In-hospital outcome of patients with culture-confirmed tuberculous pleurisy: clinical impact of pulmonary involvement

<p>Abstract</p> <p>Background</p> <p>Outcomes for hospitalized patients with tuberculous pleurisy (TP) have rarely been reported, and whether or not pulmonary involvement affects outcomes is uncertain. This study aimed to analyze the in-hospital mortality rate of culture-confirmed TP with an emphasis on the clinical impact of pulmonary involvement.</p> <p>Methods</p> <p>Patients who were hospitalized for pleural effusion (PE) of unconfirmed diagnosis and finally diagnosed as TP were identified. We classified them according to the disease extent: isolated pleurisy (isolated pleurisy group) and pleurisy with pulmonary involvement (pleuro-pulmonary group).</p> <p>Results</p> <p>Among the 205 patients hospitalized before the diagnosis was established, 51 (24.9%) belonged to the isolated pleurisy group. Compared to the pleuro-pulmonary group, patients in the isolated pleurisy group were younger, had fewer underlying co-morbidities, and presented more frequently with fever and chest pain. Fewer patients in the isolated pleurisy group had hypoalbuminemia (< 3.5 g/dL) and anemia. The two groups were similar with regards to PE analysis, resistance pattern, and timing of anti-tuberculous treatment. Patients who had a typical pathology of TP on pleural biopsy received anti-tuberculous treatment earlier than those who did not, and were all alive at discharge. The isolated pleurisy group had a lower in-hospital mortality rate, a shorter length of hospital stay and better short-term survival. In addition, the presence of underlying comorbidities and not receiving anti-tuberculous treatment were associated with a higher in-hospital mortality rate.</p> <p>Conclusion</p> <p>In culture-confirmed tuberculous pleurisy, those with pulmonary involvement were associated with a higher in-hospital mortality rate. A typical pathology for TP on pleura biopsy was associated with a better outcome.</p

Planar and van der Waals heterostructures for vertical tunnelling single electron transistors

Despite a rich choice of two-dimensional materials, which exists these days, heterostructures, both vertical (van der Waals) and in-plane, offer an unprecedented control over the properties and functionalities of the resulted structures. Thus, planar heterostructures allow p-n junctions between different two-dimensional semiconductors and graphene nanoribbons with well-defined edges; and vertical heterostructures resulted in the observation of superconductivity in purely carbon-based systems and realisation of vertical tunnelling transistors. Here we demonstrate simultaneous use of in-plane and van der Waals heterostructures to build vertical single electron tunnelling transistors. We grow graphene quantum dots inside the matrix of hexagonal boron nitride, which allows a dramatic reduction of the number of localised states along the perimeter of the quantum dots. The use of hexagonal boron nitride tunnel barriers as contacts to the graphene quantum dots make our transistors reproducible and not dependent on the localised states, opening even larger flexibility when designing future devices

Hexagonal boron nitride tunnel barriers grown on graphite by high temperature molecular beam epitaxy

We demonstrate direct epitaxial growth of high-quality hexagonal boron nitride (hBN) layers on graphite using high-temperature plasma-assisted molecular beam epitaxy. Atomic force microscopy reveals mono- and few-layer island growth, while conducting atomic force microscopy shows that the grown hBN has a resistance which increases exponentially with the number of layers, and has electrical properties comparable to exfoliated hBN. X-ray photoelectron spectroscopy, Raman microscopy and spectroscopic ellipsometry measurements on hBN confirm the formation of sp2-bonded hBN and a band gap of 5.9 ± 0.1 eV with no chemical intermixing with graphite. We also observe hexagonal moiré patterns with a period of 15 nm, consistent with the alignment of the hBN lattice and the graphite substrate

Social factors influencing child health in Ghana

Objectives Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals’ target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal. Methods ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review. Results Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices. Conclusions Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother’s health knowledge is emphasised

Magnon-assisted tunnelling in van der Waals heterostructures based on CrBr3

Van der Waals heterostructures, which are composed of layered two-dimensional materials, offer a platform to investigate a diverse range of physical phenomena and could be of use in a variety of applications. Heterostructures containing two-dimensional ferromagnets, such as chromium triiodide (CrI3), have recently been reported, which could allow two-dimensional spintronic devices to be developed. Here we study tunnelling through thin ferromagnetic chromium tribromide (CrBr3) barriers that are sandwiched between graphene electrodes. In devices with non-magnetic barriers, conservation of momentum can be relaxed by phonon-assisted tunnelling or by tunnelling through localized states. In contrast, in the devices with ferromagnetic barriers, the major tunnelling mechanisms are the emission of magnons at low temperatures and the scattering of electrons on localized magnetic excitations at temperatures above the Curie temperature. Magnetoresistance in the graphene electrodes further suggests induced spin–orbit coupling and proximity exchange via the ferromagnetic barrier. Tunnelling with magnon emission offers the possibility of spin injection

Human and machine validation of 14 databases of dynamic facial expressions

With a shift in interest toward dynamic expressions, numerous corpora of dynamic facial stimuli have been developed over the past two decades. The present research aimed to test existing sets of dynamic facial expressions (published between 2000 and 2015) in a cross-corpus validation effort. For this, 14 dynamic databases were selected that featured facial expressions of the basic six emotions (anger, disgust, fear, happiness, sadness, surprise) in posed or spontaneous form. In Study 1, a subset of stimuli from each database (N = 162) were presented to human observers and machine analysis, yielding considerable variance in emotion recognition performance across the databases. Classification accuracy further varied with perceived intensity and naturalness of the displays, with posed expressions being judged more accurately and as intense, but less natural compared to spontaneous ones. Study 2 aimed for a full validation of the 14 databases by subjecting the entire stimulus set (N = 3812) to machine analysis. A FACS-based Action Unit (AU) analysis revealed that facial AU configurations were more prototypical in posed than spontaneous expressions. The prototypicality of an expression in turn predicted emotion classification accuracy, with higher performance observed for more prototypical facial behavior. Furthermore, technical features of each database (i.e., duration, face box size, head rotation, and motion) had a significant impact on recognition accuracy. Together, the findings suggest that existing databases vary in their ability to signal specific emotions, thereby facing a trade-off between realism and ecological validity on the one end, and expression uniformity and comparability on the other