698 research outputs found
The seasonality of tuberculosis, sunlight, vitamin D, and household crowding.
BACKGROUND: Unlike other respiratory infections, tuberculosis diagnoses increase in summer. We performed an ecological analysis of this paradoxical seasonality in a Peruvian shantytown over 4 years. METHODS: Tuberculosis symptom-onset and diagnosis dates were recorded for 852 patients. Their tuberculosis-exposed cohabitants were tested for tuberculosis infection with the tuberculin skin test (n = 1389) and QuantiFERON assay (n = 576) and vitamin D concentrations (n = 195) quantified from randomly selected cohabitants. Crowding was calculated for all tuberculosis-affected households and daily sunlight records obtained. RESULTS: Fifty-seven percent of vitamin D measurements revealed deficiency (<50 nmol/L). Risk of deficiency was increased 2.0-fold by female sex (P < .001) and 1.4-fold by winter (P < .05). During the weeks following peak crowding and trough sunlight, there was a midwinter peak in vitamin D deficiency (P < .02). Peak vitamin D deficiency was followed 6 weeks later by a late-winter peak in tuberculin skin test positivity and 12 weeks after that by an early-summer peak in QuantiFERON positivity (both P < .04). Twelve weeks after peak QuantiFERON positivity, there was a midsummer peak in tuberculosis symptom onset (P < .05) followed after 3 weeks by a late-summer peak in tuberculosis diagnoses (P < .001). CONCLUSIONS: The intervals from midwinter peak crowding and trough sunlight to sequential peaks in vitamin D deficiency, tuberculosis infection, symptom onset, and diagnosis may explain the enigmatic late-summer peak in tuberculosis
Risk of acquired drug resistance during short-course directly observed treatment of tuberculosis in an area with high levels of drug resistance.
BACKGROUND: Data on the performance of standardized short-course directly observed treatment (DOTS) of tuberculosis (TB) in areas with high levels of drug resistance and on the potential impact of DOTS on amplification of resistance are limited. Therefore, we analyzed treatment results from a cross-sectional sample of patients with TB enrolled in a DOTS program in an area with high levels of drug resistance in Uzbekistan and Turkmenistan in Central Asia. METHODS: Sputum samples for testing for susceptibility to 5 first-line drugs and for molecular typing were obtained from patients starting treatment in 8 districts. Patients with sputum smear results positive for TB at the end of the intensive phase of treatment and/or at 2 months into the continuation phase were tested again. RESULTS. Among 382 patients with diagnoses of TB, 62 did not respond well to treatment and were found to be infected with an identical Mycobacterium tuberculosis strain when tested again; 19 of these patients had strains that developed new or additional drug resistance. Amplification occurred in only 1.2% of patients with initially susceptible or monoresistant TB strains, but it occurred in 17% of those with polyresistant strains (but not multidrug-resistant strains, defined as strains with resistance to at least isoniazid and rifampicin) and in 7% of those with multidrug-resistant strains at diagnosis. Overall, 3.5% of the patients not initially infected with multidrug-resistant TB strains developed such strains during treatment. Amplification of resistance, however, was found only in polyresistant Beijing genotype strains. CONCLUSIONS: High levels of amplification of drug resistance demonstrated under well-established DOTS program conditions reinforce the need for implementation of DOTS-Plus for multidrug-resistant TB in areas with high levels of drug resistance. The strong association of Beijing genotype and amplification in situations of preexisting resistance is striking and may underlie the strong association between this genotype and drug resistance
Recommended from our members
Characterization of nodular and thermal defects in hafnia/silica multilayer coatings using optical, photothermal, and atomic force microscopy
Multilayer coatings manufactured from metallic hafnium and silica sources by reactive electron beam deposition, are being developed for high fluence optics in a fusion laser with a wavelength of 1053 nm and a 3 ns pulse length. Damage threshold studies have revealed a correlation between laser damage and nodular defects, but interestingly laser damage is also present in nodule-free regions. Photothermal studies of optical coatings reveal the existence of defects with strong optical absorption in nodule-free regions of the coating. A variety of microscopic techniques were employed to characterize the effects for a better understanding of the thermal properties of nodular defects and role of thermal defects in laser damage. Photothermal microscopy, utilizing the surface thermal lensing technique, was used to map the thermal characteristics of 3 mm x 3 mm areas of the coatings. High resolution subaperture scans, with a 1 pm step size and a 3 um pump beam diameter, W= conducted on the defects to characterize their photothermal properties. Optical and atomic force microscopy was used to visually identify defects and characterize their topography. The defects were then irradiated to determine the role of nodular and thermal defects in limiting the damage threshold of the multilayer
Phytoplankton competition in deep biomass maximum
Resource competition in heterogeneous environments is still an unresolved
problem of theoretical ecology. In this article I analyze competition between
two phytoplankton species in a deep water column, where the distributions of
main resources (light and a limiting nutrient) have opposing gradients and
co-limitation by both resources causes a deep biomass maximum. Assuming that
the species have a trade-off in resource requirements and the water column is
weakly mixed, I apply the invasion threshold analysis (Ryabov and Blasius 2011)
to determine relations between environmental conditions and phytoplankton
composition. Although species deplete resources in the interior of the water
column, the resource levels at the bottom and surface remain high. As a result,
the slope of resources gradients becomes a new crucial factor which, rather
than the local resource values, determines the outcome of competition. The
value of resource gradients nonlinearly depend on the density of consumers.
This leads to complex relationships between environmental parameters and
species composition. In particular, it is shown that an increase of both the
incident light intensity or bottom nutrient concentrations favors the best
light competitors, while an increase of the turbulent mixing or background
turbidity favors the best nutrient competitors. These results might be
important for prediction of species composition in deep ocean.Comment: 13 pages, 7 figures; Theoretical Ecology 201
Recommended from our members
Thin film contamination effects on laser-induced damage of fused silica surfaces at 355 nm
Fused silica windows were artificially contaminated to estimate the resistance of target chamber debris shields against laser damage during NIF operation. Uniform contamination thin films (1 to 5 nm thick) were prepared by sputtering various materials (Au, Al, Cu, and B4C). The loss of transmission of the samples was first measured. They were then tested at 355 nm in air with an 8-ns Nd:YAG laser. The damage morphologies were characterized by Nomarski optical microscopy and SEM. Both theory and experiments showed that metal contamination for films as thin as 1 nm leads to a substantial loss of transmission. The laser damage resistance dropped very uniformly across the entire surface (e.g. 6 J/cm2 for 5 nm of Cu). The damage morphology characterization showed that contrary to clean silica, metal coated samples did not produce pits on the surface. B4C coated silica, on the other hand, led to a higher density of such damage pits. A model for light absorption in the thin film was coupled with a simple heat deposition and diffusion model to perform preliminary theoretical estimates of damage thresholds. The estimates of the loss due to light absorption and reflection pointed out significant .differences between metals (e.g. Al and Au). The damage threshold predictions were in qualitative agreement with experimental measurements
Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers
Chronopharmacokinetics of once daily dosed aminoglycosides in hospitalized infectious patients
A Novel 3-Hydroxysteroid Dehydrogenase That Regulates Reproductive Development and Longevity
A multidisciplinary approach identifies novel biochemical activities involved in the synthesisof C. elegans bile acid-like steroids, which act as hormones that regulate sterol metabolism and longevity
- β¦