Performance and operational characteristics of point-of-care tests for the diagnosis of urogenital gonococcal infections.

BACKGROUND: In 2012, there was an estimated 78 million new cases of gonorrhoea globally. Untreated infection may lead to reproductive and neonatal morbidity and facilitate HIV transmission. Diagnosis and treatment are a priority for control and prevention, yet use of point-of-care tests (POCTs) for Neisseria gonorrhoeae (NG) is limited. OBJECTIVES: To review the performance and operational characteristics of NG POCTs for diagnosis of urogenital gonorrhoea. METHODS: We compiled and synthesised findings from two separate systematic reviews which included evaluations published until August 2015. RESULTS: Six tests were included: five were immunochromatographic tests (ICTs) or optical immunoassay (OIAs) based on antigen detection; with 5-7 steps and results in 25-40 min, and one (GeneXpert CT/NG) was a 'near-patient test' based on nucleic acid amplification technique (NAAT); with three steps, electricity required, and results in 90 min. When compared with laboratory-based NAATs as the reference tests, sensitivities of ICT and OIA-based POCTs ranged from 12.5% to 70% when cervical/vaginal swabs were tested. Specificities ranged from 89% to 99.8%. The near-patient NAAT had sensitivities of >95% and specificities of >99.8% consistently across all specimen types (urine, cervical and vaginal swabs). CONCLUSIONS: Based on a limited number of evaluations, antigen detection POCTs for NG lacked sufficient sensitivity to be used for screening. A near-patient NAAT has acceptable performance, only involved a few steps, but needs electricity, a temperature-controlled environment and has a 90 min run time. To achieve wider scale up of NG POCTs, we need strong evidence of cost-effectiveness, which should inform guidelines and ultimately increase test development, demand and reduce costs

Rappresentare l’armatura culturale del territorio con QGIS: l’esperienza del PTRA della Franciacorta

Landscape features are the result of interrelated actions of man-and-nature and can provide ecosystem services that need to be protected. Since urban planning policies can impact negatively on the conservation of cultural ecosystem services, urban plans must map them and make provision for their protection. For the Plan of Franciacorta (22 municipalities in Lombardy), we chose QGIS to set up a geo-database and map cultural heritage information. QGIS can provide more flexibility than a typical map, thanks to its graphics tools. To plan the development of actions to protect the landscape and suggest a range of planning opportunities for municipalities, an integrated representation of the landscape and protected ecological elements can highlight some critical issues: municipal borders can prove an obstacle in the implementation of supra-municipal projects and protected areas can include enclaves potentially vulnerable to urban pressures. Such maps have proved useful in guiding the planning choices in the development of the landscape protection schemes. The geo-location of critical aspects has brought out a range of inter-municipal planning opportunities

A Neuro-Evolutionary Approach to Electrocardiographic Signal Classification

International audienceThis chapter presents an evolutionary Artificial Neural Networks (ANN) classifier system as a heartbeat classification algorithm designed according to the rules of the PhysioNet/Computing in Cardiology Challenge 2011 (Moody, Comput Cardiol Challenge 38:273-276, 2011), whose aim is to develop an efficient algorithm able to run within a mobile phone that can provide useful feedback when acquiring a diagnostically useful 12-lead Electrocardiography (ECG) recording. The method used to solve this problem is a very powerful natural computing analysis tool, namely evolutionary neural networks, based on the joint evolution of the topology and the connection weights relying on a novel similarity-based crossover. The chapter focuses on discerning between usable and unusable electrocardiograms tele-medically acquired from mobile embedded devices. A preprocessing algorithm based on the Discrete Fourier Transform has been applied before the evolutionary approach in order to extract an ECG feature dataset in the frequency domain. Finally, a series of tests has been carried out in order to evaluate the performance and the accuracy of the classifier system for such a challenge

Photon Pair Generation in Silicon Micro-Ring Resonator with Reverse Bias Enhancement

Photon sources are fundamental components for any quantum photonic technology. The ability to generate high count-rate and low-noise correlated photon pairs via spontaneous parametric down-conversion using bulk crystals has been the cornerstone of modern quantum optics. However, future practical quantum technologies will require a scalable integration approach, and waveguide-based photon sources with high-count rate and low-noise characteristics will be an essential part of chip-based quantum technologies. Here, we demonstrate photon pair generation through spontaneous four-wave mixing in a silicon micro-ring resonator, reporting a maximum coincidence-to-accidental (CAR) ratio of 602 (+-) 37, and a maximum photon pair generation rate of 123 MHz (+-) 11 KHz. To overcome free-carrier related performance degradations we have investigated reverse biased p-i-n structures, demonstrating an improvement in the pair generation rate by a factor of up to 2, with negligible impact on CAR.Comment: 5 pages, 3 figure

Predicting candidemia in internal medicine departments: are we chasing the Holy Grail?

Candidemia is a challenging clinical condition with high rates of morbidity and mortality.1 Key requirements for its prompt management include early identification and timely initiation of appropriate systemic antifungal therapy, consistently reported as a major determinant of survival. However, the diagnosis of candidemia can be challenging and is often delayed as there are no specific clinical signs, blood cultures have low sensitivity, and detection of fungal blood cultures takes a long time. In addition, there is evidence that a significant percentage of such infections occurs in patients admitted to internal medicine departments. This is not particularly surprising given the advanced age of many inpatients at internal medicine departments and multiple complex comorbidities. Moreover, related therapies and healthcare system contacts often involve the use of central venous catheters and other indwelling devices, potentially entailing high risk of candidemia.2 Therefore, optimization of the diagnostic and therapeutic approach is an important and still unfulfilled need for the management of candidemia in internal medicine department

Hybrid membrane distillation reverse electrodialysis configuration for water and energy recovery from human urine: an opportunity for off-grid decentralised sanitation

The integration of membrane distillation with reverse electrodialysis has been investigated as a sustainable sanitation solution to provide clean water and electrical power from urine and waste heat. Reverse electrodialysis was integrated to provide the partial remixing of the concentrate (urine) and diluate (permeate) produced from the membrane distillation of urine. Broadly comparable power densities to those of a model salt solution (sodium chloride) were determined during evaluation of the individual and combined contribution of the various monovalent and multivalent inorganic and organic salt constituents in urine. Power densities were improved through raising feed-side temperature and increasing concentration in the concentrate, without observation of limiting behaviour imposed by non-ideal salt and water transport. A further unique contribution of this application is the limited volume of salt concentrate available, which demanded brine recycling to maximise energy recovery analogous to a battery, operating in a ‘state of charge’. During recycle, around 47% of the Gibbs free energy was recoverable with up to 80% of the energy extractable before the concentration difference between the two solutions was halfway towards equilibrium which implies that energy recovery can be optimised with limited effect on permeate quality. This study has provided the first successful demonstration of an integrated MD-RED system for energy recovery from a limited resource, and evidences that the recovered power is sufficient to operate a range of low current fluid pumping technologies that could help deliver off-grid sanitation and clean water recovery at single household scale

Plant-derived bioactives and oxidative stress-related disorders: A key trend towards healthy aging and longevity promotion

Plants and their corresponding botanical preparations have been used for centuries due to their remarkable potential in both the treatment and prevention of oxidative stress-related disorders. Aging and aging-related diseases, like cardiovascular disease, cancer, diabetes, and neurodegenerative disorders, which have increased exponentially, are intrinsically related with redox imbalance and oxidative stress. Hundreds of biologically active constituents are present in each whole plant matrix, providing promissory bioactive effects for human beings. Indeed, the worldwide population has devoted increased attention and preference for the use of medicinal plants for healthy aging and longevity promotion. In fact, plant-derived bioactives present a broad spectrum of biological effects, and their antioxidant, anti-inflammatory, and, more recently, anti-aging effects, are considered to be a hot topic among the medical and scientific communities. Nonetheless, despite the numerous biological effects, it should not be forgotten that some bioactive molecules are prone to oxidation and can even exert pro-oxidant effects. In this sense, the objective of the present review is to provide a detailed overview of plant-derived bioactives in age-related disorders. Specifically, the role of phytochemicals as antioxidants and pro-oxidant agents is carefully addressed, as is their therapeutic relevance in longevity, aging-related disorders, and healthy-aging promotion. Finally, an eye-opening look into the overall evidence of plant compounds related to longevity is present