Diagnostic accuracy of TB-LAMP for pulmonary tuberculosis: a systematic review and meta-analysis.

BACKGROUND:The need for a rapid, molecular test to diagnose tuberculosis (TB) has prompted exploration of TB-LAMP (Eiken; Tokyo, Japan) for use in resource-limited settings. We conducted a systematic review to assess the accuracy of TB-LAMP as a diagnostic test for pulmonary TB. METHODS:We analyzed individual-level data for eligible patients from all studies of TB-LAMP conducted between Jan 2012 and October 2015 to compare the diagnostic accuracy of TB-LAMP with that of smear microscopy and Xpert MTB/RIF® using 3 reference standards of varying stringency. Pooled sensitivity and specificity and pooled differences in sensitivity and specificity were estimated using random effects meta-analysis. Study quality was evaluated using QUADAS-2. RESULTS:Four thousand seven hundred sixty individuals across 13 studies met eligibility criteria. Methodological quality was judged to be low for all studies. TB-LAMP had higher sensitivity than sputum smear microscopy (pooled sensitivity difference + 13·2, 95% CI 4·5-21·9%) and similar sensitivity to Xpert MTB/RIF (pooled sensitivity difference - 2·5, 95% CI -8·0 to + 2·9) using the most stringent reference standard available. Specificity of TB-LAMP was similar to that of sputum smear microscopy (pooled specificity difference - 1·8, 95% CI -3·8 to + 0·2) and Xpert MTB/RIF (pooled specificity difference 0·5, 95% CI -0·9 to + 1·8). CONCLUSIONS:From the perspective of diagnostic accuracy, TB-LAMP may be considered as an alternative test for sputum smear microscopy. Additional factors such as cost, feasibility, and acceptability in settings that continue to rely on sputum smear microscopy should be considered when deciding to adopt this technology. Xpert MTB/RIF should continue to be preferred in settings where resource and infrastructure requirements are adequate and where HIV co-infection or drug-resistance is of concern

Outlook for tuberculosis elimination in California: An individual-based stochastic model.

RationaleAs part of the End TB Strategy, the World Health Organization calls for low-tuberculosis (TB) incidence settings to achieve pre-elimination (<10 cases per million) and elimination (<1 case per million) by 2035 and 2050, respectively. These targets require testing and treatment for latent tuberculosis infection (LTBI).ObjectivesTo estimate the ability and costs of testing and treatment for LTBI to reach pre-elimination and elimination targets in California.MethodsWe created an individual-based epidemic model of TB, calibrated to historical cases. We evaluated the effects of increased testing (QuantiFERON-TB Gold) and treatment (three months of isoniazid and rifapentine). We analyzed four test and treat targeting strategies: (1) individuals with medical risk factors (MRF), (2) non-USB, (3) both non-USB and MRF, and (4) all Californians. For each strategy, we estimated the effects of increasing test and treat by a factor of 2, 4, or 10 from the base case. We estimated the number of TB cases occurring and prevented, and net and incremental costs from 2017 to 2065 in 2015 U.S. dollars. Efficacy, costs, adverse events, and treatment dropout were estimated from published data. We estimated the cost per case averted and per quality-adjusted life year (QALY) gained.Measurements and main resultsIn the base case, 106,000 TB cases are predicted to 2065. Pre-elimination was achieved by 2065 in three scenarios: a 10-fold increase in the non-USB and persons with MRF (by 2052), and 4- or 10-fold increase in all Californians (by 2058 and 2035, respectively). TB elimination was not achieved by any intervention scenario. The most aggressive strategy, 10-fold in all Californians, achieved a case rate of 8 (95% UI 4-16) per million by 2050. Of scenarios that reached pre-elimination, the incremental net cost was $20 billion (non-USB and MRF) to$48 billion. These had an incremental cost per QALY of $657,000 to$3.1 million. A more efficient but somewhat less effective single-lifetime test strategy reached as low as $80,000 per QALY.ConclusionsSubstantial gains can be made in TB control in coming years by scaling-up current testing and treatment in non-USB and those with medical risks

Investigating Multiple Candidate Genes and Nutrients in the Folate Metabolism Pathway to Detect Genetic and Nutritional Risk Factors for Lung Cancer

Purpose: Folate metabolism, with its importance to DNA repair, provides a promising region for genetic investigation of lung cancer risk. This project investigates genes (MTHFR, MTR, MTRR, CBS, SHMT1, TYMS), folate metabolism related nutrients (B vitamins, methionine, choline, and betaine) and their gene-nutrient interactions. Methods: We analyzed 115 tag single nucleotide polymorphisms (SNPs) and 15 nutrients from 1239 and 1692 non-Hispanic white, histologically-confirmed lung cancer cases and controls, respectively, using stochastic search variable selection (a Bayesian model averaging approach). Analyses were stratified by current, former, and never smoking status. Results: Rs6893114 in MTRR (odds ratio [OR] = 2.10; 95% credible interval [CI]: 1.20–3.48) and alcohol (drinkers vs. non-drinkers, OR = 0.48; 95% CI: 0.26–0.84) were associated with lung cancer risk in current smokers. Rs13170530 in MTRR (OR = 1.70; 95% CI: 1.10–2.87) and two SNP*nutrient interactions [betaine*rs2658161 (OR = 0.42; 95% CI: 0.19–0.88) and betaine*rs16948305 (OR = 0.54; 95% CI: 0.30–0.91)] were associated with lung cancer risk in former smokers. SNPs in MTRR (rs13162612; OR = 0.25; 95% CI: 0.11–0.58; rs10512948; OR = 0.61; 95% CI: 0.41–0.90; rs2924471; OR = 3.31; 95% CI: 1.66–6.59), and MTHFR (rs9651118; OR = 0.63; 95% CI: 0.43–0.95) and three SNP*nutrient interactions (choline*rs10475407; OR = 1.62; 95% CI: 1.11–2.42; choline*rs11134290; OR = 0.51; 95% CI: 0.27–0.92; and riboflavin*rs8767412; OR = 0.40; 95% CI: 0.15–0.95) were associated with lung cancer risk in never smokers. Conclusions: This study identified possible nutrient and genetic factors related to folate metabolism associated with lung cancer risk, which could potentially lead to nutritional interventions tailored by smoking status to reduce lung cancer risk

Prevalence of chronic facet arthropathy: a retrospective study

Background: To assess prevalence facet-joint arthropathy in chronic low back pain using computed tomography.Methods: A retrospective study profiled and analysed objective data from patients CT scans and previous records.Results: Facetal arthropathy was graded by Pathria’s criteria.102 joints (33.12%) were grade 1, 113 (36.69%) grade 2, 63 (20.45%) grade 3, and 30 (9.74. %) grade 4. Final result showed that females were affected more than the male in Grade II, III and IV. Age group more affected was between 46-85 years.Conclusions:Our study on chronic low back pain revealed prevalence of facet-joint involvement 66.88% (206 patients) in rural population with age group involved more than 46 years

Adsorption of CO on NaZSM-5 zeolite under moderate temperature and pressure conditions: an FTIR investigation

Adsorption of CO on NaZSM-5 zeolite was investigated at temperatures in the range 300-470 K and at pressures of 5-500 Torr using FTIR spectroscopy. The effect of exchanging the charge balancing cation in NaZSM-5 with a proton or calcium was evaluated. Data were also collected on NaY, CaY and CaX zeolites for comparison. We detected the development of six distinct CwO stretching bands with maxima at around 2111, 2130, 2146, 2160, 2176 and 2194 cm-1 during the adsorption of CO on NaZSM-5 zeolite at ambient temperatures. This was accompanied by the appearance of a prominent band at 2356 cm-1 and weak shoulder bands at frequencies around 2336, 2340, 2370 and 2380 cm-1 in the ν3 region of All the ν(CO) bands and CO2 . also the bands in the ν3 region of CO2 exhibited similar behaviour as a function of adsorbate pressure, evacuation, rise in sample temperature, and the exchange of charge balancing cation. For instance, the intensity of all the CwO stretching bands showed a similar growth behaviour with increasing adsorbate pressure, though the extent of this growth was di.erent for the individual IR bands. Similarly, these bands were removed simultaneously on evacuation. Furthermore, while all the vibrational bands in the v(CO) region showed a uniform isotopic shift corresponding to a frequency ratio ν(13C/12C) of ca. 0.977 and ν(18O/16O) of 0.976 for the adsorption of 13C16O and 12C18O, respectively, the bands in the ν3(CO2) region showed a red shift ?(13C/12C) of 0.972 with 13CO and an isotopic shift corresponding to 16O12C18O on 12C18O adsorption. No shift in ν(OH) bands was observed after CO adsorption under the conditions of this study. The results thus indicate that the individual zeolitic surface sites e.g., the Al3+ sites, Bronsted acid sites or the charge balancing cations, may not participate directly in the bonding of CO molecules at room temperature or above. Instead, the cage effect of zeolites plays an important role. The data are interpreted to suggest the formation of weakly bonded clusters of CO and CO2 molecules, occluded in the zeolitic cages and stabilized under the cationic field

ANTIOXIDANT ACTIVITY AND ANTIBACTERIAL SCREENING OF TUBERS OF AMORPHOPHALLUS KONKANENSIS AND AMORPHOPHALLUS BULBIFER (ARACEAE)

Objective: Antioxidant activity (AOA) and antibacterial screening of tubers of unexplored Amorphophallus konkanensis Hett., Yadav & Patil (AKT) and Amorphophallus bulbifer (Roxb.) Bl. (ABT). Methods: Antioxidant activity was evaluated by using ferric reducing antioxidant power (FRAP), 1 1-diphenyl-2-picrylhydrazyl (DPPH) radical, hydroxyl (OH•) radical, nitric oxide (NO∙) radical scavenging activities. Phenolics were determined by total phenolic content (TPC) assay. Antibacterial screening of different solvent extracts of tubers was tested against Gram positive and Gram negative bacterial strains by using the agar diffusion method. HPLC analysis was carried out for active phenolic compounds. Results: Tubers were extracted with three different solvents (ethanol, acetone and water). Acetone extracts of AKT and ABT exhibited the highest phenolic content 29.37±0.83 and 20.62±1.04 mg GAE/g. The AKT and ABT acetone extracts possesses highest free radical scavenging activity towards FRAP (0.632 & 0.586 O. D), DPPH (85.78% & 82.68%), hydroxyl (OH∙) radical (82.43% & 80.26%), nitric oxide (NO∙) radical (81.34% & 80.8%). The phenolic compounds tannic acid, gallic acid, quercetin, p-coumaric acid, catechin were identified by the HPLC method in acetone extracts. Among the different extracts, acetone extract of both the species of Amorphophallus showed significant antibacterial activity against all Gram positive and Gram negative bacterial strains tested. Conclusion: The results indicated that AKT and ABT can be considered as good sources of natural antioxidant for medicinal, commercial, nutraceutical and functional food applications. Antibacterial efficacy shown by these plants provides a scientific basis for their traditional uses in remedies

Off-Grid Single Phase Micro-Inverter System

In most of the households appliances, AC electricity are mostly used. This electricity are easily available but renewable energy is increasing now a days as there is shortage of traditional fissile fuel and it also hazardous to the environment. Such form of electricity can be obtained by converting the DC electricity generated by the solar panels using power electronics devices. There are so many types of inverter configuration are available which can be used for such purpose. Dealing with hundreds of watts of energy, micro-Photovoltaic (PV) type inverters can convert solar energy of each PV panel to the utility individually, with significant improvement of overall system reliability and also have a several advantages over the other topology like tuning the output of each panel, less sensitive to overheating problems etc. This paper presents a case study of a single-phase micro-PV inverter. Circuit analysis and its parameters calculation are carried out in details and demonstrated through simulation based on MATLAB/Simulink. The result proves the analysis of the circuit and provides theoretical validation for further work in research. DOI: 10.17762/ijritcc2321-8169.15085