The clinical and pathological features of sarcoidosis and tuberculosis may mimic each other, and when the caseous necrosis is not seen in tuberculosis tissue, differentiation is not easy.
This study ...evaluates the ability of real-time PCR quantification and sets the quantitive value to differentiate sarcoidosis from TB.
Formalin-fixed and paraffin-embedded sections of biopsy samples, from 104 patients with sarcoidosis, 31 patients with tuberculosis, and 55 controls with other respiratory diseases (26 with nonspecific lymphadenitis and 29 with emphysema bullae), were collected to amplify insertion sequence IS986 of Mycobacterium tuberculosis (MTB) genome by real-time quantitative PCR. The diagnostic performance of qualitative and quantitative analysis of real-time quantitative PCR was assessed by receiver-operating characteristic (ROC) curves.
MTB DNA was detected in 20 of the 104 sarcoidosis samples and 7 of the 55 control samples, but was detected in all of the 31 tuberculosis samples. The numbers of MTB genomes were 0-4.71x10(3) copies per ml in sarcoidosis samples, 1.58x10(2)-5.43x10(7) copies per ml in tuberculosis samples and 0-1.02x10(3) copies per ml in controls with quantitative analysis. Receiver-operating characteristic (ROC) curves showed that MTB genome quantification had greater diagnostic performance than MTB genome qualitation in discriminating patients with sarcoidosis from those with tuberculosis (area under the ROC curves: 0.994 vs 0.904, P<0.001). The sensitivity and specificity of qualitative analysis were 100% and 80.8% respectively. At cutoff value of 1.14x10(3) copies per ml for MTB genome quantification, the sensitivity was 96.8% and specificity was 98.1%.
The real time PCR quantification is a valuable test for differentiation between sarcoidosis and tuberculosis, and the MTB genome copies number of 1.14x10(3) copies per ml should be preferred as quantitative cutoff value for the differentiation.
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work ...out improvement strategies.
All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student's t test were used to detect statistically significant changes between Phase 1 and Phase 2.
A total of 2358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P = 0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P > 0.05).
Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.
The ear is a remarkably sensitive pressure fluctuation detector. In guinea pigs, behavioral measurements indicate a minimum detectable sound pressure of ∼20 μPa at 16 kHz. Such faint sounds produce ...0.1-nm basilar membrane displacements, a distance smaller than conformational transitions in ion channels. It seems that noise within the auditory system would swamp such tiny motions, making weak sounds imperceptible. Here we propose a new mechanism contributing to a resolution of this problem and validate it through direct measurement. We hypothesized that vibration at the apical side of hair cells is enhanced compared with that at the commonly measured basilar membrane side. Using in vivo optical coherence tomography, we demonstrated that apical-side vibrations peaked at a higher frequency, had different timing and were enhanced compared with those at the basilar membrane. These effects depend nonlinearly on the stimulus sound pressure level. The timing difference and enhancement of vibrations are important for explaining how the noise problem is circumvented.
Using 567 pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrts=4.599 GeV, near the Λ_{c}^{+}Λover ¯_{c}^{-} threshold, we study the singly Cabibbo-suppressed ...decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})=(6.70±0.48±0.25)%, B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})=(1.81±0.33±0.13)%, and B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.
Abstract
Improved energy confinement mode (I-mode) has been observed on the HL-2A tokamak. The I-mode features an edge transport barrier (ETB) in electron temperature and a low confinement mode like ...edge density. A weakly coherent mode (WCM) is observed in the edge region with the frequency of
f
∼
60
−
160
kHz and the poloidal wavenumber of
k
θ
∼
0.5
−
2.5
cm
−
1
. The maximum of WCM amplitude is located near the top of electron temperature pedestal. A critical value of
E
×
B
velocity shear for triggering the L–I transition has been found, and is much lower than that for triggering the L–H transition. Additionally, ion internal transport barrier (ITB) has been observed in the I-mode. The formation of ion ITB is due to the increase of
E
×
B
velocity shear, leading to the suppression of turbulence. Transport analysis further confirms the existence of electron ETB and ion ITB. The coexistence of electron ETB and ion ITB leads to an improved plasma confinement, which is comparable to that in the high confinement mode, suggesting that I-mode with ITB regimes could be an interesting operation scenario for future fusion devices.
MicroRNA-200 family members are expressed in the developing mouse inner ear and in zebrafish (Danio rerio) olfactory epithelia, taste buds, and neuromasts, and have also been shown to be associated ...with differentiation of olfactory and taste buds. However, the role of the miR-200 family in the inner ear of zebrafish had not been studied. We investigated the expression and function of the miR-200 family in the zebrafish inner ear via in situ hybridization and loss-of-function methods. Expression of the miR-200 family was weak and dispersed throughout the developing zebrafish inner ear. After knockdown of miR-200 family members in the developing inner ear, no significant differences in development were observed compared to the controls. Otic vesicles, otoliths, and semicircular canals appeared normal. Compared with less differentiated olfactory filaments in olfactory epithelia, the development of hair cells and statoacoustic ganglion neurons were normal. The kinocilia and stereocilia of hair cells, the innervation of hair cells, and the formation of ribbon synapses were also unaffected. Overall, we conclude that the miR-200 family has a negligible role in the development of zebrafish inner ear; the functions of the miR- 200 family may be organ-specific.
Helicobacter pylori infections are threats to public health due to their high infection rate and drug resistance. Identification of single-nucleotide variants (SNVs) in H. pylori is crucial for both ...diagnosis and therapy. Yet the clinical testing of resistant H. pylori mutants is still facing some challenges, such as the selectivity is not good enough for SNVs in abundant wild-type DNA, the lack of clinical validation and the economical burden on patients. Herein, an X-shaped DNA probe with a toehold initiator was designed, which could specifically hybridize with certain genotype DNA due to the thermodynamically driven reaction. A competitive reaction was developed to amplify the thermodynamic difference between wild-type DNA and SNVs, diminishing the interference of wild-type DNA. By this means, multiple SNVs in H. pylori were successfully identified and two SNVs related to clarithromycin resistance are chosen as model targets. A paper strip was fabricated for visual, fast screening of SNVs. Furthermore, the approach was validated using clinical samples, and a point-of-care (POCT) testing diagnosis was executed on saliva samples, demonstrating its potential for the prevention and cure of H. pylori infections.
An X-shaped DNA probe with a toehold initiator was designed to identify multiple single-nucleotide variants for clinical evaluation of Helicobacter pylori drug resistance. Display omitted
•An X-shaped DNA probe with a toehold initiator was designed aiming at drug resistance induced by single-nucleotide variants.•The strategy was validated in clinical samples collected from patients.•A competitive reaction was developed to amplify the thermodynamic difference between wild-type DNA and SNVs.•A POCT diagnosis was executed on saliva samples, demonstrating its potential for the prevention and cure of H. pylori infections.
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