How effective are rapid diagnostic tests for Chagas disease?

© 2021 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Diagnosis of chronic Chagas disease relies on the agreement of two conventional serological tests based on distinct antigens. These require cold to preserve reagents and samples, and equipment and trained personnel to run them. Moreover, results turnaround may be delayed for several weeks risking a loss to follow-up of infected subjects, summoning major disadvantages to access diagnosis (and treatment) in many highly endemic areas. Areas covered: Recent studies have shown the versatility of rapid diagnostic tests for the detection of chronic Trypanosoma cruzi infections in referral centers and in field campaigns, with a performance equivalent to that of conventional tools. Remarkably, RDTs do not require cold storage and provide results within an hour. Additionally, they are easy-to-use and can work with a tiny volume of finger-pricked whole blood. Altogether, major advantages toward generalizing their use as an alternative to conventional tests. Expert opinion: Already in 2021, only a small percentage of T. cruzi-infected people are diagnosed and treated. The unsuitability of currently used diagnostics, and of the recommended algorithm, to the conditions found in many regions do not help to fill this gap. RDTs stand as a promising solution, even though geographical validation should precede their implementation

320g Ionization-Heat Cryogenic Detector for Dark Matter Search in the EDELWEISS Experiment

The EDELWEISS experiment used in 2001 a 320g heat-and-ionization cryogenic Ge detector operated in a low-background environment in the Laboratoire Souterrain de Modane for direct WIMP detection. This detector presents an increase of more than 4 times the mass of previous detectors. Calibrations of this detector are used to determine its energy resolution and fiducial volume, and to optimize the detector design for the 1kg phase of the EDELWEISS-I experiment. Analysis of the calibrations and characteristics of a first series of 320g-detectors are presented.Comment: 4 pages, 3 figure

An Updated Portrait of the Portuguese Web

This study presents an updated characterization of the Portuguese Web derived from a crawl of 48 million contents belonging to all media types (2.5 TB of data), performed in March, 2008. The resulting data was analyzed to characterize contents, sites and domains. This study was performed within the scope of the Portuguese Web Archive.POSC/EU, UMI

Evaluation of microvascular changes in the perifoveal vascular network using optical coherence tomography angiography (OCTA) in type I diabetes mellitus: a large scale prospective trial

Background: Diabetic retinopathy (DR) is the leading cause of blindness in type 1 Diabetes Mellitus (DM) patients, as a consequence of impaired blood flow in the retina. Optical coherence tomography angiography (OCTA) is a newly developed, non-invasive, retinal imaging technique that permits adequate delineation of the perifoveal vascular network. It allows the detection of paramacular areas of capillary non perfusion and/or enlargement of the foveal avascular zone (FAZ), representing an excellent tool for assessment of DR. The relationship of these microvascular changes with systemic factors such as metabolic control or duration of the disease still needs to be elucidated. Methods: Prospective, consecutive, large-scale OCTA study. A complete ocular examination including a comprehensive series of OCTA images of different scan sizes captured with 2 OCT devices (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA, and Triton Deep Range Imaging OCT, Topcon Corp, Topcon, Japan) will be obtained as part of the yearly routine follow up visits in type 1 DM patients seen in the Diabetes Unit of the Endocrinology department which give written informed consent to participate in the project. The aim of this study is to investigate the relationship between OCTA-derived parameters and systemic factors, as metabolic control (Hb1Ac, lipid profile, cholesterol, etc), and other relevant clinical factors as demographics or duration of the disease. Discussion: This study is directed to investigate the relationship between the status of the perifoveal vascular network and systemic markers of the disease, and in particular to study whether these changes reflect those occurring elsewhere in the body affected by diabetic microvascular disease, as the kidneys or the brain. If these relationships were demonstrated, early detection of these microvascular changes by OCTA could lead to modifications in the pharmacological management of type 1 diabetic patients, as a way to reduce the risk of future complications in both the eye and other organs

The EDELWEISS Experiment : Status and Outlook

The EDELWEISS Dark Matter search uses low-temperature Ge detectors with heat and ionisation read- out to identify nuclear recoils induced by elastic collisions with WIMPs from the galactic halo. Results from the operation of 70 g and 320 g Ge detectors in the low-background environment of the Modane Underground Laboratory (LSM) are presented.Comment: International Conference on Dark Matter in Astro and Particle Physics (Dark 2000), Heidelberg, Germany, 10-16 Jul 2000, v3 minor revision

Results and evaluation of the expansion of a model of comprehensive care for Chagas disease within the National Health System: The Bolivian Chagas network

Background: Most people with chronic Chagas disease do not receive specific care and therefore are undiagnosed and do not receive accurate treatment. This manuscript discusses and evaluates a collaborative strategy to improve access to healthcare for patients with Chagas in Bolivia, a country with the highest prevalence of Chagas in the world. Methods: With the aim of reinforcing the Chagas National Programme, the Bolivian Chagas Platform was born in 2009. The first stage of the project was to implement a vertical pilot program in order to introduce and consolidate a consensual protocol-based healthcare, working in seven centers (Chagas Platform Centers). From 2015 on the model was extended to 52 primary healthcare centers, through decentralized, horizontal scaling-up. To evaluate the strategy, we have used the WHO ExpandNet program. Results: The strategy has significantly increased the number of patients cared for, with 181,397 people at risk of having T. cruzi infection tested and 57,871 (31·9%) new diagnostics performed. In those with treatment criteria, 79·2% completed the treatment. The program has also trained a significant number of health personnel through the specific Chagas guidelines (67% of healthcare workers in the intervention area). Conclusions: After being recognized by the Chagas National Programme as a healthcare model aligned with national laws and priorities, the Bolivian platform of Chagas as an innovation, includes attributes that they have made it possible to expand the strategy at the national level and could also be adapted in other countries

Final results of the EDELWEISS-II WIMP search using a 4-kg array of cryogenic germanium detectors with interleaved electrodes

The EDELWEISS-II collaboration has completed a direct search for WIMP dark matter with an array of ten 400-g cryogenic germanium detectors in operation at the Laboratoire Souterrain de Modane. The combined use of thermal phonon sensors and charge collection electrodes with an interleaved geometry enables the efficient rejection of gamma-induced radioactivity as well as near-surface interactions. A total effective exposure of 384 kg.d has been achieved, mostly coming from fourteen months of continuous operation. Five nuclear recoil candidates are observed above 20 keV, while the estimated background is 3.0 events. The result is interpreted in terms of limits on the cross-section of spin-independent interactions of WIMPs and nucleons. A cross-section of 4.4x10^-8 pb is excluded at 90%CL for a WIMP mass of 85 GeV. New constraints are also set on models where the WIMP-nucleon scattering is inelastic.Comment: 23 pages, 5 figures; matches published versio

Background studies for the EDELWEISS dark matter experiment

The EDELWEISS-II collaboration has completed a direct search for WIMP dark matter using cryogenic Ge detectors (400 g each) and 384 kg$\times$days of effective exposure. A cross-section of $4.4 \times 10^{-8}$ pb is excluded at 90% C.L. for a WIMP mass of 85 GeV. The next phase, EDELWEISS-III, aims to probe spin-independent WIMP-nucleon cross-sections down to a few $\times10^{-9}$ pb. We present here the study of gamma and neutron background coming from radioactive decays in the set-up and shielding materials. We have carried out Monte Carlo simulations for the completed EDELWEISS-II setup with GEANT4 and normalised the expected background rates to the measured radioactivity levels (or their upper limits) of all materials and components. The expected gamma-ray event rate in EDELWEISS-II at 20-200 keV agrees with the observed rate of 82 events/kg/day within the uncertainties in the measured concentrations. The calculated neutron rate from radioactivity of 1.0-3.1 events (90% C.L.) at 20-200 keV in the EDELWEISS-II data together with the expected upper limit on the misidentified gamma-ray events ($\le0.9$), surface betas ($\le0.3$), and muon-induced neutrons ($\le0.7$), do not contradict 5 observed events in nuclear recoil band. We have then extended the simulation framework to the EDELWEISS-III configuration with 800 g crystals, better material purity and additional neutron shielding inside the cryostat. The gamma-ray and neutron backgrounds in 24 kg fiducial mass of EDELWEISS-III have been calculated as 14-44 events/kg/day and 0.7-1.4 events per year, respectively. The results of the background studies performed in the present work have helped to select better purity components and improve shielding in EDELWEISS-III to further reduce the expected rate of background events in the next phase of the experiment.Comment: 15 pages, 9 figures, to be published in Astroparticle Physic