Reducing the Number of Sputum Samples Examined and Thresholds for Positivity: An Opportunity to Optimise Smear Microscopy.

SETTING: Urban health clinic, Nairobi. OBJECTIVE: To evaluate the impact on tuberculosis (TB) case detection and laboratory workload of reducing the number of sputum smears examined and thresholds for diagnosing positive smears and positive cases. DESIGN: In this prospective study, three Ziehl-Neelsen stained sputum smears from consecutive pulmonary TB suspects were examined blind. The standard approach (A), > or = 2 positive smears out of 3, using a cut-off of 10 acid-fast bacilli (AFB)/100 high-power fields (HPF), was compared with approaches B, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3, one of which is > or = 10 AFB/100 HPF; C, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3; D, > or = 1 positive smear (> or = 10 AFB/100 HPF) out of 2; and E, > or = 1 positive smear (> or = 4 AFB/100 HPF) out of 2. The microscopy gold standard was detection of at least one positive smear (> or = 4 AFB/100 HPF) out of 3. RESULTS: Among 644 TB suspects, the alternative approaches detected from 114 (17.7%) (approach B) to 123 cases (19.1%) (approach E) compared to 105 cases (16.3%) for approach A (P < 0.005). Sensitivity ranged between 82.0% (105/128) for A and 96.1% (123/128) for E. The single positive smear approaches reduced the number of smears by 36% compared to approach A. CONCLUSION: Reducing the number of specimens and the positivity threshold to define a positive case increased the sensitivity of microscopy and reduced laboratory workload

Genetic heterogeneity of hepatitis E virus in Darfur, Sudan, and neighboring Chad.

The within-outbreak diversity of hepatitis E virus (HEV) was studied during the outbreak of hepatitis E that occurred in Sudan in 2004. Specimens were collected from internally displaced persons living in a Sudanese refugee camp and two camps implanted in Chad. A comparison of the sequences in the ORF2 region of 23 Sudanese isolates and five HEV samples from the two Chadian camps displayed a high similarity (>99.7%) to strains belonging to Genotype 1. But four isolates collected in one of the Chadian camps were close to Genotype 2. Circulation of divergent strains argues for possible multiple sources of infection

Interface Dipole : Effects on Threshold Voltage and Mobility for both Amorphous and Poly-crystalline Organic Field Effect Transistors

We report a detailed comparison on the role of a self-assembled monolayer (SAM) of dipolar molecules on the threshold voltage and charge carrier mobility of organic field-effect transistor (OFET) made of both amorphous and polycrystalline organic semiconductors. We show that the same relationship between the threshold voltage and the dipole-induced charges in the SAM holds when both types of devices are fabricated on strictly identical base substrates. Charge carrier mobilities, almost constant for amorphous OFET, are not affected by the dipole in the SAMs, while for polycrystalline OFET (pentacene) the large variation of charge carrier mobilities is related to change in the organic film structure (mostly grain size).Comment: Full paper and supporting informatio

Prevalence study of yaws in the Democratic Republic of Congo using the lot quality assurance sampling method.

BACKGROUND: Until the 1970s the prevalence of non-venereal trepanomatosis, including yaws, was greatly reduced after worldwide mass treatment. In 2005, cases were again reported in the Democratic Republic of the Congo. We carried out a survey to estimate the village-level prevalence of yaws in the region of Equator in the north of the country in order to define appropriate strategies to effectively treat the affected population. METHODOLOGY/PRINCIPAL FINDINGS: We designed a community-based survey using the Lot Quality Assurance Sampling method to classify the prevalence of active yaws in 14 groups of villages (lots). The classification into high, moderate, or low yaws prevalence corresponded to World Health Organization prevalence thresholds for identifying appropriate operational treatment strategies. Active yaws cases were defined by suggestive clinical signs and positive rapid plasma reagin and Treponema pallidum hemagglutination serological tests. The overall prevalence in the study area was 4.7% (95% confidence interval: 3.4-6.0). Two of 14 lots had high prevalence (>10%), three moderate prevalence (5-10%) and nine low prevalence (<5%.). CONCLUSIONS/SIGNIFICANCE: Although yaws is no longer a World Health Organization priority disease, the presence of yaws in a region where it was supposed to be eradicated demonstrates the importance of continued surveillance and control efforts. Yaws should remain a public health priority in countries where previously it was known to be endemic. The integration of sensitive surveillance systems together with free access to effective treatment is recommended. As a consequence of our study results, more than 16,000 people received free treatment against yaws

Tuberculosis treatment in a refugee and migrant population: 20 years of experience on the Thai-Burmese border.

Although tuberculosis (TB) is a curable disease, it remains a major global health problem and an important cause of morbidity and mortality among vulnerable populations, including refugees and migrants

Negative Differential Resistance, Memory and Reconfigurable Logic Functions based on Monolayer Devices derived from Gold Nanoparticles Functionalized with Electro-polymerizable Thiophene-EDOT Units

We report on hybrid memristive devices made of a network of gold nanoparticles (10 nm diameter) functionalized by tailored 3,4(ethylenedioxy)thiophene (TEDOT) molecules, deposited between two planar electrodes with nanometer and micrometer gaps (100 nm to 10 um apart), and electropolymerized in situ to form a monolayer film of conjugated polymer with embedded gold nanoparticles (AuNPs). Electrical properties of these films exhibit two interesting behaviors: (i) a NDR (negative differential resistance) behavior with a peak/valley ratio up to 17, and (ii) a memory behavior with an ON/OFF current ratio of about 1E3 to 1E4. A careful study of the switching dynamics and programming voltage window is conducted demonstrating a non-volatile memory. The data retention of the ON and OFF states is stable (tested up to 24h), well controlled by the voltage and preserved when repeating the switching cycles (800 in this study). We demonstrate reconfigurable Boolean functions in multiterminal connected NP molecule devices.Comment: Full manuscript, figures and supporting information, J. Phys. Chem. C, on line, asap (2017

The dynamics of measles in sub-Saharan Africa.

Although vaccination has almost eliminated measles in parts of the world, the disease remains a major killer in some high birth rate countries of the Sahel. On the basis of measles dynamics for industrialized countries, high birth rate regions should experience regular annual epidemics. Here, however, we show that measles epidemics in Niger are highly episodic, particularly in the capital Niamey. Models demonstrate that this variability arises from powerful seasonality in transmission-generating high amplitude epidemics-within the chaotic domain of deterministic dynamics. In practice, this leads to frequent stochastic fadeouts, interspersed with irregular, large epidemics. A metapopulation model illustrates how increased vaccine coverage, but still below the local elimination threshold, could lead to increasingly variable major outbreaks in highly seasonally forced contexts. Such erratic dynamics emphasize the importance both of control strategies that address build-up of susceptible individuals and efforts to mitigate the impact of large outbreaks when they occur

Détection et contrôle par filtrage adaptatif des zones de frontière dans des images multitexturées

La segmentation automatique des images en régions pose le compromis classique entre la formation des régions et la détection des frontières. Dans le cadre des images multitexturées, cette dualité s'exprime dans un espace multidimensionnel, celui des attributs caractérisant les textures. Ici les attributs sont les énergies en sortie de filtres de type passe-bande orienté (filtre de Gabor 2D) intégrées sur une région d'intérêt de taille limitée. En décrivant les caractéristiques spectrales des zones de frontière entre textures, et en utilisant leurs propriétés, on montre que l'on peut diminuer l'incertitude de la position d'une frontière tout en maintenant une formation en région. Cela est réalisé par un processus simple de régularisation pour réaliser de manière adaptative l'intégration spatiale des mesures d'énergie caractérisant les textures

L\'evy flights of photons in hot atomic vapours

Properties of random and fluctuating systems are often studied through the use of Gaussian distributions. However, in a number of situations, rare events have drastic consequences, which can not be explained by Gaussian statistics. Considerable efforts have thus been devoted to the study of non Gaussian fluctuations such as L\'evy statistics, generalizing the standard description of random walks. Unfortunately only macroscopic signatures, obtained by averaging over many random steps, are usually observed in physical systems. We present experimental results investigating the elementary process of anomalous diffusion of photons in hot atomic vapours. We measure the step size distribution of the random walk and show that it follows a power law characteristic of L\'evy flights.Comment: This final version is identical to the one published in Nature Physic