highly abundant serum proteins in blood. Our platform consists of two components, the first of which is a microfluidic mixer that mixes beads containing antibodies against the highly abundant proteins in the whole blood. This complex mixture (consisting of beads, cells, and serum proteins) is then injected into the second component of our microfluidic platform, which comprises a filter trench to capture all the cells and the beads. The size-based trapping of the cells and beads into the filter trench is significantly enhanced by leveraging additional negative dielectrophoretic forces to push the micron sized particles (cells and beads which have captured the highly abundant proteins) down into the trench, allowing the serum proteins of lower abundance to flow through. In general, dielectrophoresis using bare electrodes is incapable of producing forces beyond the low piconewton range that tend to be insufficient for separation applications. However, by using electrodes passivated with atomic layer deposition, we demonstrate the application of enhanced negative DEP electrodes together with size-based flltration induced by the filter trench, to deplete 100% of the micron sized particles in the mixture.

Tunable Q-switched fiber laser based on saturable edge-state absorption in few-layer molybdenum disulfide (MoS2).

We fabricate a few-layer molybdenum disulfide (MoS2) polymer composite saturable absorber by liquid-phase exfoliation, and use this to passively Q-switch an ytterbium-doped fiber laser, tunable from 1030 to 1070 nm. Self-starting Q-switching generates 2.88 µs pulses at 74 kHz repetition rate, with over 100 nJ pulse energy. We propose a mechanism, based on edge states within the bandgap, responsible for the wideband nonlinear optical absorption exhibited by our few-layer MoS2 sample, despite operating at photon energies lower than the material bandgap.

Photon-enhanced thermionic emission from heterostructures with low interface recombination.

Photon-enhanced thermionic emission is a method of solar-energy conversion that promises to combine photon and thermal processes into a single mechanism, overcoming fundamental limits on the efficiency of photovoltaic cells. Photon-enhanced thermionic emission relies on vacuum emission of photoexcited electrons that are in thermal equilibrium with a semiconductor lattice, avoiding challenging non-equilibrium requirements and exotic material properties. However, although previous work demonstrated the photon-enhanced thermionic emission effect, efficiency has until now remained very low. Here we describe electron-emission measurements on a GaAs/AlGaAs heterostructure that introduces an internal interface, decoupling the basic physics of photon-enhanced thermionic emission from the vacuum emission process. Quantum efficiencies are dramatically higher than in previous experiments because of low interface recombination and are projected to increase another order of magnitude with more stable, low work-function coatings. The results highlight the effectiveness of the photon-enhanced thermionic emission process and demonstrate that efficient photon-enhanced thermionic emission is achievable, a key step towards realistic photon-enhanced thermionic emission based energy conversion.

BSAC standardized disc susceptibility testing method (version 11).

This article highlights key amendments incorporated into version 11 of the BSAC standardized disc susceptibility testing method, available as Supplementary data at JAC Online (http://jac.oxfordjournals.org/) and on the BSAC web site (http://bsac.org.uk/susceptibility/guidelines-standardized-disc-susceptibility-testing-method/). The basic disc susceptibility testing method remains unchanged, but there have been a number of alterations to the interpretive criteria for certain organism/drug combinations due to continuing harmonization with the EUCAST MIC breakpoints and constant efforts to improve the reliability and clinical applicability of the guidance.

Modern lineages of Mycobacterium tuberculosis in Addis Ababa, Ethiopia: implications for the tuberculosis control programe.

BACKGROUND: The genotyping of Mycobacterium tuberculosis strains is important to have unique insights into the dissemination dynamics and evolutionary genetics of this pathogen and for TB control as it allows the detection of suspected outbreaks and the tracing of transmission chains. OBJECTIVE: To characterize M. tuberculois isolates collected from newly diagnosed pulmonary TB patients in Addis Ababa METHODS: One hundred and ninety two sputum samples were cultured on Löwenstein-Jensen (LJ) slants and isolates were heat killed for molecular genotyping. The isolates were characterized using spoligotyping and were compared with the International SpoIDB4 database. RESULT: T genotype constitutes the most predominant in our study (95, 49.5%) followed by the CAS genotype (42, 21.9%). Other genotypes found were Haarlem (H) (24, 12.5%), the LAM (3, 1.5%), the Beijing genotype (1, 0.5%); four (2.1%) isolates were designated as Unknown. CONCLUSION: All the isolates belong to the modern lineage and there is high clustering in the genotype of isolates which indicated the presence of recent TB transmission. Therefore, the Tuberculosis Control Programme needs to do more in advocating and strengthening the health system for early detection and treatment of active TB cases as delay in treatment is the key factor in disease transmission.