78 research outputs found

    Transmission dynamics of pulmonary tuberculosis between autochthonous and immigrant sub-populations

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    <p>Abstract</p> <p>Background</p> <p>The overall incidence of tuberculosis (TB) in Western Europe has been declining since the 19<sup>th </sup>Century. However, immigrant sub-groups from high-prevalence countries are slowing down this trend. The aim of this study was to describe how immigration influences TB transmission in Germany. For that we prospectively investigated the dynamics of TB transmission between TB high-prevalence immigrant and TB low-prevalence local populations with molecular epidemiological methods and conventional contact investigations. Besides, we assessed transmission in relation to social mixing using an innovative tool that measures the integration of immigrants into the local social environment.</p> <p>Methods</p> <p>A prospective study of confirmed culture positive cases of pulmonary TB and their contacts was carried out in a German federal state from 2003 to 2005. Data for the study included: 1) case data routinely collected by the local public health staff and transmitted to the state health office and the national surveillance centre, 2) a study questionnaire designed to capture social interactions of relevance for TB transmission and 3) molecular genotyping data (IS<it>6110 </it>DNA fingerprint and spoligotyping). The proportion of German cases caused by foreign-born cases, and vice versa, was estimated and an integration index was computed using a selected set of questions from the study questionnaire.</p> <p>Results</p> <p>A total of 749 cases of culture-positive pulmonary tuberculosis voluntarily enrolled in the study, representing 57.8% of all registered cases diagnosed over the study period. Data that included study questionnaire and DNA fingerprinting were available for 41% (n = 308) of the study participants. Forty-seven clusters, defined as a least two cases infected by the same TB strains, were identified by molecular methods and included 132 (17%) of the study participants. Epidemiological links were identified for 28% of the clusters by conventional epidemiological data. In mixed clusters, defined as clusters including German and foreign-born individuals, the probability of cases to be caused by foreign-born cases was estimated at 18.3%. We observed a trend to mixed clusters with increasing time spent by immigrants in the host country. This group also presented comparatively higher integration indexes than immigrants in immigrant-only clusters.</p> <p>Conclusion</p> <p>Our results confirm the findings of other studies that there is no significant TB transmission from TB high-prevalence immigrant to TB low-prevalence autochthonous population. This may be explained by the good performance of tuberculosis screening programmes for certain groups arriving in Germany from high- prevalence countries, by a low degree of mixing of immigrants with the local population or by a combination of both.</p

    Who wants to talk to terrorists?

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    Interviewing terrorists or former terrorists has become an increasingly popular research method in terrorism studies. What terrorists say can shed light on motivations, decision-making processes and operational details that without first-hand testimony could only be inferred. In this chapter, a selection of these studies is reviewed alongside a consideration of global trends in terrorism and developments in terrorism research

    Personalized early detection and prevention of breast cancer: ENVISION consensus statement

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    Abstract: The European Collaborative on Personalized Early Detection and Prevention of Breast Cancer (ENVISION) brings together several international research consortia working on different aspects of the personalized early detection and prevention of breast cancer. In a consensus conference held in 2019, the members of this network identified research areas requiring development to enable evidence-based personalized interventions that might improve the benefits and reduce the harms of existing breast cancer screening and prevention programmes. The priority areas identified were: 1) breast cancer subtype-specific risk assessment tools applicable to women of all ancestries; 2) intermediate surrogate markers of response to preventive measures; 3) novel non-surgical preventive measures to reduce the incidence of breast cancer of poor prognosis; and 4) hybrid effectiveness–implementation research combined with modelling studies to evaluate the long-term population outcomes of risk-based early detection strategies. The implementation of such programmes would require health-care systems to be open to learning and adapting, the engagement of a diverse range of stakeholders and tailoring to societal norms and values, while also addressing the ethical and legal issues. In this Consensus Statement, we discuss the current state of breast cancer risk prediction, risk-stratified prevention and early detection strategies, and their implementation. Throughout, we highlight priorities for advancing each of these areas

    CTOD and J Relationships for a Growing Crack

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    Integration Of Semiformal And Formal Methods For Specifying Knowledge-Based Systems

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    . The paper describes a specification approach for knowledge-based systems (kbs) combining semiformal and formal specification techniques. The semiformal knowledge representation uses a hypermedia-based formalism which serves as a communication basis between expert and knowledge engineer. This representation is also the basis for the formalization process resulting in the formal and executable model of expertise written in KARL. A smooth transition from the semiformal to the formal specification is enabled as both description techniques use the same conceptual model to describe the system. 1 Introduction Originally, expert systems or knowledge-based systems (kbs) were developed using the rapid prototyping approach. The acquired knowledge was immediately implemented and the running prototype was used as a guide for the further knowledge acquisition process. The distinction of symbol level and knowledge level [New82] created the conceptual framework for a different process models for th..

    Surface Reactions and Fatigue Crack Growth

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