Screening of patients with tuberculosis for diabetes mellitus in China.

Objective  There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and this study aimed to assess feasibility and results of screening patients with TB for DM within the routine healthcare setting of six health facilities. Method  Agreement on how to screen, monitor and record was reached in May 2011 at a stakeholders' meeting, and training was carried out for staff in the six facilities in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012. Results  There were 8886 registered patients with TB. They were first asked whether they had DM. If the answer was no, they were screened with a random blood glucose (RBG) followed by fasting blood glucose (FBG) in those with RBG ≥ 6.1 mm (one facility) or with an initial FBG (five facilities). Those with FBG ≥ 7.0 mm were referred to DM clinics for diagnostic confirmation with a second FBG. Altogether, 1090 (12.4%) patients with DM were identified, of whom 863 (9.7%) had a known diagnosis of DM. Of 8023 patients who needed screening for DM, 7947 (99%) were screened. This resulted in a new diagnosis of DM in 227 patients (2.9% of screened patients), and of these, 226 were enrolled to DM care. In addition, 575 (7.8%) persons had impaired fasting glucose (FBG 6.1 to <7.0 mm). Prevalence of DM was significantly higher in patients in health facilities serving urban populations (14.0%) than rural populations (10.6%) and higher in hospital patients (13.5%) than those attending TB clinics (8.5%). Conclusion  This pilot project shows that it is feasible to screen patients with TB for DM in the routine setting, resulting in a high yield of patients with known and newly diagnosed disease. Free blood tests for glucose measurement and integration of TB and DM services may improve the diagnosis and management of dually affected patients

Nuclear level densities and gamma-ray strength functions in 44,45Sc

The scandium isotopes 44,45Sc have been studied with the 45Sc(3He,alpha gamma)44Sc and 45Sc(3He,3He' gamma)45Sc reactions, respectively. The nuclear level densities and gamma-ray strength functions have been extracted using the Oslo method. The experimental level densities are compared to calculated level densities obtained from a microscopic model based on BCS quasiparticles within the Nilsson level scheme. This model also gives information about the parity distribution and the number of broken Cooper pairs as a function of excitation energy. The experimental gamma-ray strength functions are compared to theoretical models of the E1, M1, and E2 strength, and to data from (gamma,n) and (gamma,p) experiments. The strength functions show an enhancement at low gamma energies that cannot be explained by the present, standard models.Comment: 21 pages, 13 figures. Published versio

The impact of social protection and poverty elimination on global tuberculosis incidence: a statistical modelling analysis of Sustainable Development Goal 1.

BACKGROUND: The End TB Strategy and the Sustainable Development Goals (SDGs) are intimately linked by their common targets and approaches. SDG 1 aims to end extreme poverty and expand social protection coverage by 2030. Achievement of SDG 1 is likely to affect the tuberculosis epidemic through a range of pathways. We estimate the reduction in global tuberculosis incidence that could be obtained by reaching SDG 1. METHODS: We developed a conceptual framework linking key indicators of SDG 1 progress to tuberculosis incidence via well described risk factor pathways and populated it with data from the SDG data repository and the WHO tuberculosis database for 192 countries. Correlations and mediation analyses informed the strength of the association between the SDG 1 subtargets and tuberculosis incidence, resulting in a simplified framework for modelling. The simplified framework linked key indicators for SDG 1 directly to tuberculosis incidence. We applied an exponential decay model based on linear associations between SDG 1 indicators and tuberculosis incidence to estimate tuberculosis incidence in 2035. FINDINGS: Ending extreme poverty resulted in a reduction in global incidence of tuberculosis of 33·4% (95% credible interval 15·5-44·5) by 2035 and expanding social protection coverage resulted in a reduction in incidence of 76·1% (45·2-89·9) by 2035; both pathways together resulted in a reduction in incidence of 84·3% (54·7-94·9). INTERPRETATION: Full achievement of SDG 1 could have a substantial effect on the global burden of tuberculosis. Cross-sectoral approaches that promote poverty reduction and social protection expansion will be crucial complements to health interventions, accelerating progress towards the End TB targets. FUNDING: World Health Organization

Microcanonical entropies and radiative strength functions of 50,51^{50,51}V

The level densities and radiative strength functions (RSFs) of $^{50,51}$V have been extracted using the ($^3$He,$\alpha \gamma$) and ($^3$He,$^3$He$^{\prime} \gamma$) reactions, respectively. From the level densities, microcanonical entropies are deduced. The high $\gamma$-energy part of the RSF is described by the giant electric dipole resonance. A significant enhancement over the predicted strength in the region of $E_{\gamma} \lesssim 3$ MeV is seen, which at present has no theoretical explanation.Comment: 16 pages including 9 figure

Extraction of thermal and electromagnetic properties in 45Ti

The level density and gamma-ray strength function of 45Ti have been determined by use of the Oslo method. The particle-gamma coincidences from the 46Ti(p,d gamma)45Ti pick-up reaction with 32 MeV protons are utilized to obtain gamma-ray spectra as function of excitation energy. The extracted level density and strength function are compared with models, which are found to describe these quantities satisfactorily. The data do not reveal any single-particle energy gaps of the underlying doubly magic 40Ca core, probably due to the strong quadruple deformation