Screening for latent tuberculosis infection among undocumented immigrants in Swiss healthcare centres; a descriptive exploratory study

BACKGROUND: Migration is one of the major causes of tuberculosis in developed countries. Undocumented patients are usually not screened at the border and are not covered by a health insurance increasing their risk of developing the disease unnoticed. Urban health centres could help identify this population at risk. The objective of this study is to assess the prevalence of latent tuberculosis infection (LTBI) and adherence to preventive treatment in a population of undocumented immigrant patients. METHODS: All consecutive undocumented patients that visited two urban healthcare centres for vulnerable populations in Lausanne, Switzerland for the first time were offered tuberculosis screening with an interferon-gamma assay. Preventive treatment was offered if indicated. Adherence to treatment was evaluated monthly over a nine month period. RESULTS: Of the 161 participants, 131 (81.4%) agreed to screening and 125 had complete examinations. Twenty-four of the 125 patients (19.2%; CI95% 12.7;27.2) had positive interferon-gamma assay results, two of which had active tuberculosis. Only five patients with LTBI completed full preventive treatments. Five others initiated the treatment but did not follow through. CONCLUSION: Screening for tuberculosis infection in this hard-to-reach population is feasible in dedicated urban clinics, and the prevalence of LTBI is high in this vulnerable population. However, the low adherence to treatment is an important public health concern, and new strategies are needed to address this problem

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

The Isothermal Oxidation of High-Purity Aluminum at High Temperature

The isothermal oxidation in air of high purity aluminum sheet was studied as a function of temperature using Thermogravimetric Analysis simultaneously with Differential Scanning Calorimetry (TGA/DSC). The rates and extents of oxidation were found to be non-linear functions of the temperature, in agreement with the literature. Between 650 °C and 750 °C very little oxidation took place; at 850 °C oxidation occurred after an induction period, while at 950 °C oxidation occurred without an induction period. At oxidation temperatures between 1050 °C and 1150 °C rapid passivation of the surface of the aluminum occurred, while at 1250 °C and above, an initial rapid mass increase was observed, followed by a more gradual increase in mass. The initial rapid increase in mass was accompanied by a significant exotherm, which was quantified by DSC. At temperatures of 1050 °C and above the specimen coalesced into a spheroidal particle, whereas at lower temperatures the original morphology was retained due to the cohesive strength of the native oxide layer. Cross-sections of oxidized specimens were characterized by scanning electron microscopy (SEM); the observed alumina skin thicknesses correlated qualitatively with the observed mass increases. Interrogation of the surface of an oxidized spheroidal particle by SEM showed a fractured alumina shell around a partially hollow core of aluminum which appeared to have grain boundaries

Crude Oil Pyrolysis Studies: Application to In Situ Superheat Steam Enhanced Oil Recovery

This work focuses on the occurrence and composition of flammable pyrolysis gases which can be expected from stimulation of heavy oil with superheat steam. These gases can have commodity value or be used to fire a conventional boiler to generate steam vapor for superheater feed. Seven oil samples taken from different US locations were tested via thermogravimetric analysis (TGA) with off-gas analysis of light hydrocarbons via mass spectrometry (MS). The samples were heated up to 500 °C at 5 °C/min in a gas flow of moist carbon dioxide and held at 500 °C until no further mass loss was noted. Then, carbonaceous residue was exposed to air at 500 °C to determine enthalpy of combustion by differential scanning calorimetry (DSC). To demonstrate that pyrolysis was indeed occurring and not simple de-volatilization, a high-molecular-weight reagent-grade organic molecule, lactose, was first demonstrated to produce components of interest. After treatment under moist CO2 at 500 °C, all samples were found to lose around 90% of mass, and the follow-up combustion process with air further reduced the residual mass to between 2% and 12%, which is presumed to be mineral matter and char. The light hydrocarbons methane, ethane, and propane, as well as hydrogen, were detected through MS during pyrolysis of each oil sample. Heavier hydrocarbons were not monitored but are assumed to have evolved, especially during periods where additional mass loss was occurring in the isothermal process, with minimal light hydrocarbon evolution. These results correspond to a possible concept of subsequent in situ combustion drive with or without heat scavenging following high-temperature pyrolysis from in situ superheat steam injection

Pyrolysis of Oils from Unconventional Resources

In this study, oils from various sources were subjected to pyrolysis conditions; that is, without oxidizer, as the samples were heated to 500 °C, and held at that temperature. The oils studied included: (1) heavy oil from Grassy Creek, Missouri; (2) oil from tar sands of Asphalt Ridge in Utah; (3) mid-continent oil shales of three formations (two of Chattanooga formation, Pennsylvanian (age) formation, and Woodford formation); and (4) a Colorado Piceance Basin shale. Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) with either gas chromatography (GC) or mass spectrometry (MS) were used to quantify the produced gases evolved in the tests. Purge gases of helium, argon, and humid carbon dioxide were utilized. Larger scale pyrolysis tests were conducted in a tube furnace coupled to a MS and a GC. The results consistently showed that pyrolysis occurred between 300 °C and 500 °C, with the majority of gases being mainly hydrogen and light alkanes. This behavior was essentially consistent, regardless of the oil source

An Assessment of the Conversion of Biomass and Industrial Waste Products to Activated Carbon

The production of biochar from biomass and industrial wastes provides both environmental and economic sustainability. An effective way to ensure the sustainability of biochar is to produce high value-added activated carbon. The desirable characteristic of activated carbon is its high surface area for efficient adsorption of contaminants. Feedstocks can include a number of locally available materials with little or negative value, such as orchard slash and crop residue. In this context, it is necessary to determine and know the conversion effects of the feedstocks to be used in the production of activated carbon. In the study conducted for this purpose; several samples (piñon wood, pecan wood, hardwood, dried grass, Wyoming coal dust, Illinois coal dust, Missouri coal dust, and tire residue) of biomass and industrial waste products were investigated for their conversion into activated carbon. Small samples (approximately 0.02 g) of the feedstocks were pyrolyzed under inert or mildly oxidizing conditions in a thermal analyzer to determine their mass loss as a function of temperature and atmosphere. Once suitable conditions were established, larger quantities (up to 0.6 g) were pyrolyzed in a tube furnace and harvested for characterization of their surface area and porosity via gas sorption analysis. Among the samples used, piñon wood gave the best results, and pyrolysis temperatures between 600 and 650 °C gave the highest yield. Slow pyrolysis or hydrothermal carbonization have come to the fore as recommended production methods for the conversion of biochar, which can be produced from biomass and industrial wastes, into activated carbon

Formation of a Reversible, Intramolecular Main-Group Metal–CO₂ Adduct

The P,P-chelated stannylene [(<i>i</i>-Pr₂P)₂N]₂Sn takes up 2 equiv of carbon dioxide (CO₂) to form an unusual product in which CO₂ binds to the Sn and P atoms, thus forming a six-membered ring complex. Gentle heating of the solid product releases CO₂, indicating that CO₂ is bound as an adduct to the main-group complex. The groups bound to the CO₂ fragment are not particularly sterically crowded or highly acidic, thus indicating that “frustrated” Lewis acid–base pairs are not required in the binding of CO₂ to main-group elements

Mechanically Encoded Cellular Shapes for Synthesis of Anisotropic Mesoporous Particles

The asymmetry that pervades molecular mechanisms of living systems increasingly informs the aims of synthetic chemistry, particularly in the development of catalysts, particles, nanomaterials, and their assemblies. For particle synthesis, overcoming viscous forces to produce complex, nonspherical shapes is particularly challenging; a problem that is continuously solved in nature when observing dynamic biological entities such as cells. Here we bridge these dynamics to synthetic chemistry and show that the intrinsic asymmetric shapes of erythrocytes can be directed, captured, and translated into composites and inorganic particles using a process of nanoscale silica-bioreplication. We show that crucial aspects in particle design such as particle–particle interactions, pore size, and macromolecular accessibility can be tuned using cellular responses. The durability of resultant particles provides opportunities for shape-preserving transformations into metallic, semiconductive, and ferromagnetic particles and assemblies. The ability to use cellular responses as “structure directing agents” offers an unprecedented toolset to design colloidal-scale materials

Formation of Ba3Nb0.75Mn2.25O9-6H during thermochemical reduction of Ba4NbMn3O12-12R

The resurgence of interest in hydrogen-related technologies has stimulated new studies aimed at advancing lesser-developed water-splitting processes, such as solar thermochemical hydrogen production (STCH). Progress in STCH has been largely hindered by a lack of new materials able to efficiently split water at a rate comparable to ceria under identical experimental conditions. BaCe0.25Mn0.75O3 (BCM) recently demonstrated enhanced hydrogen production over ceria and has the potential to further our understanding of two-step thermochemical cycles. A significant feature of the 12R hexagonal perovskite structure of BCM is the tendency to, in part, form a 6H polytype at high temperatures and reducing environments (i.e., during the first step of the thermochemical cycle), which may serve to mitigate degradation of the complex oxide. An analogous compound, namely BaNb0.25Mn0.75O3 (BNM) with a 12R structure was synthesized and displays nearly complete conversion to the 6H structure under identical reaction conditions as BCM. The structure of the BNM-6H polytype was determined from Rietveld refinement of synchrotron powder X-ray diffraction data and is presented within the context of the previously established BCM-6H structure