Significance of sputum volume production in tuberculosis patients in Kampala, Uganda

Thesis (M.S.)--Boston UniversityBackground: Traditionally, the concentration of mycobacteria in the sputum has been used as a marker of severity as well as a measure of treatment response in pulmonary tuberculosis (TB), however, because of its poor sensitivity for the prediction of TB treatment outcomes (particularly in HIV co-infected patients) more effective surrogate markers are needed. Sputum volume itself has not been previously studied as a potential determinant of treatment outcome. Objectives: To assess the association between sputum volume and clinical and radiographic markers of pulmonary TB as well as treatment outcomes among a sample of patients treated for pulmonary tuberculosis at the Mulago Hospital Uganda National Tuberculosis and Leprosy Programme (NTLP) Clinic in Kampala, Uganda. Methods and Findings: Patients admitted to NTLP between July 2003 to January 2007 were enrolled into a prospective cohort study to assess treatment outcomes during and after a course of antituberculous therapy. From this cohort, a secondary analysis of 391 study participants (with a mean follow-up time of 55 months) was conducted to assess the relationship between baseline sputum volume and TB treatment outcome. Of 296 subjects with at least one spot sputum at baseline, a multivariable analysis revealed that having higher volume sputum (≥ 3 ml) at baseline was significantly associated with the presence of cavitary disease (odds ratio (OR) 2.06, 95% confidence interval (CI) 1.2-3.54) and male gender (OR 2.1, 95% CI 1.22-3.62). Among 196 participants with spot sputum specimens who had sufficient microbiologic or demographic data to make a determination regarding their TB treatment outcome, a multivariable logistic regression revealed that having higher volume sputum (≥ 3 ml) at baseline (OR 5.76, 95% CI 1.6-28.56, p = 0.03), increased duration of pre-treatment TB symptoms(≥ 12 weeks; OR 8.07, 95% (11.69-38.59, p = 0.009) and receipt of post-secondary school education (OR 21.03, 95% CI 2.49-177.55, p = 0.005) had significant associations with an unsuccessful TB treatment outcome. Conclusions: Sputum volume produced at the time of pulmonary TB diagnosis is associated with gender and cavitary disease. Of interest, there is a statistically significant increased risk for unsuccessful TB treatment outcomes among those with higher baseline sputum spot volume (≥ 3 ml) in comparison to those with lower sputum volume (<3 mL)

Impact of a reinforcement treatment with acrylate impregnation on the mechanical behavior of black spruce as connector member.

As a previous study has shown, it is possible to increase by 50% the dowel bearing strength of black spruce with an acrylate formulation applied by impregnation. Three diameters of bolts and two orientations of loading were included in this study. The effect of treatment on the dowel-bearing strength appeared to increase while the diameter of bolt decreased. The orientation of loading was significant as the treatment had a major impact in the parallel to grain direction and no impact in the perpendicular direction. With the digital image correlation analysis, an expanded strain field perpendicular to the load direction was observed. The superior embedding capacity would help to reduce the dimensions of the timbers as well as the number of connections required in the building design. With an increase of ductility, wood connections show a safer yielding behavior

Fast Electrochemical Storage Process in Sputtered Nb2O5 Porous Thin Films

The formation of a thin film electrode exhibiting high capacity and high rate capabilities is challenging in the field of miniaturized electrochemical energy storage. Here, we present an elegant strategy to tune the morphology and the properties of sputtered porous Nb2O5 thin films deposited on Si-based substrates via the magnetron sputtering deposition technique. Kinetic analysis of the redox reactions is studied to qualify the charge storage process, where we observe a non-diffusion-controlled mechanism within the porous niobium pentoxide thin film. To improve the surface capacity of the Nb2O5 porous electrode, the thickness is progressively increased up to 0.94 μm, providing a surface capacity close to 60 μAh·cm–2 at 1 mV·s–1. The fabrication of high energy density miniaturized power sources based on the optimized T-Nb2O5 films could be achieved for Internet of Things applications requiring high rate capability

Synthesis of T-Nb2O5 thin-films deposited by Atomic Layer Deposition for miniaturized electrochemical energy storage devices

Atomic Layer Deposition has been used to grow 30 to 90 nm-thick amorphous Nb2O5 films onto Pt current collectors deposited on Si wafer. While T-Nb2O5 polymorph is obtained by further annealing at 750 °C, the film thickness and the resulting electrode areal capacity are successfully controlled by tuning the number of ALD cycles. The electrochemical analysis reveals a lithium ion intercalation redox mechanism in the T-Nb2O5 electrode. An electrode areal capacity of 8 μAh cm-² could be achieved at 1 C, with only 40% capacity loss at 30 C(2 minutes discharging time). This paper aims at demonstrating the use of Atomic Layer Deposition method in the fabrication of Nb205-based on-chip micro-devices for Internet of Things (IoT) applications

Marine ecosystem assessment for the Southern Ocean: birds and marine mammals in a changing climate

The massive number of seabirds (penguins and procellariiformes) and marine mammals (cetaceans and pinnipeds) – referred to here as top predators – is one of the most iconic components of the Antarctic and Southern Ocean. They play an important role as highly mobile consumers, structuring and connecting pelagic marine food webs and are widely studied relative to other taxa. Many birds and mammals establish dense breeding colonies or use haul-out sites, making them relatively easy to study. Cetaceans, however, spend their lives at sea and thus aspects of their life cycle are more complicated to monitor and study. Nevertheless, they all feed at sea and their reproductive success depends on the food availability in the marine environment, hence they are considered useful indicators of the state of the marine resources. In general, top predators have large body sizes that allow for instrumentation with miniature data-recording or transmitting devices to monitor their activities at sea. Development of scientific techniques to study reproduction and foraging of top predators has led to substantial scientific literature on their population trends, key biological parameters, migratory patterns, foraging and feeding ecology, and linkages with atmospheric or oceanographic dynamics, for a number of species and regions. We briefly summarize the vast literature on Southern Ocean top predators, focusing on the most recent syntheses. We also provide an overview on the key current and emerging pressures faced by these animals as a result of both natural and human causes. We recognize the overarching impact that environmental changes driven by climate change have on the ecology of these species. We also evaluate direct and indirect interactions between marine predators and other factors such as disease, pollution, land disturbance and the increasing pressure from global fisheries in the Southern Ocean. Where possible we consider the data availability for assessing the status and trends for each of these components, their capacity for resilience or recovery, effectiveness of management responses, risk likelihood of key impacts and future outlook

Trends in food supply, diet, and the risk of non-communicable diseases in three Small Island Developing States: implications for policy and research

IntroductionSmall island developing states (SIDS) are a diverse group of coastal and tropical island countries primarily located in the Caribbean and Pacific. SIDS share unique social, economic, and environmental vulnerabilities, high dependency on food imports, and susceptibility to inadequate, unhealthy diets, with high burdens of two or more types of malnutrition. Our objective was to examine trends in food availability, imports, local production, and risks of non-communicable diseases (NCDs) in three SIDS: Haiti, Saint Vincent and the Grenadines (SVG) and Fiji.MethodsData on food availability, imports, exports, and production was extracted from the Food and Agriculture Organization Database (FAOSTAT), and on overweight, obesity and diabetes prevalence from the NCD Risk Factor Collaboration database (NCD-RisC) from 1980 to 2018. Data were collated, graphed, and used to calculate import dependency ratios (IDRs) using Excel and R software.ResultsBetween 1980 and 2018, the availability of calories per capita per day has risen in Fiji and SVG by over 500, to around 3000. In Haiti, the increase is around 200, to a level of 2,200 in 2018, and in all three settings, &gt; 10% of calories in 2018 came from sugar. In Fiji and Haiti, the availability of fruit and vegetables is &lt;400 g per person per day (the minimum intake recommended by WHO). Between 1980 and 2010, both Fiji and SVG experienced high IDRs: around 80% (Fiji) and 65% (SVG). In Haiti, IDR has more than doubled since 1980, to around 30%. The prevalence of obesity (BMI &gt; 30 Kg/m2) has increased since 1980 (by 126% to 800%) and is substantially higher in women. In the most recent data for Fiji, an estimated 35% of women are obese (24% men); in SVG, 30% women (15% men); and in Haiti, 26% women (15% men).ConclusionThe increase in per capita availability of calories, which has taken place since 1980, is concurrent with an increase in IDR, a loss of local food, and increases in obesity prevalence. These findings highlight the importance of further research to understand the drivers of food supply transformations, and to influence improving nutrition, through production, availability, and consumption of nutritious local foods

Genetic Discovery and Risk Characterization in Type 2 Diabetes across Diverse Populations

Genomic discovery and characterization of risk loci for type 2 diabetes (T2D) have been conducted primarily in individuals of European ancestry. We conducted a multiethnic genome-wide association study of T2D among 53,102 cases and 193,679 control subjects from African, Hispanic, Asian, Native Hawaiian, and European population groups in the Population Architecture Genomics and Epidemiology (PAGE) and Diabetes Genetics Replication and Meta-analysis (DIAGRAM) Consortia. In individuals of African ancestry, we discovered a risk variant in th

The Genetic Basis of Hepatosplenic T-cell Lymphoma

Hepatosplenic T cell lymphoma (HSTL) is a rare and lethal lymphoma; the genetic drivers of this disease are unknown. Through whole exome sequencing of 68 HSTLs, we define recurrently mutated driver genes and copy number alterations in the disease. Chromatin modifying genes including SETD2, INO80 and ARID1B were commonly mutated in HSTL, affecting 62% of cases. HSTLs manifest frequent mutations in STAT5B (31%), STAT3 (9%), and PIK3CD (9%) for which there currently exist potential targeted therapies. In addition, we noted less frequent events in EZH2, KRAS and TP53. SETD2 was the most frequently silenced gene in HSTL. We experimentally demonstrated that SETD2 acts as a tumor suppressor gene. In addition, we found that mutations in STAT5B and PIK3CD activate critical signaling pathways important to cell survival in HSTL. Our work thus defines the genetic landscape of HSTL and implicates novel gene mutations linked to HSTL pathogenesis and potential treatment targets

A genome-wide association study identifies new susceptibility loci for esophageal adenocarcinoma and Barrett's esophagus.

Esophageal adenocarcinoma is a cancer with rising incidence and poor survival. Most such cancers arise in a specialized intestinal metaplastic epithelium, which is diagnostic of Barrett's esophagus. In a genome-wide association study, we compared esophageal adenocarcinoma cases (n = 2,390) and individuals with precancerous Barrett's esophagus (n = 3,175) with 10,120 controls in 2 phases. For the combined case group, we identified three new associations. The first is at 19p13 (rs10419226: P = 3.6 × 10(-10)) in CRTC1 (encoding CREB-regulated transcription coactivator), whose aberrant activation has been associated with oncogenic activity. A second is at 9q22 (rs11789015: P = 1.0 × 10(-9)) in BARX1, which encodes a transcription factor important in esophageal specification. A third is at 3p14 (rs2687201: P = 5.5 × 10(-9)) near the transcription factor FOXP1, which regulates esophageal development. We also refine a previously reported association with Barrett's esophagus near the putative tumor suppressor gene FOXF1 at 16q24 and extend our findings to now include esophageal adenocarcinoma