Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards

Background/PurposeDelayed diagnosis and isolation increases the risk of nosocomial transmission of tuberculosis (TB). To assess the risk of delayed management of TB, we analyzed the risk factors of prolonged delay in isolation of smear-positive TB patients in pulmonology/infectious diseases and other wards in a tertiary teaching hospital.MethodsWe enrolled smear-positive TB patients aged > 16 years with delayed respiratory isolation following hospitalization. Medical records were reviewed retrospectively. Time intervals between admission, order of sputum acid-fast staining, initiation of anti-tuberculous treatment and isolation were compared between pulmonology/infectious diseases wards (PIWs) and other wards. Risk factors were analyzed in patients with prolonged isolation delay of > 7 days in individual groups.ResultsIsolation was delayed in 191 (73.7%) of 259 hospitalized smear-positive TB patients. Median suspicion, treatment and isolation delays were 0, 3 and 4 days in PIWs and 1, 5 and 7 days in other wards. For patients admitted to non-PIWs, atypical chest radiographs, symptoms without dyspnea or not being admitted from the emergency department (ED) were risk factors for prolonged isolation delay exceeding 7 days. The only risk factor for delayed isolation in patients admitted to PIWs was age ≥ 70 years.ConclusionDelays in suspicion, treatment and isolation of TB patients were longer in non-PIWs. Clinicians should be alert to those admitted to non-PIWs with atypical chest radiographs, atypical symptoms, or not admitted from the ED

Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis

Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12–18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm

Center of pressure progression patterns during level walking in adolescents with idiopathic scoliosis.

The purpose of this study was to determine whether functional walking performance measured with Timed Up-and-Go (TUG) and center of pressure (CoP) progression pattern is different across adolescents with various curve severity of idiopathic scoliosis (IS). The CoP coordinates during a stance phase for self-paced level walking between adolescent with three different severities of IS (mild IS, moderate IS, and severe IS) and age-matched normal subjects were measured with foot pressure measurement. The average data of three trials were compared among groups with repeated measure analysis of variance. Results showed that the TUG was different between normal and AIS subjects, indicating use of TUG as a marker of functional walking performance in AIS is plausible but studies with larger sample size is needed before using TUG to identify AIS with different scoliosis severity. The results also showed that the CoP displacement, velocity and acceleration during a stance phase was different across groups, and with the most prominent deviations found in the moderate IS group. The medial-lateral shifting of the CoP trajectory at mid-foot regions in all IS groups deviated the most. A tendency of asymmetry in CoP progression pattern between feet in IS groups was also found. The deviation of the spine alignment in frontal plane could change the CoP progression patterns during level walking, suggesting the risk of the locomotors subjecting to abnormal loading during daily walking. Education and conservative interventions might be needed for preservation of medical outcome and prevention of back pain and/or musculoskeletal consequences later in the lives of AIS with and without surgical correction

The Manipulation of Real-Time Kinect-Based Robotic Arm Using Double-Hand Gestures

This study focused on utilizing the Kinect depth sensor to track double-hand gestures and control a real-time robotic arm. The control system is mainly composed of the microprocessor, a color camera, the depth sensor, and the robotic arm. The Kinect depth sensor was used to take photos of the human body to analyze the skeleton of a human body and obtain the relevant information. Such information was used to identify the gestures of the left hand and the left palm of the user. The gesture of left hand was used as an input command device. The gesture of the right hand was used for imitation movement teaching of robotic arm. From the depth sensor, the real-time images of the human body and the deep information of each joint were collected and converted to the relative positions of the robotic arm. Combining forward kinematics and inverse kinematics and D-H link, the gesture information of the right hand was calculated, which was converted via coordinates into each angle of the motor of the robotic arm. From the color camera, when the left palm was not detected, the user could simply use the right hand to control the action and movement of the real-time robotic arm. When the left palm was detected and 5 fingertips were identified, it meant the start of recording the real-time imitation movement of the robotic arm by the right hand. When 0 fingertip was identified, it meant the stoppage of the above recording. When 2 fingertips were identified, the user could not only control the real-time robotic arm but also repeat the recorded actions

Phosphoproteomic analysis of Methanohalophilus portucalensis FDF1(T) identified the role of protein phosphorylation in methanogenesis and osmoregulation

Methanogens have gained much attention for their metabolic product, methane, which could be an energy substitute but also contributes to the greenhouse effect. One factor that controls methane emission, reversible protein phosphorylation, is a crucial signaling switch, and phosphoproteomics has become a powerful tool for large-scale surveying. Here, we conducted the first phosphorylation-mediated regulation study in halophilic Methanohalophilus portucalensis FDF1(T), a model strain for studying stress response mechanisms in osmoadaptation. A shotgun approach and MS-based analysis identified 149 unique phosphoproteins. Among them, 26% participated in methanogenesis and osmolytes biosynthesis pathways. Of note, we uncovered that protein phosphorylation might be a crucial factor to modulate the pyrrolysine (Pyl) incorporation and Pyl-mediated methylotrophic methanogenesis. Furthermore, heterologous expression of glycine sarcosine N-methyltransferase (GSMT) mutant derivatives in the osmosensitive Escherichia coli MKH13 revealed that the nonphosphorylated T68A mutant resulted in increased salt tolerance. In contrast, mimic phosphorylated mutant T68D proved defective in both enzymatic activity and salinity tolerance for growth. Our study provides new insights into phosphorylation modification as a crucial role of both methanogenesis and osmoadaptation in methanoarchaea, promoting biogas production or reducing future methane emission in response to global warming and climate change