Close contacts infected with Mycobacterium tuberculosis are at high risk of tuberculosis (TB) disease and a priority for preventive treatment. Three tests measure infection: two interferon-gamma ...release assays (IGRAs) and the tuberculin skin test (TST). The objective of our study was to assess the association of positive test results in contacts with infectiousness of the presumed TB source case.
Contacts in a cohort study at 10 United States sites received both IGRAs (QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB (T-SPOT)) and TST. We defined test conversion as negative for all tests at baseline and positive for at least one on retest. Risk ratios (RR) and 95% confidence intervals (CI) assessed association of positive test results with increased infectiousness of the TB case—defined as acid-fast bacilli (AFB) on sputum microscopy or cavities on chest radiographs— and contact demographics.
Adjusted for contacts’ age, nativity, sex, and race, IGRAs (QFT-GIT RR = 6.1, 95% CI 1.7–22.2; T-SPOT RR = 9.4, 95% CI 1.1–79.1), but not TST (RR = 1.7, 95% CI 0.8–3.7), were more likely to convert among contacts exposed to persons with cavitary TB disease.
Because IGRA conversions in contacts are associated with infectiousness of the TB case, their use may improve efficiency of health department contact investigations by focusing efforts on those likely to benefit from preventive treatment in the United States.
Latent tuberculosis infection (LTBI) screening and treatment interventions that are tailored to optimize acceptance among the non-U.S.-born population are essential for U.S. tuberculosis elimination. ...We investigated the impact of medical interpreter use on LTBI treatment acceptance and completion among non-U.S.-born persons in a multisite study.
The Tuberculosis Epidemiologic Studies Consortium was a prospective cohort study that enrolled participants at high risk for LTBI at ten U.S. sites with 18 affiliated clinics from 2012 to 2017. Non-U.S.-born participants with at least one positive tuberculosis infection test result were included in analyses. Characteristics associated with LTBI treatment offer, acceptance, and completion were evaluated using multivariable logistic regression with random intercepts to account for clustering by enrollment site. Our primary outcomes were whether use of an interpreter was associated with LTBI treatment acceptance and completion. We also evaluated whether interpreter usage was associated treatment offer and whether interpreter type was associated with treatment offer, acceptance, or completion.
Among 8,761 non-U.S.-born participants, those who used an interpreter during the initial interview had a significantly greater odds of accepting LTBI treatment than those who did not use an interpreter. There was no association between use of an interpreter and a clinician's decision to offer treatment or treatment completion once accepted. Characteristics associated with lower odds of treatment being offered included experiencing homelessness and identifying as Pacific Islander persons. Lower treatment acceptance was observed in Black and Latino persons and lower treatment completion by participants experiencing homelessness. Successful treatment completion was associated with use of shorter rifamycin-based regimens. Interpreter type was not associated with LTBI treatment offer, acceptance, or completion.
We found greater LTBI treatment acceptance was associated with interpreter use among non-U.S.-born individuals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The fourth-generation QuantiFERON test for tuberculosis infection, QuantiFERON-TB Gold Plus (QFT-Plus) has replaced the earlier version, QuantiFERON-TB Gold In-Tube (QFT-GIT). A clinical need exists ...for information about agreement between QFT-Plus and other tests. We conducted this study to assess agreement of test results for QFT-Plus with those of QuantiFERON-TB Gold In-Tube (QFT-GIT), T-SPOT.TB (T-SPOT), and the tuberculin skin test (TST). Persons at high risk of latent tuberculosis infection (LTBI) and/or progression to tuberculosis (TB) disease were enrolled at the 10 sites of the Tuberculosis Epidemiologic Studies Consortium from October 2016 through May 2017; each participant received all four tests. Cohen's kappa (κ) and Wilcoxon signed-rank test compared qualitative and quantitative results of QFT-Plus with the other tests. Test results for 506 participants showed 94% agreement between QFT-Plus and QFT-GIT, with 19% positive and 75% negative results. When the tests disagreed, it was most often in the direction of QFT-GIT negative/QFT-Plus positive. QFT-Plus had similar concordance as QFT-GIT with TST (77% and 77%, respectively) and T-SPOT (92% and 91%, respectively). The study showed high agreement between QFT-GIT and QFT-Plus in a direct comparison. Both tests had similar agreement with TST and T-SPOT.
The tuberculin skin test (TST) has been preferred for screening young children for latent tuberculosis infection (LTBI) because of concerns that interferon-γ release assays (IGRAs) may be less ...sensitive in this high-risk population. In this study, we compared the predictive value of IGRAs to the TST for progression to tuberculosis disease in children, including those <5 years old.
Children <15 years old at risk for LTBI or progression to disease were tested with TST, QuantiFERON-TB Gold In-Tube test (QFT-GIT), and T-SPOT.
test (T-SPOT) and followed actively for 2 years, then with registry matches, to identify incident disease.
Of 3593 children enrolled September 2012 to April 2016, 92% were born outside the United States; 25% were <5 years old. Four children developed tuberculosis over a median 4.3 years of follow-up. Sensitivities for progression to disease for TST and IGRAs were low (50%-75%), with wide confidence intervals (CIs). Specificities for TST, QFT-GIT, and T-SPOT were 73.4% (95% CI: 71.9-74.8), 90.1% (95% CI: 89.1-91.1), and 92.9% (95% CI: 92.0-93.7), respectively. Positive and negative predictive values for TST, QFT-GIT, and T-SPOT were 0.2 (95% CI: 0.1-0.8), 0.9 (95% CI: 0.3-2.5), and 0.8 (95% CI: 0.2-2.9) and 99.9 (95% CI: 99.7-100), 100 (95% CI: 99.8-100), and 99.9 (95% CI: 99.8-100), respectively. Of 533 children with TST-positive, IGRA-negative results not treated for LTBI, including 54 children <2 years old, none developed disease.
Although both types of tests poorly predict disease progression, IGRAs are no less predictive than the TST and offer high specificity and negative predictive values. Results from this study support the use of IGRAs for children, especially those who are not born in the United States.
Exoskeleton robots generally have multi-functions and one such function is doing rehabilitation therapy in upper limb and lower limb in stroke-affected patients. A novel hybrid (serial-parallel) ...robot manipulator was proposed in this paper for rehabilitation of upper limb and its kinematics are studied systematically. This robot manipulator intends to perform wrist flexion, wrist extension, wrist radial deviation, wrist ulnar deviation, elbow flexion, elbow extension, elbow pronation and elbow supination motions. The contemporary mechanical designs especially the kinematic structure of upper limb exoskeleton robots have a unique feature that is, almost all of them use serial manipulators, and few others used parallel manipulators. The kinematic structure of the proposed robot is that of a hybrid manipulator (two parallel manipulators connected in series) which has 4-degrees-of-freedom. It is composed of an upper 3SPS-type parallel manipulator and 2SPR-type parallel manipulator connected in series.
The Jacobian and Hessian Matrix method was used to derive the manipulator kinematic formula for solving the displacement, velocity and acceleration.
A 3D model of the robotic arm was constructed and analyzed by simulation. The positioning workspace of manipulator was constructed and analyzed.
The 3SPS-type parallel manipulator has good kinematic characteristics while performing wrist motions. The 2SPR-type parallel manipulator produced singular configuration, while performing the desired rehabilitation elbow motions, it was found to not be suitable for usage in performing rehabilitation therapy in stroke-affected patients.
This article reports an unexploited method for the green synthesis of gold nanoparticles using
Amaranthus tricolor
leaves, with the aid of microwave assistance. The fresh leaf extract of the plant ...plays dual role in reducing and capping actions. The incorporation of microwave energy to this green approach overcomes the characteristic limitation of time consumption by the conventional green techniques. The synthesized gold nanoparticles are characterized using UV–vis., FT-IR, XRD, HR-TEM, EDX, DLS, and zeta potential analyses. The various functional groups in the plant extract which are responsible for the reduction and stabilization of nanoparticles were identified by FT-IR spectrum. The crystallographic peaks designated to face centered cubic lattice of the gold nanoparticles are evident from the XRD analysis. HR-TEM images illustrate the almost spherical morphology attained by the formed nanoparticles with an average particle diameter of 18.33 nm. The stability of nanoparticles is revealed by its zeta potential of − 21.3 mV. The DLS analysis results in a hydrodynamic diameter of 148.5 nm. The catalytic potential of the synthesized gold nanoparticles in the attenuation of harmful pollutants such as eosin Y and 2-nitrophenol by NaBH
4
was studied. Both the catalytic degradations were successfully completed within few minutes of the reaction and they hold to pseudo-first order kinetics. The nanoparticles accomplished good antibacterial properties towards various bacteria and are demonstrated herein. Cytotoxic activity of the synthesized nanoparticles was evaluated for human lung cancer cell line A549 using MTT assay and a LC
50
value of 102.39 ± 0.36 μg/mL was obtained.
Among the wide range of chemosensors, the development of fluorescent chemosensors has shown continued interest in the domains of chemistry, materials, biology, and ecology due to their simple ...operation, low cost, high sensitivity, specificity, live observation, and short response time. As a metal‐free and fluorescent chemosensor, graphitic carbon nitride (g‐C3N4) has emerged as a new research hotspot and received widespread interdisciplinary attention which is attributable to its favorable electrical band structure, high physicochemical stability, and “earth‐abundant” nature. This review summarizes the structure, synthetic methods, and various techniques for the modification of g‐C3N4. This review also covers the development of g‐C3N4 nanomaterials‐based sensors and their potential applications in a variety of fields. Furthermore, the comparative performance of various sensors, existing obstacles, and perspectives of g‐C3N4‐based nanomaterials are also outlined in detail.
Graphitic carbon nitride as an emerging photoluminescent material: powders, quantum dots, thin films and their applications in imaging, and sensing The crystal and electronic structure of g‐C3N4 and their synthetic approaches determine their final chemical and photophysical properties as well as the structure of materials. Potential applications in ion sensing, bio‐sensing, organics sensing, and imaging are thoroughly reviewed and discussed.
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