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1.
Curr Microbiol ; 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33521895

RESUMEN

The application of zero-valent iron particles (ZVI) for the treatment of heavily polluted environment and its biological effects have been studied for at least two decades. Still, information on the impact on bacterial metabolic pathways is lacking. This study describes the effect of microscale and nanoscale ZVI (mZVI and nZVI) on the abundance of different metabolic pathways in freshwater bacterial communities. The metabolic pathways were inferred from metabolism modelling based on 16S rRNA gene sequence data using paprica pipeline. The nZVI changed the abundance of numerous metabolic pathways compared to a less influencing mZVI. We identified the 50 most affected pathways, where 31 were related to degradation, 17 to biosynthesis, and 2 to detoxification. The linkage between pathways was two times higher in nZVI samples compared to mZVI, and was specifically higher considering the arsenate detoxification II pathway. Limnohabitans and Roseiflexus were linked to the same pathways in both nZVI and mZVI. The prediction of metabolic pathways increases our knowledge of the impacts of nZVI and mZVI on freshwater bacterioplankton.

2.
Emerg Infect Dis ; 27(3): 872-879, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33622491

RESUMEN

Vietnam, a high tuberculosis (TB) burden country, conducted national TB prevalence surveys in 2007 and 2017. In both surveys participants were screened by using a questionnaire and chest radiograph; sputum samples were then collected to test for Mycobacterium tuberculosis by smear microscopy and Löwenstein-Jensen culture. Culture-positive, smear-positive, and smear-negative TB cases were defined by laboratory results, and the prevalence of tuberculosis was compared between the 2 surveys. The results showed prevalence of culture-positive TB decreased by 37% (95% CI 11.5%-55.4%), from 199 (95% CI 160-248) cases/100,000 adults in 2007 to 125 (95% CI 98-159) cases/100,000 adults in 2017. Prevalence of smear-positive TB dropped by 53% (95% CI 27.0%-69.7%), from 99 (95% CI 78-125) cases/100,000 adults to 46 (95% CI 32-68) cases/100,000 adults; smear-negative TB showed no substantial decrease. Replacing microscopy with molecular methods for primary diagnostics might enhance diagnosis of pulmonary TB cases and further lower TB burden.

3.
Infect Dis Poverty ; 9(1): 166, 2020 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-33292638

RESUMEN

BACKGROUND: In order to end tuberculosis (TB), it is necessary to expand coverage of TB care services, including systematic screening initiatives. However, more evidence is needed for groups among whom systematic screening is only conditionally recommended by the World Health Organization. This study evaluated concurrent screening in multiple target groups using community health workers (CHW). METHODS: In our two-year intervention study lasting from October 2017 to September 2019, CHWs in six districts of Ho Chi Minh City, Viet Nam verbally screened three urban priority groups: (1) household TB contacts; (2) close TB contacts; and (3) residents of urban priority areas without clear documented exposure to TB including hotspots, boarding homes and urban slums. Eligible persons were referred for further screening with chest radiography and follow-on testing with the Xpert MTB/RIF assay. Symptomatic individuals with normal or without radiography results were tested on smear microscopy. We described the TB care cascade and characteristics for each priority group, and calculated yield and number needed to screen. Subsequently, we fitted a mixed-effect logistic regression to identify the association of these target groups and secondary patient covariates with TB treatment initiation. RESULTS: We verbally screened 321 020 people including 24 232 household contacts, 3182 social and close contacts and 293 606 residents of urban priority areas. This resulted in 1138 persons treated for TB, of whom 85 were household contacts, 39 were close contacts and 1014 belonged to urban priority area residents. The yield of active TB in these groups was 351, 1226 and 345 per 100 000, respectively, corresponding to numbers needed to screen of 285, 82 and 290. The fitted model showed that close contacts [adjusted odds ratio (aOR) = 2.07; 95% CI: 1.38-3.11; P < 0.001] and urban priority area residents (aOR = 2.18; 95% CI: 1.69-2.79; P < 0.001) had a greater risk of active TB than household contacts. CONCLUSIONS: The study detected a large number of unreached persons with TB, but most of them were not among persons in contact with an index patient. Therefore, while programs should continue to optimize screening in contacts, to close the detection gap in high TB burden settings such as Viet Nam, coverage must be expanded to persons without documented exposure such as residents in hotspots, boarding homes and urban slums.

4.
Trop Med Infect Dis ; 5(4)2020 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-33265972

RESUMEN

To accelerate the reduction in tuberculosis (TB) incidence, it is necessary to optimize the use of innovative tools and approaches available within a local context. This study evaluated the use of an existing network of community health workers (CHW) for active case finding, in combination with mobile chest X-ray (CXR) screening events and the expansion of Xpert MTB/RIF testing eligibility, in order to reach people with TB who had been missed by the current system. A controlled intervention study was conducted from January 2018 to March 2019 in five intervention and four control districts of two low to medium TB burden cities in Viet Nam. CHWs screened and referred eligible persons for CXR to TB care facilities or mobile screening events in the community. The initial diagnostic test was Xpert MTB/RIF for persons with parenchymal abnormalities suggestive of TB on CXR or otherwise on smear microscopy. We analyzed the TB care cascade by calculating the yield and number needed to screen (NNS), estimated the impact on TB notifications and conducted a pre-/postintervention comparison of TB notification rates using controlled, interrupted time series (ITS) analyses. We screened 30,336 individuals in both cities to detect and treat 243 individuals with TB, 88.9% of whom completed treatment successfully. All forms of TB notifications rose by +18.3% (95% CI: +15.8%, +20.8%). The ITS detected a significant postintervention step-increase in the intervention area for all-form TB notification rates (IRR(ß6) = 1.221 (95% CI: 1.011, 1.475); p = 0.038). The combined use of CHWs for active case findings and mobile CXR screening expanded the access to and uptake of Xpert MTB/RIF testing and resulted in a significant increase in TB notifications. This model could serve as a blueprint for expansion throughout Vietnam. Moreover, the results demonstrate the need to optimize the use of the best available tools and approaches in order to end TB.

5.
Addict Behav ; 114: 106747, 2020 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-33307406

RESUMEN

INTRODUCTION: Smoking cigarettes under the influence of alcohol or cannabis is associated with perceived pleasure. However, it is unclear whether these changes in perceived reward impact the extent of concurrent use of cigarettes with alcohol or cannabis. The current study investigated if self-reported changes in perceived reward from concurrent use of cigarettes with alcohol or cannabis are related to the extent of concurrent use in real-world contexts using a smartphone-based Ecological Momentary Assessment (EMA) study. METHODS: The sample included 126 diverse young adult smokers in the San Francisco Bay Area who reported current alcohol or cannabis use at baseline (M = 22.8 years, 50.8% male, 40.5% sexual minority, 39.7% Non-Hispanic White). Participants completed an online baseline survey and 30 days of smartphone-based daily EMA surveys of cigarette, alcohol, and cannabis use. The baseline assessed self-reported changes in perceived pleasure of smoking cigarettes while using alcohol or cannabis separately. EMA surveys included detailed questions about concurrent use (i.e., the extent of smoking while using another substance) covering the previous day. A total of 2,600 daily assessments were analyzed using mixed models. RESULTS: Higher perceived pleasure from smoking cigarettes while drinking alcohol or using cannabis at baseline were both associated with a greater extent of concurrent use of cigarettes with alcohol (b = 0.140; SE = 0.066; t = 2.1; p = .035) and cannabis (b = 0.136; SE = 0.058; t = 2.4; p = .019) on a given day. CONCLUSIONS: Results suggest that perceived reward from concurrently using cigarettes with alcohol or cannabis is associated with the extent of concurrent use. Findings can inform tailored smoking cessation interventions.

6.
Artículo en Inglés | MEDLINE | ID: mdl-33355096

RESUMEN

Colistin is extensively used in animal production in many low- and middle-income countries. There is a need to develop methodologies to benchmark and monitor changes in resistance among mixed commensal bacterial populations in farms. We aimed to evaluate the performance of a broth microdilution method based on culturing a pooled Escherichia coli suspension (30-50 organisms) obtained from each sample. To confirm the biological basis and sensitivity of the method, we cultured 16 combinations of one colistin-susceptible and one mcr-1 encoded colistin-resistant E. coli in the presence of 2mg/L colistin. Optical density (OD600nm) readings over time were used to generate a growth curve, and these values were adjusted to the values obtained in the absence of colistin (adjusted Area Under the Curve, AUCadj). The median limit of detection was 1 resistant in 104 susceptible colonies [1st - 3rd quartile, 102:1 -105:1]. We applied this method to 108 pooled faecal samples from 36 chicken flocks from the Mekong Delta (Vietnam), and determined the correlation between this method and the prevalence of colistin resistance in individual colonies harvested from field samples, determined by the Minimum Inhibitory Concentration. The overall prevalence of colistin resistance at sample and isolate level (estimated from the AUCadj) was 38.9% [95%CI, 29.8-48.8%] and 19.4% (SD± 26.3%), respectively. Increased colistin resistance was associated with recent (2 weeks) use of colistin (OR=3.67) and other, non-colistin antimicrobials (OR=1.84). Our method is a sensitive and affordable approach to monitor changes in colistin resistance in E. coli populations from faecal samples over time.IMPORTANCE Colistin (polymyxin E) is an antimicrobial with poor solubility in agar-based media, and therefore broth microdilution is the only available method for phenotypic resistance. However, estimating colistin resistance in mixed Escherichia coli populations is laborious since it requires individual colony isolation, identification and susceptibility testing. We developed a growth-based microdilution method suitable for pooled faecal samples. We validated the method by comparing it with individual MIC of 909 E. coli isolates; we then tested 108 pooled faecal samples from 36 healthy chicken flocks collected over their production cycle. A higher level of resistance was seen in flocks recently treated with colistin in water, although the observed generated resistance was short-lived. Our method is affordable, and may potentially be integrated into surveillance systems aiming at estimating the prevalence of resistance at colony level in flocks/herds. Furthermore, it may also be adapted to other complex biological systems, such as farms and abattoirs.

7.
Curr Opin Physiol ; 17: 187-196, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33184610

RESUMEN

As a versatile intracellular second messenger, calcium ion (Ca2+) regulates a plethora of physiological processes. To achieve precise control over Ca2+ signals in living cells and organisms, a set of optogenetic tools have recently been crafted by engineering photosensitive domains into intracellular signaling proteins, G-protein coupled receptors (GPCRs), receptor tyrosine kinases (RTKs), and Ca2+ channels. We highlight herein the optogenetic engineering strategies, kinetic properties, advantages and limitations of these genetically-encoded Ca2+ channel actuators (GECAs) and modulators. In parallel, we present exemplary applications in both excitable and non-excitable cells and tissues. Furthermore, we briefly discuss potential solutions for wireless optogenetics to accelerate the in vivo applications of GECAs under physiological conditions, with an emphasis on integrating near-infrared (NIR) light-excitable upconversion nanoparticles (UCNPs) and bioluminescence with optogenetics.

8.
Am J Physiol Heart Circ Physiol ; 319(6): H1302-H1312, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33095057

RESUMEN

Hyperphosphatemia is the primary risk factor for vascular calcification, which is closely associated with cardiovascular morbidity and mortality. Recent evidence showed that oxidative stress by high inorganic phosphate (Pi) mediates calcific changes in vascular smooth muscle cells (VSMCs). However, intracellular signaling responsible for Pi-induced oxidative stress remains unclear. Here, we investigated molecular mechanisms of Pi-induced oxidative stress related with intracellular Ca2+ ([Ca2+]i) disturbance, which is critical for calcification of VSMCs. VSMCs isolated from rat thoracic aorta or A7r5 cells were incubated with high Pi-containing medium. Extracellular signal-regulated kinase (ERK) and mammalian target of rapamycin were activated by high Pi that was required for vascular calcification. High Pi upregulated expressions of type III sodium-phosphate cotransporters PiT-1 and -2 and stimulated their trafficking to the plasma membrane. Interestingly, high Pi increased [Ca2+]i exclusively dependent on extracellular Na+ and Ca2+ as well as PiT-1/2 abundance. Furthermore, high-Pi induced plasma membrane depolarization mediated by PiT-1/2. Pretreatment with verapamil, as a voltage-gated Ca2+ channel (VGCC) blocker, inhibited Pi-induced [Ca2+]i elevation, oxidative stress, ERK activation, and osteogenic differentiation. These protective effects were reiterated by extracellular Ca2+-free condition, intracellular Ca2+ chelation, or suppression of oxidative stress. Mitochondrial superoxide scavenger also effectively abrogated ERK activation and osteogenic differentiation of VSMCs by high Pi. Taking all these together, we suggest that high Pi activates depolarization-triggered Ca2+ influx via VGCC, and subsequent [Ca2+]i increase elicits oxidative stress and osteogenic differentiation. PiT-1/2 mediates Pi-induced [Ca2+]i overload and oxidative stress but in turn, PiT-1/2 is upregulated by consequences of these alterations.NEW & NOTEWORTHY The novel findings of this study are type III sodium-phosphate cotransporters PiT-1 and -2-dependent depolarization by high Pi, leading to Ca2+ entry via voltage-gated Ca2+ channels in vascular smooth muscle cells. Cytosolic Ca2+ increase and subsequent oxidative stress are indispensable for osteogenic differentiation and calcification. In addition, plasmalemmal abundance of PiT-1/2 relies on Ca2+ overload and oxidative stress, establishing a positive feedback loop. Identification of mechanistic components of a vicious cycle could provide novel therapeutic strategies against vascular calcification in hyperphosphatemic patients.

9.
Artículo en Inglés | MEDLINE | ID: mdl-33092106

RESUMEN

Given the emerging tobacco landscape, dual use of cigarettes and e-cigarettes has increased among young adults, but little is known about its associated factors. Peer crowds, defined as macro-level connections between individuals with similar core values (e.g., "Hip Hop" describing a group that prefers hip hop music and values strength, honor, and respect), are a promising way to understand tobacco use patterns. We examined associations between peer crowds and tobacco use patterns by using data from a cross sectional survey of 1340 young adults in the San Francisco Bay Area in 2014. Outcomes were the past 30-day use of: neither cigarettes nor e-cigarettes; cigarettes but not e-cigarettes; e-cigarettes but not cigarettes; and both cigarettes and e-cigarettes. Peer crowds included Hipster, Hip Hop, Country, Partier, Homebody, and Young Professional. Multinomial regression analysis indicated that peer crowds were significantly associated with different tobacco use patterns. Compared to Young Professionals, Hip Hop and Hipster crowds were more likely to dual use; Hipsters were more likely to use e-cigarettes only, and Country participants were more likely to smoke cigarettes only. These findings suggest that tobacco control campaigns and cessation interventions should be tailored to different young adult peer crowds and address poly-tobacco use.

10.
Stem Cells Int ; 2020: 8897138, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879629

RESUMEN

Objective: Ascorbic acid (AA) and controlled inflammatory stimuli are postulated to possess the ability to independently exert positive effects on a variety of proliferative, pluripotency, and differentiation attributes of gingival mesenchymal stem/progenitor cells (G-MSCs). The current study's objective was to explore and compare for the first time the impact of the major inflammatory cytokines (IL-1ß/TNF-α/IFN-γ), AA, or their combination on multipotency/pluripotency, proliferative, and differentiation characteristics of G-MSCs. Design: Human G-MSCs (n = 5) were isolated and cultured in basic medium (control group), in basic medium with major inflammatory cytokines; 1 ng/ml IL-1ß, 10 ng/ml TNF-α, and 100 ng/ml IFN-γ (inflammatory group), in basic medium with 250 µmol/l AA (AA group) and in inflammatory medium supplemented by AA (inflammatory/AA group). All media were renewed three times per week. In stimulated G-MSCs intracellular ß-catenin at 1 hour, pluripotency gene expression at 1, 3, and 5 days, as well as colony-forming units (CFUs) ability and cellular proliferation over 14 days were examined. Following a five-days stimulation in the designated groups, multilineage differentiation was assessed via qualitative and quantitative histochemistry as well as mRNA expression. Results: ß-Catenin significantly decreased intracellularly in all experimental groups (p = 0.002, Friedman). AA group exhibited significantly higher cellular counts on days 3, 6, 7, and 13 (p < 0.05) and the highest CFUs at 14 days [median-CFUs (Q25/Q75); 40 (15/50), p = 0.043]. Significantly higher Nanog expression was noted in AA group [median gene-copies/PGK1 (Q25/Q75); 0.0006 (0.0002/0.0007), p < 0.01, Wilcoxon-signed-rank]. Significant multilineage differentiation abilities, especially into osteogenic and chondrogenic directions, were further evident in the AA group. Conclusions: AA stimulation enhances G-MSCs' stemness, proliferation, and differentiation properties, effects which are associated with a Wnt/ß-catenin signaling pathway activation. Apart from initially boosting cellular metabolism as well as Sox2 and Oct4A pluripotency marker expression, inflammation appeared to attenuate these AA-induced positive effects. Current results reveal that for AA to exert its beneficial effects on G-MSCs' cellular attributes, it requires to act in an inflammation-free microenvironment.

11.
Trop Med Infect Dis ; 5(3)2020 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-32937757

RESUMEN

Under-detection and -reporting in the private sector constitute a major barrier in Viet Nam's fight to end tuberculosis (TB). Effective private-sector engagement requires innovative approaches. We established an intermediary agency that incentivized private providers in two districts of Ho Chi Minh City to refer persons with presumptive TB and share data of unreported TB treatment from July 2017 to March 2019. We subsidized chest x-ray screening and Xpert MTB/RIF testing, and supported test logistics, recording, and reporting. Among 393 participating private providers, 32.1% (126/393) referred at least one symptomatic person, and 3.6% (14/393) reported TB patients treated in their practice. In total, the study identified 1203 people with TB through private provider engagement. Of these, 7.6% (91/1203) were referred for treatment in government facilities. The referrals led to a post-intervention increase of +8.5% in All Forms TB notifications in the intervention districts. The remaining 92.4% (1112/1203) of identified people with TB elected private-sector treatment and were not notified to the NTP. Had this private TB treatment been included in official notifications, the increase in All Forms TB notifications would have been +68.3%. Our evaluation showed that an intermediary agency model can potentially engage private providers in Viet Nam to notify many people with TB who are not being captured by the current system. This could have a substantial impact on transparency into disease burden and contribute significantly to the progress towards ending TB.

12.
Psychol Addict Behav ; 2020 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-32804517

RESUMEN

OBJECTIVE: Sexual minority (SM) young adults have higher rates of substance use than heterosexuals, but little is known about daily use of multiple substances, which confer numerous health risks for this population. Using daily diary data from a smartphone-based study, we examined the associations between sexual identity (i.e., SM vs. heterosexual) and patterns of same-day multiple substance use (i.e., cigarettes and alcohol, cigarettes and cannabis, alcohol and cannabis, and all 3 substances). METHOD: Young adult smokers (N = 147, aged 18-26, 51.7% female, 41.5% SM, 40.8% White) reported consecutive daily assessments on substance use over 30 days. We used generalized estimating equations to examine associations between sexual identity and patterns of same-day multiple substance use, controlling for demographic factors and psychological distress. RESULTS: Of 2,891 daily assessments, 16.7% reported same-day use of cigarettes and alcohol, 18.1% cigarettes and cannabis, 1.5% alcohol and cannabis, and 15.0% use of all 3 substances. SM participants (vs. heterosexuals) had significantly greater odds of reporting days with use of cigarettes and cannabis [Adjusted Odds Ratio (AOR) = 2.05, 95% Confidence Interval (CI) [1.04, 4.01]] and use of all three substances (AOR = 2.79, 95% CI [1.51, 5.14]) than days with single substance use or no use. CONCLUSIONS: These findings warrant tailored interventions addressing multiple substance use among SM young adults and temporally accurate measures of multiple substance use patterns. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

13.
Anim Sci J ; 91(1): e13412, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32618066

RESUMEN

The Vietnamese Ban pig is a precious genetic resource that needs to be preserved. In vitro embryo production from in vitro matured (IVM) oocytes is an important tool for the utilization of cryopreserved porcine sperm. The aim of this study was to compare two media for the IVM of Ban pig oocytes. Immature oocytes were subjected to IVM either in a non-defined (TCM-199 + pig follicular fluid) or in a defined base medium (POM + epidermal growth factor). At the end of IVM, the oocytes were in vitro fertilized (IVF) with frozen Ban sperm. Ten hours after IVF, the oocytes were either subjected to orcein staining to check fertilization and maturation status or cultured in vitro for 7 days. There was no difference between the two IVM media in terms of percentages of oocyte maturation and blastocyst production. However, the percentage of male pronuclear formation after IVF and the total cell numbers in blastocysts were higher with the defined system. Zygotes obtained by the two IVM systems survived vitrification at similar rates. In conclusion, the two IVM systems were both effective for the production of Ban pig embryos; however, better embryo quality was achieved with the defined one.


Asunto(s)
Blastocisto , Embrión de Mamíferos , Fertilización In Vitro/métodos , Técnicas de Maduración In Vitro de los Oocitos/métodos , Técnicas de Maduración In Vitro de los Oocitos/veterinaria , Oocitos , Espermatozoides , Porcinos , Vitrificación , Cigoto , Animales , Criopreservación/veterinaria , Femenino , Masculino , Vietnam
14.
Nat Commun ; 11(1): 3720, 2020 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-32709855

RESUMEN

The quantum walk formalism is a widely used and highly successful framework for modeling quantum systems, such as simulations of the Dirac equation, different dynamics in both the low and high energy regime, and for developing a wide range of quantum algorithms. Here we present the circuit-based implementation of a discrete-time quantum walk in position space on a five-qubit trapped-ion quantum processor. We encode the space of walker positions in particular multi-qubit states and program the system to operate with different quantum walk parameters, experimentally realizing a Dirac cellular automaton with tunable mass parameter. The quantum walk circuits and position state mapping scale favorably to a larger model and physical systems, allowing the implementation of any algorithm based on discrete-time quantum walks algorithm and the dynamics associated with the discretized version of the Dirac equation.

16.
Clin Infect Dis ; 2020 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-32521000

RESUMEN

Delamanid, a-first-in-class bicyclic nitroimidazole, was recently approved for multidrug-resistant tuberculosis treatment. Pitted against the hope for improving treatment outcomes is the threat of the rapid resistance emergence. This review provides information on the mechanisms of action, resistance emergence and drug susceptibility testing (DST) for delamanid. Delamanid resistance has already been reported in both in vitro experiments and clinical settings. Although mutations conferring delamanid resistance have been identified in fbiA, fbiB, fbiC, ddn and fgd1 genes of Mycobacterium tuberculosis, knowledge about the molecular resistance mechanisms is limited and there remains no standardized DST method. The rapid acquisition of delamanid resistance emphasizes the need for optimal use of new drugs, the need of drug resistance surveillance and a comprehensive understanding of drug resistance mechanisms. Further studies are necessary to investigate genetic and phenotypic changes that determine clinically relevant delamanid resistance to help develop a rapid delamanid DST.

17.
J Infect Dev Ctries ; 14(5): 479-487, 2020 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-32525834

RESUMEN

INTRODUCTION: Tuberculous meningitis (TBM) is the most dangerous form of tuberculosis with high mortality and disability rates. However, the delayed diagnostic process is often due to the absence of the gold standard tests leading to a lack of information about the sensitivity and specificity of diagnostic tests. This study aims to estimate the prevalence of TBM and determine the performance of four diagnostic procedures: the mycobacteria growth culture test, Gene Xpert assay, and analysis of protein levels and leukocyte count taken from cerebrospinal fluid. METHODOLOGY: We used a Bayesian latent class analysis to estimate the prevalence of TBM with 95% credible interval (CI), and the specificity and sensitivity of the four diagnostic procedures. The area under the receiver operating characteristic curve (AUC) of the cerebrospinal protein levels and leukocyte count were also compared and estimated using different thresholds. RESULTS: A total of 1,213 patients suspected of having TBM were included. The estimated TBM prevalence was 34.8 % (95% CI: 28.8 - 41.3). The sensitivity of culture test and Gene Xpert assay was 62.7% (95% CI: 52.5 - 74.0), and 57.5% (95% CI: 51.0 - 64.0), and the specificity of Gene-Xpert was 95. 9% (95% CI: 92.0 - 99.8). The AUC for leukocyte count was 76.0%, and for protein level was 73.4%. CONCLUSIONS: This study provided better information about the performance of four routine diagnostic tests and the prevalence of TBM which can enhance disease control and improve treatment outcomes.

18.
Nat Commun ; 11(1): 2736, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32483194

RESUMEN

Superplasticity describes a material's ability to sustain large plastic deformation in the form of a tensile elongation to over 400% of its original length, but is generally observed only at a low strain rate (~10-4 s-1), which results in long processing times that are economically undesirable for mass production. Superplasticity at high strain rates in excess of 10-2 s-1, required for viable industry-scale application, has usually only been achieved in low-strength aluminium and magnesium alloys. Here, we present a superplastic elongation to 2000% of the original length at a high strain rate of 5 × 10-2 s-1 in an Al9(CoCrFeMnNi)91 (at%) high-entropy alloy nanostructured using high-pressure torsion. The high-pressure torsion induced grain refinement in the multi-phase alloy combined with limited grain growth during hot plastic deformation enables high strain rate superplasticity through grain boundary sliding accommodated by dislocation activity.

19.
Biomech Model Mechanobiol ; 19(6): 2375-2395, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32535739

RESUMEN

Wrinkling is a ubiquitous surface phenomenon in many biological tissues and is believed to play an important role in arterial health. As arteries are highly nonlinear, anisotropic, multilayered composite systems, it is necessary to investigate wrinkling incorporating these material characteristics. Several studies have examined surface wrinkling mechanisms with nonlinear isotropic material relationships. Nevertheless, wrinkling associated with anisotropic constitutive models such as Ogden-Gasser-Holzapfel (OGH), which is suitable for soft biological tissues, and in particular arteries, still requires investigation. Here, the effects of OGH parameters such as fibers' orientation, stiffness, and dispersion on the onset of wrinkling, wrinkle wavelength and amplitude are elucidated through analysis of a bilayer system composed of a thin, stiff neo-Hookean membrane and a soft OGH substrate subjected to compression. Critical contractile strain at which wrinkles occur is predicted using both finite element analysis and analytical linear perturbation approach. Results suggest that besides stiffness mismatch, anisotropic features associated with fiber stiffness and distribution might be used in natural layered systems to adjust wrinkling and subsequent folding behaviors. Further analysis of a bilayer system with fibers in the (x-y) plane subjected to compression in the x direction shows a complex dependence of wrinkling strain and wavelength on fiber angle, stiffness, and dispersion. This behavior is captured by an approximation utilizing the linearized anisotropic properties derived from OGH model. Such understanding of wrinkling in this artery wall-like system will help identify the role of wrinkling mechanisms in biological artery in addition to the design of its synthetic counterparts.

20.
BMC Public Health ; 20(1): 934, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32539700

RESUMEN

BACKGROUND: To achieve the WHO End TB Strategy targets, it is necessary to detect and treat more people with active TB early. Scale-up of active case finding (ACF) may be one strategy to achieve that goal. Given human resource constraints in the health systems of most high TB burden countries, volunteer community health workers (CHW) have been widely used to economically scale up TB ACF. However, more evidence is needed on the most cost-effective compensation models for these CHWs and their potential impact on case finding to inform optimal scale-up policies. METHODS: We conducted a two-year, controlled intervention study in 12 districts of Ho Chi Minh City, Viet Nam. We engaged CHWs as salaried employees (3 districts) or incentivized volunteers (3 districts) to conduct ACF among contacts of people with TB and urban priority groups. Eligible persons were asked to attend health services for radiographic screening and rapid molecular diagnosis or smear microscopy. Individuals diagnosed with TB were linked to appropriate care. Six districts providing routine NTP care served as control area. We evaluated additional cases notified and conducted comparative interrupted time series (ITS) analyses to assess the impact of ACF by human resource model on TB case notifications. RESULTS: We verbally screened 321,020 persons in the community, of whom 70,439 were eligible for testing and 1138 of them started TB treatment. ACF activities resulted in a + 15.9% [95% CI: + 15.0%, + 16.7%] rise in All Forms TB notifications in the intervention areas compared to control areas. The ITS analyses detected significant positive post-intervention trend differences in All Forms TB notification rates between the intervention and control areas (p = 0.001), as well as between the employee and volunteer human resource models (p = 0.021). CONCLUSIONS: Both salaried and volunteer CHW human resource models demonstrated additionality in case notifications compared to routine case finding by the government TB program. The salaried employee CHW model achieved a greater impact on notifications and should be prioritized for scale-up, given sufficient resources.


Asunto(s)
Agentes Comunitarios de Salud/estadística & datos numéricos , Análisis Costo-Beneficio/estadística & datos numéricos , Tamizaje Masivo/métodos , Tamizaje Masivo/estadística & datos numéricos , Tuberculosis/diagnóstico , Recursos Humanos/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Ciudades/estadística & datos numéricos , Femenino , Humanos , Análisis de Series de Tiempo Interrumpido , Masculino , Persona de Mediana Edad , Vietnam
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