Use of low-dose computed tomography to assess pulmonary tuberculosis among healthcare workers in a tuberculosis hospital

BACKGROUND: According to the World Health Organization, China is one of 22 countries with serious tuberculosis (TB) infections and one of the 27 countries with serious multidrug-resistant TB strains. Despite the decline of tuberculosis in the overall population, healthcare workers (HCWs) are still at a high risk of infection. Compared with high-income countries, the TB prevalence among HCWs is higher in low- and middle-income countries. Low-dose computed tomography (LDCT) is becoming more popular due to its superior sensitivity and lower radiation dose. However, there have been no reports about active pulmonary tuberculosis (PTB) among HCWs as assessed with LDCT. The purposes of this study were to examine PTB statuses in HCWs in hospitals specializing in TB treatment and explore the significance of the application of LDCT to these workers. METHODS: This study retrospectively analysed the physical examination data of healthcare workers in the Beijing Chest Hospital from September 2012 to December 2015. Low-dose lung CT examinations were performed in all cases. The comparisons between active and inactive PTB according to the CT findings were made using the Pearson chi-square test or the Fisher’s exact test. Comparisons between the incidences of active PTB in high-risk areas and non-high-risk areas were performed using the Pearson chi-square test. Analyses of active PTB were performed according to different ages, numbers of years on the job, and the risks of the working areas. Active PTB as diagnosed by the LDCT examinations alone was compared with the final comprehensive diagnoses, and the sensitivity and positive predictive value were calculated. RESULTS: A total of 1 012 participants were included in this study. During the 4-year period of medical examinations, active PTB was found in 19 cases, and inactive PTB was found in 109 cases. The prevalence of active PTB in the participants was 1.24%, 0.67%, 0.81%, and 0.53% for years 2012 to 2015. The corresponding incidences of active PTB among the tuberculosis hospital participants were 0.86%, 0.41%, 0.54%, and 0.26%. Most HCWs with active TB (78.9%, 15/19) worked in the high-risk areas of the hospital. There was a significant difference in the incidences of active PTB between the HCWs who worked in the high-risk and non-high-risk areas (odds ratio [OR], 14.415; 95% confidence interval (CI): 4.733 – 43.896). Comparisons of the CT signs between the active and inactive groups via chi-square tests revealed that the tree-in-bud, cavity, fibrous shadow, and calcification signs exhibited significant differences (P = 0.000, 0.021, 0.001, and 0.024, respectively). Tree-in-bud and cavity opacities suggest active pulmonary tuberculosis, whereas fibrous shadow and calcification opacities are the main features of inactive pulmonary tuberculosis. Comparison with the final comprehensive diagnoses revealed that the sensitivity and positive predictive value of the diagnoses of active PTB based on LDCT alone were 100% and 86.4%, respectively. CONCLUSIONS: Healthcare workers in tuberculosis hospitals are a high-risk group for active PTB. Yearly LDCT examinations of such high-risk groups are feasible and necessary. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0274-6) contains supplementary material, which is available to authorized users

Investigation of ultra-thin Al₂O₃ film as Cu diffusion barrier on low-k (k=2.5) dielectrics

Ultrathin Al(2)O(3) films were deposited by PEALD as Cu diffusion barrier on low-k (k=2.5) material. The thermal stability and electrical properties of the Cu/low k system with Al(2)O(3) layers with different thickness were studied after annealing. The AES, TEM and EDX results revealed that the ultrathin Al(2)O(3) films are thermally stable and have excellent Cu diffusion barrier performance. The electrical measurements of dielectric breakdown and TDDB tests further confirmed that the ultrathin Al(2)O(3) film is a potential Cu diffusion barrier in the Cu/low-k interconnects system

Determining layer number of two dimensional flakes of transition-metal dichalcogenides by the Raman intensity from substrate

Transition-metal dichalcogenide (TMD) semiconductors have been widely studied due to their distinctive electronic and optical properties. The property of TMD flakes is a function of its thickness, or layer number (N). How to determine N of ultrathin TMDs materials is of primary importance for fundamental study and practical applications. Raman mode intensity from substrates has been used to identify N of intrinsic and defective multilayer graphenes up to N=100. However, such analysis is not applicable for ultrathin TMD flakes due to the lack of a unified complex refractive index ($\tilde{n}$) from monolayer to bulk TMDs. Here, we discuss the N identification of TMD flakes on the SiO$_2$/Si substrate by the intensity ratio between the Si peak from 100-nm (or 89-nm) SiO$_2$/Si substrates underneath TMD flakes and that from bare SiO$_2$/Si substrates. We assume the real part of $\tilde{n}$ of TMD flakes as that of monolayer TMD and treat the imaginary part of $\tilde{n}$ as a fitting parameter to fit the experimental intensity ratio. An empirical $\tilde{n}$, namely, $\tilde{n}_{eff}$, of ultrathin MoS$_{2}$, WS$_{2}$ and WSe$_{2}$ flakes from monolayer to multilayer is obtained for typical laser excitations (2.54 eV, 2.34 eV, or 2.09 eV). The fitted $\tilde{n}_{eff}$ of MoS$_{2}$ has been used to identify N of MoS$_{2}$ flakes deposited on 302-nm SiO$_2$/Si substrate, which agrees well with that determined from their shear and layer-breathing modes. This technique by measuring Raman intensity from the substrate can be extended to identify N of ultrathin 2D flakes with N-dependent $\tilde{n}$ . For the application purpose, the intensity ratio excited by specific laser excitations has been provided for MoS$_{2}$, WS$_{2}$ and WSe$_{2}$ flakes and multilayer graphene flakes deposited on Si substrates covered by 80-110 nm or 280-310 nm SiO$_2$ layer.Comment: 10 pages, 4 figures. Accepted by Nanotechnolog

4-Eth­oxy-N′-propanoylpyridine-2-carbohydrazide

In the crystal structure of the title compound, C11H15N3O3, mol­ecules are linked into a chain by inter­molecular N—H⋯O hydrogen bonds

NaI (Tl) Calorimeter Calibration and Simulation for Coulomb Sum Rule Experiment in Hall-A at Jefferson Lab

A precision measurment of inclusive electron scattering cross sections was carried out at Jefferson Lab in the quasi-elastic region for ${^4}$He, ${^{12}}$C, ${^{56}}$Fe and ${^{208}}$Pb targets. Longitudinal ($R_{L}$) and transverse ($R_{T}$) response functions of nucleon were extracted in the momentum transfer range 0.55 GeV/c$\le$$|q|$$\le$1.0 GeV/c. To achieve the above goal, a NaI (Tl) calorimeter was used to distinguish good electrons from background including pions and low energy electrons rescattered from walls of the spectrometer magnets. Due to a large set of kinematics and changes in HV settings, a number of calibrations were performed for the NaI (Tl) detector. Corrections for a few blocks of NaI (Tl) with bad or no signal were applied. The resolution of NaI (Tl) detector after calibration reached $\frac{\delta E}{\sqrt{E}} \approx 3\%$ at E=1 GeV. The performance of NaI (Tl) detector was compared with a simulation

Prevalence of insomnia symptoms and their associated factors in patients treated in outpatient clinics of four general hospitals in Guangzhou, China

Background: Data on the prevalence of insomnia symptoms in medical outpatient clinics in China are lacking. This study examined the prevalence of insomnia symptoms and their socio-demographic correlates in patients treated at medical outpatient clinics affiliated with four general hospitals in Guangzhou, a large metropolis in southern China. Method: A total of 4399 patients were consecutively invited to participate in the study. Data on insomnia and its socio-demographic correlates were collected with standardized questionnaires. Results: The prevalence of any type of insomnia symptoms was 22.1% (95% confidence interval (CI): 20.9–23.3%); the prevalence of difficulty initiating sleep was 14.3%, difficulty maintaining sleep was 16.2%, and early morning awakening was 12.4%. Only 17.5% of the patients suffering from insomnia received sleeping pills. Multiple logistic regression analysis revealed that male gender, education level, rural residence, and being unemployed or retired were negatively associated with insomnia symptoms, while lacking health insurance, older age and more severe depressive symptoms were positively associated with insomnia symptoms. Conclusions: Insomnia symptoms are common in patients attending medical outpatient clinics in Guangzhou. Increasing awareness of sleep hygiene measures, regular screening and psychosocial and pharmacological interventions for insomnia are needed in China. Trial registration: ChiCTR-INR-16008066. Registered 8 March 2016