Performance of a Whole-Blood Interferon-Gamma Release Assay with Mycobacterium RD1-Specific Antigens among HIV-Infected Persons

Objective. To evaluate the usefulness of one of IGRAs, QuantiFERON-TB Gold (QFT-G), in human immunodeficiency virus- (HIV- ) infected patients with various CD4+ T cell counts. Methods. The QFT-G assay was performed using QFT-G kits among 107 HIV-infected patients including 9 cases with active tuberculosis (TB). Results. In HIV-infected patients with CD4+ > 50/μL, QFT-G positive rate for active TB patients was 5/6 (sensitivity = 83%), and that for those without active disease was 1/69 (specificity = 99%). The frequency of indeterminate QFT-G test was significantly higher in those with CD4+ less than 50/μL (P < .0001). At the same time there was a proportional relationship between CD4+ and interferon-gamma response to mitogen (positive control) in QFT-G test (P = .0001). Conclusions. Our data suggested that QFT-G had high sensitivity and specificity in HIV-infected populations with CD4+ greater than 50/μL. However, QFT-G did not perform well in HIV-positive patients with CD4+ less than 50/μL

Rapid-onset dystonia-Parkinsonism phenotype consistency for a novel variant of ATP1A3 in patients across 3 global populations

info:eu-repo/semantics/publishedVersio

Quality assessment of an interferon-gamma release assay for tuberculosis infection in a resource-limited setting

<p>Abstract</p> <p>Background</p> <p>When a test for diagnosis of infectious diseases is introduced in a resource-limited setting, monitoring quality is a major concern. An optimized design of experiment and statistical models are required for this assessment.</p> <p>Methods</p> <p>Interferon-gamma release assay to detect tuberculosis (TB) infection from whole blood was tested in Hanoi, Viet Nam. Balanced incomplete block design (BIBD) was planned and fixed-effect models with heterogeneous error variance were used for analysis. In the first trial, the whole blood from 12 donors was incubated with nil, TB-specific antigens or mitogen. In 72 measurements, two laboratory members exchanged their roles in harvesting plasma and testing for interferon-gamma release using enzyme linked immunosorbent assay (ELISA) technique. After intervention including checkup of all steps and standard operation procedures, the second trial was implemented in a similar manner.</p> <p>Results</p> <p>The lack of precision in the first trial was clearly demonstrated. Large within-individual error was significantly affected by both harvester and ELISA operator, indicating that both of the steps had problems. After the intervention, overall within-individual error was significantly reduced (<it>P </it>< 0.0001) and error variance was no longer affected by laboratory personnel in charge, indicating that a marked improvement could be objectively observed.</p> <p>Conclusion</p> <p>BIBD and analysis of fixed-effect models with heterogeneous variance are suitable and useful for objective and individualized assessment of proficiency in a multistep diagnostic test for infectious diseases in a resource-constrained laboratory. The action plan based on our findings would be worth considering when monitoring for internal quality control is difficult on site.</p

Dating Model for Dome Fuji Icecore using Data Assimilation

第3回極域科学シンポジウム/第35回極域気水圏シンポジウム 11月29日（木） 国立国語研究所 ２階ロビ

Prevalence and Risk Factors for Tuberculosis Infection among Hospital Workers in Hanoi, Viet Nam

BACKGROUND: Transmission of tuberculosis (TB) to health care workers (HCWs) is a global issue. Although effective infection control measures are expected to reduce nosocomial TB, HCWs' infection has not been assessed enough in TB high burden countries. We conducted a cross-sectional study to determine the prevalence of TB infection and its risk factors among HCWs in Hanoi, Viet Nam. METHODOLOGY/PRINCIPAL FINDINGS: A total of 300 HCWs including all staff members in a municipal TB referral hospital received an interferon-gamma release assay (IGRA), QuantiFERON-TB Gold In-Tube(TM), followed by one- and two-step tuberculin skin test (TST) and a questionnaire-based interview. Agreement between the tests was evaluated by kappa statistics. Risk factors for TB infection were analyzed using a logistic regression model. Among the participants aged from 20 to 58 years (median = 40), prevalence of TB infection estimated by IGRA, one- and two-step TST was 47.3%, 61.1% and 66.3% respectively. Although the levels of overall agreement between IGRA and TST were moderate, the degree of agreement was low in the group with BCG history (kappa = 0.29). Working in TB hospital was associated with twofold increase in odds of TB infection estimated by IGRA. Increased age, low educational level and the high body mass index also demonstrated high odds ratios of IGRA positivity. CONCLUSIONS/SIGNIFICANCE: Prevalence of TB infection estimated by either IGRA or TST is high among HCWs in the hospital environment for TB care in Viet Nam and an infection control program should be reinforced. In communities with heterogeneous history of BCG vaccination, IGRA seems to estimate TB infection more accurately than any other criteria using TST

Rigidez métrica e expressividade na interpretação musical: uma teoria neuropsicológica

Rubato has always been related to musical performance expressivity. In the last 150 years, however, Western art music teaching has emphasized strict metric regularity in the performance of pieces composed before the Romantic era. Such practice however is not consensual. The present study is an interdisciplinary, descriptive analysis, based on musicological, psychological, and neuroscientific data that aims to explain the reasons of the polemic related to the function of maintaining strict metric regularity in musical performance. We have found in cognitive psychological data, information that supports the relationship between rubato and musical expressiveness. There is also evidence that the maintenance of strict metric regularity could inhibit expressiveness. This inhibition seems to be related to the level of difficulty that one experiences when asked to keep a strict tempo. Despite the inhibiting component, observations in musical teaching indicate that the practice of strict metric regularity is an indispensable instrument to a more elaborated expressive musical interpretation. Therefore this present study analyzes the importance of this practice in the development of musical expressiveness

A sequential Bayesian approach for the estimation of the age-depth relationship of the Dome Fuji ice core

International audienceA technique for estimating the age–depth relationship in an ice core and evaluating its uncertainty is presented. The age–depth relationship is determined by the accumulation of snow at the site of the ice core and the thinning process as a result of the deformation of ice layers. However, since neither the accumulation rate nor the thinning process is fully known, it is essential to incorporate observational information into a model that describes the accumulation and thinning processes. In the proposed technique, the age as a function of depth is estimated by making use of age markers and δ 18 O data. The age markers provide reliable age information at several depths. The data of δ 18 O are used as a proxy of the temperature for estimating the accumulation rate. The estimation is achieved using the particle Markov chain Monte Carlo (PMCMC) method, which is a combination of the sequential Monte Carlo (SMC) method and the Markov chain Monte Carlo method. In this hybrid method, the posterior distributions for the parameters in the models for the accumulation and thinning process are computed using the Metropolis method, in which the likelihood is obtained with the SMC method, and the posterior distribution for the age as a function of depth is obtained by collecting the samples generated by the SMC method with Metropolis iterations. The use of this PMCMC method enables us to estimate the age–depth relationship without assuming either lin-earity or Gaussianity. The performance of the proposed technique is demonstrated by applying it to ice core data from Dome Fuji in Antarctica

Clinical Study Performance of a Whole-Blood Interferon-Gamma Release Assay with Mycobacterium RD1-Specific Antigens among HIV-Infected Persons

Objective. To evaluate the usefulness of one of IGRAs, QuantiFERON-TB Gold (QFT-G), in human immunodeficiency virus-(HIV-) infected patients with various CD4 + T cell counts. Methods. The QFT-G assay was performed using QFT-G kits among 107 HIV-infected patients including 9 cases with active tuberculosis (TB). Results. In HIV-infected patients with CD4 + &gt; 50/μL, QFT-G positive rate for active TB patients was 5/6 (sensitivity = 83%), and that for those without active disease was 1/69 (specificity = 99%). The frequency of indeterminate QFT-G test was significantly higher in those with CD4 + less than 50/μL (P &lt; .0001). At the same time there was a proportional relationship between CD4 + and interferon-gamma response to mitogen (positive control) in QFT-G test (P = .0001). Conclusions. Our data suggested that QFT-G had high sensitivity and specificity in HIV-infected populations with CD4 + greater than 50/μL. However, QFT-G did not perform well in HIV-positive patients with CD4 + less than 50/μL