Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States.

Knowing one's HIV status is particularly important in the setting of recent tuberculosis (TB) exposure. Blood tests for assessment of tuberculosis infection, such as the QuantiFERON Gold in-tube test (QFT; Cellestis Limited, Carnegie, Victoria, Australia), offer the possibility of simultaneous screening for TB and HIV with a single blood draw. We performed a cross-sectional analysis of all contacts to a highly infectious TB case in a large meatpacking factory. Twenty-two percent were foreign-born and 73% were black. Contacts were tested with both tuberculin skin testing (TST) and QFT. HIV testing was offered on an opt-out basis. Persons with TST >or=10 mm, positive QFT, and/or positive HIV test were offered latent TB treatment. Three hundred twenty-six contacts were screened: TST results were available for 266 people and an additional 24 reported a prior positive TST for a total of 290 persons with any TST result (89.0%). Adequate QFT specimens were obtained for 312 (95.7%) of persons. Thirty-two persons had QFT results but did not return for TST reading. Twenty-two percent met the criteria for latent TB infection. Eighty-eight percent accepted HIV testing. Two (0.7%) were HIV seropositive; both individuals were already aware of their HIV status, but one had stopped care a year previously. None of the HIV-seropositive persons had latent TB, but all were offered latent TB treatment per standard guidelines. This demonstrates that opt-out HIV testing combined with QFT in a large TB contact investigation was feasible and useful. HIV testing was also widely accepted. Pairing QFT with opt-out HIV testing should be strongly considered when possible.

Opportunistic Control Over Shared Wireless Channels

© 2015 IEEE.We consider a wireless control architecture with multiple control loops over a shared wireless medium. A scheduler observes the random channel conditions that each control system experiences over the shared medium and opportunistically selects systems to transmit at a set of non-overlapping frequencies. The transmit power of each system also adapts to channel conditions and determines the probability of successfully receiving and closing the loop. We formulate the optimal design of channel-aware scheduling and power allocation that minimize the total power consumption while meeting control performance requirements for all systems. In particular, it is required that for each control system a given Lyapunov function decreases at a specified rate in expectation over the random channel conditions. We develop an offline algorithm to find the optimal communication design, as well as an online protocol which selects scheduling and power variables based on a random observed channel sequence and converges almost surely to the optimal operating point. Simulations illustrate the power savings of our approach compared to other non-channel-aware schemes.