Interferon-γ release assays (IGRA) with Resuscitation promoting factor (Rpf) proteins enhanced tuberculosis (TB) screening and diagnosis in adults but have not been evaluated in children. Children ...often develop paucibacillary TB and their immune response differs from that of adults, which together affect TB disease diagnostics and immunodiagnostics. We assessed the ability of Rpf to identify infection among household TB-exposed children in The Gambia and investigated their ability to discriminate Mycobacterium tuberculosis complex (MTBC) infection from active TB disease in children.
Detailed clinical investigations were done on 93 household TB-exposed Gambian children and a tuberculin skin test (TST) was administered to asymptomatic children. Venous blood was collected for overnight stimulation with ESAT-6/CFP-10-fusion protein (EC), purified protein derivative and RpfA, B, C, D and E. Interferon gamma (IFN-γ) production was measured by ELISA in supernatants and corrected for the background level. Infection status was defined by IGRA with EC and TB disease by mycobacterial confirmation and/or clinical diagnosis. We compared IFN-γ levels between infected and uninfected children and between infected and TB diseased children using a binomial logistic regression model while correcting for age and sex. A Receiver Operating Characteristics analysis was done to find the best cut-off for IFN-γ level and calculate sensitivity and specificity.
Interferon gamma production was significantly higher in infected (IGRA+, n = 45) than in uninfected (IGRA-, n = 20) children after stimulation with RpfA, B, C, and D (P = 0.03; 0.007; 0.03 and 0.003, respectively). Using RpfB and D-specific IFN-γ cut-offs (33.9 pg/mL and 67.0 pg/mL), infection was classified with a sensitivity-specificity combination of 73-92% and 77-72% respectively, which was similar to and better than 65-75% for TST. Moreover, IFN-γ production was higher in infected than in TB diseased children (n = 28, 5 bacteriologically confirmed, 23 clinically diagnosed), following RpfB and D stimulation (P = 0.02 and 0.03, respectively).
RpfB and RpfD show promising results for childhood MTBC infection screening, and both performed similar to and better than the TST in our study population. Additionally, both antigens appear to discriminate between infection and disease in children and thus warrant further investigation as screening and diagnostic antigens for childhood TB.
Quality-Diversity (QD) methods are algorithms that aim to generate a set of diverse and high-performing solutions to a given problem. Originally developed for evolutionary robotics, most QD studies ...are conducted on a limited set of domains - mainly applied to locomotion, where the fitness and the behavior signal are dense. Grasping is a crucial task for manipulation in robotics. Despite the efforts of many research communities, this task is yet to be solved. Grasping cumulates unprecedented challenges in QD literature: it suffers from reward sparsity, behavioral sparsity, and behavior space misalignment. The present work studies how QD can address grasping. Experiments have been conducted on 15 different methods on 10 grasping domains, corresponding to 2 different robot-gripper setups and 5 standard objects. An evaluation framework that distinguishes the evaluation of an algorithm from its internal components has also been proposed for a fair comparison. The obtained results show that MAP-Elites variants that select successful solutions in priority outperform all the compared methods on the studied metrics by a large margin. We also found experimental evidence that sparse interaction can lead to deceptive novelty. To our knowledge, the ability to efficiently produce examples of grasping trajectories demonstrated in this work has no precedent in the literature.
Reinforcement learning (RL) aims at building a policy that maximizes a task-related reward within a given domain. When the domain is known, i.e., when its states, actions and reward are defined, ...Markov Decision Processes (MDPs) provide a convenient theoretical framework to formalize RL. But in an open-ended learning process, an agent or robot must solve an unbounded sequence of tasks that are not known in advance and the corresponding MDPs cannot be built at design time. This defines the main challenges of open-ended learning: how can the agent learn how to behave appropriately when the adequate states, actions and rewards representations are not given? In this paper, we propose a conceptual framework to address this question. We assume an agent endowed with low-level perception and action capabilities. This agent receives an external reward when it faces a task. It must discover the state and action representations that will let it cast the tasks as MDPs in order to solve them by RL. The relevance of the action or state representation is critical for the agent to learn efficiently. Considering that the agent starts with a low level, task-agnostic state and action spaces based on its low-level perception and action capabilities, we describe open-ended learning as the challenge of building the adequate representation of states and actions, i.e., of redescribing available representations. We suggest an iterative approach to this problem based on several successive Representational Redescription processes, and highlight the corresponding challenges in which intrinsic motivations play a key role.
Microorganisms perform countless tasks on Earth and they are expected to be essential for human space exploration. Despite the interest in the responses of bacteria to space conditions, the findings ...on the effects of microgravity have been contradictory, while the effects of Martian gravity are nearly unknown. We performed the ESA BioRock experiment on the International Space Station to study microbe-mineral interactions in microgravity, simulated Mars gravity and simulated Earth gravity, as well as in ground gravity controls, with three bacterial species:
Sphingomonas desiccabilis
,
Bacillus subtilis
, and
Cupriavidus metallidurans
. To our knowledge, this was the first experiment to study simulated Martian gravity on bacteria using a space platform. Here, we tested the hypothesis that different gravity regimens can influence the final cell concentrations achieved after a multi-week period in space. Despite the different sedimentation rates predicted, we found no significant differences in final cell counts and optical densities between the three gravity regimens on the ISS. This suggests that possible gravity-related effects on bacterial growth were overcome by the end of the experiment. The results indicate that microbial-supported bioproduction and life support systems can be effectively performed in space (e.g., Mars), as on Earth.
Abstract
Background
Despite the benefits of cardiac rehabilitation and secondary prevention, patients with coronary heart disease frequently fail to meet their daily physical activity goals. When one ...is stuck in a cycle of bad habits, changing one's behavior can be very challenging. One of the difficulties to maintaining a healthy lifestyle may be a lack of motivation. The use of game design elements (such as points, leaderboards, progress bars, and badges) in non-game contexts to promote motivation and engagement is known as gamification. It could be a powerful tool for encouraging patients to engage in physical activity. However, solid ideas that utilize the fundamental experience and psychological impacts of gaming mechanics must be built upon.
Purpose
The aim of this study is to look into the impact of a smartphone-based gamification intervention on physical activity engagement and other related psychological outcomes in patients with coronary heart disease, as well as the 24-week maintenance of effects beyond the 12-week intervention.
Methods
Participants with coronary heart disease were randomly assigned to three groups (control group, individual group and team group). The individual and team groups received gamified behavior intervention based on behavioral economic principles. Based on the Individual group, the team earned social incentives (collaboration). The intervention lasted 12 weeks, with another 12 weeks of follow-up. The primary outcomes included the change in daily steps and the proportion of patient-days that step goals achieved. The secondary outcomes included competence, autonomous, relatedness and autonomous motivation.
Results
The follow-up period has now been completed by 65 participants (mean age 52.8+10.3, 18.2% female) completed the follow-up period. Compared with the control group (n=17), participants in the individual group (n=25) had a significantly greater increase in mean daily steps from baseline during the intervention group (difference 956; 95% CI, 243–1623; P<0.01), and had a significantly greater proportion of patient-days that step goals achieved (difference 0.35; 95% CI, 0.03–0.12; P<0.001), competence (difference 0.5, 95% CI, 0.3–0.7; P<0.001), autonomous motivation (difference 3.2; 95% CI, 2.0–4.0; P<0.001). However, no significant difference of change in step counts was found between team group (n=23) and control group. During the follow-up period, mean daily steps and autonomous motivation in the individual declined but remained significantly greater than that in the control arm compared with baseline (steps: difference 452; 95% CI, 138–818; P<0.05) (motivation: difference 1.2; 95% CI, 0.3–1.8; P<0.05).
Conclusions
A smartphone-based gamification intervention was found to be an effective strategy to enhance motivation and physical activity engagement, as well as having a great maintenance effect.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work is financially supported by a Construction Programme of Independent Innovation Ability of Community Health Nursing Engineering Laboratory in Jilin Province (Study code: 2020C038-8) awarded to FL.
As humans explore and settle in space, they will need to mine elements to support industries such as manufacturing and construction. In preparation for the establishment of permanent human ...settlements across the Solar System, we conducted the ESA BioRock experiment on board the International Space Station to investigate whether biological mining could be accomplished under extraterrestrial gravity conditions. We tested the hypothesis that the gravity (
) level influenced the efficacy with which biomining could be achieved from basalt, an abundant material on the Moon and Mars, by quantifying bioleaching by three different microorganisms under microgravity, simulated Mars and Earth gravitational conditions. One element of interest in mining is vanadium (V), which is added to steel to fabricate high strength, corrosion-resistant structural materials for buildings, transportation, tools and other applications. The results showed that
and
enhanced the leaching of vanadium under the three gravity conditions compared to sterile controls by 184.92 to 283.22%, respectively. Gravity did not have a significant effect on mean leaching, thus showing the potential for biomining on Solar System objects with diverse gravitational conditions. Our results demonstrate the potential to use microorganisms to conduct elemental mining and other bioindustrial processes in space locations with non-1 ×
gravity. These same principles apply to extraterrestrial bioremediation and elemental recycling beyond Earth.
The International Space Station (ISS) is an orbital living and working environment extending from the original Zarya control module built in 1998. The expected life span of the completed station is ...around 10 years and during this period it will be constantly manned. It is inevitable that the ISS will also be home to an unknown number of microorganisms. This survey reports on microbiological contamination in potable water, air, and on surfaces inside the ISS. The viable counts in potable water did not exceed
1.0
×
10
2
CFU
/
ml
.
Sphingomonas sp. and
Methylobacterium sp. were identified as the dominant genera. Molecular analysis demonstrated the presence of nucleic acids belonging to various pathogens, but no viable pathogens were recovered. More than 500 samples were collected at different locations over a period of 6 years to characterize air and surface contamination in the ISS. Concentrations of airborne bacteria and fungi were lower than
7.1
×
10
2
and
4.4
×
10
1
CFU
/
m
3
, respectively.
Staphylococcus sp. was by far the most dominant airborne bacterial genus, whereas
Aspergillus sp. and
Penicillium sp. dominated the fungal population. The bacterial concentrations in surface samples fluctuated from
2.5
×
10
1
to
4.3
×
10
4
CFU
/
100
cm
2
.
Staphylococcus sp. dominated in all of these samples. The number of fungi varied between
2.5
×
10
1
and
3.0
×
10
5
CFU
/
100
cm
2
, with
Aspergillus sp. and
Cladosporium sp. as the most dominant genera. Furthermore, the investigations identified the presence of several (opportunistic) pathogens and strains involved in the biodegradation of structural materials.
A key treatment for patients with varying stages of heart failure with preserved ejection fraction (HFpEF) is exercise. Yet, despite a Class 1A recommendation, only one-third of patients exercise ...sufficiently. A huge treatment gap exists between guidelines and clinical practice. PRIORITY aims to establish the feasibility, clinical effectiveness and cost-effectiveness of a hybrid centre and home-based personalized exercise and physical activity intervention for patients along the HFpEF continuum.
An assessor-blinded, multicenter randomized controlled trial will be conducted among 312 patients along the HFpEF continuum. Participants will be randomized (1:1) to the PRIORITY intervention or a comparator group receiving only a written exercise prescription. Participants in the PRIORITY group will receive 18 supervised centre-based exercise sessions during one year, supplemented with a remotely guided home-based physical activity program. Outcomes will be assessed at baseline, 4 months, one and two years. The primary outcome is the peak oxygen uptake (pVO2) at 1-year. Secondary outcomes include physical activity, other physical fitness parameters, cardiovascular health, echocardiographic parameters, health-related quality of life and costs at 1-year FU. Machine learning algorithms will analyse big data on physical activity collected during the 1-year intervention to develop models that can predict physical activity uptake and adherence as well as changes in fitness and health. A cost-utility analysis will be performed to evaluate the cost-effectiveness of the PRIORITY intervention compared to the control condition.
We anticipate that participants in the supervised home-based exercise intervention group will have a greater increase in pVO2 compared to those receiving a written exercise prescription.
This trial is registered at ClinicalTrials.gov (NCT04745013) and is currently in the recruitment stage.
Abstract Objectives With more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS® Auditory ...Questionnaire is presented here as the first module of the LittlEARS® test battery. The LittlEARS® Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who receive a cochlear implant or hearing aid prior to 24 months of age. This paper presents results from two studies: one validating the LittlEARS® Auditory Questionnaire on children with normal hearing who are German speaking and a second validating the norm curves found after adaptation and administration of the questionnaire to children with normal hearing in 15 different languages. Methods Scores from a group of 218 German and Austrian children with normal hearing between 5 days and 24 months of age were used to create a norm curve. The questionnaire was adapted from the German original into English and then 15 other languages to date. Regression curves were found based on parental responses from 3309 normal hearing infants and toddlers. Curves for each language were compared to the original German validation curve. Results The results of the first study were a norm curve which reflects the age-dependence of auditory behaviour, reliability and homogeneity as a measure of auditory behaviour, and calculations of expected and critical values as a function of age. Results of the second study show that the regression curves found for all the adapted languages are essentially equal to the German norm curve, as no statistically significant differences were found. Conclusions The LittlEARS® Auditory Questionnaire is a valid, language-independent tool for assessing the early auditory behaviour of infants and toddlers with normal hearing. The results of this study suggest that the LittlEARS® Auditory Questionnaire could also be very useful for documenting children's progress with their current amplification, providing evidence of the need for implantation, or highlighting the need for follow-up in other developmental areas.
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