Corrigendum: Editorial: Visual Snow: Old Problem, New Understanding.

[This corrects the article DOI: 10.3389/fneur.2022.884752.]

Evaluation of a point-of-care tuberculosis test-and-treat algorithm on early mortality in people with HIV accessing antiretroviral therapy (TB Fast Track study): study protocol for a cluster randomised controlled trial.

BACKGROUND: Early mortality for HIV-positive people starting antiretroviral therapy (ART) remains high in resource-limited settings, with tuberculosis the most important cause. Existing rapid diagnostic tests for tuberculosis lack sensitivity among HIV-positive people, and consequently, tuberculosis treatment is either delayed or started empirically (without bacteriological confirmation). We developed a management algorithm for ambulatory HIV-positive people, based on body mass index and point-of-care tests for haemoglobin and urine lipoarabinomannan (LAM), to identify those at high risk of tuberculosis and mortality. We designed a clinical trial to test whether implementation of this algorithm reduces six-month mortality among HIV-positive people with advanced immunosuppression. METHODS/DESIGN: The TB Fast Track study is an open, pragmatic, cluster randomised superiority trial, with 24 primary health clinics randomised to implement the intervention or standard of care. Adults (aged ≥18 years) with a CD4 count of 150 cells/μL or less, who have not received any tuberculosis treatment in the last three months, or ART in the last six months, are eligible. In intervention clinics, the study algorithm is used to classify individuals as at high, medium or low probability of tuberculosis. Those classified as high probability start tuberculosis treatment immediately, followed by ART after two weeks. Medium-probability patients follow the South African guidelines for test-negative tuberculosis and are reviewed within a week, to be re-categorised as low or high probability. Low-probability patients start ART as soon as possible. The primary outcome is all-cause mortality at six months. Secondary outcomes include severe morbidity, time to ART start and cost-effectiveness. DISCUSSION: This trial will test whether a primary care-friendly management algorithm will enable nurses to identify HIV-positive patients at the highest risk of tuberculosis, to facilitate prompt treatment and reduce early mortality. There remains an urgent need for better diagnostic tests for tuberculosis, especially for people with advanced HIV disease, which may render empirical treatment unnecessary. TRIAL REGISTRATION: This trial was registered with Current Controlled Trials (identifier: ISRCTN35344604 ) on 12 September 2012

Rapid Imaging of Earthquake Ruptures with Combined Geodetic and Seismic Analysis

Rapid determination of the location and extent of earthquake ruptures is helpful for disaster response, as it allows prediction of the likely area of major damage from the earthquake and can help with rescue and recovery planning. With the increasing availability of near real-time data from the Global Positioning System (GPS) and other global navigation satellite system receivers in active tectonic regions, and with the shorter repeat times of many recent and newly launched satellites, geodetic data can be obtained quickly after earthquakes or other disasters. We have been building a data system that can ingest, catalog, and process geodetic data and combine it with seismic analysis to estimate the fault rupture locations and slip distributions for large earthquakes

Systems and Methods for Advanced Rapid Imaging and Analysis for Earthquakes

Many embodiments provide a hybrid data processing system (HySDS) of an end-to-end geodetic imaging data system enabling near-real-time science, assessment, response, and rapid recovery. The HySDS may be an operation data processing system that integrates data from many different geodetic data sources and/or sensors, including interferometric synthetic aperture radar (InSAR), GPS, pixel tracking, seismology, and/or modeling, and processes the data to generate actionable high quality science data products. The HySDS may provide for an automated imaging and analysis capabilities that is able to handle the imminent increases in raw data from new and existing geodetic monitoring sensor systems

Performance characteristics of the Cepheid Xpert MTB/RIF test in a tuberculosis prevalence survey.

BACKGROUND: Xpert MTB/RIF ("Xpert") is a molecular test for detection of Mycobacterium tuberculosis (MTB) in sputum. Performance characteristics have been established for its use during passive tuberculosis (TB) case detection in symptomatic TB suspects, but Xpert performance has not been assessed in other settings. Objectives were to determine Xpert performance and costs in the context of a TB prevalence survey. METHODOLOGY/PRINCIPAL FINDINGS: This was a diagnostic sub-study of a TB prevalence survey conducted in gold mining companies in South Africa. Sputa (one per participant) were tested using smear microscopy, liquid culture (reference comparator), and Xpert. Costs were collected using an ingredients approach and analyzed using a public health program perspective. 6893 participants provided a sputum specimen. 187/6893 (2.7%) were positive for MTB in culture, 144/6893 (2.1%) were positive for MTB by Xpert, and 91/6893 (1.3%) were positive for acid fast bacilli by microsocopy. Sensitivity, specificity, positive predictive value, and negative predictive value for detection of MTB by Xpert were 62.6% (95% confidence interval [CI] 55.2, 69.5), 99.6% (99.4, 99.7), 81.3% (73.9, 87.3), and 98.9 (98.6, 98.8); agreement between Xpert and culture was 98.5% (98.2, 98.8). Sensitivity of microscopy was 17.6% (12.5, 23.9). When individuals with a history of TB treatment were excluded from the analysis, Xpert specificity was 99.8 (99.7, 99.9) and PPV was 90.6 (83.3, 95.4) for detection of MTB. For the testing scenario of 7000 specimens with 2.7% of specimens culture positive for MTB, costs were $165,690 for Xpert and$115,360 for the package of microscopy plus culture. CONCLUSION: In the context of a TB prevalence survey, the Xpert diagnostic yield was substantially higher than that of microscopy yet lower than that of liquid culture. Xpert may be useful as a sole test for TB case detection in prevalence surveys, particularly in settings lacking capacity for liquid culture

Software for Generating Troposphere Corrections for InSAR Using GPS and Weather Model Data

Atmospheric errors due to the troposphere are a limiting error source for spaceborne interferometric synthetic aperture radar (InSAR) imaging. This software generates tropospheric delay maps that can be used to correct atmospheric artifacts in InSAR data. The software automatically acquires all needed GPS (Global Positioning System), weather, and Digital Elevation Map data, and generates a tropospheric correction map using a novel algorithm for combining GPS and weather information while accounting for terrain. Existing JPL software was prototypical in nature, required a MATLAB license, required additional steps to acquire and ingest needed GPS and weather data, and did not account for topography in interpolation. Previous software did not achieve a level of automation suitable for integration in a Web portal. This software overcomes these issues. GPS estimates of tropospheric delay are a source of corrections that can be used to form correction maps to be applied to InSAR data, but the spacing of GPS stations is insufficient to remove short-wavelength tropospheric artifacts. This software combines interpolated GPS delay with weather model precipitable water vapor (PWV) and a digital elevation model to account for terrain, increasing the spatial resolution of the tropospheric correction maps and thus removing short wavelength tropospheric artifacts to a greater extent. It will be integrated into a Web portal request system, allowing use in a future L-band SAR Earth radar mission data system. This will be a significant contribution to its technology readiness, building on existing investments in in situ space geodetic networks, and improving timeliness, quality, and science value of the collected dat

Breast, cervical, and colorectal cancer screening rates amongst female Cambodian, Somali, and Vietnamese immigrants in the USA

<p>Abstract</p> <p>Introduction</p> <p>Minority women, particularly immigrants, have lower cancer screening rates than Caucasian women, but little else is known about cancer screening among immigrant women. Our objective was to assess breast, cervical, and colorectal cancer screening rates among immigrant women from Cambodia, Somalia, and Vietnam and explore screening barriers.</p> <p>Methods</p> <p>We measured screening rates by systematic chart review (N = 100) and qualitatively explored screening barriers via face-to-face questionnaire (N = 15) of women aged 50–75 from Cambodia, Somalia, and Vietnam attending a general medicine clinic (Portland, Maine, USA).</p> <p>Results</p> <p><it>Chart Review </it>– Somali women were at higher risk of being unscreened for breast, cervical, and colorectal cancer compared with Cambodian and Vietnamese women. A longer period of US residency was associated with being screened for colorectal cancer. We observed a 7% (OR 1.07, 95% CI 1.01–1.13, p = 0.01) increase in the odds that a woman would undergo a fecal occult blood test for each additional year in the US, and a 39% increase in the odds of a woman being screened by colonoscopy or flexible sigmoidoscopy for every five years of additional US residence (OR 1.39, 95% CI 1.21–1.61, p = 0.02). We did not observe statistically significant relationships between odds of being screened by mammography, clinical breast exam or papanicolaou test according to years in the US. <it>Questionnaire </it>– We identified several barriers to breast, cervical, and colorectal cancer screening, including discomfort with exams conducted by male physicians.</p> <p>Discussion</p> <p>Somali women were less likely to be screened for breast, cervical, and colorectal cancer than Cambodian and Vietnamese women in this population, and uptake of colorectal cancer screening is associated with years of residency in this country. Future efforts to improve equity in cancer screening among immigrants may require both provider and community education.</p