Tuberculin skin test in close contacts in case of school tuberculosis outbreak / 中国学校卫生

Objective@#To evaluate the role of tuberculin skin test prified protein derivative (PPD) in defining the screening scope of close contacts of tuberculosis cases in disposal of tuberculosis outbreak in schools.@*Methods@#In a senior middle school in August 2019, 1 553 students of the grade two were tested by PPD because of a school tuberculosis outbreak. PPD results were compared to grade one students without any association with this tuberculosis epidemic, who were also tested by PPD when beginning school. Potential association between PPD distribution characteristics and tuberculosis case distribution were analyzed.@*Results@#Twenty nine grade two students were diagnozed as tuberculosis infection, seven of which were PPD positive, and with the same MIRU-VNTR genotype. In grade one, 0.1 % (1/796) student showed strong PPD positive, 34.3% (273/796) student showed positive. For grade two students, significant higher rate of strong PPD positive [5.9% (45/757)], and PPD positive [52.0% (394/757)] were observed ( χ 2=45.71, 49.90, P <0.01). Proportion of strong PPD positive in the first floor of the teaching building ( 19.4 %), where tuberculosis cases clustered, was significantly higher than that in other floors ( χ 2=89.81, P <0.01); Number of strong PPD positive students increased with TB cases in each floor of the teaching building ( r =0.99, P <0.01). Proportion of strong PPD positive and PPD positive in floors of the dormitory, where TB cases lived, was significantly higher than in other floors ( χ 2=49.4, 64.9 , P <0.01). Number of strong PPD positive and PPD positive students increased with TB cases in each floor of the teaching building ( r =0.84, 0.56, P <0.01).@*Conclusion@#Strong PPD positive rate well reflects tuberculosis infection of close contacts, and is recommended for defining the scope of screening.

Patterns of Deterioration in Moderate Patients With COVID-19 From Jan 2020 to Mar 2020: A Multi-Center, Retrospective Cohort Study in China.

Background: Around the globe, moderate cases account for the largest proportion of all coronavirus disease 2019 (COVID-19) patients, and deteriorated moderate patients contribute the most in mortality. However, published articles failed to address the deterioration details of moderate cases, especially on when and how they deteriorated. Methods: All moderate COVID-19 patients hospitalized in Guangdong Province from January 14 to March 16, 2020, were included in this multicenter retrospective cohort study and were divided into deteriorated and non-deteriorated groups according to clinical status. Symptoms and demographic, therapeutic, and laboratory test result characteristics were collected to explore the features of disease deterioration. Results: Of 1,168 moderate patients included, 148 (13%) deteriorated to severe (130 cases) or critical (18 cases) status. Over 20% of the older subgroup (>50 years old) showed deterioration. The median time for deterioration was 11 days after onset [interquartile range (IQR) 9-14 days]. In addition, 12.2% severe cases could further develop to critical status after 3 days (IQR 2-6.5 days) of having a severe condition. Respiratory dysfunction and hypoxia were the major manifestations as disease deterioration, while 76 cases (52.1%) showed respiratory rate >30 breaths/min, 119 cases (80.4%) showed SaO2 <93%, 100 cases (67.5%) had 201 < PaO2/FiO2 < 300, and 27 cases (18.9%) had blood lactic acid >2.0 mmol/L. In view of multiple organ dysfunction, 87.8% of acute respiratory distress syndrome (ARDS), 20.2% of acute kidney injury (AKI), 6.8% of coagulopathy, 4% of acute heart failure (AHF), 3.4% of acute hepatic injury (AHI), and 5.4% of shock occurred in deteriorated patients, while organ injury occurred in the following sequence: ARDS, AKI, AHF, coagulopathy, AHI, and shock. Conclusions: The deteriorated pattern of moderate COVID-19 patients is characterized as the 11th day from onset (IQR 9-14 days) being an important time point of disease deterioration with further exacerbation to critical condition in 3 days (IQR 2-6.5 days), A RDS followed by AKI being the typical modes of sequential organ damage.

Epidemiological and Clinical Findings of Short-Term Recurrence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid Polymerase Chain Reaction Positivity in 1282 Discharged Coronavirus Disease 2019 Cases: A Multicenter, Retrospective, Observational Study.

BACKGROUND: Short-term recurrence of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) polymerase chain reaction (PCR) in discharged coronavirus disease 2019 (COVID-19) patients attracts the public's concern. This study aimed to determine the clinical and epidemiological results of such patients. METHODS: This retrospective study was conducted on 32 designated hospitals for COVID-19 patients discharged from January 14 to March 10, 2020. After 28-day followed-up, patients who tested positive again for SARS-CoV-2 RNA and confirmed by reverse-transcriptase polymerase chain reaction were re-admitted to hospital for further treatments. All of the close contacts of patients who tested positive again were asked to self-segregate for 14 days. Data of epidemiology, symptoms, laboratory tests, and treatments were analyzed in those patients, and their close contacts were investigated. RESULTS: Of 1282 discharged patients, 189 (14.74%) tested positive again for SARS-CoV-2 RNA during 28-day follow-up. The median time from discharge to the next positive test was 8 days (interquartile range [IQR], 5-13). Patients in the group that tested positive again were younger (34 vs 45 years, P < .001) with a higher proportion of moderate symptoms (95.77% vs 84.35%, P < .001) in the first hospitalization than in the negative group. During the second hospitalization, all patients who tested positive again showed normal peripheral white blood cells and lymphocytes and no new symptoms of COVID-19; 78.31% further improved on chest computed tomography scan compared with the first discharge, yet 25.93% accepted antiviral therapy. The median time of re-positive to negative test was 8 days (IQR, 4-15). None of the close contacts developed COVID-19. CONCLUSIONS: Our data suggest that the short-term recurrence of positive SARS-CoV-2 RNA in discharged patients is not a relapse of COVID-19, and the risk of onward transmission is very low. This provides important information for managing COVID-19 patients.

Effect of Thermal Cleaning Prior to p-GaN Gate Regrowth for Normally Off High-Electron-Mobility Transistors.

This work studied the effect of thermal cleaning in metal-organic chemical vapor deposition (MOCVD) prior to p-GaN gate regrowth for normally off high-electron-mobility transistors. X-ray photoelectron spectroscopy, capacitance-voltage measurement, and atomic force microscopy were employed to identify the effects of thermal cleaning before p-GaN regrowth. It was found that the residual damage was hardly repaired at a relatively low thermal cleaning temperature, while GaN decomposition would occur at an excessively high temperature. Thermal cleaning at 850 °C for 2 min in MOCVD can effectively remove the surface contamination and alleviate the etch damage without causing any significant deterioration of the AlGaN barrier. In addition, the density of interface states ( Dit) in the p-GaN gate was reduced from 1012-1013 to 1011-1012 eV-1·cm-2, resulting in a low gate reverse leakage of 0.1 nA/mm @ VDS-OFF = 180 V, a high Ion/ Ioff ratio of 4 × 1010, and a relatively high threshold voltage of +1.7 V @ ID = 10 µA/mm.

On-wafer fabrication of cavity mirrors for InGaN-based laser diode grown on Si.

Direct bandgap III-V semiconductor lasers grown on silicon (Si) are highly desired for monolithic integration with Si photonics. Fabrication of semiconductor lasers with a Fabry-Pérot cavity usually includes facet cleavage, however, that is not compatible with on-chip photonic integration. Etching as an alternative approach holds a great advantage in preparing cavity mirrors with no need of breaking wafer into bars. However, gallium nitride (GaN) sidewalls prepared by dry etching often have a large roughness and etching damages, which would cause mirror loss due to optical scattering and carrier injection loss because of surface non-radiative recombination. A wet chemical polishing process of GaN sidewall facets formed by dry etching was studied in detail to remove the etching damages and smooth the vertical sidewalls. The wet chemical polishing technique combined with dry etching was successfully applied to the on-wafer fabrication of cavity mirrors, which enabled the realization of room temperature electrically injected InGaN-based laser diodes grown on Si.

Room-temperature electrically pumped InGaN-based microdisk laser grown on Si.

Silicon photonics has been longing for an efficient on-chip light source that is electrically driven at room temperature. Microdisk laser featured with low-loss whispering gallery modes can emit directional lasing beam through a closely coupled on-chip waveguide efficiently, and hence is particularly suitable for photonics integration. The realization of electrically pumped III-nitride microdisk laser grown on Si has been impeded by the conventional undercut structure, poor material quality, and a limited quality of GaN microdisk formed by dry etching. Here we report a successful fabrication of room-temperature electrically pumped InGaN-based microdisk lasers grown on Si. A dramatic narrowing of the electroluminescence spectral line-width and a clear discontinuity in the slope of light output power plotted as a function of the injection current provide an unambiguous evidence of lasing. This is the first observation of electrically pumped lasing in InGaN-based microdisk lasers grown on Si at room temperature.