220 fs Er-Yb:glass laser mode-locked by a broadband low-loss Si/Ge saturable absorber

We demonstrate femtosecond performance of an ultra-broadband high-index-contrast saturable Bragg reflector consisting of a silicon/silicon-dioxide/germanium structure that is fully compatible with CMOS processing. This device offers a reflectivity bandwidth of over 700 nm and sub-picosecond recovery time of the saturable loss. It is used to achieve mode-locking of an Er-Yb:glass laser centered at 1540 nm, generating 220 fs pulses, with the broadest output spectrum to date

Defining the research agenda to measure and reduce tuberculosis stigmas

This is an Open Access article, © 2017 International Union Against Tuberculosis and Lung Disease. Content in the UH Research Archive is made available for personal research, educational, and non-commercial purposes only. Unless otherwise stated, all content is protected by copyright, and in the absence of an open license, permissions for further re-use should be sought from the publisher, the author, or other copyright holder.Crucial to finding and treating the 4 million tuberculosis (TB) patients currently missed by National TB Programs, TB stigma is receiving well-deserved and long-delayed attention at the global level. However, the ability to measure and evaluate the success of TB stigma reduction efforts is limited by the need for additional tools. At a 2016 TB stigma measurement meeting held in The Hague, stigma experts discussed and proposed a research agenda around four themes: (1) Drivers: What are the main drivers and domains of TB stigma(s)?; (2) Consequences: How consequential are TB stigmas? How are negative impacts most felt?; (3) Burden: What is the global prevalence and distribution of TB stigma(s)? What explains any variation? (4): Intervention: What can be done to reduce the extent and impact of TB stigma(s)? Each theme was further subdivided into research topics to be addressed to move the agenda forward. These include more clarity on what causes TB stigmas to emerge and thrive, the difficulty of measuring the complexity of stigma, and the improbability of a universal stigma ‘cure’. Notwithstanding, these challenges should not hinder investments in TB stigma measurement and reduction. We believe it is time to focus on how and not whether the global community should measure and reduce TB stigma.Peer reviewedFinal Published versio

Mortality among patients with tuberculosis requiring intensive care: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>To describe the characteristics of patients with tuberculosis (TB) requiring intensive care and to identify the factors that predicts in-hospital mortality in a city of a developing country with intermediate-to-high TB endemicity.</p> <p>Methods</p> <p>We conducted a retrospective, cohort study, between November 2005 and November 2007. The patients with TB requiring intensive care were included. Predictors of mortality were assessed. The primary outcome was the in-hospital mortality.</p> <p>Results</p> <p>During the study period, 67 patients with TB required intensive care. Of them, 62 (92.5%) had acute respiratory failure and required mechanical ventilation. Forty-four (65.7%) patients died. Coinfection with human immunodeficiency virus was present in 46 (68.7%) patients. Early intensive care unit admission and ventilator-associated pneumonia were independently associated with the in-hospital mortality.</p> <p>Conclusions</p> <p>In this study we found a high mortality rate in TB patients requiring intensive care, especially in those with an early ICU admission.</p

Clinical Prediction Rule for Stratifying Risk of Pulmonary Multidrug-Resistant Tuberculosis

Multidrug-resistant tuberculosis (MDR-TB), resistance to at least isoniazid and rifampin, is a worldwide problem.To develop a clinical prediction rule to stratify risk for MDR-TB among patients with pulmonary tuberculosis.Derivation and internal validation of the rule among adult patients prospectively recruited from 37 health centers (Perú), either a) presenting with a positive acid-fast bacillus smear, or b) had failed therapy or had a relapse within the first 12 months.Among 964 patients, 82 had MDR-TB (prevalence, 8.5%). Variables included were MDR-TB contact within the family, previous tuberculosis, cavitary radiologic pattern, and abnormal lung exam. The area under the receiver-operating curve (AUROC) was 0.76. Selecting a cut-off score of one or greater resulted in a sensitivity of 72.6%, specificity of 62.8%, likelihood ratio (LR) positive of 1.95, and LR negative of 0.44. Similarly, selecting a cut-off score of two or greater resulted in a sensitivity of 60.8%, specificity of 87.5%, LR positive of 4.85, and LR negative of 0.45. Finally, selecting a cut-off score of three or greater resulted in a sensitivity of 45.1%, specificity of 95.3%, LR positive of 9.56, and LR negative of 0.58.A simple clinical prediction rule at presentation can stratify risk for MDR-TB. If further validated, the rule could be used for management decisions in resource-limited areas

Standardized Treatment of Active Tuberculosis in Patients with Previous Treatment and/or with Mono-resistance to Isoniazid: A Systematic Review and Meta-analysis

Performing a systematic review of studies evaluating retreatment of tuberculosis or treatment of isoniazid mono-resistant infection, Dick Menzies and colleagues find a paucity of evidence to support the WHO-recommended regimen

Oil and Gas Projects in the Western Amazon: Threats to Wilderness, Biodiversity, and Indigenous Peoples

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.The western Amazon is the most biologically rich part of the Amazon basin and is home to a great diversity of indigenous ethnic groups, including some of the world’s last uncontacted peoples living in voluntary isolation. Unlike the eastern Brazilian Amazon, it is still a largely intact ecosystem. Underlying this landscape are large reserves of oil and gas, many yet untapped. The growing global demand is leading to unprecedented exploration and development in the region. Without improved policies, the increasing scope and magnitude of planned extraction means that environmental and social impacts are likely to intensify. We review the most pressing oil- and gas-related conservation policy issues confronting the region. These include the need for regional Strategic Environmental Impact Assessments and the adoption of roadless extraction techniques. We also consider the conflicts where the blocks overlap indigenous peoples’ territories

Tuberculosis Incidence in Prisons: A Systematic Review

A systematic review by Iacopo Baussano and colleagues synthesizes published research to show that improved tuberculosis (TB) control in prisons could significantly reduce the burden of TB both inside and outside prisons

Nanostructures Technology, Research, and Applications

Contains reports on twenty-four research projects and a list of publications.Joint Services Electronics Program Grant DAAHO4-95-1-0038Defense Advanced Research Projects Agency/Semiconductor Research Corporation SA1645-25508PGU.S. Army Research Office Grant DAAHO4-95-1-0564Defense Advanced Research Projects Agency/U.S. Navy - Naval Air Systems Command Contract N00019-95-K-0131Suss Advanced Lithography P. O. 51668National Aeronautics and Space Administration Contract NAS8-38249National Aeronautics and Space Administration Grant NAGW-2003Defense Advanced Research Projects Agency/U.S. Army Research Office Grant DAAHO4-951-05643M CorporationDefense Advanced Research Projects Agency/U.S. Navy - Office of Naval Research Contract N66001-97-1-8909National Science Foundation Graduate FellowshipU.S. Army Research Office Contract DAAHO4-94-G-0377National Science Foundation Contract DMR-940034National Science Foundation Grant DMR 94-00334Defense Advanced Research Projects Agency/U.S. Air Force - Office of Scientific Research Contract F49620-96-1-0126Harvard-Smithsonian Astrophysical Observatory Contract SV630304National Aeronautics and Space Administration Grant NAG5-5105Los Alamos National Laboratory Contract E57800017-9GSouthwest Research Institute Contract 83832MIT Lincoln Laboratory Advanced Concepts ProgramMIT Lincoln Laboratory Contract BX-655