QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting.

To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults with confirmed TB in Tanzania. Sensitivity and specificity of QFT and TST for diagnosing active TB as well as indeterminate QFT rates and IFN-γ levels were assessed in 211 TB suspect children in a Tanzanian district hospital and contrasted in 90 adults with confirmed pulmonary TB. Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27) and 6% (2/31) respectively. In adults sensitivity of QFT and TST was 84% (73/87) and 85% (63/74). The QFT indeterminate rate in children and adults was 27% and 3%. Median levels of IFN-γ were lower in children than adults, particularly children <2 years and HIV infected. An indeterminate result was associated with age <2 years but not malnutrition or HIV status. Overall childhood mortality was 19% and associated with an indeterminate QFT result at baseline. QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performance in Tanzanian adults was good and comparable to performance in high-income countries. Indeterminate results in children were associated with young age and increased mortality. Neither test can be recommended for diagnosing active TB in children with immature or impaired immunity in a high-burden setting

Ages and Metallicities of Hickson Compact Group Galaxies

Hickson Compact Groups (HCGs) constitute an interesting extreme in the range of environments in which galaxies are located, as the space density of galaxies in these small groups are otherwise only found in the centres of much larger clusters. The work presented here uses Lick indices to make a comparison of ages and chemical compositions of galaxies in HCGs with those in other environments (clusters, loose groups and the field). The metallicity and relative abundance of `$\alpha$-elements' show strong correlations with galaxy age and central velocity dispersion, with similar trends found in all environments. However, we show that the previously reported correlation between $\alpha$-element abundance ratios and velocity dispersion disappears when a full account is taken of the the abundance ratio pattern in the calibration stars. This correlation is thus found to be an artifact of incomplete calibration to the Lick system. Variations are seen in the ranges and average values of age, metallicity and $\alpha$-element abundance ratios for galaxies in different environments. Age distributions support the hierarchical formation prediction that field galaxies are on average younger than their cluster counterparts. However, the ages of HCG galaxies are shown to be more similar to those of cluster galaxies than those in the field, contrary to the expectations of current hierarchical models. A trend for lower velocity dispersion galaxies to be younger was also seen. This is again inconsistent with hierarchical collapse models, but is qualitatively consistent with the latest N-body-SPH models based on monolithic collapse in which star formation continues for many Gyr in low mass halos.Comment: 18 pages. Submitted for publication in MNRA

Model validation for a noninvasive arterial stenosis detection problem

Copyright @ 2013 American Institute of Mathematical SciencesA current thrust in medical research is the development of a non-invasive method for detection, localization, and characterization of an arterial stenosis (a blockage or partial blockage in an artery). A method has been proposed to detect shear waves in the chest cavity which have been generated by disturbances in the blood flow resulting from a stenosis. In order to develop this methodology further, we use both one-dimensional pressure and shear wave experimental data from novel acoustic phantoms to validate corresponding viscoelastic mathematical models, which were developed in a concept paper [8] and refined herein. We estimate model parameters which give a good fit (in a sense to be precisely defined) to the experimental data, and use asymptotic error theory to provide confidence intervals for parameter estimates. Finally, since a robust error model is necessary for accurate parameter estimates and confidence analysis, we include a comparison of absolute and relative models for measurement error.The National Institute of Allergy and Infectious Diseases, the Air Force Office of Scientific Research, the Deopartment of Education and the Engineering and Physical Sciences Research Council (EPSRC)

Challenges of Loss to Follow-up in Tuberculosis Research.

In studies evaluating methods for diagnosing tuberculosis (TB), follow-up to verify the presence or absence of active TB is crucial and high dropout rates may significantly affect the validity of the results. In a study assessing the diagnostic performance of the QuantiFERON®-TB Gold In-Tube test in TB suspect children in Tanzania, factors influencing patient adherence to attend follow-up examinations and reasons for not attending were examined. In 160 children who attended and 102 children who did not attend scheduled 2-month follow-up baseline health characteristics, demographic data and risk factors for not attending follow-up were determined. Qualitative interviews were used to understand patient and caretakers reasons for not returning for scheduled follow-up. Being treated for active tb in the dots program (OR: 4.14; 95% CI:1.99-8.62;p-value<0.001) and receiving money for the bus fare (OR:129; 95% CI 16->100;P-value<0.001) were positive predictors for attending follow-up at 2 months, and 21/85(25%) of children not attending scheduled follow-up had died. Interviews revealed that limited financial resources, i.e. lack of money for transportation and poor communication, were related to non-adherence. Patients lost to follow-up is a potential problem for TB research. Receiving money for transportation to the hospital and communication is crucial for adherence to follow-up conducted at a study facility. Strategies to ensure follow-up should be part of any study protocol

The giant, horizontal and asymptotic branches of galactic globular clusters. I. The catalog, photometric observables and features

A catalog including a set of the most recent Color Magnitude Diagrams (CMDs) is presented for a sample of 61 Galactic Globular Clusters (GGCs). We used this data-base to perform an homogeneous systematic analysis of the evolved sequences (namely, Red Giant Branch (RGB), Horizontal Branch (HB) and Asymptotic Giant Branch (AGB)). Based on this analysis, we present: (1) a new procedure to measure the level of the ZAHB (V_ZAHB) and an homogeneous set of distance moduli obtained adopting the HB as standard candle; (2) an independent estimate for RGB metallicity indicators and new calibrations of these parameters in terms of both spectroscopic ([Fe/H]_CG97) and global metallicity ([M/H], including also the alpha-elements enhancement). The set of equations presented can be used to simultaneously derive a photometric estimate of the metal abundance and the reddening from the morphology and the location of the RGB in the (V,B-V)-CMD. (3) the location of the RGB-Bump (in 47 GGCs) and the AGB-Bump (in 9 GGCs). The dependence of these features on the metallicity is discussed. We find that by using the latest theoretical models and the new metallicity scales the earlier discrepancy between theory and observations (~0.4 mag) completely disappears.Comment: 51 pages, 23 figures, AAS Latex, macro rtrpp4.sty included, accepted by A

Building galaxies by accretion and in-situ star formation

We examine galaxy formation in a cosmological AMR simulation, which includes two high resolution boxes, one centered on a 3 \times 10^14 M\odot cluster, and one centered on a void. We examine the evolution of 611 massive (M\ast > 10^10M\odot) galaxies. We find that the fraction of the final stellar mass which is accreted from other galaxies is between 15 and 40% and increases with stellar mass. The accreted fraction does not depend strongly on environment at a given stellar mass, but the galaxies in groups and cluster environments are older and underwent mergers earlier than galaxies in lower density environments. On average, the accreted stars are ~2.5 Gyrs older, and ~0.15 dex more metal poor than the stars formed in-situ. Accreted stellar material typically lies on the outskirts of galaxies; the average half-light radius of the accreted stars is 2.6 times larger than that of the in-situ stars. This leads to radial gradients in age and metallicity for massive galaxies, in qualitative agreement with observations. Massive galaxies grow by mergers at a rate of approximately 2.6% per Gyr. These mergers have a median (mass-weighted) mass ratio less than 0.26 \pm 0.21, with an absolute lower limit of 0.20, for galaxies with M\ast ~ 10^12 M\odot. This suggests that major mergers do not dominate in the accretion history of massive galaxies. All of these results agree qualitatively with results from SPH simulations by Oser et al. (2010, 2012).Comment: 18 pages, 12 figures, submitted to MNRA