Reducing the Number of Sputum Samples Examined and Thresholds for Positivity: An Opportunity to Optimise Smear Microscopy.

SETTING: Urban health clinic, Nairobi. OBJECTIVE: To evaluate the impact on tuberculosis (TB) case detection and laboratory workload of reducing the number of sputum smears examined and thresholds for diagnosing positive smears and positive cases. DESIGN: In this prospective study, three Ziehl-Neelsen stained sputum smears from consecutive pulmonary TB suspects were examined blind. The standard approach (A), > or = 2 positive smears out of 3, using a cut-off of 10 acid-fast bacilli (AFB)/100 high-power fields (HPF), was compared with approaches B, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3, one of which is > or = 10 AFB/100 HPF; C, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3; D, > or = 1 positive smear (> or = 10 AFB/100 HPF) out of 2; and E, > or = 1 positive smear (> or = 4 AFB/100 HPF) out of 2. The microscopy gold standard was detection of at least one positive smear (> or = 4 AFB/100 HPF) out of 3. RESULTS: Among 644 TB suspects, the alternative approaches detected from 114 (17.7%) (approach B) to 123 cases (19.1%) (approach E) compared to 105 cases (16.3%) for approach A (P < 0.005). Sensitivity ranged between 82.0% (105/128) for A and 96.1% (123/128) for E. The single positive smear approaches reduced the number of smears by 36% compared to approach A. CONCLUSION: Reducing the number of specimens and the positivity threshold to define a positive case increased the sensitivity of microscopy and reduced laboratory workload

A Large Outbreak of Hepatitis E Among a Displaced Population in Darfur, Sudan, 2004: The Role of Water Treatment Methods.

BACKGROUND: The conflict in Darfur, Sudan, was responsible for the displacement of 1.8 million civilians. We investigated a large outbreak of hepatitis E virus (HEV) infection in Mornay camp (78,800 inhabitants) in western Darfur. METHODS: To describe the outbreak, we used clinical and demographic information from cases recorded at the camp between 26 July and 31 December 2004. We conducted a case-cohort study and a retrospective cohort study to identify risk factors for clinical and asymptomatic hepatitis E, respectively. We collected stool and serum samples from animals and performed a bacteriological analysis of water samples. Human samples were tested for immunoglobulin G and immunoglobulin M antibody to HEV (for serum samples) and for amplification of the HEV genome (for serum and stool samples). RESULTS: In 6 months, 2621 hepatitis E cases were recorded (attack rate, 3.3%), with a case-fatality rate of 1.7% (45 deaths, 19 of which involved were pregnant women). Risk factors for clinical HEV infection included age of 15-45 years (odds ratio, 2.13; 95% confidence interval, 1.02-4.46) and drinking chlorinated surface water (odds ratio, 2.49; 95% confidence interval, 1.22-5.08). Both factors were also suggestive of increased risk for asymptomatic HEV infection, although this was not found to be statistically significant. HEV RNA was positively identified in serum samples obtained from 2 donkeys. No bacteria were identified from any sample of chlorinated water tested. CONCLUSIONS: Current recommendations to ensure a safe water supply may have been insufficient to inactivate HEV and control this epidemic. This research highlights the need to evaluate current water treatment methods and to identify alternative solutions adapted to complex emergencies

A Look Back at an Ongoing Problem: Shigella dysenteriae Type 1 Epidemics in Refugee Settings in Central Africa (1993–1995)

BACKGROUND: Shigella dysenteriae type 1 (Sd1) is a cause of major dysentery outbreaks, particularly among children and displaced populations in tropical countries. Although outbreaks continue, the characteristics of such outbreaks have rarely been documented. Here, we describe the Sd1 outbreaks occurring between 1993 and 1995 in 11 refugee settlements in Rwanda, Tanzania and Democratic Republic of the Congo (DRC). We also explored the links between the different types of the camps and the magnitude of the outbreaks. METHODOLOGY/PRINCIPAL FINDINGS: Number of cases of bloody diarrhea and deaths were collected on a weekly basis in 11 refugee camps, and analyzed retrospectively. Between November 1993 and February 1995, 181,921 cases of bloody diarrhea were reported. Attack rates ranged from 6.3% to 39.1% and case fatality ratios (CFRs) from 1.5% to 9.0% (available for 5 camps). The CFRs were higher in children under age 5. In Tanzania where the response was rapidly deployed, the mean attack rate was lower than in camps in the region of Goma without an immediate response (13.3% versus 32.1% respectively). CONCLUSIONS/SIGNIFICANCE: This description, and the areas where data is missing, highlight both the importance of collecting data in future epidemics, difficulties in documenting outbreaks occurring in complex emergencies and most importantly, the need to assure that minimal requirements are met

Near-infrared luminescent and magnetic cyano-bridged coordination polymers Nd(phen)(n)(DMF)(m)[M(CN)(8)] (M = Mo, W)

New cyano-bridged coordination polymers [Nd(phen)(2)(DMF)(2)(H(2)O)Mo(CN)(8)] center dot 2H(2)O (1) and [Nd(phen)(DMF)(5)M(CN)(8)] center dot xH(2)O [M = Mo (2), W (3); phen = 1,10-phenanthroline] have one-dimensional structures with variable number of phenanthroline ligands. Compounds exhibit photoluminescence in the near-infrared region and ferromagnetic Nd(3+)-M(5+) interactions

Phase behavior and material properties of hollow nanoparticles

Effective pair potentials for hollow nanoparticles like the ones made from carbon (fullerenes) or metal dichalcogenides (inorganic fullerenes) consist of a hard core repulsion and a deep, but short-ranged, van der Waals attraction. We investigate them for single- and multi-walled nanoparticles and show that in both cases, in the limit of large radii the interaction range scales inversely with the radius, $R$, while the well depth scales linearly with $R$. We predict the values of the radius $R$ and the wall thickness $h$ at which the gas-liquid coexistence disappears from the phase diagram. We also discuss unusual material properties of the solid, which include a large heat of sublimation and a small surface energy.Comment: Revtex, 13 pages with 8 Postscript files included, submitted to Phys. Rev.

Electromagnetic energy penetration in the self-induced transparency regime of relativistic laser-plasma interactions

Two scenarios for the penetration of relativistically intense laser radiation into an overdense plasma, accessible by self-induced transparency, are presented. For supercritical densities less than 1.5 times the critical one, penetration of laser energy occurs by soliton-like structures moving into the plasma. At higher background densities laser light penetrates over a finite length only, that increases with the incident intensity. In this regime plasma-field structures represent alternating electron layers separated by about half a wavelength by depleted regions.Comment: 9 pages, 4 figures, submitted for publication to PR

Structure formation in active networks

Structure formation and constant reorganization of the actin cytoskeleton are key requirements for the function of living cells. Here we show that a minimal reconstituted system consisting of actin filaments, crosslinking molecules and molecular-motor filaments exhibits a generic mechanism of structure formation, characterized by a broad distribution of cluster sizes. We demonstrate that the growth of the structures depends on the intricate balance between crosslinker-induced stabilization and simultaneous destabilization by molecular motors, a mechanism analogous to nucleation and growth in passive systems. We also show that the intricate interplay between force generation, coarsening and connectivity is responsible for the highly dynamic process of structure formation in this heterogeneous active gel, and that these competing mechanisms result in anomalous transport, reminiscent of intracellular dynamics

An operator representation for Matsubara sums

In the context of the imaginary-time formalism for a scalar thermal field theory, it is shown that the result of performing the sums over Matsubara frequencies associated with loop Feynman diagrams can be written, for some classes of diagrams, in terms of the action of a simple linear operator on the corresponding energy integrals of the Euclidean theory at T=0. In its simplest form the referred operator depends only on the number of internal propagators of the graph. More precisely, it is shown explicitly that this \emph{thermal operator representation} holds for two generic classes of diagrams, namely, the two-vertex diagram with an arbitrary number of internal propagators, and the one-loop diagram with an arbitrary number of vertices. The validity of the thermal operator representation for diagrams of more complicated topologies remains an open problem. Its correctness is shown to be equivalent to the correctness of some diagrammatic rules proposed a few years ago.Comment: 4 figures; references added, minor changes in notation, final version accepted for publicatio

Radiative rotational lifetimes and state-resolved relative detachment cross sections from photodetachment thermometry of molecular anions in a cryogenic storage ring

Photodetachment thermometry on a beam of OH$^-$ in a cryogenic storage ring cooled to below 10 K is carried out using two-dimensional, frequency and time dependent photodetachment spectroscopy over 20 minutes of ion storage. In equilibrium with the low-level blackbody field, we find an effective radiative temperature near 15 K with about 90% of all ions in the rotational ground state. We measure the J = 1 natural lifetime (about 193 s) and determine the OH$^-$ rotational transition dipole moment with 1.5% uncertainty. We also measure rotationally dependent relative near-threshold photodetachment cross sections for photodetachment thermometry.Comment: Manuscript LaTeX with 5 pages, 3 figures, and 1 table plus LaTeX supplement with 12 pages, 3 figures and 3 tables. This article has been accepted by Physical Review Letter

Who I Am: The Meaning of Early Adolescents’ Most Valued Activities and Relationships, and Implications for Self-Concept Research

Self-concept research in early adolescence typically measures young people’s self-perceptions of competence in specific, adult-defined domains. However, studies have rarely explored young people’s own views of valued self-concept factors and their meanings. For two major self domains, the active and the social self, this mixed-methods study identified factors valued most by 526 young people from socioeconomically diverse backgrounds in Ireland (10-12 years), and explored the meanings associated with these in a stratified subsample (n = 99). Findings indicate that self-concept scales for early adolescence omit active and social self factors and meanings valued by young people, raising questions about content validity of scales in these domains. Findings also suggest scales may under-represent girls’ active and social selves; focus too much on some school-based competencies; and, in omitting intrinsically salient self domains and meanings, may focus more on contingent (extrinsic) rather than true (intrinsic) self-esteem