The Tuberculin Skin Test versus QuantiFERON TB Gold® in Predicting Tuberculosis Disease in an Adolescent Cohort Study in South Africa

Setting: This study was conducted in a high tuberculosis (TB) burden area in Worcester, South Africa, with a notified all TB incidence rate of 1,400/100,000. Main Objective: To compare the predictive value of a baseline tuberculin skin test (TST) with that of the QuantiFERON TB Gold (In-tube) assay (QFT) for subsequent microbiologically confirmed TB disease among adolescents. Methods: Adolescents aged 12-18 years were recruited from high schools in the study area. At baseline, blood was drawn for QFT and a TST administered. Participants were followed up for up to 3.8 years for incident TB disease (median 2.4 years). Results: After exclusions, 5244 (82.4%) of 6,363 adolescents enrolled, were analysed. The TB incidence rate was 0.60 cases per 100 person years (pyrs) (95% CI 0.43-0.82) for baseline TST positive (>= 5 mm) participants and 0.64 cases per 100 pyrs (95% CI 0.45-0.87) for baseline QFT positive participants. TB incidence rates were 0.22 per 100 pyrs (0.11-0.39) and 0.22 per 100 pyrs (0.12-0.38) among those with a negative baseline TST and QFT respectively. Sensitivity for incident TB disease was 76.9% for TST and 75.0% for QFT (p = 0.81). Positive predictive value was 1.4% for TST and 1.5% for QFT. Conclusion: Positive TST and QFT tests were moderately sensitive predictors of progression to microbiologically confirmed TB disease. There was no significant difference in the predictive ability of these tests for TB disease amongst adolescents in this high burden setting. Therefore, these findings do not support use of QFT in preference to TST to predict the risk of TB disease in this study populatio

‘Follow the Innovation’ – The Second Year of a Joint Experimentation and Learning Approach to Transdisciplinary Research in Uzbekistan

In 2008, the BMBF-funded, interdisciplinary research project 'Economic and Ecological Restructuring of Land- and Water Use in the Region Khorezm (Uzbekistan) initiated a participatory approach to innovation development and diffusion with local stakeholders. Since mid 2008, four selected agricultural project innovations are jointly tested by teams of researchers, local farmers and water managers under real-life settings. While the activities during the first year focussed on induced learning by scientists, the second year's emphasis was on the identification of and integration with the appropriate stakeholders and the conducting of jointly designed and implemented experiments to test, validate, and if needed, adapt the selected innovation packages. This paper documents these and focuses on the sub-processes within each team, how the team members understood and approached stakeholder collaboration, how they operationalised their scientific thinking into practical steps, and what impacts these processes had in terms of improving or validating the innovations

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Effect of flooding on distribution and mode of transportation of Lake Nasser sediments, Egypt

Sediment samples have been collected from Lake Nasser during drought and flooding periods to study the effect of flood season on bottom sediment distribution and mode of transportation. Ten sectors with three sites in each sector were chosen from upstream of Aswan High Dam to Adindan. The study showed that Lake Nasser sediments are heterogeneous and are mainly silty clay and clayey silt. Eastern and western sides of the lake include more sand. Depth controlled distribution of grain size (deeper is finer). Sands increase with the starting of the flood season. During drought periods suspension was the most predominant mode of transportation; i.e. sediments transported by a medium of considerable density. During flooding period siltation and suspension were most predominant modes of transportation; i.e. environment with a high energy, various overlapping processes, and variety of depositional environments. C–M diagram indicates that sediments during drought periods behaved as pelagic suspension in which sediments settled from a suspension in stagnant water, rolling; overbank facies suspension and uniform suspension were of less importance. During the flooding period there was no clear trend for studied sediments of pelagic suspension; rolling, graded suspension, overbank facies suspension, suspension, and uniform suspension were widely distributed

Metal pollution assessment in the surface sediment of Lake Nasser, Egypt

Eight heavy metals were measured seasonally in the sediment of Lake Nasser during 2013. 27 sites were chosen through 9 sectors across the main channel of the lake from Abu-Simbel to Aswan High Dam to assess the levels of the selected metals. The abundance of these metals was in the order of Fe > Mn > Zn > Cr > Ni > Cu > Pb > Cd, with mean concentrations of 12.41 mg/g, 279.56, 35.38, 30.79, 27.56, 21.78, 11.21 and 0.183 μg/g, respectively. Heavy metals are positively correlated with fine particles (mud fractions) and organic matter accumulation. The results showed perspicuous spatial high significant differences (P < 0.01) for all the measured metals. Fe, Cr, Ni, Pb and Cd exhibited temporally high significant differences (P < 0.01) before and after the flood period. Four Pollution Indices were used for the environmental assessment of Lake Nasser sediment. The indices included three single indices, Enrichment Factor (EF), Index of Geo-accumulation (Igeo) and Contamination Factor (CF). While the fourth, Pollution Load Index (PLI) was an integrated index. The pollution indexes confirmed that the Lake Nasser sediment was not contaminated with these elements. Sediments of Lake Nasser may be represented as a reference for the pre-industrial background of River Nile Sediments downstream Aswan High Dam

Risks Assessment of Potentially Toxic Elements’ Contamination in the Egyptian Red Sea Surficial Sediments

The potential impact of tourism, industrial, and urban activities on Egypt’s Red Sea coastline, which is well-known for its economic and environmental importance, was investigated at fifteen coastal sites. In the present study, the concentration of cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn) in marine sediments from these sites, was determined using Inductively Coupled Plasma Mass Spectrometers (ICP-MS). In detail, various pollution indices, statistical analyses, and spatial distribution patterns were used to assess the pollution status, impacts of human activities, ecological risks, and sources of potentially toxic elements (PTEs) in surface marine sediment. A detailed comparison with up-to-date data was conducted. These sediments were composed predominantly of fine and very fine sands. Mean grain size distribution typically depends on the source of the sediment from the following two prime sources: terrigenous (autochthonous) and biogenic (allochthonous). The detected PTE mean concentrations were as follows: Fe > Mn > Zn > Cr > Ni > Pb > Co > Cu > Cd. Multivariate statistical analysis results revealed their close distribution and association. Cd and Pb levels in the studied area have been slightly impacted by anthropogenic inputs. According to the calculated pollution indices, although a minimal or moderate contamination degree was detected in the study area, it was determined that there was a low to moderate ecological risk. The slightly high degree of contamination and risk centered in the middle of the study area around phosphate mining and related activities. More attention should be given to the concentrations and sources of Cd, Ni, and Pb as the main pollution factors

Spatial Distribution, Contamination Levels, and Health Risk Assessment of Potentially Toxic Elements in Household Dust in Cairo City, Egypt

Urban areas&rsquo; pollution, which is owing to rapid urbanization and industrialization, is one of the most critical issues in densely populated cities such as Cairo. The concentrations and the spatial distribution of fourteen potentially toxic elements (PTEs) in household dust were investigated in Cairo City, Egypt. PTE exposure and human health risk were assessed using the USEPA&rsquo;s exposure model and guidelines. The levels of As, Cd, Cr, Cu, Hg, Mo, Ni, Pb, and Zn surpassed the background values. Contamination factor index revealed that contamination levels are in the sequence Cd &gt; Hg &gt; Zn &gt; Pb &gt; Cu &gt; As &gt; Mo &gt; Ni &gt; Cr &gt; Co &gt; V &gt; Mn &gt; Fe &gt; Al. The degree of contamination ranges from considerably to very high pollution. Elevated PTE concentrations in Cairo&rsquo;s household dust may be due to heavy traffic emissions and industrial activities. The calculated noncarcinogenic risk for adults falls within the safe limit, while those for children exceed that limit in some sites. Cairo residents are at cancer risk owing to prolonged exposure to the indoor dust in their homes. A quick and targeted plan must be implemented to mitigate these risks