EPIDEMIOLOGY OF TUBERCULOSIS IN INTERNATIONALLY DISPLACED CHILDREN RESETTLING IN HARRIS COUNTY

Background More than 300,000 refugees arrived in the United States (U.S.) from 2010-2015, and Texas accepts the 2nd highest number of refugees. Texas also accepts large numbers of asylees, parolees, and special immigrant visa holders. Additionally, a large proportion of trafficked persons in the U.S. live in or pass through Texas. Foreign-born children are disproportionately affected by tuberculosis (TB) and account for two-thirds of U.S. childhood TB cases. Children are at greater risk for progression from TB infection to disease and experience greater morbidity and mortality from TB disease. This makes screening for and treatment of TB infection in children from high-prevalence areas an important public health intervention. Since 2007, children 2-14 years old emigrating from high-prevalence countries (TB incidence \u3e20 cases /100,000 persons) have been tested for TB infection. Children ≥15 years old are additionally screened with a chest radiograph. The Centers for Disease Control and Prevention (CDC) recommends treatment of children with TB infection, as treatment reduces the risk of life threatening disease and prevents future transmission. There are few studies describing the epidemiology of TB in internationally displaced children relocating to the U.S.; there have been no studies centered on Texas. We describe the secular trends and comparative epidemiology of positive TSTs and IGRAs in children of different immigration statuses cared for through the Houston-area public health program. Methods This was a retrospective cross-sectional study of children \u3c18 years-old evaluated by the Harris County Public Health Refugee Health Screening Program between January 1st, 2010 and December 31st, 2015 with the following immigration statuses: refugee, asylee, parolee, special immigrant visa holder, or victim of human trafficking. We analyzed factors associated with TB test positivity, infection and disease for children with these immigration statuses. Data are from the U.S. Committee for Refugees and Immigrants (USCRI), the Harris County Public Health Refugee Health Screening Program, and the Texas Children\u27s Hospital TB clinic. Chi-square test or Fisher’s exact test were used for dichotomous variables, one-way ANOVAs for univariate analyses, and Wilcoxon rank sum or Kruskal-Wallis for continuous variables. Multivariate logistic regression was performed to further analyze factors associated with TB test positivity. To assess secular trends in usage and positivity, monthly totals were analyzed using linear regression and the Wilcoxon Sign Rank test. A p-value \u3c0.05 was considered significant. Children \u3c 5 years were typically tested using tuberculin skin test (TSTs) and older children typically using interferon-gamma release assays (IGRAs). The primary outcome was a positive test of TB infection (TST and/or IGRA). Children who were TST+/IGRA- with no known contacts, a normal chest radiograph and no signs or symptoms consistent with TB disease were typically considered uninfected. However, there were some children who met these criteria who were considered to have TB infection and were treated as such –this typically occurred earlier in the study period, and was most commonly due to young age (\u3c 2 years old) or some variability in provider practice. Results The program evaluated 5,990 children, of whom 5870 (98%) were tested, predominantly (64%) with an IGRA alone. During the study period, IGRA use increased (p\u3c0.001), though percentages of positive test results (IGRA or TST) did not decline significantly (p=0.10). Overall, 364 (6.2%) children had at least one positive test of infection: 143/1,842 (7.8%) tested with TST alone, 129/3,730 (63.6%) tested with IGRA alone, and 92/298 (30.9%) had at least one positive test result for those tested with both TST and IGRA. Among the 364 children with any positive test of infection, 4 (1.1%) were diagnosed with TB disease, 325 (89.3%) were diagnosed with TB infection, and 35 (9.6%) were considered uninfected. Three factors were significantly associated with a positive TST or IGRA result: region of origin, younger age group, and HIV infection. All children were more likely to have a positive TST compared to IGRA (OR 2.92, 95% CI: 2.37-3.59). Discordant test results were common (20%) and most often were TST+/IGRA- (95.0%). 35/57 (61.4%) of children who were TST+/IGRA- were considered uninfected and did not receive therapy for TB infection; none developed TB disease. The 22/57 (38.6%) TST+/IGRA- children who were treated for TB infection, were treated as such typically due to young age (\u3c 2 years old) or variability in provider practice. Conclusions Positive TST results were twice as common as positive IGRA results and discordant TST/IGRA results were common. Positive TST results in BCG-immunized children frequently represent cross-reactivity and false positivity. Use of IGRAs as opposed to TSTs in BCG-immunized children would reduce false positive tests and allow for TB infection therapy to be targeted to those who would most benefit. These findings support 2018 changes in U.S. immigration guidelines that mandate IGRA use for recently immigrated children above 2 years of age

Automatic best wireless network selection based on key performance indicators

Introducing cognitive mechanisms at the application layer may lead to the possibility of an automatic selection of the wireless network that can guarantee best perceived experience by the final user. This chapter investigates this approach based on the concept of Quality of Experience (QoE), by introducing the use of application layer parameters, namely Key Performance Indicators (KPIs). KPIs are defined for different traffic types based on experimental data. A model for an ap- plication layer cognitive engine is presented, whose goal is to identify and select, based on KPIs, the best wireless network among available ones. An experimenta- tion for the VoIP case, that foresees the use of the One-way end-to-end delay (OED) and the Mean Opinion Score (MOS) as KPIs is presented. This first implementation of the cognitive engine selects the network that, in that specific instant, offers the best QoE based on real captured data. To our knowledge, this is the first example of a cognitive engine that achieves best QoE in a context of heterogeneous wireless networks

EFEKTIFITAS KAMPANYE PEMILIHAN PRESIDEN DAN WAKIL PRESIDEN 2019 DI KELURAHAN KAWANGKOAN BAWAH

Penelitian ini mengkaji apakah kampanye dapat mempengaruhi pilihan masyarakat pada pemilihan Presiden dan Wakil Presiden tahun 2019 di Kelurahan Kawangkoan Bawah. Dengan menggunakan metode kualitatif (Sugiyono, 2015), dan pendekatan yang dikemukakan oleh Nimmo (2011) tentang media kampanye. Temuan penelitian menggambarkan bahwa factor-faktor yang mempengaruhi pilihan masyarakat pada saat pemilihan Presiden dan Wakil Presiden tahun 2019, khususnya di Kelurahan Kawangkoan Bawah, yaitu adanya politik uang, sehingga para oknum tim sukses masih mengandalkan politik uang atau suap ke masyarakat jelang hari pencoblosan untuk menarik simpati masyarakat. Selain itu kampanye melalui social media atau menggunakan sosial media facebook, cukup efektif memberikan informasi ke masyrakat tentang pemilu dan juga cukup cepat menarik simpati masyarakat. Kata Kunci: Efektifitas; Kampanye  ABSTRACTThis study examines whether the campaign can influence people's choices in the 2019 presidential and vice presidential elections in Kawangkoan Bawah Village. By using qualitative methods (Sugiyono, 2015), and the approach proposed by Nimmo (2011) about campaign media. The research findings illustrate that the factors that influence people's choices during the 2019 Presidential and Vice Presidential elections, especially in the Kawangkoan Bawah Village, namely the existence of money politics, so that the elements of the successful team still rely on money politics or bribes to the public ahead of voting day to attract public sympathy. In addition, campaigns through social media or using social media Facebook, are quite effective in providing information to the public about elections and also quickly attracting public sympathy. Keywords: Effectiveness; Campaig

When Life Gives You Lemonade, Hold Onto It

A piece of flash fiction about spilled lemonade on a horrible day

On the 2-categories of weak distributive laws

A weak mixed distributive law (also called weak entwining structure) in a 2-category consists of a monad and a comonad, together with a 2-cell relating them in a way which generalizes a mixed distributive law due to Beck. We show that a weak mixed distributive law can be described as a compatible pair of a monad and a comonad, in 2-categories extending, respectively, the 2-category of comonads and the 2-category of monads. Based on this observation, we define a 2-category whose 0-cells are weak mixed distributive laws. In a 2-category K which admits Eilenberg-Moore constructions both for monads and comonads, and in which idempotent 2-cells split, we construct a fully faithful 2-functor from this 2-category of weak mixed distributive laws to K^{2 x 2}.Comment: 15 pages LaTeX source, final version to appear in Comm. Algebr

Mitochondria and neuroprotection in stroke: Cationic arginine-rich peptides (CARPs) as a novel class of mitochondria-targeted neuroprotective therapeutics

Stroke is the second leading cause of death globally and represents a major cause of devastating long-term disability. Despite sustained efforts to develop clinically effective neuroprotective therapies, presently there is no clinically available neuroprotective agent for stroke. As a central mediator of neurodamaging events in stroke, mitochondria are recognised as a critical neuroprotective target, and as such, provide a focus for developing mitochondrial-targeted therapeutics. In recent years, cationic arginine-rich peptides (CARPs) have been identified as a novel class of neuroprotective agent with several demonstrated mechanisms of action, including their ability to target mitochondria and exert positive effects on the organelle. This review provides an overview on neuronal mitochondrial dysfunction in ischaemic stroke pathophysiology and highlights the potential beneficial effects of CARPs on mitochondria in the ischaemic brain following stroke

Proteomic analysis of cortical neuronal cultures treated with poly-arginine peptide-18 (R18) and exposed to glutamic acid excitotoxicity

Poly-arginine peptide-18 (R18) has recently emerged as a highly effective neuroprotective agent in experimental stroke models, and is particularly efficacious in protecting cortical neurons against glutamic acid excitotoxicity. While we have previously demonstrated that R18 can reduce excitotoxicity-induced neuronal calcium influx, other molecular events associated with R18 neuroprotection are yet to investigated. Therefore, in this study we were particularly interested in protein expression changes in R18 treated neurons subjected to excitotoxicity. Proteomic analysis was used to compare protein expression patterns in primary cortical neuronal cultures subjected to: (i) R18-treatment alone (R18); (ii) glutamic acid excitotoxic injury (Glut); (iii) R18-treatment and glutamic acid injury (R18 + Glut); (iv) no treatment (Cont). Whole cell lysates were harvested 24 h post-injury and subjected to quantitative proteomic analysis (iTRAQ), coupled with liquid chromatography-tandem mass spectrometry (LC-MS/ MS) and subsequent bioinformatic analysis of differentially expressed proteins (DEPs). Relative to control cultures, R18, Glut, and R18 + Glut treatment resulted in the detection of 5, 95 and 14 DEPs respectively. Compared to Glut alone, R18 + Glut revealed 98 DEPs, including 73 proteins whose expression was also altered by treatment with Glut and/or R18 alone, as well as 25 other uniquely regulated proteins. R18 treatment reversed the up- or down-regulation of all 73 Glut-associated DEPs, which included proteins involved in mitochondrial integrity, ATP generation, mRNA processing and protein translation. Analysis of protein-protein interactions of the 73 DEPs showed they were primarily associated with mitochondrial respiration, proteasome activity and protein synthesis, transmembrane trafficking, axonal growth and neuronal differentiation, and carbohydrate metabolism. Identified protein pathways associated with proteostasis and energy metabolism, and with pathways involved in neurodegeneration. Collectively, the findings indicate that R18 neuroprotection following excitotoxicity is associated with preservation of neuronal protein profiles, and differential protein expression that assists in maintaining mitochondrial function and energy production, protein homeostasis, and membrane trafficking

Fundamental Limits of Low-Density Spreading NOMA with Fading

Spectral efficiency of low-density spreading non-orthogonal multiple access channels in the presence of fading is derived for linear detection with independent decoding as well as optimum decoding. The large system limit, where both the number of users and number of signal dimensions grow with fixed ratio, called load, is considered. In the case of optimum decoding, it is found that low-density spreading underperforms dense spreading for all loads. Conversely, linear detection is characterized by different behaviors in the underloaded vs. overloaded regimes. In particular, it is shown that spectral efficiency changes smoothly as load increases. However, in the overloaded regime, the spectral efficiency of low- density spreading is higher than that of dense spreading

Molecular dissection of Phaseolus vulgaris polygalacturonase-inhibiting protein 2 reveals the presence of hold/release domains affecting protein trafficking toward the cell wall

The plant endomembrane system is massively involved in the synthesis, transport and secretion of cell wall polysaccharides and proteins; however, the molecular mechanisms underlying trafficking toward the apoplast are largely unknown. Besides constitutive, the existence of a regulated secretory pathway has been proposed. A polygalacturonase inhibitor protein (PGIP2), known to move as soluble cargo and reach the cell wall through a mechanism distinguishable from default, was dissected in its main functional domains (A, B, C, D), and C sub-fragments (C1–10), to identify signals essential for its regulated targeting. The secretion patterns of the fluorescent chimeras obtained by fusing different PGIP2 domains to the green fluorescent protein (GFP) were analyzed. PGIP2 N-terminal and leucine-rich repeat domains (B and C, respectively) seem to operate as holding/releasing signals, respectively, during PGIP2 transit through the Golgi. The B domain slows down PGIP2 secretion by transiently interacting with Golgi membranes. Its depletion leads, in fact, to the secretion via default (Sp2-susceptible) of the ACD-GFP chimera faster than PGIP2. Depending on its length (at least the first 5 leucine-rich repeats are required), the C domain modulates B interaction with Golgi membranes allowing the release of chimeras and their extracellular secretion through a Sp2 independent pathway. The addition of the vacuolar sorting determinant Chi to PGIP2 diverts the path of the protein from cell wall to vacuole, suggesting that C domain is a releasing rather than a cell wall sorting signal