Economic evaluation of latent tuberculosis infection screening among health care workers in Houston

Since interferon-gamma release assays (IGRAs) were introduced in the 2000's, tuberculin skin testing (TST) and IGRAs have been used in various latent tuberculosis infection (LTBI) screening settings. IGRAs are laboratory-based tests and are considered not to be affected by previous Bacille de Calmette et Guérin (BCG) vaccination; however, they are more costly when compared directly with TST, which does not require specimen processing in a laboratory. This study aimed to examine TST and two types of IGRAs, QuantiFERON-TB Gold in Tube (QFT-GIT) and T-SPOT. TB (TSPOT), from an economic viewpoint. Firstly, a systematic literature review was conducted to identify cost related analyses of LTBI screening. Secondly, specific cost information detailing each test's items and labor was collected from an LTBI screening program of health care workers in Houston, and the cost of each test was computed. Thirdly, using the computed cost estimate of each test, cost-effectiveness analyses were conducted to compare TST and IGRAs.^ A literature search showed that a limited number of studies have been conducted, but the IGRA's economic advantages were common among studies. Cost analyses showed that IGRAs were much more costly than TST. The results were consistent with previous studies. In cost-effectiveness analyses, where test cost and consequential TB-related cost were considered, IGRAs showed variable advantages over TST depending on the targeted population. When only non BCG-vaccinated people were considered, TST was the least costly option among the three tests. On the other hand, when only BCG-vaccinated people were considered, IGRAs were less costly options. These results were mostly consistent even with varying assumption parameters.^ IGRAs can be more costly than TST, but their economic disadvantages are alleviated when the target population was BCG-vaccinated. Based on current knowledge, IGRAs may be recommended in a population where the BCG history is mixed. Additional studies are needed to better understand IGRA's reliability among low-incidence and low-risk populations in which background TB prevalence is low.^

Cancer screening behaviors among Asian Americans in Houston, Texas

Background: Cancer is the second-leading cause of death in the United States, and Asian Americans/Pacific Islanders are the only racial/ethnic group for which cancer is the leading cause of death. Regular cancer screenings help to identify precancerous lesions and cancer at an earlier stage, when the cancer is more treatable. Ethnic disparities in participation in cancer screenings are also striking, and evidence indicates that Asian Americans may have lower rates of cancer screening participation than other racial/ethnic groups. The Health of Houston Survey 2010 (HHS 2010) is an address-based survey, administered via telephone, website, and mail, of over 5,000 respondents in Houston and Harris County that provides recent data on the health status and needs of the Houston community. HHS 2010 researchers oversampled for Asians and Vietnamese Americans in order to obtain a sample size large enough to obtain statistical power. This dataset provides a unique opportunity to examine the cancer screening behaviors and predictors of Vietnamese and Chinese Americans living in Houston, Texas.^ Methods: This study was a secondary data analysis of HHS 2010 data. The data were analyzed to compare the breast, cervical, and colorectal cancer screening compliance rates of Vietnamese and Chinese Americans with other racial/ethnic groups in Houston, Texas. Key predictors of participation and barriers to cancer screening were identified.^ Results: The results of this study indicate that in Houston, Vietnamese Americans and Asian Americans as a whole have strikingly lower rates of participation in cancer screenings compared to other ethnic groups. Chinese Americans had the highest rate of noncompliance for mammography of all ethnic groups; Asian Americans and Vietnamese Americans also had high rates of noncompliance. Similarly, Vietnamese and Asian Americans had high rates of noncompliance with colorectal cancer screening recommendations. Importantly, Vietnamese, Chinese, and Asian Americans had by far the worst pap test participation, with noncompliance rates more than double that of all other racial/ethnic groups. In general, the findings indicated several key predictors in cancer screening behaviors, including English language proficiency, years lived in the United States, health insurance, college education, and income; however, the significance and patterns of these variables varied by ethnic group as well as cancer site.^ Conclusions: This secondary analysis highlights the disparities in cancer screening participation among Vietnamese, Chinese, and Asian Americans in Houston, Texas and indicate the need to identify Asian Americans as a high-risk group in need of health promotion attention. Barriers to screening and educational needs appear to be specific to each target ethnic group. Thus, health educators and health professionals in Houston must focus on the specific educational needs of the key ethnic groups that make up the Houston population. Further, more ethnic-specific research is needed to examine the health behaviors and needs of Houston's Asian American subgroups.^

Colorectal cancer screening: Participation and determinants in West Texas

Early detection by screening is the key to colorectal cancer control. However, colorectal cancer screening and its determinants in rural areas have not been adequately studied. This goal of this study was to investigate the screening participation and determinants of colonoscopy, sigmoidoscopy, and/or fecal occult blood test (FOBT) in subjects of Project Frontier from the rural counties of Cochran, Bailey and Parmer, Texas. Subjects ( n=820 with 435 Hispanics, 355 Non-Hispanic Whites, 26 African Americans, and 4 unknown ethnicity; 255 males, 565 females, aged from 40 to 92 years) were from Project FRONTIER. Stepwise logistic regression analysis was performed. Explanatory variables included ethnicity (Hispanic, Non-Hispanic white and African American), gender, health insurance, smoking status, household income, education (years), physical activity, overweight, other health screenings, personal physicians, family history (first-degree relatives) of cancers, and preferred language (English vs. Spanish) for interview/testing. The screening percentage for ever having had a colonoscopy/sigmoidoscopy (51.8%) in this cohort aged 50 years or older is well below the percentage of the nation (65.2%) and Texas (64.6%) while the percentage for FOBT (29.2%) is higher than in the nation (17.2%) and Texas (14.9%). However, Hispanics had significantly lower participation than non-Hispanic whites for colonoscopy/sigmoidoscopy (37.0% vs. 66.0%) and FOBT (16.5% vs. 41.7%), respectively. Stepwise logistic regression showed that predictors for colonoscopy, sigmoidoscopy or FOBT included Hispanic race (p = 0.0045), age (p < 0.0001), other screening procedure (p < 0.0001), insurance status (p < 0.0001) and physician status (p = 0.0053). Screening percentage for colonoscopy/sigmoidoscopy in this rural cohort is well below the national and Texas level mainly due to the lower participation of Hispanics vs. Non-Hispanic whites. Health insurance, having had a personal physician, having had screenings for other cancers, race, and older age are among the main predictors.^

Planning, implementation, and evaluation of an HIV -screening program for pregnant women

The purpose of this study was to evaluate the effectiveness of an HIV-screening program at a private health-care institution where the providers were trained to counsel pregnant women about the HIV-antibody test according to the latest recommendations made by the U.S. Public Health Service (PHS) and the Texas legislature. A before-and-after study design was selected for the study. The participants were OB/GYN nurses who attended an educational program and the patients they counseled about the HIV test. Training improved the nurses' overall knowledge about the content of the program and nurses were more likely to offer the HIV test to all pregnant women regardless of their risk of infection. Still, contrary to what was predicted, the nurses did not give more information to increase the knowledge pregnant women had about HIV infection, transmission, and available treatments. Consequently, many women were not given the chance to correctly assess their risk during the counseling session and there was no evidence that knowledge would reduce the propensity of many women to deny being at risk for HIV. On the other hand, pregnant women who received prenatal care after the implementation of the HIV-screening program were more likely to be tested than women who received prenatal care before its implementation (96% vs. 48%); in turn, the likelihood that more high-risk women would be tested for HIV also increased (94% vs. 60%). There was no evidence that mandatory testing with right of refusal would deter women from being tested for HIV. When the moment comes for a woman to make her decision, other concerns are more important to her than whether the option to be tested is mandatory or not. The majority of pregnant women indicated that their main reasons for being tested were: (a) the recommendation of their health-care provider; and (b) concern about the risks to their babies. Recommending that all pregnant women be tested regardless of their risk of infection, together with making the HIV test readily available to all women, are probably the two best ways of increasing the patients' participation in an HIV-screening program for pregnant women. ^

A new set of relativistic screening constants for the screened hydrogenic model

AnewRelativisticScreenedHydrogenicModel has been developed to calculate atomic data needed to compute the optical and thermodynamic properties of high energy density plasmas. The model is based on anewset of universal screeningconstants, including nlj-splitting that has been obtained by fitting to a large database of ionization potentials and excitation energies. This database was built with energies compiled from the National Institute of Standards and Technology (NIST) database of experimental atomic energy levels, and energies calculated with the Flexible Atomic Code (FAC). The screeningconstants have been computed up to the 5p3/2 subshell using a Genetic Algorithm technique with an objective function designed to minimize both the relative error and the maximum error. To select the best set of screeningconstants some additional physical criteria has been applied, which are based on the reproduction of the filling order of the shells and on obtaining the best ground state configuration. A statistical error analysis has been performed to test the model, which indicated that approximately 88% of the data lie within a ±10% error interval. We validate the model by comparing the results with ionization energies, transition energies, and wave functions computed using sophisticated self-consistent codes and experimental data.

Characterization of thin film PV modules under standard test conditions: Results of indoor and outdoor measurements and the effects of sunlight exposure

Photovoltaic modules based on thin film technology are gaining importance in the photovoltaic market, and module installers and plant owners have increasingly begun to request methods of performing module quality control. These modules pose additional problems for measuring power under standard test conditions (STC), beyond problems caused by the temperature of the module and the ambient variables. The main difficulty is that the modules’ power rates may vary depending both on the amount of time they have been exposed to the sun during recent hours and on their history of sunlight exposure. In order to assess the current state of the module, it is necessary to know its sunlight exposure history. Thus, an easily accomplishable testing method that ensures the repeatability of the measurements of the power generated is needed. This paper examines different tests performed on commercial thin film PV modules of CIS, a-Si and CdTe technologies in order to find the best way to obtain measurements. A method for obtaining indoor measurements of these technologies that takes into account periods of sunlight exposure is proposed. Special attention is paid to CdTe as a fast growing technology in the market.

Contribution sharing of a fuel mixture components to the fuel cell potencial of a direct alcohol fuel cell

The increasing worldwide demand for electricity impels to develop clean and renewable energy resources. In the field of portable power devices not only size and weight represent important aspects to take into account, but the fuel and its storage are also critical issues to consider. In this last sense, the direct methanol (MeOH) fuel cells (DMFC) play an important role as they can offer high power and energy density, low emissions, ambient operating conditions and fast and convenient refuelling.

Perspectives on the design and use of direct alcohol fuel cells fed by alcohol blends

The fast-growing power demand by portable electronic devices has promoted the increase of global production of portable PEM fuel cell, a quarter of them consist of direct methanol fuel cell (DMFC) units. These present the advantage of being fuelled directly with a liquid fuel, as well as direct ethanol fuel cells (DEFC) do.

Novel fast random search clustering approach for mixing matrix identification in MIMO linear blind inverse problems with sparse inputs

In this paper we propose a novel fast random search clustering (RSC) algorithm for mixing matrix identification in multiple input multiple output (MIMO) linear blind inverse problems with sparse inputs. The proposed approach is based on the clustering of the observations around the directions given by the columns of the mixing matrix that occurs typically for sparse inputs. Exploiting this fact, the RSC algorithm proceeds by parameterizing the mixing matrix using hyperspherical coordinates, randomly selecting candidate basis vectors (i.e. clustering directions) from the observations, and accepting or rejecting them according to a binary hypothesis test based on the Neyman–Pearson criterion. The RSC algorithm is not tailored to any specific distribution for the sources, can deal with an arbitrary number of inputs and outputs (thus solving the difficult under-determined problem), and is applicable to both instantaneous and convolutive mixtures. Extensive simulations for synthetic and real data with different number of inputs and outputs, data size, sparsity factors of the inputs and signal to noise ratios confirm the good performance of the proposed approach under moderate/high signal to noise ratios. RESUMEN. Método de separación ciega de fuentes para señales dispersas basado en la identificación de la matriz de mezcla mediante técnicas de "clustering" aleatorio.

A Reliable Open-Source System Architecture for the Fast Designing and Prototyping of Autonomous Multi-UAV Systems: Simulation and Experimentation

During the process of design and development of an autonomous Multi-UAV System, two main problems appear. The first one is the difficulty of designing all the modules and behaviors of the aerial multi-robot system. The second one is the difficulty of having an autonomous prototype of the system for the developers that allows to test the performance of each module even in an early stage of the project. These two problems motivate this paper. A multipurpose system architecture for autonomous multi-UAV platforms is presented. This versatile system architecture can be used by the system designers as a template when developing their own systems. The proposed system architecture is general enough to be used in a wide range of applications, as demonstrated in the paper. This system architecture aims to be a reference for all designers. Additionally, to allow for the fast prototyping of autonomous multi-aerial systems, an Open Source framework based on the previously defined system architecture is introduced. It allows developers to have a flight proven multi-aerial system ready to use, so that they can test their algorithms even in an early stage of the project. The implementation of this framework, introduced in the paper with the name of “CVG Quadrotor Swarm”, which has also the advantages of being modular and compatible with different aerial platforms, can be found at https://​github.​com/​Vision4UAV/​cvg_​quadrotor_​swarm with a consistent catalog of available modules. The good performance of this framework is demonstrated in the paper by choosing a basic instance of it and carrying out simulation and experimental tests whose results are summarized and discussed in this paper.

Cladistic association analysis of Y chromosome effects on alcohol dependence and related personality traits

Association between Y chromosome haplotype variation and alcohol dependence and related personality traits was investigated in a large sample of psychiatrically diagnosed Finnish males. Haplotypes were constructed for 359 individuals using alleles at eight loci (seven microsatellite loci and a nucleotide substitution in the DYZ3 alphoid satellite locus). A cladogram linking the 102 observed haplotype configurations was constructed by using parsimony with a single-step mutation model. Then, a series of contingency tables nested according to the cladogram hierarchy were used to test for association between Y haplotype and alcohol dependence. Finally, using only alcohol-dependent subjects, we tested for association between Y haplotype and personality variables postulated to define subtypes of alcoholism—antisocial personality disorder, novelty seeking, harm avoidance, and reward dependence. Significant association with alcohol dependence was observed at three Y haplotype clades, with significance levels of P = 0.002, P = 0.020, and P = 0.010. Within alcohol-dependent subjects, no relationship was revealed between Y haplotype and antisocial personality disorder, novelty seeking, harm avoidance, or reward dependence. These results demonstrate, by using a fully objective association design, that differences among Y chromosomes contribute to variation in vulnerability to alcohol dependence. However, they do not demonstrate an association between Y haplotype and the personality variables thought to underlie the subtypes of alcoholism.

Design of fast enzymes by optimizing interaction potential in active site

The diffusional encounter between substrate and enzyme, and hence catalytic efficiency, can be enhanced by mutating charged residues on the surface of the enzyme. In this paper we present a simple method for screening such mutations. This is based on our earlier result that electrostatic enhancement of the enzyme-substrate binding rate constant can be accounted for just by the interaction potential within the active site. Assuming that catalytic and structural integrity is maintained, the catalytic efficiency can be optimized by surface charge mutations which lead to stronger interaction potential within the active site. Application of the screening method on superoxide dismutase shows that only charge mutations close to the active site will have practical effect on the catalytic efficiency. This rationalizes a large number of findings obtained in previous simulation and experimental studies.

Slow and fast dietary proteins differently modulate postprandial protein accretion

The speed of absorption of dietary amino acids by the gut varies according to the type of ingested dietary protein. This could affect postprandial protein synthesis, breakdown, and deposition. To test this hypothesis, two intrinsically 13C-leucine-labeled milk proteins, casein (CAS) and whey protein (WP), of different physicochemical properties were ingested as one single meal by healthy adults. Postprandial whole body leucine kinetics were assessed by using a dual tracer methodology. WP induced a dramatic but short increase of plasma amino acids. CAS induced a prolonged plateau of moderate hyperaminoacidemia, probably because of a slow gastric emptying. Whole body protein breakdown was inhibited by 34% after CAS ingestion but not after WP ingestion. Postprandial protein synthesis was stimulated by 68% with the WP meal and to a lesser extent (+31%) with the CAS meal. Postprandial whole body leucine oxidation over 7 h was lower with CAS (272 ± 91 μmol⋅kg−1) than with WP (373 ± 56 μmol⋅kg−1). Leucine intake was identical in both meals (380 μmol⋅kg−1). Therefore, net leucine balance over the 7 h after the meal was more positive with CAS than with WP (P < 0.05, WP vs. CAS). In conclusion, the speed of protein digestion and amino acid absorption from the gut has a major effect on whole body protein anabolism after one single meal. By analogy with carbohydrate metabolism, slow and fast proteins modulate the postprandial metabolic response, a concept to be applied to wasting situations.

Avaliação do potencial fotoprotetor e identificação de metabólitos secundários do fungo endofítico Annulohypoxylon stygium associado à alga marinha Bostrychia radicans

Os organismos marinhos constituem uma fonte potencial de metabólitos secundários biologicamente ativos. Neste contexto, os micro-organismos isolados de algas marinhas, dentre eles fungos endofíticos, representam alvos para a pesquisa de novas substâncias com potencial farmacológico pronunciado. Substâncias naturais provenientes de espécies de fungos associados às algas marinhas vêm sendo bastante utilizadas em formulações fotoprotetoras devido à ação antioxidante e ao potencial contra a radiação solar. Deste modo, o presente trabalho teve como objetivo a investigação biológica e química dos fungos endofíticos marinhos pertencentes à família Xylariaceae, o Annulohypoxylon stygium, o Cladosporium sp. e o Acremonium implicatum (Hypocreaceae). A princípio, foi realizado um screening para avaliar a absorção de luz ultravioleta na faixa do UVA e UVB pelos extratos obtidos em escala piloto destes fungos endofíticos associados às algas marinhas. O extrato do fungo A. stygium apresentou intensa absorção na região do UV, mostrando-se promissor para a produção de metabólitos secundários com ação fotoprotetora. Além do ensaio proposto, foi realizada a avaliação do potencial antibacteriano e antifúngico da espécie A. stygium. O estudo químico em escala ampliada deste fungo proporcionou o isolamento e identificação de uma substância inédita da classe derivada da 2,5- dicetopiperazina, 3-benzilideno-2-metil-hexahidro-pirrolo [1,2-?] pirazina-1,4-diona (Sf3), e além desta, foram isolados mais quatro metabólitos como, os diasteroisômeros 1-fenil-1,2- propanediol (Sd2) e 1-fenil-1,2-propanediol (Sd3), 1,3-benzodioxole-5-metanol (Sc1), 1,2- propanodiol-1-(1,3-benzodioxol-5-il) (Se1). Ainda foi possível a desreplicação de substâncias via cromatografia gasosa acoplada à espectrometria de massas (CG-EM), entre elas o ácido palmítico, palmitato de metila, ácido metil linoléico, ácido oléico, álcool benzílico e o piperonal. Quanto ao estudo da atividade biológica, não foi observado potencial antibacteriano e antifúngico para os extratos e frações do fungo. Entretanto, notouse um potencial como fotoprotetor in vitro para as frações n-Hexano/AcOEt (2:3) e n- Hexano/AcOEt (1:4) obtidas a partir do extrato do cultivo de 28 dias do fungo A. stygium, extraído com solventes diclorometano/metanol (CH2Cl2/MeOH 2:1) e para a substância (Sf3) isolada do mesmo. Desta forma, o estudo químico e biológico do fungo Annulohypoxylon stygium demonstrou potencial para a produção de metabólitos secundários com atividade fotoprotetora, visto que uma estrutura inédita com esta atividade foi isolada e identificada como produto natural.