Performance of tuberculin skin test measured against interferon gamma release assay as reference standard in children

Objectives. International guidelines differ in the threshold of tuberculin skin test (TST) induration regarded as indicating Mycobacterium (M.) tuberculosis infection. Interferon gamma release assay (IGRA) results were used as reference to assess performance of TST induration thresholds for detection of M. tuberculosis infection in children. Design. Systematic review which included studies containing data on TST, IGRA, and Bacillus Calmette-Gu´erin (BCG) status in children. Data bases searched were PubMed, EMBASE, and the Cochrane library. Specificities and sensitivities were calculated for TST thresholds 5, 10, and 15mm and correlated with age and geographical latitude. Results. Eleven studies with 2796 children were included. For BCG immunised children diameters of 5, 10, and 15mmhad median sensitivities of 87, 70, and 75%and specificities of 67, 93, and 90%, respectively. In non-BCG immunised children median sensitivities were 94, 95, and 83% and specificities 91, 95, and 97%. At the 10mm threshold age correlated negatively with sensitivity of TST

STM investigation of model systems for atomic and molecular scale electronics

In this thesis, I explore model systems for planar atomic and molecular scale electronics on surfaces. The nanoscale systems are experimentally investigated by combining scanning tunneling microscopy (STM) with atomic and molecular manipulation. Furthermore, the on-surface chemical synthesis of molecules, as well as the construction of atomic wires on selected surfaces is applied. Polycyclic aromatic hydrocarbon (PAH) molecules play a key role in this work, as they can provide the functionality of the molecular scale devices. In the first part of this work, I investigate different PAH´s on the Au(111) surface. The precursor molecules form supramolecular assemblies and the on-surface synthesis approach to obtain the desired molecular products is used. In particular, bisanthene molecules via a cyclodehydrogenation reaction and the non-alternant polyaromatic hydrocarbon diindenopyrene after a thermally induced debromination followed by selective ring-closure to form a five-membered ring are obtained. An interesting surface for future applications is the passivated silicon Si(001)-(2x1):H. I prepare this surface and characterize the substrate. The surface has a band gap and molecules are electronically decoupled from the semiconducting substrate due to the passivation layer. Furthermore, atomic defects on this substrate, so called dangling bonds (DB´s), have defined electronic states. I show that it is possible to produce DB defects controllably by applying voltage pulses using the tip of the STM and achieve with this method atomic wires with DB´s. The third part of this thesis deals with the investigation of molecular structures on Si(001)-(2x1):H. I present the generation of hexacene by a surface assisted reduction. This result can be generalized for the generation of PAH´s after deoxygenation on passivated silicon and can open new routes to design functional molecules on this substrate. Secondly, one-dimensional chains of acetylbiphenyl (ABP) molecules are explored. They interact via its pi-stacked phenyl rings that are considered as conducting channel. Finally, I demonstrate that a single ABP molecule acts as a switch, as one can reversibly passivate and depassivate a single DB by a hydrogen transfer. In the last part of this work, I test the new low-temperature four-probe STM located at CEMES-CNRS in Toulouse. This machine is constructed for the development of molecular scale devices. For this purposes an atomic precision is needed for all the different tips at the same time and a high stability of this scanning probe microscope must be achieved. I perform a manipulation experiment of molecules to test the necessary submolecular precision. For that reason, supramolecular assemblies of ABP molecules on Au(111) are imaged and manipulated by any of the four tips using the lateral manipulation mode as well as by voltage pulses. The stability of the system is shown, as all tips of the four-probe STM work independently in parallel.:1 Introduction 2 Fundamentals of scanning tunneling microscopy 2.1 The working principle 2.2 Scanning tunneling spectroscopy 2.3 Manipulation modes 2.4 Modeling 3 Experimental setup, materials and methods 3.1 The scanning tunneling microscope 3.2 The Au(111) surface 3.3 Further experimental details 4 On-surface synthesis of molecules 4.1 Introduction 4.2 Generation of a periacene 4.3 Investigating a non-alternant PAH 4.4 Conclusion 5 The passivated silicon surface 5.1 Introduction 5.2 Preparation of passivated silicon 5.3 Characterization of Si(001)-(2x1):H 5.4 Tip-induced formation of dangling bonds 5.5 Conclusion 6 Organic molecules on passivated silicon 6.1 Introduction 6.2 Hexacene generated on passivated silicon 6.3 Acetylbiphenyl on passivated silicon 6.4 Conclusion 7 Testing a low temperature four-probe STM 7.1 Introduction 7.2 The four-probe STM 7.3 Performance test of the four-probe STM on Au(111) 7.4 Manipulation of ABP assemblies 7.5 Conclusion 8 Summary and outlook 9 Appendix 9.1 Dibromo-dimethyl-naphtalene on Au(111) 9.2 Epiminotetracene on Au(111) Bibliography Curriculum vitae Scientific contributions Acknowledgement Statement of authorshipIn dieser Arbeit untersuche ich Modellsysteme für planare atomare und molekulare Elektronik auf Oberflächen. Die Systeme auf der Nanoskala werden experimentell durch die Kombination aus Rastertunnelmikroskopie (RTM) und atomarer sowie molekularer Manipulation untersucht. Moleküle werden durch die oberflächenchemische Synthese generiert und atomare Drähte auf ausgewählten Oberflächen hergestellt. Polyzyklisch aromatische Kohlenwasserstoff (PAK) Moleküle spielen bei dieser Arbeit eine Schlüsselrolle, da sie die passiven und aktiven Elemente auf molekularem Maßstab darstellen können. Im ersten Teil dieser Arbeit untersuche ich verschiedene PAK´s auf der Au(111)-Oberfläche. Die Präkursoren bilden dabei supramolekulare Anordnungen und ich nutze die Oberflächensynthese, um die gewünschten molekulare Produkte zu erhalten. Im Speziellen habe ich Bisanthen-Moleküle über eine Zyklodehydrogenationsreaktion und das nicht-alternierende PAK Diindenopyren erzeugt. Dieses entsteht nach einer thermisch-induzierten Debromierung gefolgt von selektivem Ringschluss, sodass ein fünfgliedriger Ring gebildet wird. Eine interessante Oberfläche für zukünftige Anwendungen ist das passivierte Silizium Si(001)-(2x1):H. Ich habe diese Oberfläche erfolgreich präpariert und das Substrat charakterisiert. Die Oberfläche hat eine Bandlücke und Moleküle sind elektronisch von dem halbleitenden Substrat durch die Passivierungsschicht entkoppelt. Desweiteren haben atomare Defekte dieser Oberfläche, sogenannte Dangling-Bond´s (DB’s), definierte elektronische Zustände innerhalb der Bandlücke. Ich habe DB´s kontrolliert durch Spannungspulse mithilfe der Spitze des RTM erzeugt und stelle so atomare Drähte mit DB Defekten her. Der dritte Teil dieser Arbeit befasst sich mit der Untersuchung molekularer Strukturen auf Si(001)-(2x1):H. Die Erzeugung von Hexacen auf passivierten Silizium durch eine oberflächenunterstützte Reduktion wird gezeigt. Dieses Ergebnis ist eine neue Strategie für die Herstellung von PAK´s nach der Deoxygenierung und eröffnet neue Wege um funktionelle Moleküle auf diesem Substrat zu entwerfen. Zweitens zeige ich, dass Acetylbiphenyl (ABP) Moleküle eindimensionale Ketten auf dieser Oberfläche bilden. Diese interagieren über ihre Phenylringe, welche als leitender Kanal gesehen werden können. Zudem kann ein einzelnes ABP Molekül wie ein Schalter genutzt werden, da es reversibel einzelne DB´s durch Wasserstoffübertragung passivieren und depassivieren kann. Im letzten Teil dieser Arbeit wird das neue Tieftemperatur Vier-Sonden RTM, welches sich in CEMES-CNRS in Toulouse befindet, getestet. Diese Maschine ist für die Herstellung und Untersuchung von Geräten im molekularem Maßstab konstruiert worden. Zu diesem Zweck ist eine atomare Präzision für die verschiedenen Spitzen zur gleichen Zeit erforderlich und eine hohe Stabilität des Rastersondenmikroskops muss gewährleistet sein. Ich führe ein Manipulationsversuch an Molekülen durch, um die notwendige submolekulare Präzision zu testen. Dafür werden supramolekulare Anordnungen von ABP-Molekülen auf Au(111) abgebildet und die Strukturen mit jeder der vier Spitzen im lateralen Manipulationsmodus und durch Spannungpulse bewegt. Damit habe ich die Stabilität des Systems getestet und konnte zeigen, dass alle Spitzen des Systems unabhängig voneinander parallel arbeiten.:1 Introduction 2 Fundamentals of scanning tunneling microscopy 2.1 The working principle 2.2 Scanning tunneling spectroscopy 2.3 Manipulation modes 2.4 Modeling 3 Experimental setup, materials and methods 3.1 The scanning tunneling microscope 3.2 The Au(111) surface 3.3 Further experimental details 4 On-surface synthesis of molecules 4.1 Introduction 4.2 Generation of a periacene 4.3 Investigating a non-alternant PAH 4.4 Conclusion 5 The passivated silicon surface 5.1 Introduction 5.2 Preparation of passivated silicon 5.3 Characterization of Si(001)-(2x1):H 5.4 Tip-induced formation of dangling bonds 5.5 Conclusion 6 Organic molecules on passivated silicon 6.1 Introduction 6.2 Hexacene generated on passivated silicon 6.3 Acetylbiphenyl on passivated silicon 6.4 Conclusion 7 Testing a low temperature four-probe STM 7.1 Introduction 7.2 The four-probe STM 7.3 Performance test of the four-probe STM on Au(111) 7.4 Manipulation of ABP assemblies 7.5 Conclusion 8 Summary and outlook 9 Appendix 9.1 Dibromo-dimethyl-naphtalene on Au(111) 9.2 Epiminotetracene on Au(111) Bibliography Curriculum vitae Scientific contributions Acknowledgement Statement of authorshi

Extrapulmonary manifestations of severe respiratory syncytial virus infection – a systematic review

INTRODUCTION: Respiratory syncytial virus (RSV) bronchiolitis is the most important cause for admission to the paediatric intensive care unit in infants with lower respiratory tract infection. In recent years the importance of extrapulmonary manifestations of RSV infection has become evident. This systematic review aimed at summarizing the available evidence on manifestations of RSV infection outside the respiratory tract, their causes and the changes in clinical management required. METHODS: Databases searched were Medline (1950 to present), EMBASE (1974 to present), PubMed and reference lists of relevant articles. Summarized were the findings of articles reporting on manifestations of RSV infection outside the respiratory tract in patients of all age groups. RESULTS: Extrapulmonary manifestations reported in previous observational studies included cardiovascular failure with hypotension and inotrope requirements associated with myocardial damage as evident from elevated cardiac troponin levels (35–54% of ventilated infants), cardiac arrhythmias like supraventricular tachycardias and ventricular tachycardias, central apnoeas (16–21% of admissions), focal and generalized seizures, focal neurological abnormalities, hyponatraemia (33%) associated with increased antidiuretic hormone secretion, and hepatitis (46–49% of ventilated infants). RSV or its genetic material have been isolated from cerebrospinal fluid, myocardium, liver and peripheral blood. CONCLUSION: The data summarized indicate a systemic dissemination of RSV during severe disease. Cerebral and myocardial involvement may explain the association of RSV with some cases of sudden infant death. In infants with severe RSV infection cardiac rhythm, blood pressure and serum sodium need to be monitored and supportive treatment including fluid management adjusted accordingly

Changes in ion transport in inflammatory disease

Ion transport is essential for maintenance of transmembranous and transcellular electric potential, fluid transport and cellular volume. Disturbance of ion transport has been associated with cellular dysfunction, intra and extracellular edema and abnormalities of epithelial surface liquid volume. There is increasing evidence that conditions characterized by an intense local or systemic inflammatory response are associated with abnormal ion transport. This abnormal ion transport has been involved in the pathogenesis of conditions like hypovolemia due to fluid losses, hyponatremia and hypokalemia in diarrhoeal diseases, electrolyte abnormalites in pyelonephritis of early infancy, septicemia induced pulmonary edema, and in hypersecretion and edema induced by inflammatory reactions of the mucosa of the upper respiratory tract. Components of membranous ion transport systems, which have been shown to undergo a change in function during an inflammatory response include the sodium potassium ATPase, the epithelial sodium channel, the Cystic Fibrosis Transmembrane Conductance Regulator and calcium activated chloride channels and the sodium potassium chloride co-transporter. Inflammatory mediators, which influence ion transport are tumor necrosis factor, gamma interferon, interleukins, transforming growth factor, leukotrienes and bradykinin. They trigger the release of specific messengers like prostaglandins, nitric oxide and histamine which alter ion transport system function through specific receptors, intracellular second messengers and protein kinases. This review summarizes data on in vivo measurements of changes in ion transport in acute inflammatory conditions and in vitro studies, which have explored the underlying mechanisms. Potential interventions directed at a correction of the observed abnormalities are discussed

Immigration in France: How French Perception Affects Muslim Integration

In this paper I examine the process of Muslim immigrants\u27 integration, probing into the negative French perceptions of immigrants and how these perceptions may affect the process of integration and assimilation. I begin with a brief overview of French history as related to Muslim societies and how French culture and policies have evolved to their current state, such as the new strict policy on identity card renewal and the promise to integrate if accepted into the country. Next I deal strictly with immigration in France, including the policies and procedures of the French government and the perceptions of the French population. In addition I examine the perception of North African immigrants in particular, especially North African Muslims, and their sense of security. I close with a section on French identity, how it has evolved and how it has room to continue its evolution. Citations from French sources are translated by myself