Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

Background: Pleural tuberculosis (TB) diagnosis often requires invasive procedures such as pleural biopsy. The aim of this study was to evaluate the role of real-time polymerase chain reaction (PCR) for the IS6110 sequence of M. tuberculosis in pleural fluid specimens as a rapid and non-invasive test for pleural TB diagnosis. Findings: For this cross-sectional study, 150 consecutive patients with pleural effusion diagnosed by chest radiography, who were referred for diagnostic thoracocentesis and pleural biopsy and met eligibility criteria, had a pleural fluid specimen submitted for real-time PCR testing. Overall, 98 patients had pleural TB and 52 had pleural effusion secondary to other disease. TB diagnosis was obtained using acid-fast bacilli (AFB) smear or culture for mycobacteria and/or histopathologic examination in 94 cases and by clinical findings in 4 cases. Sensitivity, specificity, positive and negative predictive values of PCR testing for pleural TB diagnosis were 42.8% (95% CI 38.4 - 44.8), 94.2% (95% CI 85.8 - 98.0), 93.3% (95% CI 83.6 - 97.7), and 48.5% (95% CI 44.2 - 50.4), respectively. The realtime PCR test improved TB detection from 30.6% to 42.9% when compared to AFB smear and culture methods performed on pleural fluid specimens, although the best sensitivity was achieved by combining the results of culture and histopathology of pleural tissue specimens. Conclusion: The real-time PCR test of pleural fluid specimens is a useful and non-invasive additional assay for fast diagnosis of pleural TB

liquid biopsy as tool to monitor and predict clinical benefit from chemotherapy ct and immunotherapy it in advanced non small cell lung cancer ansclc a prospective study

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The Impact of Different Types of Assistive Devices on Gait Measures and Safety in Huntington's Disease

BACKGROUND: Gait and balance impairments lead to frequent falls and injuries in individuals with Huntington's disease (HD). Assistive devices (ADs) such as canes and walkers are often prescribed to prevent falls, but their efficacy is unknown. We systematically examined the effects of different types of ADs on quantitative gait measures during walking in a straight path and around obstacles. METHODS: Spatial and temporal gait parameters were measured in 21 subjects with HD as they walked across a GAITRite walkway under 7 conditions (i.e., using no AD and 6 commonly prescribed ADs: a cane, a weighted cane, a standard walker, and a 2, 3 or 4 wheeled walker). Subjects also were timed and observed for number of stumbles and falls while walking around two obstacles in a figure-of-eight pattern. RESULTS: Gait measure variability (i.e., coefficient of variation), an indicator of fall risk, was consistently better when using the 4WW compared to other ADs. Subjects also walked the fastest and had the fewest number of stumbles and falls when using the 4WW in the figure-of-eight course. Subjects walked significantly slower using ADs compared to no AD both across the GAITRite and in the figure-of-eight. Measures reflecting gait stability and safety improved with the 4WW but were made worse by some other ADs

Is there a standard procedure for assessing and providing assistive devices for people with neuro-disabling conditions in United Kingdom? A nation-wide survey

Background: Assistive devices are currently provided to people with neuro-disabling conditions to promote or maintain independence in activities of daily living. However, it is unclear whether assessment procedures performed by health care professionals to guide the provision of assistive devices are standardized.  Objective: To explore the assessment and service-delivery processes of assistive devices for people with multiple sclerosis, cerebrovascular disease and Parkinson's disease experiencing physical disability by health care professionals in the United Kingdom.  Methods: A survey was conducted among UK health care professionals working with people with neuro-disabling conditions. Descriptive and content analyses were used to code survey data.  Results: In total, 231 health care professionals completed the survey: 93 occupational therapists, 136 physiotherapists and 2 assistant practitioners. Less than half of the respondents (46%) reported use of local, national, or combined guidelines when assessing a service user's suitability or need for assistive devices. When guidelines were used, they were not consistent and not specifically for assistive devices. The respondents stated that when users were allocated small and portable assistive devices, they were supplied within four weeks. This period increased for large equipment, major home adaptions or if external specialist services and/or funding was needed.  Conclusions: Standardized operating procedures for assistive device provision are not being carried out within the UK. Variable access to assistive devices supplied by the state indicates inequity across regions. Future research should explore potential benefits of developing standardized assessment procedures for the provision of assistive devices and devise methods to reduce current variability in service delivery

Euclid preparation: XXX. Performance assessment of the NISP red grism through spectroscopic simulations for the wide and deep surveys

This work focusses on the pilot run of a simulation campaign aimed at investigating the spectroscopic capabilities of the Euclid Near-Infrared Spectrometer and Photometer (NISP), in terms of continuum and emission line detection in the context of galaxy evolutionary studies. To this purpose, we constructed, emulated, and analysed the spectra of 4992 star-forming galaxies at 0:3 ≥ z ≥ 2:5 using the NISP pixel-level simulator. We built the spectral library starting from public multi-wavelength galaxy catalogues, with value-added information on spectral energy distribution (SED) fitting results, and stellar population templates from Bruzual & Charlot (2003, MNRAS, 344, 1000). Rest-frame optical and near-IR nebular emission lines were included using empirical and theoretical relations. Dust attenuation was treated using the Calzetti extinction law accounting for the differential attenuation in line-emitting regions with respect to the stellar continuum. The NISP simulator was configured including instrumental and astrophysical sources of noise such as the dark current, read-out noise, zodiacal background, and out-of-field stray light. In this preliminary study, we avoided contamination due to the overlap of the slitless spectra. For this purpose, we located the galaxies on a grid and simulated only the first order spectra.We inferred the 3.5δ NISP red grism spectroscopic detection limit of the continuum measured in the H band for star-forming galaxies with a median disk half-light radius of 0: 004 at magnitude H = 19:5 = 0:2ABmag for the Euclid Wide Survey and at H = 20:8 = 0:6ABmag for the Euclid Deep Survey. We found a very good agreement with the red grism emission line detection limit requirement for the Wide and Deep surveys. We characterised the effect of the galaxy shape on the detection capability of the red grism and highlighted the degradation of the quality of the extracted spectra as the disk size increased. In particular, we found that the extracted emission line signal-to-noise ratio (S/N) drops by 45% when the disk size ranges from 0: 0025 to 100. These trends lead to a correlation between the emission line S/N and the stellar mass of the galaxy and we demonstrate the effect in a stacking analysis unveiling emission lines otherwise too faint to detect

Euclid: Forecasts from the void-lensing cross-correlation

The Euclid space telescope will survey a large dataset of cosmic voids traced by dense samples of galaxies. In this work we estimate its expected performance when exploiting angular photometric void clustering, galaxy weak lensing, and their cross-correlation. To this aim, we implemented a Fisher matrix approach tailored for voids from the Euclid photometric dataset and we present the first forecasts on cosmological parameters that include the void-lensing correlation. We examined two different probe settings, pessimistic and optimistic, both for void clustering and galaxy lensing. We carried out forecast analyses in four model cosmologies, accounting for a varying total neutrino mass, Mν, and a dynamical dark energy (DE) equation of state, w(z), described by the popular Chevallier-Polarski-Linder parametrization. We find that void clustering constraints on h and Ωb are competitive with galaxy lensing alone, while errors on ns decrease thanks to the orthogonality of the two probes in the 2D-projected parameter space. We also note that, as a whole, with respect to assuming the two probes as independent, the inclusion of the void-lensing cross-correlation signal improves parameter constraints by 10 − 15%, and enhances the joint void clustering and galaxy lensing figure of merit (FoM) by 10% and 25%, in the pessimistic and optimistic scenarios, respectively. Finally, when further combining with the spectroscopic galaxy clustering, assumed as an independent probe, we find that, in the most competitive case, the FoM increases by a factor of 4 with respect to the combination of weak lensing and spectroscopic galaxy clustering taken as independent probes. The forecasts presented in this work show that photometric void clustering and its cross-correlation with galaxy lensing deserve to be exploited in the data analysis of the Euclid galaxy survey and promise to improve its constraining power, especially on h, Ωb, the neutrino mass, and the DE evolution

Euclid: Cosmological forecasts from the void size function

The Euclid mission $-$ with its spectroscopic galaxy survey covering a sky area over $15\,000 \ \mathrm{deg}^2$ in the redshift range $0.9<1.8\ -$ will provide a sample of tens of thousands of cosmic voids. This paper explores for the first time the constraining power of the void size function on the properties of dark energy (DE) from a survey mock catalogue, the official Euclid Flagship simulation. We identify voids in the Flagship light-cone, which closely matches the features of the upcoming Euclid spectroscopic data set. We model the void size function considering a state-of-the art methodology: we rely on the volume conserving (Vdn) model, a modification of the popular Sheth & van de Weygaert model for void number counts, extended by means of a linear function of the large-scale galaxy bias. We find an excellent agreement between model predictions and measured mock void number counts. We compute updated forecasts for the Euclid mission on DE from the void size function and provide reliable void number estimates to serve as a basis for further forecasts of cosmological applications using voids. We analyse two different cosmological models for DE: the first described by a constant DE equation of state parameter, $w$, and the second by a dynamic equation of state with coefficients $w_0$ and $w_a$. We forecast $1\sigma$ errors on $w$ lower than the $10\%$, and we estimate an expected figure of merit (FoM) for the dynamical DE scenario $\mathrm{FoM}_{w_0,w_a} = 17$ when considering only the neutrino mass as additional free parameter of the model. The analysis is based on conservative assumptions to ensure full robustness, and is a pathfinder for future enhancements of the technique. Our results showcase the impressive constraining power of the void size function from the Euclid spectroscopic sample, both as a stand-alone probe, and to be combined with other Euclid cosmological probes...

Euclid: Forecasts from redshift-space distortions and the Alcock-Paczynski test with cosmic voids

Euclid is poised to survey galaxies across a cosmological volume of unprecedented size, providing observations of more than a billion objects distributed over a third of the full sky. Approximately 20 million of these galaxies will have their spectroscopy available, allowing us to map the three-dimensional large-scale structure of the Universe in great detail. This paper investigates prospects for the detection of cosmic voids therein and the unique benefit they provide for cosmological studies. In particular, we study the imprints of dynamic (redshift-space) and geometric (Alcock-Paczynski) distortions of average void shapes and their constraining power on the growth of structure and cosmological distance ratios. To this end, we made use of the Flagship mock catalog, a state-of-the-art simulation of the data expected to be observed with Euclid. We arranged the data into four adjacent redshift bins, each of which contains about 11000 voids and we estimated the stacked void-galaxy cross-correlation function in every bin. Fitting a linear-theory model to the data, we obtained constraints on f/b and DMH, where f is the linear growth rate of density fluctuations, b the galaxy bias, D-M the comoving angular diameter distance, and H the Hubble rate. In addition, we marginalized over two nuisance parameters included in our model to account for unknown systematic effects in the analysis. With this approach, Euclid will be able to reach a relative precision of about 4% on measurements of f/b and 0.5% on DMH in each redshift bin. Better modeling or calibration of the nuisance parameters may further increase this precision to 1% and 0.4%, respectively. Our results show that the exploitation of cosmic voids in Euclid will provide competitive constraints on cosmology even as a stand-alone probe. For example, the equation-of-state parameter, w, for dark energy will be measured with a precision of about 10%, consistent with previous more approximate forecasts