A tuberculin skin test survey among Ghanaian school children.

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Addo, Kennedy Kwasi; van den Hof, Susan; Mensah, Gloria Ivy; Hesse, Adukwei; Bonsu, Christian; Koram, Kwadwo Ansah; Afutu, Felix Kwami; Bonsu, Frank Adae

2010-01-26

Ghana has not conducted a national tuberculin survey or tuberculosis prevalence survey since the establishment of the National Tuberculosis Control Programme. The primary objective of this study was therefore to determine the prevalence of tuberculin skin sensitivity in Ghanaian school children aged 6-10 years in 8 out of 10 regions of Ghana between 2004 and 2006. Tuberculin survey was conducted in 179 primary schools from 21 districts in 8 regions. Schools were purposively selected so as to reflect the proportion of affluent private and free tuition public schools as well as the proportion of small and large schools. Of the 24,778 children registered for the survey, 23,600 (95.2%) were tested of which 21,861 (92.6%) were available for reading. The age distribution showed an increase in numbers of children towards older age: 11% of the children were 6 years and 25%, 10 years. Females were 52.5% and males 47.5%. The proportion of girls was higher in all age groups (range 51.4% to 54.0%, p < 0.001). BCG scar was visible in 89.3% of the children. The percentage of children with a BCG scar differed by district and by age. The percentage of children with a BCG scar decreased with increasing age in all districts, reflecting increasing BCG vaccination coverage in Ghana in the last ten years. The risk of tuberculosis infection was low in the northern savannah zones compared to the southern coastal zones. Using a cut-off of 15 mm, the prevalence of infection ranged from 0.0% to 5.4% and the Annual Risks of Tuberculosis Infection 0.0% to 0.6%. There was an increase in the proportion of infected children after the age of 7 years. Children attending low and middle-class schools had a higher risk of infection than children attending upper-class schools. Tuberculosis infection is still a public health problem in Ghana and to monitor the trend, the survey needs to be repeated at 5 years interval.

Differences in tuberculin reactivity as determined in a veterans administration employee health screening program.

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Mehta, Sanjay R; MacGruder, Cathy; Looney, David; Johns, Scott; Smith, Davey M

2009-04-01

In response to a difference in pricing, the San Diego Veterans Administration Medical Center changed its tuberculin preparation from Tubersol to Aplisol in the fall of 2006. Following the change, an increased number of employee skin test conversions was noted. Employee tuberculin skin test converters from 2006 were screened with the QuantiFERON Gold (QFT-G) gamma interferon release assay. Those employees who tested negative by QFT-G were asked to repeat their skin test with both Tubersol and Aplisol tuberculin preparations. Of the new purified protein derivative converters, 12 of 14 returned for repeat testing with QFT-G, and the assay was negative for 83% (10/12), positive for 8% (1/12), and indeterminate for 8% (1/12) of the individuals. Nine of the individuals who were QFT-G negative agreed to repeat skin testing with both tuberculin preparations, and 7/8 (87.5%) demonstrated reactivity with the Aplisol preparation, while 0/8 (0%) reacted to the Tubersol preparation. A change from Tubersol to Aplisol resulted in elevated tuberculin skin test conversion rates that may be due to false-positive reactions. The differences in skin test reactivity between preparations support CDC guidelines that recommend that institutions should not change tuberculin preparations, as doing so may falsely increase the number of positive reactions.

STUDIES ON TUBERCULIN FEVER

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Hall, Charles H.; Atkins, Elisha

1959-01-01

Evidence has been presented that the fever elicited by intravenous administration of old tuberculin (O.T.) in BCG-infected rabbits is a specific property of this hypersensitivity system and is probably not due to contamination of tuberculin with bacterial endotoxins. Daily injections of O.T. in sensitized animals resulted in a rapid tolerance to its pyrogenic effect. Tuberculin tolerance can be differentiated from that occurring with endotoxins and was invariably associated with the development of a negative skin test. The mechanism of this tolerance would thus appear to be desensitization. A circulating pyrogen found during tuberculin fever was indistinguishable in its biologic effects from endogenous pyrogens obtained in several other types of experimental fever. This material produced fevers in normal recipients and therefore may be clearly differentiated from O.T. itself which was pyrogenic only to sensitized animals. Since the titer of serum pyrogen was directly proportional to the degree of fever induced by injection of O.T. in the donor animals, a causal relation is suggested. On the basis of these findings, it is postulated that tuberculin fever is due to a circulating endogenous pyrogen released by a specific action of O.T. on sensitized cells of the host. PMID:13641561

Comparison of sensitivity of quantiferon-tb gold test and tuberculin skin test in active pulmonary tuberculosis

International Nuclear Information System (INIS)

Khalil, K.F.; Ambreen, A.; Butt, T.

2013-01-01

Objective: To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Study Design: Analytical study. Place and Duration of Study: Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. Methodology: QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against positive growth for Mycobacterium tuberculosis. Results: Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 A+- 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. Conclusion: QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis. (author)

CD14-159C/T polymorphism in the development of delayed skin hypersensitivity to tuberculin.

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Magdalena Druszczynska

Full Text Available The skin tuberculin test (TST, an example of a delayed-type hypersensitivity (DTH reaction, is based on measuring the extent of skin induration to mycobacterial tuberculin (PPD. Little is known about the genetic basis of TST reactivity, widely used for diagnosing TB infection. The study investigated the relationship of the single base change polymorphic variants in CD14 gene (CD14(-159C/T with the development of DTH to PPD in BCG-vaccinated Polish Caucasian individuals. We found persistent lack of TST reactivity in about 40% of healthy subjects despite receiving more than one dose of BCG. The TST size was negatively correlated with the number of BCG inoculations. The distribution of C/T genotype was significantly more frequent among TST-negative compared with TST-positive individuals. The concentration of serum sCD14 was positively associated with mCD14 expression, but not with the TST status or CD14(-159C/T polymorphism. A significant increase in mCD14 expression and serum sCD14 levels was found in TB group. We hypothesize that CD14(-159C/T polymorphic variants might be one of genetic components in the response to attenuated M. bovis BCG bacilli.

[IFN-gamma enzyme-linked immunospot assay versus PPD tuberculin skin test in the diagnosis of tuberculous epididymitis].

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Huang, Hao; Yang, Xi-Fei; Deng, Qun-Yi; Li, Bing; Liu, Guo-Hui; Zhang, Jie-Yun; Yang, Da-Fei

2012-06-01

To explore the potential application of IFN-gamma enzyme-linked immunospot (ELISPOT) assay in the diagnosis of tuberculous epididymitis (TE) by comparing ELISPOT assay with the traditional purified protein derivative (PPD) tuberculin skin test. We examined 13 TE patients using an in-house ELISPOT kit, another 11 TE patients by PPD skin testing, and 57 healthy male volunteers by parallel test with both the methods. Twelve (92.3%) of the 13 TE cases were positive on ELISPOT assay, and 10 (90.9%) of the 11 TE cases positive on PPD skin test, with no statistically significant differences between the two groups (P > 0.05). Among the 57 healthy male volunteers, 8 (14.0%) were positive on ELISPOT, and 28 (49.1%) positive on PPD test, the latter significantly higher than the former (P PPD test in the examination of tuberculous epididymitis. As for specificity, ELISPOT assay seems better than PPD test in differentiating tuberculous epididymitis patients from healthy males.

Intradermal tuberculin testing of wild African lions (Panthera leo) naturally exposed to infection with Mycobacterium bovis.

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Keet, D F; Michel, A L; Bengis, R G; Becker, P; van Dyk, D S; van Vuuren, M; Rutten, V P M G; Penzhorn, B L

2010-08-26

African lions in the southern half of Kruger National Park (KNP) are infected with Mycobacterium bovis. Historically, reliable detection of mycobacteriosis in lions was limited to necropsy and microbiological analysis of lesion material collected from emaciated and ailing or repeat-offender lions. We report on a method of cervical intradermal tuberculin testing of lions and its interpretation capable of identifying natural exposure to M. bovis. Infected lions (n=52/95) were identified by detailed necropsy and mycobacterial culture. A large proportion of these confirmed infected lions (45/52) showed distinct responses to bovine tuberculin purified protein derivative (PPD) while responses to avian tuberculin PPD were variable and smaller. Confirmed uninfected lions from non-infected areas (n=11) responded variably to avian tuberculin PPD only. Various non-tuberculous mycobacteria (NTM) were cultured from 45/95 lions examined, of which 21/45 were co-infected with M. bovis. Co-infection with M. bovis and NTM did not influence skin reactions to bovine tuberculin PPD. Avian tuberculin PPD skin reactions were larger in M. bovis-infected lions compared to uninfected ones. Since NTM co-infections are likely to influence the outcome of skin testing, stricter test interpretation criteria were applied. When test data of bovine tuberculin PPD tests were considered on their own, as for a single skin test, sensitivity increased (80.8-86.5%) but false positive rate for true negatives (18.75%) remained unchanged. Finally, the adapted skin test procedure was shown not to be impeded by persistent Feline Immunodeficiency Virus(Ple) co-infection. Copyright 2010 Elsevier B.V. All rights reserved.

Antibody response to a sterile filtered PPD tuberculin in M. bovis infected and M. bovis sensitized cattle.

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Rennie, Bryan; Filion, Lionel G; Smart, Nonie

2010-11-09

Bovine tuberculosis, caused by Mycobacterium bovis, afflicts approximately 50 million cattle worldwide and is detected by the tuberculin skin test (TST). While it has long been recognized that purified protein derivative (PPD) tuberculin is composed of a mixture of M. bovis derived protein components, little is known about the quality, relative quantity and identity of the proteins that make up PPD tuberculin. We manufactured a sterile filtered PPD tuberculin (SF-PPD) from a nine-week-old M. bovis culture supernatant in order to characterise the culture filtrate proteins (CFP) which make up M. bovis PPD tuberculin and to compare the antibody response of M. bovis infected versus M. bovis sensitized cattle. SF-PPD resolved into approximately 200 discrete spots using two-dimensional polyacrylamide gel electrophoresis (2-DE) while fewer than 65 spots could be discerned from 2-DE gels of tuberculin derived from autoclaved culture supernatant. Two dimensional Western blot analyses indicated that sera from M. bovis sensitized cattle recognized additional SF-PPD antigens as compared to M. bovis infected cattle at seven weeks post infection/sensitization. However, application of a comparative tuberculin skin test resulted in an antibody boosting response to the same set of M. bovis CFPs in both the M. bovis infected and M. bovis sensitized cattle. We concluded that it is the heat sterilization of the M. bovis CFPs that causes severe structural changes to the M. bovis proteins. This work suggests that M. bovis infected cattle and cattle artificially sensitized to M. bovis with an injection of heat killed cells exhibit similar antibody responses to M. bovis antigens.

Decreased delayed hypersensitivity to tuberculin demonstrated in experimental leptospirosis in guinea pigs

DEFF Research Database (Denmark)

Colding, H; Johansen, K S; Bentzon, M W

1976-01-01

Skin reactivity to tuberculin has been studied during the course of experimental leptospirosis in guinea pigs. A depression of the delayed hypersensitivity to tuberculin was demonstrated in the infected animals. The depression was most pronounced when icterus had developed. The depression...

Specificity of the Tuberculin Skin Test and the T-SPOT."TB" Assay among Students in a Low-Tuberculosis Incidence Setting

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Talbot, Elizabeth A.; Harland, Dawn; Wieland-Alter, Wendy; Burrer, Sherry; Adams, Lisa V.

2012-01-01

Objective: Interferon-[gamma] release assays (IGRAs) are an important tool for detecting latent "Mycobacterium tuberculosis" infection (LTBI). Insufficient data exist about IGRA specificity in college health centers, most of which screen students for LTBI using the tuberculin skin test (TST). Participants: Students at a low-TB incidence college…

Comparison of Tuberculin Skin Test result and interferon gamma response to human PPD in BCG scar positive and negative children.

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Sayyahfar, Shirin; Karimi, Abdollah; Fahimzad, Alireza; Shamshiri, Ahmad Reza

2014-03-01

The aim of this study is to compare Tuberculin Skin Test (TST) result and interferon gamma response to human PPD (purified protein derivative), in scar positive and scar negative BCG-vaccinated children. Between August 2007 and May 2008 a total of 236 children aged 1-168 months (mean 21 months) admitted to Mofid Children's Hospital, Tehran, Iran, were enrolled in a cross-sectional study. Each patient was examined for BCG vaccine scar and tested with TST and human PPD-based Interferon Gamma Release Assay (IGRA). Two hundred and twenty one cases out of 236 (44% female, 1-168 months, mean age 21 months) were scar positive of whom 95% TST result was negative. Human PPD-based IGRA was positive in 110 (49.8%), negative in 85 (38.4 %) and indeterminate in 26 (11.8%) of scar positive patients. Fifteen children (40% female, 1-156 months; mean age 42 months) were scar negative. All the scar negative cases were TST negative. Human PPD-based IGRA was positive in 10 (66.7%), negative in 4 (26.7%) and indeterminate in 1 (6.7%) of scar negative patients. Immune responsiveness to human PPD antigens in scar positive and negative children may not correspond with results of the Tuberculin Skin Test. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

The comparative performance of the single intradermal test and the single intradermal comparative tuberculin test in Irish cattle, using tuberculin PPD combinations of differing potencies.

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Good, M; Clegg, T A; Costello, E; More, S J

2011-11-01

In national bovine tuberculosis (BTB) control programmes, testing is generally conducted using a single source of bovine purified protein derivative (PPD) tuberculin. Alternative tuberculin sources should be identified as part of a broad risk management strategy as problems of supply or quality cannot be discounted. This study was conducted to compare the impact of different potencies of a single bovine PPD tuberculin on the field performance of the single intradermal comparative tuberculin test (SICTT) and single intradermal test (SIT). Three trial potencies of bovine PPD tuberculin, as assayed in naturally infected bovines, namely, low (1192IU/dose), normal (6184IU/dose) and high (12,554IU/dose) were used. Three SICTTs (using) were conducted on 2102 animals. Test results were compared based on reactor-status and changes in skin-thickness at the bovine tuberculin injection site. There was a significant difference in the number of reactors detected using the high and low potency tuberculins. In the SICTT, high and low potency tuberculin detected 40% more and 50% fewer reactors, respectively, than normal potency tuberculin. Furthermore, use of the low potency tuberculin in the SICTT failed to detect 20% of 35 animals with visible lesions, and in the SIT 11% of the visible lesion animals would have been classified as negative. Tuberculin potency is critical to the performance of both the SICTT and SIT. Tuberculin of different potencies will affect reactor disclosure rates, confounding between-year or between-country comparisons. Independent checks of tuberculin potency are an important aspect of quality control in national BTB control programmes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Concordant or discordant results by the tuberculin skin test and the quantiFERON-TB test in children reflect immune biomarker profiles

DEFF Research Database (Denmark)

Dhanasekaran, S; Jenum, S; Stavrum, R

2014-01-01

The tuberculin skin test (TST) and QuantiFERON-TB-Gold-In-tube (QFTGIT) are adjunctive tests used in the diagnosis of pediatric tuberculosis (TB). Neither test can rule out TB; however, a positive test usually triggers preventive treatment in TB contacts aged <5 years. TST and QFTGIT can give div...

TUBERCULIN DIAGNOSTICS: TO BE OR NOT TO BE?

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N. M. Koretskaya

2013-01-01

Full Text Available Tuberculin diagnostics — is a diagnostic method of detection of specific sensitization to Mycobactrerium tuberculosis (MBT. It is used as a specific test during mass population screening on tuberculosis (mass tuberculin diagnostics and for individual examinations (individual tuberculin diagnostics. The aims of the mass diagnostics are: revealing of the patients contaminated with MBT for the first time; revealing of the patients with hyperergic and increasing reactions to tuberculin; selection of the population for vaccination against tuberculosis with weakened BCG vaccine in infants older than 2 months of life who had not been vaccinated after birth, as well for re-vaccination with BCG vaccine; early diagnostics of tuberculosis in children and adolescents; determination of epidemiological characteristics of tuberculosis (population contamination with MBT, yearly risk of contamination with MBT. On mass tuberculin diagnostics it is used only the united intradermal tuberculin Mantoux test with 2 tuberculin units (TU of purified tuberculin in standard solution (prepared form. In the article the author discusses questions of tuberculosis diagnostics in children and adolescents, lists indications to mass tuberculin diagnostics with Mantoux test with 2 TU PPD and test with recombinant tuberculosis allergen. Advantages of both methods, which should be used in order to increase efficacy of tuberculosis diagnostics among children population, are described. It was concluded that switch to the mass screening of tuberculosis with the means of recombinant tuberculosis allergen is not rational under current conditions. The appropriateness of 2-steps examination (necessity of test with recombinant tuberculosis allergen after receiving a positive result of Mantoux test with 2 TU PPD is explained. 

Using ELISPOT to expose false positive skin test conversion in tuberculosis contacts.

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Philip C Hill

2007-01-01

Full Text Available Repeat tuberculin skin tests may be false positive due to boosting of waned immunity to past mycobacterial exposure. We evaluated whether an ELISPOT test could identify tuberculosis (TB contacts with boosting of immunity to non-tuberculous mycobacterial exposure.We conducted tuberculin and ELISPOT tests in 1665 TB contacts: 799 were tuberculin test negative and were offered a repeat test after three months. Those with tuberculin test conversion had an ELISPOT, chest X-ray and sputum analysis if appropriate. We compared converters with non-converters, assessed the probability of each of four combinations of ELISPOT results over the two time points and estimated boosting with adjustment for ELISPOT sensitivity and specificity. 704 (72% contacts had a repeat tuberculin test; 176 (25% had test conversion, which increased with exposure to a case (p = 0.002, increasing age (p = 0.0006 and BCG scar (p = 0.06. 114 tuberculin test converters had ELISPOT results: 16(14% were recruitment positive/follow-up positive, 9 (8% positive/negative, 34 (30% negative/positive, and 55 (48% were negative/negative. There was a significant non-linear effect of age for ELISPOT results in skin test converters (p = 0.038. Estimates of boosting ranged from 32%-41% of skin test converters with increasing age. Three converters were diagnosed with TB, two had ELISPOT results: both were positive, including one at recruitment.We estimate that approximately one third of tuberculin skin test conversion in Gambian TB case contacts is due to boosting of immunity to non-tuberculous mycobacterial exposure. Further longitudinal studies are required to confirm whether ELISPOT can reliably identify case contacts with tuberculin test conversion that would benefit most from prophylactic treatment.

Characteristics of children with positive tuberculin skin test.

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Hocaoğlu, Arzu Babayiğit; Erge, Duygu Olmez; Anal, Ozden; Makay, Balahan; Uzuner, Nevin; Karaman, Ozkan

2011-01-01

The aim of the study was to define the characteristics of children with latent tuberculosis diagnosed with positive tuberculin skin test (TST) and evaluate potential risk factors in children with positive TST. Children followed with the diagnosis of latent tuberculosis infection were included in the study retrospectively. Demographic characteristics of patients including history of atopy, respiratory infections, family history of tuberculosis and atopy, number of BCG vaccinations, findings of physical examination and laboratory data were extracted from patient's file. Eighty-one children (51 male, 30 female) who had positive TST were retrospectively evaluated in the study. Mean age of the patients was 8.00 ± 4.00 years. Only 13 (16%) of the children had contact with a case who had active tuberculosis. It was shown that the age of the patients, number of BCG scars and BCG vaccination significantly affected TST reaction size. TST size was not affected with time passed after last dose of BCG vaccination, family history of tuberculosis, presence of TST positive case in the family, exposure to cigarette smoke, number of household family members and presence of respiratory allergic disease. The patient's age, numbers of BCG vaccination and BCG scars significantly affect TST results in childhood. This may cause difficulty in diagnosing latent tuberculosis infection and in decision of initiating prophylactic treatment. The results of this study may show that recently developed, more accurate and convenient in vitro tests that they have higher costs and require sophisticated laboratory, can be used to diagnose latent tuberculosis.

Extent and effects of recurrent shortages of purified-protein derivative tuberculin skin test antigen solutions - United States, 2013.

Science.gov (United States)

2013-12-13

Two purified-protein derivative (PPD) tuberculin skin test (TST) antigen solutions are approved by the U.S. Food and Drug Administration (FDA): Tubersol (Sanofi Pasteur Limited) and Aplisol (JHP Pharmaceuticals, LLC). Tubersol was out of production in late 2012 through April 2013. Shortages of Aplisol have resulted from increased demand as practitioners have sought a substitute for Tubersol. Tubersol production resumed in May 2013, and supplies had been nearly restored by early June. However, in mid-July, state tuberculosis (TB) control officials notified CDC of difficulty obtaining Tubersol and Aplisol. Sanofi Pasteur notified FDA of a temporary delay in the availability of tuberculin in the 10-dose and 50-dose presentations. In mid-October, the 10-dose presentation was being returned to market, on allocation, which means that historical purchasing practices determine the amount that customers are allotted. In late October, the 50-dose presentation was being returned to market, also on allocation, one vial per historical customer per month. Supplies are forecast to approach normal during January 2014, after distributors have restored their supply chains. A compensatory surge in testing after deferment of testing during the periods of shortage might cause further temporary instability of supplies. In mid-August 2013, officials in 29 of 52 U.S. jurisdictions noted a shortage of at least one PPD TST antigen solution in health departments to the extent that it interrupted activities. This report includes a summary of the extent and effects of the shortages and a reiteration of advice on how to adapt to them.

Clinical evaluation of MPT-64 and MPT-59, two proteins secreted from Mycobacterium tuberculosis, for skin test reagents

DEFF Research Database (Denmark)

Wilcke, J T; Jensen, B N; Ravn, P

1996-01-01

: In a small scale clinical investigation, skin reactions to these antigens were compared to reactions to tuberculin PPD RT23 in 1) patients with active tuberculosis, 2) BCG vaccinated healthy subjects with close contact with tuberculous patients, and 3) BCG vaccinated healthy subjects without contact...... with tuberculous patients. Tests for in vitro reactivity to these antigens were carried out in similar groups. RESULTS: All subjects gave positive reaction to tuberculin PPD RT23, whereas approximately half of the subjects in each of the three groups reacted to MPT-59. Two subjects (one patient with tuberculosis...... and one healthy bacille Calmette-Guérin vaccinated subject without patient contact) reacted to MPT-64. The studies of cell proliferation and induction of interferon-gamma (IFN-gamma) following stimulation with tuberculin PPD and MPT-64 supported this profile of reactivity. CONCLUSION: None...

Is tuberculin testing before BCG vaccination necessary for children over three months of age?

LENUS (Irish Health Repository)

Hennessy, B

2008-03-01

In July 2007 Irish national policy changed such that children aged 3 months to 6 years no longer routinely require tuberculin (Mantoux) skin testing prior to BCG vaccination. Previous to that a tuberculin test was required in all children in this age group pre vaccination. While the previous policy was in place this study was conducted to assess the value of this test. The observation that children are frightened by the test (an injection into the skin) prompted the study. The author conducted a retrospective study of the results of 1,854 tuberculin tests performed as a prerequisite to BCG vaccination and found that only 0.7% of children had a positive test result (induration > 5mm). None of 107 children < 6 years of age tested positive. Those > 12 years were more likely to test positive than younger children (1.09% vs 0.4% respectively, p < 0.05). This study suggests that testing young children before BCG vaccination has a low yield of positive results and adds little to the detection of latent or active TB.

The History of In Vivo Tuberculin Testing in Bovines: Tuberculosis, a “One Health” Issue

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Margaret Good

2018-04-01

Full Text Available Tuberculosis (TB is more than 3 million years old thriving in multiple species. Ancestral Mycobacterium tuberculosis gave rise to multiple strains including Mycobacterium bovis now distributed worldwide with zoonotic transmission happening in both directions between animals and humans. M. bovis in milk caused problems with a significant number of deaths in children under 5 years of age due largely to extrapulmonary TB. This risk was effectively mitigated with widespread milk pasteurization during the twentieth century, and fewer young children were lost to TB. Koch developed tuberculin in 1890 and recognizing the possibility of using tuberculin to detect infected animals the first tests were quickly developed. Bovine TB (bTB control/eradication programmes followed in the late nineteenth century/early twentieth century. Many scientists collaborated and contributed to the development of tuberculin tests, to refining and optimizing the production and standardization of tuberculin and to determining test sensitivity and specificity using various methodologies and injection sites. The WHO, OIE, and EU have set legal standards for tuberculin production, potency assay performance, and intradermal tests for bovines. Now, those using tuberculin tests for bTB control/eradication programmes rarely, see TB as a disease. Notwithstanding the launch of the first-ever roadmap to combat zoonotic TB, many wonder if bTB is actually a problem? Is there a better way of dealing with bTB? Might alternative skin test sites make the test “better” and easier to perform? Are all tuberculins used for testing equally good? Why have alternative “better” tests not been developed? This review was prompted by these types of questions. This article attempts to succinctly summarize the data in the literature from the late nineteenth century to date to show why TB, and zoonotic TB specifically, was and still is important as a “One Health” concern, and that the

The value of counting BCG scars for interpretation of tuberculin skin tests in a tuberculosis hyperendemic shanty-town, Peru

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Saito, M.; Bautista, C. T.; Gilman, R. H.; Bowering, A.; Levy, M. Z.; Evans, C. A.

2010-01-01

SUMMARY SETTING The tuberculin skin test (TST) is widely used as a diagnostic or screening test for Mycobacterium tuberculosis infection and disease. A peri-urban shanty-town in the desert hills of south Lima, Peru, highly endemic for tuberculosis, and where bacille Calmette-Guérin (BCG) vaccine had been given in multiple doses until 1995. OBJECTIVE To analyze the effect of multiple BCG vaccines on TST in a community-based setting. DESIGN Point-prevalence survey of TST reactions of 572 people aged 6–26 years from 255 households. TST reactions were compared to the observed number of BCG scars and other potential risk factors (age, living with a TST-positive person, and contact with active tuberculosis). RESULT People with two or more scars had significantly larger reactions, even after adjusting for potential risk factors. The adjusted population attributable fraction of being TST-positive and having two or more BCG scars was 26%. CONCLUSION There is no demonstrated benefit of repeat BCG vaccination. We therefore recommend that physicians take into consideration the number of BCG scars when interpreting the TST and that programs give no more than one BCG vaccination. PMID:15260275

Two-step Raman spectroscopy method for tumor diagnosis

Science.gov (United States)

Zakharov, V. P.; Bratchenko, I. A.; Kozlov, S. V.; Moryatov, A. A.; Myakinin, O. O.; Artemyev, D. N.

2014-05-01

Two-step Raman spectroscopy phase method was proposed for differential diagnosis of malignant tumor in skin and lung tissue. It includes detection of malignant tumor in healthy tissue on first step with identification of concrete cancer type on the second step. Proposed phase method analyze spectral intensity alteration in 1300-1340 and 1640-1680 cm-1 Raman bands in relation to the intensity of the 1450 cm-1 band on first step, and relative differences between RS intensities for tumor area and healthy skin closely adjacent to the lesion on the second step. It was tested more than 40 ex vivo samples of lung tissue and more than 50 in vivo skin tumors. Linear Discriminant Analysis, Quadratic Discriminant Analysis and Support Vector Machine were used for tumors type classification on phase planes. It is shown that two-step phase method allows to reach 88.9% sensitivity and 87.8% specificity for malignant melanoma diagnosis (skin cancer); 100% sensitivity and 81.5% specificity for adenocarcinoma diagnosis (lung cancer); 90.9% sensitivity and 77.8% specificity for squamous cell carcinoma diagnosis (lung cancer).

Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study

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Sara S Dhanawade

2015-01-01

Full Text Available Background: There is considerable variation in BCG scar failure rate on available data and correlation between BCG scar and tuberculin conversion remains controversial. Through this study we aimed to determine the scar failure rate and tuberculin conversion in term infants vaccinated with BCG within the first month. Materials and Methods: A prospective cohort study was conducted among 85 consecutive infants weighing >2 kg attending the immunization clinic of a medical college hospital. Fifteen subjects who could not complete the follow up were excluded. Total of 70 cases were analyzed. All babies were administered 0.1 ml of BCG and examined at 3 months (+1 week for scar. Tuberculin test was done with 5TU PPD. An induration of >5 mm was considered positive. Statistical analysis was done using Microsoft Excel and SPSS-22. Results: Out of the 70 infants, 41 (58.6% were males. Although majority (72.9% of infants were vaccinated within 7 days, only 18 (25.7% received BCG within 48 hours of birth. Sixty-four (91.4% had a visible scar at 12 weeks post vaccination representing a scar failure rate of 8.6%. Tuberculin test was positive in 50 (71.4%. The mean ± s.d. for scar and tuberculin skin test (TST reaction size was 4.93 ± 2.01 mm and 6.01 ± 3.22 mm, respectively. The association between scar formation and tuberculin positivity was highly significant (P < 0.001. There was significant correlation between scar size and TST size (r = 0.401, P = 0.001 Conclusions: Less than 10% of infants fail to develop a scar following BCG vaccination. There is good correlation between scar positivity and tuberculin conversion.

Tuberculosis screening of new hospital employees: compliance, clearance to work time, and cost using tuberculin skin test and interferon-gamma release assays.

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Foster-Chang, Sarah A; Manning, Mary L; Chandler, Laura

2014-11-01

Selection of the most suitable test(s) for detection of Mycobacterium tuberculosis (TB) infection should be based on purpose, setting, effectiveness, and cost. Two tests are available to screen for latent TB: the tuberculin skin test (TST) and the more recent interferon-gamma release assays (IGRAs). Based on the administrative, logistic, and technical ease of use, an IGRA trial was initiated by the occupational health department at an urban Veteran's Administration health care facility for TB screening of new employees. As a result, new employees completing the pre-placement process within the organization's designated 14 days increased from 77% to 97%, new employee clearance to work time decreased from 13.18 to 5.91 days, and new employee TB screening costs were reduced by 40%. The IGRA is an acceptable alternative to the TST and has significant potential to improve the process of pre-placement TB screening. Copyright 2014, SLACK Incorporated.

A chromosome 5q31.1 locus associates with tuberculin skin test reactivity in HIV-positive individuals from tuberculosis hyper-endemic regions in east Africa.

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Rafal S Sobota

2017-06-01

Full Text Available One in three people has been infected with Mycobacterium tuberculosis (MTB, and the risk for MTB infection in HIV-infected individuals is even higher. We hypothesized that HIV-positive individuals living in tuberculosis-endemic regions who do not get infected by Mycobacterium tuberculosis are genetically resistant. Using an "experiment of nature" design that proved successful in our previous work, we performed a genome-wide association study of tuberculin skin test positivity using 469 HIV-positive patients from prospective study cohorts of tuberculosis from Tanzania and Uganda to identify genetic loci associated with MTB infection in the context of HIV-infection. Among these individuals, 244 tested were tuberculin skin test (TST positive either at enrollment or during the >8 year follow up, while 225 were not. We identified a genome-wide significant association between a dominant model of rs877356 and binary TST status in the combined cohort (Odds ratio = 0.2671, p = 1.22x10-8. Association was replicated with similar significance when examining TST induration as a continuous trait. The variant lies in the 5q31.1 region, 57kb downstream from IL9. Two-locus analyses of association of variants near rs877356 showed a haplotype comprised of rs877356 and an IL9 missense variant, rs2069885, had the most significant association (p = 1.59x10-12. We also replicated previously linked loci on chromosomes 2, 5, and 11. IL9 is a cytokine produced by mast cells and TH2 cells during inflammatory responses, providing a possible link between airway inflammation and protection from MTB infection. Our results indicate that studying uninfected, HIV-positive participants with extensive exposure increases the power to detect associations in complex infectious disease.

Diagnosis of Latent Tuberculosis in Patients with Systemic Lupus Erythematosus: T.SPOT.TB versus Tuberculin Skin Test

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Maria Del Mar Arenas Miras

2014-01-01

Full Text Available Early studies in patients with systemic lupus erythematosus (SLE reported increased incidence of tuberculosis. The tuberculin skin test (TST is the technique of choice to detect latent tuberculosis infection (LTBI but has several limitations. Objectives. We compared TST and the newer T.SPOT.TB test to diagnose LTBI in SLE patients. Methods. In this observational cohort study conducted between August 2009 and February 2012, we recruited 92 patients from those attending the SLE clinic of our university hospital. Data recorded were epidemiological and sociodemographic characteristics. Laboratory analyses included TST and T.SPOT.TB tests. Results. Of the patients studied, 92% were women with an average age of 42.7 years. Overall, the degree of correlation between the two tests was low (Kappa index = 0.324 but was better in patients not receiving corticosteroids (CTC/immunosuppressive (IS therapy (Kappa = 0.436 and in those receiving hydroxychloroquine (Kappa = 0.473. While TST results were adversely affected by those receiving CTC and/or IS drugs (P=0.021, the T.SPOT.TB results were not. Conclusion. Although the TST test remains a useful tool for diagnosing LTBI in SLE patients, the T.SPOT.TB test is perhaps better employed when the patient is receiving CTC and/or IS drugs.

Evaluation of the tuberculin skin test and the interferon-γ release assay for TB screening in French healthcare workers

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Raffi Francois

2009-11-01

Full Text Available Abstract Introduction Using French cut-offs for the Tuberculin Skin Test (TST, results of the TST were compared with the results of an Interferon-γ Release Assay (IGRA in Healthcare Workers (HCW after contact to AFB-positive TB patients. Methods Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI if an increase of >10 mm or if TST ≥ 15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. Results All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST ≥ 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041. In 10 (16.7% out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20% out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3% IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. Conclusion The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST.

Managing Occupational Irritant Contact Dermatitis Using a Two-Step Skincare Regimen Designed to Prevent Skin Damage and Support Skin Recovery.

Science.gov (United States)

von Grote, Erika C; Palaniswarmy, Kiruthi; Meckfessel, Matthew H

2016-12-01

Occupational irritant contact dermatitis (ICD) affecting the hands is a common and difficult-to-manage condition. Occupations that necessitate contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing elevate the risk of ICD. Management strategies that do not adequately prevent accumulated damage and repair skin, can develop into chronic dermatoses which negatively impact work productivity and quality of life. A 2-step skin-care regimen (Excipial Daily Protection Hand Cream (EP) and Excipial Rapid Repair Hand Cream (ER), Galderma Laboratories, L.P.) has been developed as a daily-use management strategy to protect and repair vulnerable hands. The protective barrier cream is formulated with aluminum chlorohydrate and designed for pre-exposure application to enhance the skin's natural protective barrier and minimize excessive moisture while wearing protective gloves. The repair cream, a lipid-rich formulation, is intended for post-exposure application to rehydrate and facilitate the skin's natural healing process. The results of 3 clinical studies highlighted in this review demonstrate how the use of a 2-step skin-care regimen offers a greater protective effect against ICD than the use of barrier cream alone, and also how the formulation of the barrier cream used in these studies helps minimize the occlusion effect caused by gloves and does not interfere with the antibacterial efficacy of an alcohol-based hand sanitizer. This 2-step skin-care regimen is effectively designed to manage and minimize the risk of ICD development in a variety of patients and provides clinicians an additional tool for helping patients manage ICD. J Drugs Dermatol. 2016;15(12):1504-1510.

Clinical evaluation of MPT-64 and MPT-59, two proteins secreted from Mycobacterium tuberculosis, for skin test reagents

DEFF Research Database (Denmark)

Wilcke, J T; Jensen, B N; Ravn, P

1996-01-01

and one healthy bacille Calmette-Guérin vaccinated subject without patient contact) reacted to MPT-64. The studies of cell proliferation and induction of interferon-gamma (IFN-gamma) following stimulation with tuberculin PPD and MPT-64 supported this profile of reactivity. CONCLUSION: None...... of the experimental skin test antigens had properties superior to tuberculin PPD RT23 in humans. The failure of MPT-64 to induce delayed type hypersensitivity reactions in the majority of tuberculosis patients is discussed, in view of the potent reactivity to MPT-64 in tuberculous guinea pigs....

Interferon gamma, interferon-gamma-induced-protein 10, and tuberculin responses of children at high risk of tuberculosis infection

DEFF Research Database (Denmark)

Petrucci, Roberta; Abu Amer, Nabil; Gurgel, Ricardo Queiroz

2008-01-01

BACKGROUND: Children in contact with adults with pulmonary tuberculosis (TB) are at risk for infection and disease progression, and chemoprophylaxis may reduce this risk. The identification of infection is based on the tuberculin skin test (TST) and interferon-gamma (INF-gamma) release assays...

Interferon gamma, interferon-gamma-induced-protein 10, and tuberculin responses of children at high risk of tuberculosis infection

DEFF Research Database (Denmark)

Petrucci, Roberta; Abu Amer, Nabil; Gurgel, Ricardo Queiroz

2008-01-01

BACKGROUND: Children in contact with adults with pulmonary tuberculosis (TB) are at risk for infection and disease progression, and chemoprophylaxis may reduce this risk. The identification of infection is based on the tuberculin skin test (TST) and interferon-gamma (INF-gamma) release assays. Ot...

Tuberculin skin test and interferon-gamma release assay values are associated with antimicrobial peptides expression in  polymorphonuclear cells during latent tuberculous infection

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Julio E Castañeda-Delgado

2014-06-01

Full Text Available It has been reported that patients with progressive tuberculosis (TB express abundant amounts of the antimicrobial peptides (AMPs cathelicidin (LL-37 and human neutrophil peptide-1 (HNP-1 in circulating cells, whereas latent TB infected donors showed no differences when compared with purified protein derivative (PPD and QuantiFERON®-TB Gold (QFT-healthy individuals. The aim of this study was to determine whether LL-37 and HNP-1 production correlates with higher tuberculin skin test (TST and QFT values in TB household contacts. Twenty-six TB household contact individuals between 26-58 years old TST and QFT positive with at last two years of latent TB infection were recruited. AMPs production by polymorphonuclear cells was determined by flow cytometry and correlation between TST and QFT values was analysed. Our results showed that there is a positive correlation between levels of HNP-1 and LL-37 production with reactivity to TST and/or QFT levels. This preliminary study suggests the potential use of the expression levels of these peptides as biomarkers for progression in latent infected individuals.

Assessment of the respiratory metabolism in the skin from transcutaneous measurements of pO2 and pCO2: potential for non-invasive monitoring of response to tuberculin skin testing.

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Abbot, N C; Spence, V A; Swanson-Beck, J; Carnochan, F M; Gibbs, J H; Lowe, J G

1990-03-01

A method is described for non-invasive transcutaneous (tc) measurement of tissue respiratory gas tensions in the skin on the forearm for study of delayed hypersensitivity reactions in man. Steady state values for tcpO2 and tcpCO2 were measured, and the skin respiratory rate (oxygen consumption) and the tissue pH were estimated from the changes in tcpO2 and tcpCO2 observed after interruption of the arterial circulation by cuff occlusion for 4 minutes. The extent of within-experiment and between subject variation in the steady-state measurements was not great (coefficient of variation 10%): tcpCO2.ss (steady state) was higher in men and tcpO2.ss was higher in women, but the extent of these sex differences was also small. Reference ranges have been established for tc measurements and calculated indices of tissue respiration in the undisturbed forearm skin of normal volunteers, against which the changes induced by tuberculin testing can be assessed. Severe changes, indicative of profound hypoxia and acidosis, are seen in intense delayed hypersensitivity reactions. Similar, but less severe changes were seen at the site of skin tests on BCG-vaccinated subjects who were 'negative' by conventional criteria of measurement of dermal induration and they became greatly exaggerated after successful re-vaccination. Intradermal injection of saline did not induce hypoxia or local acidosis. These new methods are very sensitive indicators of the tissue response in the DHS reaction.

Tuberculous Lymphadenitis: Skin Delayed-Type Hypersensitivity ...

African Journals Online (AJOL)

Tuberculous Lymphadenitis: Skin Delayed-Type Hypersensitivity Reaction and Cellular Immune Responses. ... The tuberculin skin test (TST) and peripheral blood mono-nuclear cells (PBMCs) culture were conducted using PPD. The cytokines were measured using commercial kits. Results: The mean TST was 24.6 ±8.0 ...

Pre-employment screening of latent tuberculosis infection among healthcare workers using tuberculin skin test and QuantiFERON-TB Gold test at a tertiary care hospital in Saudi Arabia

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Mohamed El-Helaly

2014-11-01

Full Text Available Summary: Objective: To assess the agreement between the tuberculin skin test (TST and the QuantiFERON-TB Gold test (QFT-G as pre-employment screening tests for latent tuberculosis infection (LTBI among healthcare workers. Methods: A retrospective cross-sectional study was conducted among 1412 healthcare workers who were screened for LTBI during the period from August 2009 to May 2011 at a tertiary-care hospital in the Kingdom of Saudi Arabia (KSA. The studied population was screened for LTBI using both TST and QFT-G simultaneously. The agreement between both tests was quantified using the Kappa coefficient (κ. Results: Comparing the results of QFT-G with TST, the tests had a significant overall agreement of 73.7% (1040/1412; κ = 0.33; p < 0.01. Negative concordance comprised 60.1% of the results, and positive concordance comprised 13.5%. However, positive TST but negative QFT comprised 16.3% of the results, and negative TST but positive QFT-G comprised 10.1%. Concordance was significantly associated with young age, female gender, Saudi-born nationals, and early career but not job type (clinical versus non-clinical nor status of Bacillus Calmette–Guerin (BCG vaccination. Conclusions: This study demonstrated 73.7% overall agreement between TST and QFT-G results among healthcare workers during pre-employment screening for LTBI. The results need to be confirmed in future studies before recommending QFT-G as a pre-employment screening test for LTBI. Keywords: Latent tuberculosis infection, Healthcare workers, Tuberculin skin test, QuantiFERON-TB Gold test

Teste de tuberculinização em caprinos (Capra hircus experimentalmente sensibilizados Tuberculin test in experimentally sensitized goats (Capra hircus

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Paulo Eduardo Gomes da Silva

2006-06-01

Full Text Available Foram estabelecidos critérios de interpretação do teste de tuberculinização aplicado ao diagnóstico da tuberculose em grupos de caprinos experimentalmente sensibilizados. Dos 30 animais utilizados, dez foram sensibilizados com Mycobacterium avium - amostra D4 (grupo A e dez com Mycobacterium bovis - amostra AN5 (grupo B. Dez caprinos não foram sensibilizados e constituíram o grupo controle (grupo C. No teste cervical simples, realizado com tuberculina bovina (M. bovis e lido às 72 horas pós-tuberculinização (p.t., as reações positivas foram aquelas em que houve aumento da espessura da dobra de pele igual ou superior a 3,9mm; reações inconclusivas, quando situadas entre 1,8 e 3,8mm, e negativas quando iguais ou menores que 1,7mm. A análise dos resultados do teste cervical comparativo, realizado com o M. avium e M. bovis e lido às 72 horas p.t., indicou reação positiva quando o aumento da espessura da dobra da pele induzida pela tuberculina bovina superou a reação à aviária em pelo menos 2,5mm; reação inconclusiva quando a diferença entre a reação à tuberculina bovina e à tuberculina aviária ficou situada entre 1,9 e 2,4mm; e negativa quando a reação bovina ultrapassou a aviária em até 1,8mm. Às 96 horas após a injeção da tuberculina, foi efetuada a avaliação histológica do local das reações tuberculínicas colhendo-se amostras de pele de cinco caprinos dos grupos A e B e de quatro animais do grupo controle; os resultados confirmaram a presença, nos grupos sensibilizados, de infiltrado inflamatório, constituído, preferencialmente, por células mononucleares.The tuberculin skin test was established with the aim to be applied in the diagnosis of tuberculosis in experimentally sensitized goats. Thirty goats were alocated into three groups with ten animals each. The animals in group A were sensitized with Mycobacterium avium sample D4; group B with Mycobacterium bovis sample AN5; and group C (control was

Serial testing of refugees for latent tuberculosis using the QuantiFERON-gold in-tube: effects of an antecedent tuberculin skin test.

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Baker, Cristina A; Thomas, William; Stauffer, William M; Peterson, Phillip K; Tsukayama, Dean T

2009-04-01

Screening for latent tuberculosis infection (LTBI) in refugee populations immigrating to low-incidence countries remains a challenge. We assessed the characteristics of the QuantiFERON-Gold In-Tube (QFT-GIT) compared with the tuberculin skin test (TST) in 198 refugees of all ages from tuberculosis-endemic countries. Diagnostic agreement between the first QFT-GIT and simultaneous TST was 78% (kappa = 0.56) and between serial QFT-GITs was 89% (kappa = 0.76). In serial QFT-GIT testing, 70% of subjects had an increased QFT-GIT value, perhaps the result of an antecedent TST in the setting of previous TB exposure. This boosting seemed to become less prevalent with time from TST and occurred less frequently in those with negative first QFT-GIT readings. Despite small changes in the quantitative results caused by nonspecific variation and boosting, the diagnostic result of the QFT-GIT was reliable. The QFT-GIT shows the potential to replace the TST for LTBI screening in refugees from tuberculosis-endemic areas.

[Robert Koch was right. Towards a new interpretation of tuberculin therapy].

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Cardona, Pere J

2006-01-01

At the centenary of Robert Koch's Nobel Prize award, tuberculosis treatment with tuberculin, which was announced in Berlin in 1890, is still considered a failure. Nevertheless, there is now sufficient information supporting the idea that tuberculin therapy was widely used until the second half of the twentieth century; thus, the impact of this treatment should be studied and related to the decrease in tuberculosis-related mortality recorded in that period. Moreover, tuberculin therapy has inspired at least two new immunotherapies; these, however, were directed toward precisely the opposite effect: suppression of the Koch phenomenon. Thus, inoculation of Mycobacterium vaccae polarizes the immune response towards the Th1 type; and inoculation of RUTI avoids local immunodepression after short-term chemotherapy without inducing toxicity. For this reason, Robert Koch's work on antituberculosis therapy should be reread and proper recognition given to his contribution in this field.

Tuberculin Skin Test and Quantiferon in BCG Vaccinated, Immunosuppressed Patients with Moderate-to-Severe Inflammatory Bowel Disease.

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Kurti, Zsuzsanna; Lovasz, Barbara Dorottya; Gecse, Krisztina Barbara; Balint, Anita; Farkas, Klaudia; Morocza-Szabo, Agnes; Gyurcsanyi, Andras; Kristof, Katalin; Vegh, Zsuzsanna; Gonczi, Lorant; Kiss, Lajos Sandor; Golovics, Petra Anna; Lakatos, Laszlo; Molnar, Tamas; Lakatos, Peter Laszlo

2015-12-01

There are few data available on the effect of immunomodulator/biological therapy on the accuracy of the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in BCG-vaccinated immunosuppressed patients with inflammatory bowel disease (IBD). Our aim was to define the accuracy, predictors and agreement of TST and IGRA in a BCG-vaccinated immunosuppressed referral IBD cohort. 166 consecutive moderate-to-severe IBD patients (122 Crohn's disease, CD and 44 ulcerative colitis, UC) were enrolled in a prospective study from three centers. Patients were treated with immunosuppressives and/or biologicals. IGRA and TST were performed on the same day. Both in- and outpatient records were collected and comprehensively reviewed. TST positivity rate was 23.5%, 21.1%,14.5% and 13.9% when cut-off values of 5, 10, 15 and 20mm were used. IGRA positivity rate was 8.4% with indeterminate result in 0.6%. Chest X-ray was suggestive of latent tuberculosis in 2 patients. Correlation between TST and IGRA was moderate (kappa: 0.39-0.41, p15mm) should be considered to identify patients at risk for latent TB. Accuracy is satisfactory in BCG-vaccinated, immunosuppressed IBD patients. Smoking is a risk factor for TST positivity.

Screening health care workers with interferon-γ release assay versus tuberculin skin test: impact on costs and adherence to testing (the SWITCH study).

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Wrighton-Smith, Peter; Sneed, Laurie; Humphrey, Frances; Tao, Xuguang; Bernacki, Edward

2012-07-01

To determine the price point at which an interferon-γ release assay (IGRA) is less costly than a tuberculin skin test (TST) for health care employee tuberculosis screening. A multidecision tree-based cost model incorporating inputs gathered from time-motion studies and parallel testing by IGRA and TST was conducted in a subset of our employees. Administering a TST testing program costs $73.20 per person screened, $90.80 per new hire, and $63.42 per annual screen. Use of an IGRA for employee health testing is cost saving at an IGRA test cost of $54.83 or less per test and resulted in higher completion rates because of the elimination of the need for a second visit to interpret the TST. Using an IGRA for employee health screening can be an institutional cost saving and results in higher compliance rates.

The stability of human, bovine and avian tuberculin purified protein derivative (PPD).

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Maes, Mailis; Giménez, José Francisco; D'Alessandro, Adriana; De Waard, Jacobus H

2011-11-15

Guidelines recommend storing tuberculin purified protein derivative (PPD) refrigerated. However, especially in developing countries, maintaining the product refrigerated under field conditions can be difficult, limiting its use. Here we determine the effect of prolonged exposure to high temperatures on the potency of human, bovine and avian tuberculin PPD. Human, bovine and avian tuberculin PPD were stored for several weeks exposed to temperatures ranging from 37º to 100ºC. The potency was evaluated in vivo, in sensitized or naturally infected animals. Most test situations didn't affect the biological activity of the tuberculin PPDs and only very long and extreme incubations (several days at 100 °C) compromised the potency. Tuberculin PPD is very stable and can be stored or transported for long periods without refrigeration. 

Delayed Hypersensitivity to Tuberculin and Other Antigens in a ...

African Journals Online (AJOL)

Delayed hypersensitivi:y is a valuable index of cellular immune function, provided that the incidence of positive readions in the population is known. One hundred and sixty-two hospital pat;ents were examined, using tuberculin. (PPD), streptokinase and antigens derived from Candida albicans and mumps. Whereas 75% of ...

[Deep alkali burns: Evaluation of a two-step surgical strategy].

Science.gov (United States)

Devinck, F; Deveaux, C; Bennis, Y; Deken-Delannoy, V; Jeanne, M; Martinot-Duquennoy, V; Guerreschi, P; Pasquesoone, L

2018-04-10

Chemical burns are rare but often lead to deep cutaneous lesions. Alkali agents have a deep and long lasting penetrating power, causing burns that evolve over several days. The local treatment for these patients is excision of the wound and split thickness skin graft. Early excision and immediate skin grafting of alkali burns are more likely to be complicated by graft failure and delayed wound healing. We propose a two-step method that delays skin grafting until two-three days after burn wound excision. Our population included 25 controls and 16 cases. Men were predominant with a mean age of 41.9 years. In 78% of cases, burns were located on the lower limbs. The mean delay between the burn and excision was 16.5 days. In cases, the skin graft was performed at a mean of 11.3 days after the initial excision. We did not unveil any significant difference between both groups for the total skin surface affected, topography of the burns and the causal agent. Wound healing was significantly shorter in cases vs controls (37.5 days vs 50.3 days; P<0.025). Furthermore, we observed a decreased number of graft failures in cases vs controls (13.3% vs 46.7%; P=0.059). Our study shows the relevance of a two-step surgical strategy in patients with alkali chemical burns. Early excision followed by interval skin grafting is associated with quicker wound healing and decreased rate of graft failure. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

QuantiFERON-TB Gold In-Tube as a Confirmatory Test for Tuberculin Skin Test in Tuberculosis Contact Tracing: A Noninferiority Clinical Trial.

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Muñoz, Laura; Santin, Miguel; Alcaide, Fernando; Ruíz-Serrano, Maria Jesús; Gijón, Paloma; Bermúdez, Elena; Domínguez-Castellano, Angel; Navarro, María Dolores; Ramírez, Encarnación; Pérez-Escolano, Elvira; López-Prieto, María Dolores; Gutiérrez-Rodriguez, José; Anibarro, Luis; Calviño, Laura; Trigo, Matilde; Cifuentes, Carmen; García-Gasalla, Mercedes; Payeras, Antoni; Gasch, Oriol; Espasa, Mateu; Agüero, Ramon; Ferrer, Diego; Casas, Xavier; González-Cuevas, Araceli; García-Zamalloa, Alberto; Bikuña, Edurne; Lecuona, María; Galindo, Rosa; Ramírez-Lapausa, Marta; Carrillo, Raquel

2018-01-18

Screening strategies based on interferon-γ release assays in tuberculosis contact tracing may reduce the need for preventive therapy without increasing subsequent active disease. We conducted an open-label, randomized trial to test the noninferiority of a 2-step strategy with the tuberculin skin test (TST) followed by QuantiFERON-TB Gold In-Tube (QFT-GIT) as a confirmatory test (the TST/QFT arm) to the standard TST-alone strategy (TST arm) for targeting preventive therapy in household contacts of patients with tuberculosis. Participants were followed for 24 months after randomization. The primary endpoint was the development of tuberculosis, with a noninferiority margin of 1.5 percentage points. A total of 871 contacts were randomized. Four contacts in the TST arm and 2 in the TST/QFT arm developed tuberculosis. In the modified intention-to-treat analysis, this accounted for 0.99% in the TST arm and 0.51% in the TST/QFT arm (-0.48% difference; 97.5% confidence interval [CI], -1.86% to 0.90%); in the per-protocol analysis, the corresponding rates were 1.67% and 0.82% in the TST and TST/QFT arms, respectively (-0.85% difference; 97.5% CI, -3.14% to 1.43%). Of the 792 contacts analyzed, 65.3% in the TST arm and 42.2% in the TST/QFT arm were diagnosed with tuberculosis infection (23.1% difference; 95% CI, 16.4% to 30.0%). In low-incidence settings, screening household contacts with the TST and using QFT-GIT as a confirmatory test is not inferior to TST-alone for preventing active tuberculosis, allowing a safe reduction of preventive treatments. NCT01223534. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Private sector tuberculosis prevention in the US: Characteristics associated with interferon-gamma release assay or tuberculin skin testing.

Science.gov (United States)

Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

2018-01-01

To determine whether latent tuberculosis infection risk factors are associated with an increased likelihood of latent tuberculosis infection testing in the US private healthcare sector. A national sample of medical and pharmacy claims representing services rendered January 2011 through December 2013 for 3,997,986 commercially insured individuals in the US who were 0 to 64 years of age. We used multivariable logistic regression models to determine whether TB/LTBI risk factors were associated with an increased likelihood of Interferon-Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) testing in the private sector. 4.31% (4.27-4.34%) received at least one TST/IGRA test between 2011 and 2013 while 1.69% (1.67-1.72%) received a TST/IGRA test in 2013. Clinical risk factors associated with a significantly increased likelihood of testing included HIV, immunosuppressive therapy, exposure to tuberculosis, a history of tuberculosis, diabetes, tobacco use, end stage renal disease, and alcohol use disorder. Other significant variables included gender, age, asthma, the state tuberculosis rate, population density, and percent of foreign-born persons in a county. Private sector TST/IGRA testing is not uncommon and testing varies with clinical risk indicators. Thus, the private sector can be a powerful resource in the fight against tuberculosis. Analyses of administrative data can inform how best to leverage private sector healthcare toward tuberculosis prevention activities.

Bovine Tuberculosis in Cattle in the Highlands of Cameroon: Seroprevalence Estimates and Rates of Tuberculin Skin Test Reactors at Modified Cut-Offs

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J. Awah-Ndukum

2012-01-01

Full Text Available The aim of this study was to obtain epidemiological estimates of bovine tuberculosis (TB prevalence in cattle in the highlands of Cameroon using two population-based tuberculin skin test (TST surveys in the years 2009 and 2010. However, prior to the TST survey in 2010, blood was collected from already chosen cattle for serological assay. Anti-bovine TB antibodies was detected in 37.17% of tested animals and bovine TB prevalence estimates were 3.59%–7.48%, 8.92%–13.25%, 11.77%–17.26% and 13.14%–18.35% for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and single TST, respectively. The agreement between TST and lateral flow was generally higher in TST positive than in TST negative subjects. The K coefficients were 0.119, 0.234, 0.251 and 0.254 for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and the single TST groups, respectively. Chi square statistics revealed that strong (P48 associations existed between seroprevalence rates and TST reactors. The study suggested that using lateral flow assay and TST at severe interpretations could improve the perception of bovine TB in Cameroon. The importance of defining TST at modified cut-offs and disease status by post-mortem detection and mycobacterial culture of TB lesions in local environments cannot be overemphasised.

Latent tuberculosis infection, tuberculin skin test and vitamin D status in contacts of tuberculosis patients: a cross-sectional and case-control study

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Arnedo-Pena Alberto

2011-12-01

Full Text Available Abstract Background Deficient serum vitamin D levels have been associated with incidence of tuberculosis (TB, and latent tuberculosis infection (LTBI. However, to our knowledge, no studies on vitamin D status and tuberculin skin test (TST conversion have been published to date. The aim of this study was to estimate the associations of serum 25-hydroxyvitamin D3 (25[OH]D status with LTBI prevalence and TST conversion in contacts of active TB in Castellon (Spain. Methods The study was designed in two phases: cross-sectional and case-control. From November 2009 to October 2010, contacts of 42 TB patients (36 pulmonary, and 6 extra-pulmonary were studied in order to screen for TB. LTBI and TST conversion cases were defined following TST, clinical, analytic and radiographic examinations. Serum 25(OHD levels were measured by electrochemiluminescence immunoassay (ECLIA on a COBAS® 410 ROCHE® analyzer. Logistic regression models were used in the statistical analysis. Results The study comprised 202 people with a participation rate of 60.1%. Only 20.3% of the participants had a sufficient serum 25(OHD (≥ 30 ng/ml level. In the cross-sectional phase, 50 participants had LTBI and no association between LTBI status and serum 25(OHD was found. After 2 months, 11 out of 93 negative LTBI participants, without primary prophylaxis, presented TST conversion with initial serum 25(OHD levels: a:19.4% (7/36: Conclusions The results suggest that sufficient serum 25(OHD levels protect against TST conversion.

Assessment of a Protein Cocktail-Based Skin Test for Bovine Tuberculosis in a Double-Blind Field Test in Cattle

Science.gov (United States)

Xin, Ting; Jia, Hong; Ding, Jiabo; Li, Pingjun; Yang, Hongjun; Hou, Shaohua; Yuan, Weifeng; Guo, Xiaoyu; Wang, Haichun; Liang, Qianqian; Li, Ming

2013-01-01

Bovine tuberculosis (bTB) is a worldwide zoonosis caused mainly by Mycobacterium bovis. The traditional diagnostic method used often is the tuberculin skin test, which uses bovine purified protein derivatives (PPD-B). However, it is difficult to maintain uniformity of PPD-B from batch to batch, and it shares common antigens with nonpathogenic environmental mycobacteria. To overcome these problems, M. bovis-specific antigens that showed good T cell stimulation, such as CFP-10, ESAT-6, Rv3615c, etc., have been used in the skin test, but there have been no large-scale clinical studies on these antigens. In this study, two combinations (CFP-10/ESAT-6/TB10.4 protein cocktail and CFP-10/ESAT-6/Rv3872/MPT63 protein cocktail) were developed and used as stimuli in the skin test. Cattle were double-blind tested to assess the efficiency of the protein cocktail-based skin tests. The results showed that the CFP-10/ESAT-6/TB10.4 protein cocktail-based skin test can differentiate TB-infected cattle from Mycobacterium avium-infected ones and that it shows a high degree of agreement with the traditional tuberculin skin test (κ = 0.8536) and gamma interferon (IFN-γ) release assay (κ = 0.8154). Compared to the tuberculin skin test, the relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 87% and 97%, respectively., The relative sensitivity and relative specificity of the CFP-10/ESAT-6/TB10.4-based skin test were 93% and 92%, respectively, on comparison with the IFN-γ release assay. The correlation between the increases in skin thickness observed after the inoculation of stimuli was high (PPD-B versus CFP-10/ESAT-6/TB10.4, Spearman r of 0.8435). The correlation between the optical density at 450 nm (OD450) obtained after blood stimulation with PPD-B and the increase in skin thickness observed after inoculation of the CFP-10/ESAT-6/TB10.4 protein cocktail was high (Spearman r = 0.7335). Therefore, the CFP-10/ESAT-6/TB10.4-based skin test

The feasibility of the interferon gamma release assay and predictors of discordance with the tuberculin skin test for the diagnosis of latent tuberculosis infection in a remote Aboriginal community.

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Gonzalo G Alvarez

Full Text Available The tuberculin skin test (TST is the standard test used to screen for latent TB infection (LTBI in the northern Canadian territory of Nunavut. Interferon gamma release assays (IGRA are T cell blood-based assays to diagnose LTBI. The Bacillus Calmette-Guerin (BCG vaccine is part of the routine immunization schedule in Nunavut. The objective of this study was to test the feasibility, and predictors of discordance between the Tuberculin Skin Test (TST and the IGRA assay in a medically under-serviced remote arctic Aboriginal population.Both the TST and QuantiFERON-TB Gold (Qiagen group IGRA tests were offered to people in their homes as part of a public health campaign aimed at high TB risk residential areas in Iqaluit, Nunavut, Canada. Feasibility was measured by the capacity of the staff to do the test successfully as measured by the proportion of results obtained.In this population of predominantly young Inuit who were mostly BCG vaccinated, the use of IGRA for the diagnosis of LTBI was feasible. IGRA testing resulted in more available test results reaching patients (95.6% vs 90.9% p = 0.02 but took longer (median 8 days (IGRA vs 2 days (TST, p value < 0.0001. 44/256 participants (17.2% had discordant results. Multivariable regression analysis suggested that discordant results were most likely to have received multiple BCG vaccinations (RR 20.03, 95% CI, 3.94-101.82, followed by BCG given post infancy (RR 8.13, 95% CI, 2.54-26.03 and then to a lesser degree when BCG was given in infancy (RR 6.43, 95% CI, 1.72-24.85.IGRA is feasible in Iqaluit, Nunavut, a remote Arctic community. IGRA testing results in more test results available to patients compared to TST. This test could result in fewer patients requiring latent TB treatment among those previously vaccinated with BCG in a region with limited public health human resources.

Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.

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Fernanda Mattos de Souza

Full Text Available An interferon-γ release assay, QuantiFERON-TB (QFT test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI. Here, we compared the performance of QFT with tuberculin skin test (TST measured at two different cut-off points among primary health care work (HCW in Brazil.A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31, and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22. We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value.Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.

Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.

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de Souza, Fernanda Mattos; do Prado, Thiago Nascimento; Pinheiro, Jair dos Santos; Peres, Renata Lyrio; Lacerda, Thamy Carvalho; Loureiro, Rafaela Borge; Carvalho, Jose Américo; Fregona, Geisa; Dias, Elias Santos; Cosme, Lorrayne Beliqui; Rodrigues, Rodrigo Ribeiro; Riley, Lee Wood; Maciel, Ethel Leonor Noia

2014-01-01

An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil. A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points. We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value. Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.

Mycobacterium tuberculosis epitope-specific interferon-g production in healthy Brazilians reactive and non-reactive to tuberculin skin test

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Bosco Christiano Maciel da Silva

2014-12-01

Full Text Available The interferon (IFN-γ response to peptides can be a useful diagnostic marker of Mycobacterium tuberculosis (MTB latent infection. We identified promiscuous and potentially protective CD4+ T-cell epitopes from the most conserved regions of MTB antigenic proteins by scanning the MTB antigenic proteins GroEL2, phosphate-binding protein 1 precursor and 19 kDa antigen with the TEPITOPE algorithm. Seven peptide sequences predicted to bind to multiple human leukocyte antigen (HLA-DR molecules were synthesised and tested with IFN-γ enzyme-linked immunospot (ELISPOT assays using peripheral blood mononuclear cells (PBMCs from 16 Mantoux tuberculin skin test (TST-positive and 16 TST-negative healthy donors. Eighty-eight percent of TST-positive donors responded to at least one of the peptides, compared to 25% of TST-negative donors. Each individual peptide induced IFN-γ production by PBMCs from at least 31% of the TST-positive donors. The magnitude of the response against all peptides was 182 ± 230 x 106 IFN-γ spot forming cells (SFC among TST-positive donors and 36 ± 62 x 106 SFC among TST-negative donors (p = 0.007. The response to GroEL2 (463-477 was only observed in the TST-positive group. This combination of novel MTB CD4 T-cell epitopes should be tested in a larger cohort of individuals with latent tuberculosis (TB to evaluate its potential to diagnose latent TB and it may be included in ELISPOT-based IFN-γ assays to identify individuals with this condition.

Tuberculin immunotherapy: its history and lessons to be learned.

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Vilaplana, Cristina; Cardona, Pere-Joan

2010-02-01

The use of tuberculin for the therapy of tuberculosis was attempted more than 100 years ago and abandoned because of its adverse reactions. In this historical review we point out that some of the intensive efforts to avoid the reactions were based on the best scientific rationale available at that time. Balancing the dosage and intervals of tuberculin delivery with clinical and laboratory monitoring of patients achieved a limited success, with implications, toward current research in the field. The role of economical and social aspects at that time is also a lesson to be learned toward current approaches to tuberculosis control. Copyright 2009 Elsevier Masson SAS. All rights reserved.

STUDIES ON TUBERCULIN FEVER. 3. MECHANISMS INVOLVED IN THE RELEASE OF ENDOGENOUS PYROGEN IN VITRO.

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ATKINS, E; HEIJN, C

1965-08-01

In a search for the source of the circulating endogenous pyrogen (EP) that mediates tuberculin-induced fever, tuberculin was incubated in vitro with various tissues of rabbits sensitized by intravenous infection with BCG. Evidence was obtained that tuberculin specifically stimulates cells in the blood of sensitized rabbits to generate pyrogen in vitro, whereas both lymph node and spleen cells from the same donors were inactive. Since normal blood cells, incubated in plasma of sensitized donors, were similarly activated, it is postulated that circulating antibodies play a role in sensitizing cells (presumably granulocytes) to release pyrogen on contact with tuberculin) both in vitro and in vivo. Release of endogenous pyrogen in vitro may be a sensitive means of detecting immunologic reactions between antigen and specifically sensitized blood cells-in other allergic states accompanied by fever.

Screening of latent tuberculosis infection among health care workers working in Hajj pilgrimage area in Saudi Arabia, using interferon gamma release assay and tuberculin skin test.

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Bukhary, Zakeya A; Amer, Soliman M; Emara, Magdy M; Abdalla, Mohammad E; Ali, Sahar A

2018-01-01

Interferon gamma release assays (IGRA) is highly specific for Mycobacterium tuberculosis and is the preferred test in BCG-vaccinated individuals. The few studies that have screened health care workers (HCWs) in Saudi Arabia for latent tuberculosis infection (LTBI) using IGRA have varied in agreement with the traditional tuberculin skin test (TST). Assess the prevalence of LTBI among HCWs working in the Hajj pilgrimage using IGRA and TST and measuring their agreement. Cross-sectional prospective. Multiple non-tertiary care hospitals. HCWs who worked during the Hajj pilgrimage in Saudi Arabia in December 2015. Data was collected by standarized questionnaire. Samples were drawn and analyzed by standard methods. The prevalence of LTBI among HCW and the agreement by kappa statistic between QFT-GIT and TST. 520 subjects. Nurses accounted for 30.7% of the sample and physicians, 19.2%. The majority were BCG vaccinated (98.5%). There were a total of 56 positive by QFT-GIT and the LTBI rate was 10.8%. In 50 QFT positive/476 TST negative the LTBI rate was 10.5% in discordant tests, and in 6 QFT positive/44 TST positive it was 13.6% in concordant tests. The overall agreement between both tests was poor-83% and kappa was 0.02. LTBI prevalence was associated with longer employment (13.1 [9.2] years). The QFT-GIT positive test was significantly higher in physicians (P=.02) and in HCWs working in chest hospitals 16/76 (21.05%) (P=.001). Agreement between the tests was poor. QFT-GIT detected LTBI when TST was negative in HCWs who had a history of close contact with TB patients. A second step TST was not feasible within 2-3 weeks. None.

[Tuberculin reactivity among ninth-grade schoolchildren in the city of Havana, Cuba].

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Borroto Gutiérrez, Susana M; González Ochoa, Edilberto; Armas Pérez, Luisa; Urbino López-Chávez, Amelia; Martínez, Ana Maribel; Llanes, María Josefa; Sevy Court, José; Carreras Corzo, Libertad

2003-09-01

To determine the proportion of 14-year-old schoolchildren in the city of Havana, Cuba, with a positive tuberculin skin test, as an indicator of the prevalence of tuberculosis infection among them. Using single-stage cluster sampling, 1 936 Mantoux (tuberculin) tests were carried out with ninth-grade students (cohort born in 1985) during the 1999- 2000 school year in 20 basic high schools randomly selected in Havana. The tests were performed according to the standard technique recommended by the World Health Organization, and they were read after 72 hours. The percentage of skin tests that were positive and the average diameter of the indurations were calculated for the cohort overall and for the two genders. The means and the percentages were compared using the chi-square test, with 95% confidence intervals. The computer software used was Epi Info version 6.0. Of the tests read, 96% of them were negative (0-4 mm), 2.5% were doubtful (5-9 mm), and 1.5% were positive (>/=10 mm). The percentage of reactivity was 0.1% when a cutoff value of 15 mm was used. The mean diameter of the indurations was 0.41 mm. No statistically significant difference was found between the genders. In this study the proportion of schoolchildren with tuberculin reactivity, using an induration-diameter cutoff point of 10 mm, was very low (1.5%), and it was much lower (0.1%) when a cutoff point of 15 mm was used. The skin reactions with an induration diameter of >/=10 mm could be the expression of a natural infection if one takes into account the low frequency of bacillary tuberculosis in Cuba and that there is an inverse relationship between the time elapsed from the BCG vaccination and the intensity of the response to tuberculin. Therefore, that would mean that in this case (l)the point (.)prevalence of tuberculosis infection in this group of schoolchildren wou d be 1.5% ResumenObjetivos. Determinar la proporción de personas que reaccionan a la tuberculina como indicador de la prevalencia de

Tuberculosis skin testing, anergy and protein malnutrition in Peru.

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Pelly, T F; Santillan, C F; Gilman, R H; Cabrera, L Z; Garcia, E; Vidal, C; Zimic, M J; Moore, D A J; Evans, C A

2005-09-01

Malnutrition and intestinal parasites cause immunosuppression. This may cause false-negative tuberculin skin tests (TST) and failure to identify tuberculosis (TB) infection. To assess factors associated with TST positivity and anergy in disadvantaged communities in Peru. A study of 212 randomly selected adults: 102 in a rural Amazonian village and 110 shanty town residents in urban Lima. Respectively 52% and 53% of urban and rural jungle populations were TST-positive. Using simultaneous tetanus and candida skin tests, 99% had at least one positive skin test. Generalised anergy was therefore rare, despite frequent intestinal parasitic infection, including 34% helminth infection prevalence in the jungle. TST positivity was associated with age (P = 0.001), known TB contact (P = 0.02) and poor household ventilation (P = 0.007). TST positivity was not significantly associated with crowding, reported past TB, single/multiple BCG vaccination, income, intestinal parasites, dietary factors, body mass index or body fat. Individuals with lower anthropometric body protein, as measured by corrected arm muscle area, were less likely to be TST-positive (P = 0.02), implying that protein malnutrition caused tuberculin-specific anergy. These results identify the importance of household ventilation for community TB transmission and add to the evidence that protein malnutrition suppresses TB immunity, causing false-negative TST results.

Loss of receptor on tuberculin-reactive T-cells marks active pulmonary tuberculosis.

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Mathias Streitz

Full Text Available BACKGROUND: Tuberculin-specific T-cell responses have low diagnostic specificity in BCG vaccinated populations. While subunit-antigen (e.g. ESAT-6, CFP-10 based tests are useful for diagnosing latent tuberculosis infection, there is no reliable immunological test for active pulmonary tuberculosis. Notably, all existing immunological tuberculosis-tests are based on T-cell response size, whereas the diagnostic potential of T-cell response quality has never been explored. This includes surface marker expression and functionality of mycobacterial antigen specific T-cells. METHODOLOGY/PRINCIPAL FINDINGS: Flow-cytometry was used to examine over-night antigen-stimulated T-cells from tuberculosis patients and controls. Tuberculin and/or the relatively M. tuberculosis specific ESAT-6 protein were used as stimulants. A set of classic surface markers of T-cell naïve/memory differentiation was selected and IFN-gamma production was used to identify T-cells recognizing these antigens. The percentage of tuberculin-specific T-helper-cells lacking the surface receptor CD27, a state associated with advanced differentiation, varied considerably between individuals (from less than 5% to more than 95%. Healthy BCG vaccinated individuals had significantly fewer CD27-negative tuberculin-reactive CD4 T-cells than patients with smear and/or culture positive pulmonary tuberculosis, discriminating these groups with high sensitivity and specificity, whereas individuals with latent tuberculosis infection exhibited levels in between. CONCLUSIONS/SIGNIFICANCE: Smear and/or culture positive pulmonary tuberculosis can be diagnosed by a rapid and reliable immunological test based on the distribution of CD27 expression on peripheral blood tuberculin specific T-cells. This test works very well even in a BCG vaccinated population. It is simple and will be of great utility in situations where sputum specimens are difficult to obtain or sputum-smear is negative. It will also help

Evaluación de la respuesta a la tuberculina en estudiantes del área de la salud Evaluation of the response to tuberculin among university students in the health field

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María Patricia Arbeláez M.

2000-10-01

. Tuberculin skin test reactivity was evaluated by the size of induration 72 hours after intradermal injection of two tuberculin units of purified protein derivative RT 23. There were no differences in tuberculin reactivity between students from the health programs and from the nonhealth programs, irrespective of the academic level. However, there was a significantly higher proportion of positive skin tests among students with a BCG scar. These results suggest that undergraduate health students do not have extensive contact with TB patients or with clinical samples from such patients. Nevertheless, the results do not rule out TB as an occupational risk for health personnel.

Tuberculin skin testing and treatment modulates interferon-gamma release assay results for latent tuberculosis in migrants.

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Matthew K O'Shea

Full Text Available Identifying latent tuberculosis infection (LTBI in people migrating from TB endemic regions to low incidence countries is an important control measure. However, no prospective longitudinal comparisons between diagnostic tests used in such migrant populations are available.To compare commercial interferon (IFN-gamma release assays (IGRAs and the tuberculin skin test (TST for diagnosing LTBI in a migrant population, and the influence of antecedent TST and LTBI treatment on IGRA performance.This cohort study, performed from February to September 2012, assessed longitudinal IGRA and TST responses in Nepalese military recruits recently arrived in the UK. Concomitant T-SPOT.TB, QFT-GIT and TST were performed on day 0, with IGRAs repeated 7 and 200 days later, following treatment for LTBI if necessary.166 Nepalese recruits were prospectively assessed. At entry, 21 individuals were positive by T-SPOT.TB and 8 individuals by QFT-GIT. There was substantial agreement between TST and T-SPOT.TB positives at baseline (71.4% agreement; κ = 0.62; 95% CI:0.44-0.79, but only moderate concordance between positive IGRAs (38.1% agreement; κ = 0.46; 95% CI:0.25-0.67. When reassessed 7 days following TST, numbers of IGRA-positive individuals changed from 8 to 23 for QFT-GIT (p = 0.0074 and from 21 to 23 for T-SPOT.TB (p = 0.87. This resulted in an increase in IGRA concordance to substantial (64.3% agreement; κ = 0.73; 95% CI:0.58-0.88. Thus, in total on day 0 and day 7 after testing, 29 out of 166 participants (17.5% provided a positive IGRA and of these 13 were TST negative. Two hundred days after the study commenced and three months after treatment for LTBI was completed by those who were given chemoprophylaxis, 23 and 21 participants were positive by T-SPOT.TB or QFT-GIT respectively. When individual responses were examined longitudinally within this population 35% of the day 7 QFT-GIT-positive, and 19% T-SPOT.TB-positive individuals, were

In vitro culture of skin-homing T lymphocytes from inflammatory skin diseases

DEFF Research Database (Denmark)

Bang, Karen; Lund, Marianne; Mogensen, Søren C

2005-01-01

We, in this study, describe how T lymphocytes in a skin biopsy can proliferate in vitro for up to 3 months by using T-cell growth factors - interleukin-2 (IL-2) and IL-4 yielding approximately 100-160 million T lymphocytes within 1 month. We established cell lines from three tuberculin skin tests......, four positive patch tests, 15 of 16 biopsies from atopic dermatitis (AD), 15 of 19 biopsies from mycosis fungoides (MF), 12 of 24 biopsies from psoriasis vulgaris, which was significantly less than AD (P lymphocytes (P ... to immediate halt of proliferation. Blood mononuclear cells from patients and biopsies from healthy persons never gave cell lines. All cells were T lymphocytes expressing CD45RO+, HLA-DR+ and CD150. The CD7 expression was significantly increased in cell lines from AD (P

9 CFR 113.409 - Tuberculin-PPD Bovis, Intradermic.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Tuberculin-PPD Bovis, Intradermic. 113... REQUIREMENTS Diagnostics and Reagents § 113.409 Tuberculin—PPD Bovis, Intradermic. Tuberculin—PPD Bovis... completed product from each serial shall be subjected to a comparison specificity test using a Reference PPD...

Automation of an interferon-γ release assay and comparison to the tuberculin skin test for screening basic military trainees for Mycobacterium tuberculosis infection.

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Goodwin, Donald J; Mazurek, Gerald H; Campbell, Brandon H; Bohanon, Jamaria; West, Kevin B; Bell, James J; Powell, Richard; Toney, Sean; Morris, John A; Yamane, Grover K; Sjoberg, Paul A

2014-03-01

We automated portions of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) and assessed its quality when performed concurrently with the tuberculin skin test (TST) among U.S. Air Force basic military trainees (BMTs). The volume of blood collected for QFT-GIT was monitored. At least one of the three tubes required for QFT-GIT had blood volume outside the recommended 0.8- to 1.2-mL range for 688 (29.0%) of 2,373 subjects who had their blood collected. Of the 2,124 subjects who had TST and QFT-GIT completed, TST was positive for 0.6%; QFT-GIT was positive for 0.3% and indeterminate for 2.0%. Among 2,081 subjects with completed TST and determinate QFT-GIT results, overall agreement was 99.5% but positive agreement was 5.6%. Specificity among the 1,546 low-risk BMTs was identical (99.7%). Indeterminate QFT-GIT results were 2.7 times more likely when mitogen tubes contained >1.2 mL blood than when containing 0.8- to 1.2-mL blood. Automation can facilitate QFT-GIT completion, especially if the recommended volume of blood is collected. Mycobacterium tuberculosis infection prevalence among BMTs based on TST and QFT-GIT is similar and low. Selectively testing those with significant risk may be more appropriate than universal testing of all recruits. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Effect of Pregnancy on Interferon Gamma Release Assay and Tuberculin Skin Test Detection of Latent TB Infection Among HIV-Infected Women in a High Burden Setting.

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LaCourse, Sylvia M; Cranmer, Lisa M; Matemo, Daniel; Kinuthia, John; Richardson, Barbra A; Horne, David J; John-Stewart, Grace

2017-05-01

Peripartum immunologic changes may affect latent tuberculosis infection (LTBI) diagnostic performance among HIV-infected women. HIV-infected women were serially tested with tuberculin skin test (TST) and interferon gamma release assay [QuantiFERON TB Gold In-tube (QFT)] in pregnancy and 6 weeks postpartum in Kenya. Prevalence, sensitivity and agreement, and correlates of QFT/TST positivity were assessed. Quantitative QFT mitogen and Mycobacterium tuberculosis antigen (Mtb-Ag) responses were compared by peripartum stage. Incidence of test conversion at 6 weeks postpartum was evaluated in baseline TST-/QFT- women. Among 100 HIV-infected women, median age was 26 years, median CD4 was 555 cells per cubic millimeter, and 88% were on antiretrovirals. More women were QFT+ than TST+ in both pregnancy (35.4% vs. 13.5%, P = 0.001) and postpartum (29.6% vs. 14.8%, P pregnancy vs. postpartum, and specifically among persistently QFT+ women (Mtb-Ag: 3.46 vs. 4.48 IU/mL, P = 0.007). QFT indeterminate rate was higher in pregnancy (16%) compared with postpartum (0%) because of lower mitogen response. QFT identified >2-fold more women with LTBI compared with TST in pregnancy and postpartum. Lower QFT Mtb-Ag and mitogen responses in pregnancy compared with postpartum suggest that pregnancy-associated immunologic changes may influence LTBI test performance.

Identification of proteins from tuberculin purified protein derivative (PPD) by LC-MS/MS.

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Borsuk, Sibele; Newcombe, Jane; Mendum, Tom A; Dellagostin, Odir A; McFadden, Johnjoe

2009-11-01

The tuberculin purified protein derivative (PPD) is a widely used diagnostic antigen for tuberculosis, however it is poorly defined. Most mycobacterial proteins are extensively denatured by the procedure employed in its preparation, which explains previous difficulties in identifying constituents from PPD to characterize their behaviour in B- and T-cell reactions. We here described a proteomics-based characterization of PPD from several different sources by LC-MS/MS, which combines the solute separation power of HPLC, with the detection power of a mass spectrometer. The technique is able to identify proteins from complex mixtures of peptide fragments. A total of 171 different proteins were identified among the four PPD samples (two bovine PPD and two avium PPD) from Brazil and UK. The majority of the proteins were cytoplasmic (77.9%) and involved in intermediary metabolism and respiration (24.25%) but there was a preponderance of proteins involved in lipid metabolism. We identified a group of 21 proteins that are present in both bovine PPD but were not detected in avium PPD preparation. In addition, four proteins found in bovine PPD are absent in Mycobacterium bovis BCG vaccine strain. This study provides a better understanding of the tuberculin PPD components leading to the identification of additional antigens useful as reagents for specific diagnosis of tuberculosis.

Molecular signatures distinguishing active from latent tuberculosis in peripheral blood mononuclear cells, after in vitro antigenic stimulation with purified protein derivative of tuberculin (PPD) or Candida: a preliminary report.

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Stern, Joel N H; Keskin, Derin B; Romero, Viviana; Zuniga, Joaquin; Encinales, Liliana; Li, Changlin; Awad, Carlos; Yunis, Edmond J

2009-01-01

Purified protein derivative (PPD) or tuberculin skin testing is used to identify infected individuals with Mycobacterium tuberculosis (Mtb) and to assess cell-mediated immunity to Mtb. In the present study, we compared PBMC cultures in the presence of tuberculin or Candida antigens using cytokine bead arrays and RNA microarrays. Measurements of different cytokines and chemokines in supernatants of PMBC cultures in the presence of PPD showed increased levels of interferon (IFN)-gamma in active tuberculosis infection (ATBI) and latent TB infected (LTBI) compared to controls, and increased levels of TNF-alpha in ATBI compared with LTBI. Also, we found increase of IL-6 in cultures of PPD positive and controls but not in the cultures with Candida. We also report the molecular signature of tuberculosis infection, in ATBI patients, the following genes were found to be up-regulated and absent in LTBI individuals: two kinases (JAK3 and p38MAPK), four interleukins (IL-7, IL-2, IL-6, and IFNbeta1), a chemokine (HCC-4) a chemokine receptor (CxCR5), two interleukin receptors (IL-1R2 and IL-18R1), and three additional ones (TRAF5, Smad2, CIITA, and NOS2A). By contrast, IL-17 and IGFBP3 were significantly up-regulated in LTBI. And, STAT4, GATA3, Fra-1, and ICOS were down-regulated in ATBI but absent in LTBI. Conversely, TLR-10, IL-15, DORA, and IKK-beta were down-regulated in LTBI but not in ATBI. Interestingly, the majority of the up-regulated genes found in ATBI were found in cultures stimulated with tuberculin (PPD) or Candida antigens, suggesting that these pathogens stimulate similar immunological pathways. We believe that the molecular signature distinguishing active from latent tuberculosis infection may require using cytokine bead arrays along with RNA microarrays testing cell cultures at different times following in vitro proliferation assays using several bacterial antigens and PPD.

Aspects of temporary specific anergy to tuberculin in Vietnamese refugees

NARCIS (Netherlands)

Veen, Jacob

1992-01-01

De vragen die in het onderzoek beantwoord dienden te worden waren: 1) Kan bevestigd worden dat bij Vietnamese vluchtelingen een groot aantal negatieve tuberculine huidtesten na herhaling van de test een positief resultaat vertoont (Mantoux-omslag) ; 2) Kunnen deze omslagen worden verklaard door een

Influence of isoniazid on naturally acquired tuberculin allergy and on induction of allergy by BCG vaccination*

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Narain, Raj; Bagga, A. S.; Naganna, K.; Mayurnath, S.

1970-01-01

Previous studies on the influence of isoniazid on the size of the tuberculin reaction have given conflicting results. A controlled study in an area with high prevalence of low-grade allergy has been carried out by the administration of isoniazid or placebo tablets. For those not vaccinated with BCG, isoniazid in a single daily dose of 5 mg/kg body-weight tended to reduce somewhat the size of the tuberculin reaction among those with reactions of 12 mm or more at the initial tuberculin test. In people who were vaccinated with BCG, isoniazid given simultaneously resulted in significantly less increase in the size of post-vaccination tuberculin reactions as compared with controls; the difference was still significant, in tests conducted 4½ months after the discontinuation of isoniazid. However, in spite of isoniazid, the post-vaccination allergy induced by BCG was quite considerable. This considerable increase in post-vaccination allergy suggests that the vaccination was successful in spite of the administration of isoniazid and makes it clear that primary chemoprophylaxis could be combined with BCG vaccination. Administration of isoniazid for 2 months is estimated to have killed about 90% of the bacilli in the BCG vaccine injected intracutaneously. PMID:5312322

Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions

Directory of Open Access Journals (Sweden)

Joel Monárrez-Espino

2014-11-01

Full Text Available A cohort of 123 adult contacts was followed for 18‐24 months (86 completed the follow-up to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT and tuberculin skin test (TST (PPD from TUBERSOL, Aventis Pasteur, Canada for diagnosing latent tuberculosis (TB in household contacts of TB patients using conventional (C and borderline zone (BZ definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL conversion was defined as 0.70 (BZ and reversion was defined as ≥0.35 to 10 (BZ and reversion was defined as ≥5 to <5 (C. The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%. The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.

Correlation between tuberculin skin test and IGRAs with risk factors for the spread of infection in close contacts with sputum smear positive in pulmonary tuberculosis.

Science.gov (United States)

de Souza-Galvão, Maria Luiza; Latorre, Irene; Altet-Gómez, Neus; Jiménez-Fuentes, María Ángeles; Milà, Celia; Solsona, Jordi; Seminario, Maria Asunción; Cantos, Adela; Ruiz-Manzano, Juan; Domínguez, José

2014-05-13

The aim of the study was to assess the correlation between the tuberculin skin test (TST) and in vitro interferon-gamma released assays (IGRAs) with risk factors for the spread of infection in smear positive pulmonary tuberculosis (TB) contacts. We recruited prospective contacts with smear positive pulmonary TB cases. We looked at human immunodeficiency virus (HIV) infection and other conditions of immunosuppression, presence of BCG vaccination and the degree of exposure to the index case. Patients underwent the TST, chest radiography, sputum analysis when necessary, and IGRA assays (QFN-G-IT and T-SPOT.TB). Presence of cough, diagnostic delay (days between first symptoms and TB diagnostic), contact conditions: room size (square meters) and index of overcrowding (square meters per person) were investigated in the index case. 156 contacts (119 adults, 37 children) of 66 TB patients were enrolled, 2.4 (1-14) contacts per TB case. The positivity of the TST did not correlate with the risk factors studied: presence of cough (p = 0.929); delayed diagnosis (p = 0.244); room size (p = 0.462); overcrowding (p = 0.800). Both QFN-G-IT and T-SPOT.TB, showed significant association with cough (p = 0.001, and p = 0.007) and room size (p = 0.020, and p = 0.023), respectively. Both IGRA associated better than TST with certain host-related risk factors involved in the transmission of disease, such as the presence of cough.

Safety and efficacy of the C-Tb skin test to diagnose Mycobacterium tuberculosis infection, compared with an interferon γ release assay and the tuberculin skin test: a phase 3, double-blind, randomised, controlled trial.

Science.gov (United States)

Ruhwald, Morten; Aggerbeck, Henrik; Gallardo, Rafael Vázquez; Hoff, Søren T; Villate, José I; Borregaard, Bettine; Martinez, José A; Kromann, Ingrid; Penas, Antón; Anibarro, Luis L; de Souza-Galvão, Maria Luiza; Sánchez, Francisca; Rodrigo-Pendás, Jose Ángel; Noguera-Julian, Antoni; Martínez-Lacasa, Xavier; Tuñez, Maria Victoria; Fernández, Virginia Leiro; Millet, Joan P; Moreno, Antonio; Cobos, Nazaret; Miró, José M; Roldan, Llanos; Orcau, Angels; Andersen, Peter; Caylá, Joan A

2017-04-01

Targeted screening and treatment of Mycobacterium tuberculosis infection substantially reduces the risk of developing active tuberculosis. C-Tb (Statens Serum Institute, Copenhagen, Denmark) is a novel specific skin test based on ESAT-6 and CFP10 antigens. We investigated the safety and diagnostic potential of C-Tb compared with established tests in the contact-tracing setting. Negative controls, close contacts, occasional contacts, and patients with active pulmonary tuberculosis were enrolled at 13 centres in Spain. We compared C-Tb with the QuantiFERON-TB Gold In-Tube ([QFT] Qiagen, Hilden, Germany) interferon γ release assay (IGRA) and the purified protein derivative (PPD) RT 23 tuberculin skin test ([TST] Statens Serum Institute). All participants older than 5 years were tested with QFT. Some participants in the negative control group received C-Tb without the TST to test for potential interactions between C-Tb and PPD RT 23. The rest were randomly assigned in blocks of ten and tested with both C-Tb and TST, with five in each block receiving injection of C-Tb in the right arm and the TST in the left arm and five vice versa. The primary and safety analyses were done in all participants randomly assigned to a group who received any test. This trial is registered with ClinicalTrials.gov, number NCT01631266, and with EudraCT, number 2011-005617-36. From July 24, 2012, to Oct 2, 2014, 979 participants were enrolled, of whom 263 were negative controls, 299 were occasional contacts, 316 were close contacts, and 101 were patients with tuberculosis. 970 (99%) participants completed the trial. Induration sizes were similar for C-Tb and TST, but TST positivity was affected by BCG vaccination status. We found a strong positive trend towards C-Tb test positivity with increasing risk of infection, from 3% in negative controls to 16% in occasional contacts, to 43% in close contacts. C-Tb and QFT results were concordant in 785 (94%) of 834 participants aged 5 years and older

Modulation of Immune Response in Asthmatic Patients by Using Inhaled Tuberculin

International Nuclear Information System (INIS)

Abou Gamrah, E.M.; Borai, I.H.; Zahran, W.E.; Labib, I.B.; Lotfy, O.A.

2008-01-01

Bronchial asthma is a chronic immuno inflammatory reversible lung disease with airway responsiveness to various stimuli which relived by proper therapy using inhaled steroids or the highly expensive recombinant interferon gamma (IFN-gamma). This study undertaken to investigate for the first time a novel treatment method using inhaled tuberculin (PPD) to determine whether PPD inhalation could be safely and effectively delivered into the airways of bronchial asthmatic patients in attempt to bring immurite deviation away from atopy via inhaling an economic dose of tuberculin. Sixty patients suffering from mild atopic bronchial asthma along with twenty healthy volunteers were included in our study. Patients were randomly categorized into three equally-sized groups received 2, 5 and 10 PPD units respectively. Treatment doses taken every 72 hours for two weeks. Respiratory function tests were examined before and after treatment regime. Interleukin 2 (IL-2), IL-4 and immunoglobulin E (IgE)w ere measured by ELISA technique in serum and bronchoalveolar lavage fluid (BALF) samples before and after treatment regime. Eosinophil count in BALF was also examined. The results showed that PPD treatment doses caused a significant increase in lung function standards (FEV1 and FEV1/FVC ratio) as compared with before treatment values. Also, the different doses of PPD resulted in a highly significant increase in the levels of serum and BALF IL-2 with a concomitant significant decrease in BALF IL-4

Two-step chemical decontamination technology

International Nuclear Information System (INIS)

Rankin, W.N.

1992-01-01

An improved two-step chemical decontamination technique was recently developed at INEL. This memorandum documents the addition of this technology to the SRTC arsenal of decontamination technology. A two-step process using NAOH, KMnO 4 followed by HNO 3 was used for cleaning doorstops (small casks) in the SRTC High Level Caves in 1967. Subsequently, more aggressive chemical techniques have been found to be much more effective for our applications. No further work on two-step technology is planned

Evaluation of the prognostic value of IFN-gamma release assay and tuberculin skin test in household contacts of infectious tuberculosis cases in Senegal.

Directory of Open Access Journals (Sweden)

Christian Lienhardt

2010-05-01

Full Text Available Chemoprophylaxis of contacts of infectious tuberculosis (TB cases is recommended for TB control, particularly in endemic countries, but is hampered by the difficulty to diagnose latent TB infection (LTBI, classically assessed through response to the Tuberculin Skin Test (TST. Interferon-gamma release assays (IGRA are proposed new tools to diagnose LTBI, but there are limited data on their ability to predict the development of active TB disease. To address this, we investigated the response to TST and IGRA in household contacts of infectious TB cases in a TB high-burden country and the potential correlation with development of TB.Prospective household contacts study conducted in two health centres in Dakar, Senegal. A total of 2679 household contacts of 206 newly detected smear and/or culture positive index TB cases aged 18 years or greater were identified A TST was performed in each contact and an ESAT6/CFP10 ELISPOT assay performed in a random sample of those. Contacts were followed-up for 24 months. TB was diagnosed in 52 contacts, an incidence rate of 9.27/1000 person-years. In univariable analysis, the presence of positive TST (> or = 10 mm and ELISPOT (>32 SFC/million PBMC responses at baseline were associated with active TB during follow-up: Rate Ratio [RR] = 2.32 (95%CI:1.12-4.84 and RR = 2.09 (95%CI:0.83-5.31, respectively. After adjustment for age, sex and proximity to index case, adjusted RRs were 1.51 (95%CI:0.71-3.19 and 1.98 (95%CI:0.77-5.09, respectively. Restricting analysis to the 40 microbiologically confirmed cases, the adjusted RR for positive ELISPOT was 3.61 (95%CI:1.03-12.65. The median ELISPOT response in contacts who developed TB was 5-fold greater than in those who did not develop TB (p = 0.02.TST and IGRAs are markers of a contact of the immune system with tubercle bacilli. In a TB endemic area, a high ELISPOT response may reflect increased bacterial replication that may subsequently be associated with development of TB

Tuberculin-purified protein derivative-, MPT-64-, and ESAT-6-stimulated gamma interferon responses in medical students before and after Mycobacterium bovis BCG vaccination and in patients with tuberculosis

DEFF Research Database (Denmark)

Johnson, P D; Stuart, R L; Grayson, M L

1999-01-01

QuantiFERON-TB (QIFN) (CSL Limited) is a whole-blood assay for the recognition of infection with Mycobacterium tuberculosis. QIFN measures gamma interferon (IFN-gamma) production when purified protein derivatives (PPDs) of mycobacteria are incubated with venous blood samples. The specificity...... of QIFN in medical students before and after BCG immunization was assessed, and sensitivity in patients with tuberculosis was assessed. Antigens were PPD derived from M. tuberculosis and two M. tuberculosis-specific proteins, ESAT-6 and MPT-64. Of 60 medical students, all of whom had 0-mm tuberculin skin...... tests (TSTs) at study entry, 58 (97%) were initially classified as negative for M. tuberculosis infection by PPD QIFN. Five months after BCG immunization, 7 of 54 students (13%) had a TST result of >/=10 mm and 11 of 54 students (20%) tested positive by PPD QIFN. ESAT-6- and MPT-64-stimulated IFN...

48 CFR 14.503-2 - Step two.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Step two. 14.503-2 Section... AND CONTRACT TYPES SEALED BIDDING Two-Step Sealed Bidding 14.503-2 Step two. (a) Sealed bidding... submitting acceptable technical proposals in step one; (2) Include the provision prescribed in 14.201-6(t...

Interferon Gamma Release Assay versus Tuberculin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country.

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Sahal Al Hajoj

Full Text Available Health care workers (HCW's are always at an increased risk of contracting tuberculosis (TB infection. In Saudi Arabia, Interferon Gamma Release Assay (IGRA has not been evaluated as a screening tool for latent TB infection (LTBI among HCW's considering their high demographic diversity. During February 2012 to January 2015 a cross sectional study has been conducted in a tertiary care center with maximum demographically diverse staff population in the capital city-Riyadh. After a short interview and consenting, all the candidates were subjected to tuberculin skin test (TST and QuantiFERON TB gold In-tube test (QFT. A logistic regression analysis was carried out for establishing the associations between putative risk factors and the diagnostic tests. The candidates were classified according to geographical origin and a detailed analysis was conducted on the impact of their origin towards the results of TST and QFT. Of the 1595 candidates enrolled, 90.6% were BCG vaccinated, female (67.9% and mainly nurses (53.2%. Candidates with high risk of suspected or confirmed TB patient exposure were 56.1% and 76.5% of them had <10 year's work experience. TST positivity was observed in 503 (31.5% candidates, while QFT was positive among 399 (25%. Majority of the candidates were non-Saudi (83% and predominantly (52.4% from Western Pacific region. Concordant results were obtained in 14.2% of positive cases and 57.7% negative cases. The disagreements between the two tests were relatively high (kappa co-efficient-0.312±0.026, p value- <0.00001 as TST positive/QFT negative discordance was 54.8% while TST negative/QFT positive discordance was 15.7%. Age of the candidates, BCG vaccination, and South East Asian origin were associated with TST positivity while Occupational TB exposure and geographical origin of the candidates were associated with QFT positivity. A regular follow up on recently TST converted candidates showed no progression to active TB. The putative

A retrospective review of pain control by a two-step irradiance schedule during topical ALA-photodynamic therapy of non-melanoma skin cancer.

Science.gov (United States)

Zeitouni, Nathalie C; Paquette, Anne D; Housel, Joseph P; Shi, Yi; Wilding, Gregory E; Foster, Thomas H; Henderson, Barbara W

2013-02-01

Photodynamic therapy (PDT) with topical δ-aminolevulinic acid (ALA) of non-melanoma skin cancers is often associated with treatment-limiting pain. A previous study on basal cell carcinomas (BCCs) at Roswell Park Cancer Institute evaluated a two-step irradiance scheme as a means of minimizing pain, preserving outcomes, and limiting treatment time. We used an initial low irradiance until 90% of the protoporphyrin IX was photobleached, followed by a high irradiance interval until the prescribed fluence was delivered. Success of this pilot investigation motivated integration of the protocol into routine practice. Here, we present a retrospective review of recent clinical experience in a broad patient population. This was a retrospective review of an existing dermatology database. Fourteen caucasion patients-nine men and five women, ages 18-80, with a total of 51 superficial and 73 nodular BCCs, and three Bowen's disease lesions-were included. ALA was applied to each lesion for approximately 4 hours. Lesions received an initial irradiance of 30-50 mW/cm(2) for 20 J/cm(2) , followed by 150 mW/cm(2) for a total fluence of 200-300 J/cm(2) . Pain was assessed using a visual analog scale (VAS). Clinical outcome was determined at 6-12 months. Median VAS scores were 1.0 for both irradiances. Five of 127 lesions required pain control with 1% xylocaine. Pain was strongly influenced by lesion location but not by lesion type, number, or size. Complete responses were achieved in 84.1% of BCCs, which compares favorably with reported results for single ALA-PDT treatments. Two of three Bowen's disease lesions showed a complete response. Complete responses for nodular BCCs were 37%, which are also within the range of reported outcomes. A two-step irradiance protocol in ALA-PDT effectively minimizes pain, maintains excellent clinical outcomes in superficial lesions, and adds minimal treatment time. Copyright © 2013 Wiley Periodicals, Inc.

Development of a one-step approach for the reconstruction of full thickness skin defects using minced split thickness skin grafts and biodegradable synthetic scaffolds as a dermal substitute.

Science.gov (United States)

Sharma, Kavita; Bullock, Anthony; Ralston, David; MacNeil, Sheila

2014-08-01

Tissue engineering has progressed in delivering laboratory-expanded keratinocytes to the clinic; however the production of a suitable alternative to a skin graft, containing both epidermis and dermis still remains a challenge. To develop a one-step approach to wound reconstruction using finely minced split thickness skin and a biodegradable synthetic dermal substitute. This was explored in vitro using scalpel diced pieces of split thickness human skin combined with synthetic electrospun polylactide (PLA) scaffolds. To aid the spreading of tissue, 1% methylcellulose was used and platelet releasate was examined for its effect on cellular outgrowth from tissue explants. The outcome parameters included the metabolic activity of the migrating cells and their ability to produce collagen. Cell presence and migration on the scaffolds were assessed using fluorescence microscopy and SEM. Cells were identified as keratinocytes by immunostaining for pan-cytokeratin. Collagen deposition was quantified by using Sirius red. Skin cells migrated along the fibers of the scaffold and formed new collagen. 1% methylcellulose improved the tissue handling properties of the minced skin. Platelet releasate did not stimulate the migration of skin cells along scaffold fibers. Immunohistochemistry and SEM confirmed the presence of both epithelial and stromal cells in the new tissue. We describe the first key steps in the production of a skin substitute to be assembled in theatre eliminating the need for cell culture. Whilst further experiments are needed to develop this technique it can be a useful addition to armamentarium of the reconstructive surgeon. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Traumatic Degloving of Penoscrotal Skin: Report of Two Cases

Directory of Open Access Journals (Sweden)

R. Yegane

2014-05-01

Full Text Available Skin avulsions of male genitals are a rare traumatic plastic surgery and urologic emergency. This kind of trauma occur mainly because of accidents with industrial machines or agricultural machine belts. In this paper we reported two patients with traumatic avulsion of penile and scrotal skin. These patients wound were covered with split thickness skin graft after two weeks. We recommend for using a split thickness skin graft to cover the penis and scrotal degloved area because of this operation has minimal invasiveness and rapid healing.

Two-step two-stage fission gas release model

International Nuclear Information System (INIS)

Kim, Yong-soo; Lee, Chan-bock

2006-01-01

Based on the recent theoretical model, two-step two-stage model is developed which incorporates two stage diffusion processes, grain lattice and grain boundary diffusion, coupled with the two step burn-up factor in the low and high burn-up regime. FRAPCON-3 code and its in-pile data sets have been used for the benchmarking and validation of this model. Results reveals that its prediction is in better agreement with the experimental measurements than that by any model contained in the FRAPCON-3 code such as ANS 5.4, modified ANS5.4, and Forsberg-Massih model over whole burn-up range up to 70,000 MWd/MTU. (author)

Diagnosis of latent Mycobacterium tuberculosis infection: is the demise of the Mantoux test imminent?

Science.gov (United States)

Rothel, James S; Andersen, Peter

2005-12-01

Tuberculosis is responsible for more then 2 million deaths worldwide each year and vies with HIV as the world's most fatal infectious disease. In many developing countries, attempts to control the spread of infection rely solely on identification and treatment of those with active disease, ignoring subclinical infection. However, in developed countries, large efforts are also expended to identify and give prophylactic drugs to people with latent tuberculosis infection. Until recently, the 100-year-old tuberculin skin test (Mantoux) has been the only available diagnostic test for latent tuberculosis infection, despite its many well-known limitations. Advances in scientific knowledge have led to the development of tests for tuberculosis that measure the production of interferon-gamma by T-cells stimulated in vitro with Mycobacterium tuberculosis-specific antigens. These interferon-gamma tests are highly specific and unaffected by prior Bacille Calmette-Guérin vaccination or immune reactivity to most atypical mycobacteria. They are more sensitive than the tuberculin skin test in detecting people with active tuberculosis, and their results correlate more closely with M. tuberculosis exposure risk factors than the tuberculin skin test in people likely to have latent tuberculosis infection. Science has caught up with one of the oldest diagnostic tests still in use worldwide, and the adoption of new, tuberculosis-specific interferon-gamma-based tests should move us one step closer to better control of this insidious pathogen.

Tuberculin purified protein derivative (PPD) immunoassay as an in vitro alternative assay for identity and confirmation of potency.

Science.gov (United States)

Ho, Mei M; Kairo, Satnam K; Corbel, Michael J

2006-01-01

Tuberculin purified protein derivative (PPD) currently can only be standardised by delayed hypersensitivity skin reactions in sensitised guinea pigs. An in vitro dot blot immunoassay was developed for both identity and confirmation of potency estimation of PPD. Polyclonal antibodies (mainly IgG) were generated and immunoreacted with human, bovine and, to lesser extent, avian PPD preparations. Combining size exclusion chromatography (FPLC-SEC) and dot blot immunoassay, the results showed that PPD preparations were mixtures of very heterogeneous tuberculoproteins ranging in size from very large aggregates to very small degraded molecules. All individual fractions of PPD separated by size were immunoreactive, although those of the largest molecular sizes appeared the most immunoreactive in this in vitro dot blot immunoassay. This method is very sensitive and specific to tuberculoproteins and can be an in vitro alternative for the in vivo intradermal skin assay which uses guinea pigs for identity of PPD preparations. Although the capacity of PPD to elicit cell-mediated immune responses on intradermal testing has to be confirmed by in vivo assay, the dot blot immunoassay offers a rapid, sensitive and animal-free alternative to in vivo testing for confirming the identity of PPD preparations with appropriate potencies. This alternative assay would be particularly useful for national regulatory laboratories for confirming the data of manufacturers and thus reducing the use of animals.

Tuberculin purified protein derivative-reactive T cells in cord blood lymphocytes.

OpenAIRE

Shiratsuchi, H; Tsuyuguchi, I

1981-01-01

Lymphocytes obtained from cord blood of newborn babies who were born of healthy mothers were studied in vitro for their responsiveness to purified protein derivative (PPD) of tuberculin. Cord blood lymphocytes proliferated in vitro by stimulation with PPD, despite wide variations in the results. Studies with fractionated lymphocytes revealed that PPD-responding cells belonged to E-rosetting, nylon wool-nonadherent T lymphocytes. Non-E-rosetting B lymphocytes alone did not proliferate at all a...

Acral peeling skin syndrome: report of two cases.

Science.gov (United States)

García, Elena García; Carreño, Rosario Granados; Martínez González, Miguel A; Reyes, José Jiménez

2005-01-01

Peeling skin syndrome is a rare dermatosis characterized by spontaneous and painless peeling of the skin. The authors report two patients with history of spontaneous, asymptomatic, and noninflammatory peeling skin of the acral surfaces after soaking in water. On light microscopy, blisters were located in the mid layers of the stratum corneum, above the granular layer. Ultrastructural examination revealed increased intercellular lipids and abnormal, "moth-eaten," keratohyalin granules, but the authors were unable to determine whether the separation initiated within the horny cells or between adjacent cells. These patients represented a localized variant of peeling skin syndrome.

One-step breast reconstruction with polyurethane-covered implants after skin-sparing mastectomy.

Science.gov (United States)

Rancati, Alberto; Soderini, Alejandro; Dorr, Julio; Gercovich, Gustavo; Tessari, Luciano; Gonzalez, Eduardo

2013-12-01

Skin-sparing mastectomy (SSM) and immediate one-step breast reconstruction with implants has become an increasingly popular, effective treatment for selected patients with breast carcinoma. However, it is associated with high complication rates. Breast augmentation with polyurethane-covered implants (PCIs) has consistently had optimal short-term and long-term results with low rates of capsular contracture. The aim of this study was to evaluate the clinical and aesthetic outcomes of immediate one-step breast reconstruction with PCI after SSM in early breast cancer patients at a single institution. We reviewed the records of 221 consecutive breast cancer patients who underwent one-stage immediate reconstruction with PCI after SSM from 1995 through 2005. Patient and tumour characteristics, type of reconstruction, postoperative complications, aesthetic results and recurrence rate were analysed. The mean age of the patients was 52±11 years (range, 30-76; standard deviation (SD), 11). The American Joint Committee on Cancer (AJCC) pathologic stages were 0 (10%), I (63.3%) and II (26.7%). Thirty-nine (17.65%; confidence interval (CI)=13.04-23.1) of the 221 patients had complications; seven had prosthesis extrusion requiring an implant (five due to skin necrosis, one due to infection and one due to late haematoma). In six of these seven cases, the procedure was indicated for local recurrence after conservative breast surgery with adjunctive radiation therapy (rescue procedure). Thirty-two (14.4%) patients had minor complications: 12 had cutaneous rash, four had malpositioned implants and 16 had inadequate implant projection. At long-term follow-up, four (1.8%) patients had developed grade IV capsular contracture associated with postoperative radiation therapy. At a median follow-up of 98 months (range, 36-156), 14 (6.3%) patients had tumour recurrence and 12.2% had distant metastasis. Nineteen patients had died of cancer, and 192 (86.8%) remained disease free. One

Examine Your Skin

Medline Plus

Full Text Available ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ...

A SKIN TEST FOR DETECTING GROUP C HEMOLYTIC STREPTOCOCCAL INFECTION CAUSING EPIZOOTIC LYMPHADENITIS IN GUINEA PIGS

Science.gov (United States)

Moen, Johannes K.

1936-01-01

1. A skin test with a crude bacterial extract prepared from group C (Lancefield) hemolytic streptococci was used as a means of detecting possible carriers of the streptococcus causing epizootic lymphadenitis in guinea pigs. A positive test similar to a positive tuberculin reaction was considered presumptive evidence of present or recent infection with this streptococcus. 2. 20 positive reactors were found in 330 supposedly normal guinea pigs. 3. 195 negatively reacting animals were used as a breeding stock which yielded 1,296 progeny over a period of 15 months. None of the breeding stock or their progeny showed evidence of spontaneous lymphadenitis. Skin tests of 100 of the progeny were all negative. 4. The use of this skin test as a means of obtaining guinea pig breeding stock free of the streptococcus causing spontaneous lymphadenitis is suggested. PMID:19870552

Tuberculin reactivity and tuberculosis epidemiology in the Pakaanóva (Wari') Indians of Rondônia, south-western Brazilian Amazon.

Science.gov (United States)

Escobar, A L; Coimbra, C E A; Camacho, L A B; Santos, R V

2004-01-01

To investigate the characteristics of tuberculin skin test reactivity in the Pakaanóva Indians, in Amazonia, Brazil, after revaccination of all study participants with bacille Calmette-Guerin (BCG). The investigation was designed as a post-BCG vaccination purified protein derivative (PPD) survey. Data included PPD readings, age, sex, nutritional status, place of residence, previous tuberculosis, physical examinations and BCG status. Bivariate and multivariate logistic regression analyses were conducted. About 90% (n = 505) of the total population participated. One third (32.1%) of the subjects presented induration > or = 10 mm at 72 h. Induration sizes showed weak linear correlation with age; differences between sexes were not observed. Skin reaction was not associated with nutritional status. Individuals with a history of tuberculosis were six times more likely to test positive. History of tuberculosis, age, and previous BCG vaccination were significantly associated with PPD reactivity in the multivariate analyses. The Pakaanóva showed a high proportion (58.4%) of non-reactors, even with a recent BCG booster. Sex differences in PPD reactivity were either not present or could not be demonstrated. The association between age and PPD reactivity resembles that observed in other Amazonian populations. The authors discuss the potential of PPD testing as a screening tool to enhance tuberculosis detection, especially in indigenous populations in Amazonia with limited access to health services.

Uncovering of melanin fluorescence in human skin tissue

Science.gov (United States)

Scholz, Matthias; Stankovic, Goran; Seewald, Gunter; Leupold, Dieter

2007-07-01

Due to its extremely low fluorescence quantum yield, in the conventionally (one-photon) excited autofluorescence of skin tissue, melanin fluorescence is masked by several other endogenous and possibly also exogenous fluorophores (e.g. NADH, FAD, Porphyrins). A first step to enhance the melanin contribution had been realized by two-photon fs-pulse excitation in the red/near IR, based on the fact that melanin can be excited by stepwise two-photon absorption, whereas all other fluorophores in this spectral region allow only simultaneous two-photon excitation. Now, the next and decisive step has been realized: Using an extremely sensitive detection system, for the first time twophoton fluorescence of skin tissue excited with pulses in the ns-range could be measured. The motivation for this step was based on the fact that the population density of the fluorescent level resulting from a stepwise excitation has a different dependence of the pulse duration than that from a simultaneous excitation (Δt2 vs. Δt). Due to this strong discrimination between the fluorophores, practically pure melanin fluorescence can be obtained. Examples for in-vivo, ex-vivo as well as paraffin embedded skin tissue will be shown. The content of information with respect to early diagnosis of skin deseases will be discussed.

ONE-STEP AND TWO-STEP CALIBRATION OF A PORTABLE PANORAMIC IMAGE MAPPING SYSTEM

Directory of Open Access Journals (Sweden)

P.-C. Wang

2012-07-01

Full Text Available A Portable Panoramic Image Mapping System (PPIMS is proposed for rapid acquisition of three-dimensional spatial information. By considering the convenience of use, cost, weight of equipment, precision, and power supply, the designed PPIMS is equipped with 6 circularly arranged cameras to capture panoramic images and a GPS receiver for positioning. The motivation for this design is to develop a hand-held Mobile Mapping System (MMS for some difficult accessing areas by vehicle MMS, such as rugged terrains, forest areas, heavily damaged disaster areas, and crowed places etc. This PPIMS is in fact a GPS assisted close-range photogrammetric system. Compared with the traditional close-range photogrammetry, PPIMS can reduce the need of ground control points significantly. Under the condition of knowing the relative geometric relationships of the equipped sensors, the elements of exterior orientation of each captured image can be solved. However, the procedure of a system calibration should be done accurately to determine the relative geometric relationships of multi-cameras and the GPS antenna center, before the PPIMS can be applied for geo-referenced mapping. In this paper, both of one-step and two-step calibration procedures for PPIMS are performed to determine the lever-arm offsets and boresight angles among cameras and GPS. The performance of the one-step and two-step calibration is evaluated through the analysis of the experimental results. The comparison between these two calibration procedures was also conducted. The two-step calibration method outperforms the one-step calibration method in terms of calibration accuracy and operation convenience. We expect that the proposed two-step calibration procedure can also be applied to other platform-based MMSs.

Protecting health care workers from tuberculosis: a 10-year experience.

Science.gov (United States)

Welbel, Sharon F; French, Audrey L; Bush, Patricia; DeGuzman, Delia; Weinstein, Robert A

2009-10-01

Cook County Hospital (CCH) is an inner-city, large public hospital. Twenty-five percent of Chicago's tuberculosis (TB) cases are diagnosed at CCH. We wanted to review and analyze interventions implemented over a 10-year period at CCH to prevent TB infection in health care workers. We performed a retrospective review of interventions to prevent health care-associated tuberculosis. We collated and analyzed tuberculin skin test conversions in our employees for the same time period. From 1990 to 2002, we cared for over 1800 in-patients with tuberculosis. During 1992-1997, multiple interventions to eliminate health care-associated spread of tuberculosis were implemented. Tuberculin skin test conversions in our employees decreased markedly from January 1994 through December 2002. Two drops in tuberculin skin test conversion rates occurred: one after introduction of basic administrative and engineering controls and a second after we experienced a decrease in missed TB cases and the introduction of N-95 personal respirators with 1-time qualitative fit testing. Our annual health care worker skin test conversion rate fell significantly when our primary interventions were relatively simple administrative and engineering controls. Educating health care workers to promptly recognize patients with TB and placing exhaust fans to create negative-pressure respiratory isolation rooms were probably our 2 most potent infection control measures.

3D cell printing of in vitro stabilized skin model and in vivo pre-vascularized skin patch using tissue-specific extracellular matrix bioink: A step towards advanced skin tissue engineering.

Science.gov (United States)

Kim, Byoung Soo; Kwon, Yang Woo; Kong, Jeong-Sik; Park, Gyu Tae; Gao, Ge; Han, Wonil; Kim, Moon-Bum; Lee, Hyungseok; Kim, Jae Ho; Cho, Dong-Woo

2018-06-01

3D cell-printing technique has been under spotlight as an appealing biofabrication platform due to its ability to precisely pattern living cells in pre-defined spatial locations. In skin tissue engineering, a major remaining challenge is to seek for a suitable source of bioink capable of supporting and stimulating printed cells for tissue development. However, current bioinks for skin printing rely on homogeneous biomaterials, which has several shortcomings such as insufficient mechanical properties and recapitulation of microenvironment. In this study, we investigated the capability of skin-derived extracellular matrix (S-dECM) bioink for 3D cell printing-based skin tissue engineering. S-dECM was for the first time formulated as a printable material and retained the major ECM compositions of skin as well as favorable growth factors and cytokines. This bioink was used to print a full thickness 3D human skin model. The matured 3D cell-printed skin tissue using S-dECM bioink was stabilized with minimal shrinkage, whereas the collagen-based skin tissue was significantly contracted during in vitro tissue culture. This physical stabilization and the tissue-specific microenvironment from our bioink improved epidermal organization, dermal ECM secretion, and barrier function. We further used this bioink to print 3D pre-vascularized skin patch able to promote in vivo wound healing. In vivo results revealed that endothelial progenitor cells (EPCs)-laden 3D-printed skin patch together with adipose-derived stem cells (ASCs) accelerates wound closure, re-epithelization, and neovascularization as well as blood flow. We envision that the results of this paper can provide an insightful step towards the next generation source for bioink manufacturing. Copyright © 2018 Elsevier Ltd. All rights reserved.

Outbreak of pulmonary tuberculosis in which tuberculosis developed from QuantiFERON-TB second generation (QFT-2G) test negative persons

International Nuclear Information System (INIS)

Yamaguchi, Junichi; Ooba, Yuko; Kaneda, Mie; Uchida, Kiyomi; Ishikawa, Yo; Suzuki, Kiminori; Yagi, Takenori; Sasaki, Yuka; Yamagishi, Fumio

2007-01-01

The purpose of this study was to clarify the points to be considered when QuantiFERON-TB second generation (QFT-2G) tests are used in the contacts examination by public health center. We analyzed the results of contacts examination on 43 workplace colleagues (39 y/o and younger) of a pulmonary tuberculosis patient (bII2, Gaffky 9, cough for 1.5 months). After two months of the last contact with the index case, tuberculin skin tests, QFT-2G tests and chest X-rays were undertaken. After 6 months, chest X-rays were taken, and after 9 months, QFT-2G tests and chest CT scans were also undertaken. The tuberculin skin tests after two months showed a bimodal distribution, and 10 were QFT-2G positive and 2 showed doubtful reaction. The latter 12 persons underwent chemoprophylaxis. After 6 months, however, out of 31 QFT-2G negative persons, 2 developed pulmonary tuberculosis. Moreover, after 9 months, chest CT scans revealed 5 pulmonary tuberculosis patients. Three out of 7 new patients showed positive or doubtful reactions in QFT-2G tests undertaken after 9 months. The sensitivity of QFT-2G tests is reported to be 80 to 90%, and the possibility of false negative is not negligible. We propose measures for public health center to conduct the contacts examination as follows; In case of high QFT-2G positive (including doubtful reaction) rate and/or a bimodal distribution of tuberculin skin test result, many infected persons are likely to be included in the group; and the following measures are recommended; Necessity of chemoprophylaxis should be judged considering both tuberculin skin test results and the situation of contact with the index case, and not only by QFT-2G test results. QFT-2G negative persons also need to be followed with chest X-rays. (author)

Comparative analysis of single-step and two-step biodiesel production using supercritical methanol on laboratory-scale

International Nuclear Information System (INIS)

Micic, Radoslav D.; Tomić, Milan D.; Kiss, Ferenc E.; Martinovic, Ferenc L.; Simikić, Mirko Ð.; Molnar, Tibor T.

2016-01-01

Highlights: • Single-step supercritical transesterification compared to the two-step process. • Two-step process: oil hydrolysis and subsequent supercritical methyl esterification. • Experiments were conducted in a laboratory-scale batch reactor. • Higher biodiesel yields in two-step process at milder reaction conditions. • Two-step process has potential to be cost-competitive with the single-step process. - Abstract: Single-step supercritical transesterification and two-step biodiesel production process consisting of oil hydrolysis and subsequent supercritical methyl esterification were studied and compared. For this purpose, comparative experiments were conducted in a laboratory-scale batch reactor and optimal reaction conditions (temperature, pressure, molar ratio and time) were determined. Results indicate that in comparison to a single-step transesterification, methyl esterification (second step of the two-step process) produces higher biodiesel yields (95 wt% vs. 91 wt%) at lower temperatures (270 °C vs. 350 °C), pressures (8 MPa vs. 12 MPa) and methanol to oil molar ratios (1:20 vs. 1:42). This can be explained by the fact that the reaction system consisting of free fatty acid (FFA) and methanol achieves supercritical condition at milder reaction conditions. Furthermore, the dissolved FFA increases the acidity of supercritical methanol and acts as an acid catalyst that increases the reaction rate. There is a direct correlation between FFA content of the product obtained in hydrolysis and biodiesel yields in methyl esterification. Therefore, the reaction parameters of hydrolysis were optimized to yield the highest FFA content at 12 MPa, 250 °C and 1:20 oil to water molar ratio. Results of direct material and energy costs comparison suggest that the process based on the two-step reaction has the potential to be cost-competitive with the process based on single-step supercritical transesterification. Higher biodiesel yields, similar or lower energy

Two steps sintering alumina doped with niobia

International Nuclear Information System (INIS)

Gomes, L.B.; Hatzfeld, J.; Heck, M.; Pokorny, A.; Bergmann, C.P.

2014-01-01

In this work, high surface area commercial alumina was doped with niobia and sintered in two steps in order to obtain dense materials with lower processing temperatures. The powders were milled and uniaxially pressed (200 MPa). The first step of sintering took place at 1100°C for 3, 6, 9 and 12 hours, followed by the second step at 1350°C for 3 hours. The relative density, porosity and water absorption of the samples were determined by the Archimedes method. The crystalline phases were analyzed by X-ray Diffraction (XRD) and the morphology of the samples after sintering, evaluated by Scanning Electron Microscopy (SEM). The results indicate that the use of niobia combined with the two steps sintering promotes an increase in the density of the material, even at lower sintering temperatures. (author)

Uncertainty Principles on Two Step Nilpotent Lie Groups

Indian Academy of Sciences (India)

Abstract. We extend an uncertainty principle due to Cowling and Price to two step nilpotent Lie groups, which generalizes a classical theorem of Hardy. We also prove an analogue of Heisenberg inequality on two step nilpotent Lie groups.

Skin preparation with alcohol versus alcohol followed by any antiseptic for preventing bacteraemia or contamination of blood for transfusion.

Science.gov (United States)

Webster, Joan; Bell-Syer, Sally E M; Foxlee, Ruth

2015-02-12

Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood), severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective. To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient. In December 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs. Two review authors independently assessed studies for inclusion. No studies (RCTs or quasi RCTs) met the inclusion criteria. We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process.

Acral peeling skin syndrome: a case of two brothers.

Science.gov (United States)

Wakade, Oojwala; Adams, Beth; Shwayder, Tor

2009-01-01

We report two brothers of Middle Eastern descent with consanguineous parents who present with numerous fragile, flaccid blisters on the hands and feet. In addition to spontaneous peeling, they can manually peel skin from acral areas without pain. The symptoms worsen with warm temperatures, excessive water exposure, and perspiration. Two biopsies from flaccid blisters on the feet were taken from the older brother, which revealed cleavage at the level of the stratum corneum. A diagnosis of acral peeling skin syndrome was made.

Two-step rapid sulfur capture. Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-04-01

The primary goal of this program was to test the technical and economic feasibility of a novel dry sorbent injection process called the Two-Step Rapid Sulfur Capture process for several advanced coal utilization systems. The Two-Step Rapid Sulfur Capture process consists of limestone activation in a high temperature auxiliary burner for short times followed by sorbent quenching in a lower temperature sulfur containing coal combustion gas. The Two-Step Rapid Sulfur Capture process is based on the Non-Equilibrium Sulfur Capture process developed by the Energy Technology Office of Textron Defense Systems (ETO/TDS). Based on the Non-Equilibrium Sulfur Capture studies the range of conditions for optimum sorbent activation were thought to be: activation temperature > 2,200 K for activation times in the range of 10--30 ms. Therefore, the aim of the Two-Step process is to create a very active sorbent (under conditions similar to the bomb reactor) and complete the sulfur reaction under thermodynamically favorable conditions. A flow facility was designed and assembled to simulate the temperature, time, stoichiometry, and sulfur gas concentration prevalent in the advanced coal utilization systems such as gasifiers, fluidized bed combustors, mixed-metal oxide desulfurization systems, diesel engines, and gas turbines.

First-in-man open clinical trial of a combined rdESAT-6 and rCFP-10 tuberculosis specific skin test reagent.

Directory of Open Access Journals (Sweden)

Winnie Bergstedt

2010-06-01

Full Text Available Tuberculin is still the only available skin test reagent for the diagnosis of mycobacterial infection. The product has a remarkable sensitivity, but poor specificity. Previous studies, including two human phase I clinical trials, have indicated that rdESAT-6 has a potential as an improved skin test reagent. Animal studies have shown that the sensitivity may be increased by inclusion of the genetically related CFP-10 antigen in the preparation without loosing specificity.In this study a Lactococcus fermented, recombinant skin test reagent consisting of a 1ratio1 wt/wt of rdESAT-6 and CFP-10 was manufactured according to GMP standards and tested for the first time in 42 healthy adult volunteers. The two doses of 0.01 microg or 0.1 microg were injected intradermally by the Mantoux technique with 6 or 12 weeks interval. No serious adverse events and only mild adverse reactions were reported. The reagent elicited a positive skin test reaction after the first injection in one participant, who most likely was latently infected with M. tuberculosis as indicated by an appreciable IFN gamma response just below the Quantiferon(R cut-off level at the screening visit. None of the remaining participants in the four groups had any skin test reactions and sensitisation by the reagent could therefore be excluded.The investigational skin test reagent rdESAT-6 and CFP-10 appeared safe and non-sensitising in this first-in-man clinical trial in human volunteers and can now be tested in larger clinical trials involving individuals with latent M. tuberculosis infection or active TB disease.ClinicalTrials.gov NCT00793702.

Influência do tamanho do frasco de tuberculina nos resultados da prova tuberculínica Influence of vial size on the results of the tuberculin test

Directory of Open Access Journals (Sweden)

Antonio Ruffino-Netto

2005-04-01

Full Text Available INTRODUÇÃO: A solução de tuberculina é armazenada em frascos de diferentes tamanhos. Sua adsorção ao frasco pode influenciar o resultado da prova tuberculínica. OBJETIVO: Avaliar o efeito do tamanho do frasco de armazenamento da tuberculina nos resultados obtidos na prova tuberculínica. MÉTODO: Sessenta e três pacientes internados com diagnóstico de tuberculose ativa foram submetidos a duas provas tuberculínicas simultâneas, em ambos os antebraços. A técnica usada foi a de Mantoux e consistiu na aplicação de 0,1 ml de tuberculina armazenada em frascos de 5 ml ou de 1,5 ml, no antebraço direito e no antebraço esquerdo, de forma aleatória. A leitura da induração foi efetuada de forma cega por um único leitor treinado previamente. As leituras com diferenças de até 2 mm foram consideradas resultados concordantes. RESULTADOS: Vinte e um pacientes não tiveram induração e foram excluídos da análise. Entre os 42 pacientes restantes, a média dos diâmetros das indurações obtidas nas provas com tuberculina armazenada nos frascos grandes foi maior do que as obtidas com a armazenada em frascos pequenos. A concordância entre as leituras foi obtida em 40,5% delas (17/42, e a diferença foi negativa (frasco grande menor que frasco pequeno em 16,7% (7/42 e positiva em 42,9% delas (18/42. CONCLUSÃO: O tamanho do frasco de armazenamento da tuberculina pode influenciar o resultado da prova tuberculínica. A adsorção da tuberculina à parede do frasco pode explicar o fenômeno. Os autores alertam para o impacto dessas variações nos estudos epidemiológicos e operacionais.BACKGROUND: Tuberculin purified protein derivative is stored in vials of various sizes. Its adsorption to the vial can influence the results of tuberculin tests. OBJECTIVE: To evaluate the effect of vial size on the results obtained in tuberculin tests. METHODS: Sixty-four inpatients with active tuberculosis were submitted to two simultaneous tuberculin tests

A SKIN TEST FOR DETECTING GROUP C HEMOLYTIC STREPTOCOCCAL INFECTION CAUSING EPIZOOTIC LYMPHADENITIS IN GUINEA PIGS : APPLICATIONS IN SELECTING BREEDING STOCK.

Science.gov (United States)

Moen, J K

1936-09-30

1. A skin test with a crude bacterial extract prepared from group C (Lancefield) hemolytic streptococci was used as a means of detecting possible carriers of the streptococcus causing epizootic lymphadenitis in guinea pigs. A positive test similar to a positive tuberculin reaction was considered presumptive evidence of present or recent infection with this streptococcus. 2. 20 positive reactors were found in 330 supposedly normal guinea pigs. 3. 195 negatively reacting animals were used as a breeding stock which yielded 1,296 progeny over a period of 15 months. None of the breeding stock or their progeny showed evidence of spontaneous lymphadenitis. Skin tests of 100 of the progeny were all negative. 4. The use of this skin test as a means of obtaining guinea pig breeding stock free of the streptococcus causing spontaneous lymphadenitis is suggested.

Comparison of single-step and two-step purified coagulants from Moringa oleifera seed for turbidity and DOC removal.

Science.gov (United States)

Sánchez-Martín, J; Ghebremichael, K; Beltrán-Heredia, J

2010-08-01

The coagulant proteins from Moringa oleifera purified with single-step and two-step ion-exchange processes were used for the coagulation of surface water from Meuse river in The Netherlands. The performances of the two purified coagulants and the crude extract were assessed in terms of turbidity and DOC removal. The results indicated that the optimum dosage of the single-step purified coagulant was more than two times higher compared to the two-step purified coagulant in terms of turbidity removal. And the residual DOC in the two-step purified coagulant was lower than in single-step purified coagulant or crude extract. (c) 2010 Elsevier Ltd. All rights reserved.

Dual skin tests with Mycobacterium avium sensitin and PPD to detect misdiagnosis of latent tuberculosis infection.

Science.gov (United States)

Larson, E M; O'Donnell, M; Chamblee, S; Horsburgh, C R; Marsh, B J; Moreland, J D; Johnson, L S; von Reyn, C Fordham

2011-11-01

A positive tuberculin skin test (TST) may indicate cross-reacting immunity to non-tuberculous mycobacteria (NTM) and not latent tuberculosis infection (LTBI). To assess misclassification of LTBI, as assessed by skin testing with Mycobacterium avium sensitin (MaS), and to determine how this misclassification affects the analysis of risk factors for LTBI. In a population-based survey, participants underwent skin testing with M. tuberculosis purified protein derivative (PPD) and MaS. A PPD-dominant skin test was a reaction that was ≥ 3 mm larger than the MaS reaction; a MaS-dominant skin test was a reaction that was ≥ 3 mm larger than the PPD reaction. Of 447 randomly selected persons, 135 (30%) had a positive PPD test. Of these, 21 (16%) were MaS- dominant, and were therefore attributable to NTM and misclassified as LTBI. PPD reactions of 5-14 mm were more likely to be misclassified than those ≥ 15 mm (OR = 5.0, 95%CI 1.9-13.2). Adjusting for misclassification had only a small impact on the analysis of risk factors for LTBI. A substantial number of individuals who are diagnosed with LTBI are actually sensitized to NTM. Using dual skin testing would reduce misdiagnosis and prevent unnecessary treatment.

Evaluation of dermal-epidermal skin equivalents ('composite-skin') of human keratinocytes in a collagen-glycosaminoglycan matrix(Integra artificial skin).

Science.gov (United States)

Kremer, M; Lang, E; Berger, A C

2000-09-01

Integra artificial skin (Integra LifeSciences Corp., Plainsboro, NJ, USA) is a dermal template consisting of bovine collagen, chondroitin-6-sulphate and a silastic membrane manufactured as Integra. This product has gained widespread use in the clinical treatment of third degree burn wounds and full thickness skin defects of different aetiologies. The product was designed to significantly reduce the time needed to achieve final wound closure in the treatment of major burn wounds, to optimise the sparse autologous donor skin resources and to improve the durable mechanical quality of the skin substitute. The clinical procedure requires two stages. The first step creates a self neodermis, the second creates a self epidermis on the neodermis. However, it is desirable to cover major burn wounds early in a single step by a skin substitute consisting of a dermal equivalent seeded in vitro with autologous keratinocytes ('composite-skin') out of which a full thickness skin develops in vivo.The goal of this experimental study was to develop a method to integrate human keratinocytes in homogeneous distribution and depth into Integra Artificial Skin. The seeded cell-matrix composites were grafted onto athymic mice in order to evaluate their potential to reconstitute a human epidermis in vivo. We were able to demonstrate that the inoculated human keratinocytes reproducibly displayed a homogeneous pattern of distribution, adherence, proliferation and confluence. The cell-matrix composites grafted in this model exhibited good wound adherence, complete healing, minor wound contraction and had the potential to reconstitute an elastic, functional and durable human skin. Histologically we were able to show that the inoculated human keratinocytes in vivo colonised the matrix in a histomorphologically characteristic epidermal pattern (keratomorula, keratinocyte bubbling) and developed a persisting, stratified, keratinising epidermis which immunohistologically proved to be of human

Dynamic skin deformation simulation using musculoskeletal model and soft tissue dynamics

Institute of Scientific and Technical Information of China (English)

Akihiko Murai; Q. Youn Hong; Katsu Yamane; Jessica K. Hodgins

2017-01-01

Deformation of skin and muscle is essential for bringing an animated character to life. This deformation is difficult to animate in a realistic fashion using traditional techniques because of the subtlety of the skin deformations that must move appropriately for the character design. In this paper, we present an algorithm that generates natural, dynamic, and detailed skin deformation (movement and jiggle) from joint angle data sequences. The algorithm has two steps: identification of parameters for a quasi-static muscle deformation model, and simulation of skin deformation. In the identification step, we identify the model parameters using a musculoskeletal model and a short sequence of skin deformation data captured via a dense marker set. The simulation step first uses the quasi-static muscle deformation model to obtain the quasi-static muscle shape at each frame of the given motion sequence (slow jump). Dynamic skin deformation is then computed by simulating the passive muscle and soft tissue dynamics modeled as a mass–spring–damper system. Having obtained the model parameters, we can simulate dynamic skin deformations for subjects with similar body types from new motion data. We demonstrate our method by creating skin deformations for muscle co-contraction and external impacts from four different behaviors captured as skeletal motion capture data. Experimental results show that the simulated skin deformations are quantitatively and qualitatively similar to measured actual skin deformations.

Dynamic skin deformation simulation using musculoskeletal model and soft tissue dynamics

Institute of Scientific and Technical Information of China (English)

Akihiko Murai; Q.Youn Hong; Katsu Yamane; Jessica K.Hodgins

2017-01-01

Deformation of skin and muscle is essential for bringing an animated character to life. This deformation is difficult to animate in a realistic fashion using traditional techniques because of the subtlety of the skin deformations that must move appropriately for the character design. In this paper, we present an algorithm that generates natural, dynamic, and detailed skin deformation(movement and jiggle) from joint angle data sequences. The algorithm has two steps: identification of parameters for a quasi-static muscle deformation model, and simulation of skin deformation. In the identification step, we identify the model parameters using a musculoskeletal model and a short sequence of skin deformation data captured via a dense marker set. The simulation step first uses the quasi-static muscle deformation model to obtain the quasi-static muscle shape at each frame of the given motion sequence(slow jump). Dynamic skin deformation is then computed by simulating the passive muscle and soft tissue dynamics modeled as a mass–spring–damper system. Having obtained the model parameters, we can simulate dynamic skin deformations for subjects with similar body types from new motion data. We demonstrate our method by creating skin deformations for muscle co-contraction and external impacts from four different behaviors captured as skeletal motion capture data. Experimental results show that the simulated skin deformations are quantitatively and qualitatively similar to measured actual skin deformations.

Imaging immune response of skin mast cells in vivo with two-photon microscopy

Science.gov (United States)

Li, Chunqiang; Pastila, Riikka K.; Lin, Charles P.

2012-02-01

Intravital multiphoton microscopy has provided insightful information of the dynamic process of immune cells in vivo. However, the use of exogenous labeling agents limits its applications. There is no method to perform functional imaging of mast cells, a population of innate tissue-resident immune cells. Mast cells are widely recognized as the effector cells in allergy. Recently their roles as immunoregulatory cells in certain innate and adaptive immune responses are being actively investigated. Here we report in vivo mouse skin mast cells imaging with two-photon microscopy using endogenous tryptophan as the fluorophore. We studied the following processes. 1) Mast cells degranulation, the first step in the mast cell activation process in which the granules are released into peripheral tissue to trigger downstream reactions. 2) Mast cell reconstitution, a procedure commonly used to study mast cells functioning by comparing the data from wild type mice, mast cell-deficient mice, and mast-cell deficient mice reconstituted with bone marrow-derived mast cells (BMMCs). Imaging the BMMCs engraftment in tissue reveals the mast cells development and the efficiency of BMMCs reconstitution. We observed the reconstitution process for 6 weeks in the ear skin of mast cell-deficient Kit wsh/ w-sh mice by two-photon imaging. Our finding is the first instance of imaging mast cells in vivo with endogenous contrast.

Cytomorphology of skin adnexal tumors: A tale of two scalp swellings

Directory of Open Access Journals (Sweden)

Hemlata Panwar

2018-01-01

Full Text Available The primary and metastatic tumors of the skin can be effectively diagnosed by fine needle aspiration cytology (FNAC; however, the cytomorphological features of skin adnexal tumors are rarely described in the literature. We hereby describe the cytological features of two histologically confirmed cases of benign skin adnexal tumors. Case 1 is of a 46-year-old female who presented with an elevated firm nodule over the scalp. A cytological diagnosis of benign adnexal tumor possibly of sebaceous origin was given. The nodule was excised and histopathological examination confirmed the diagnosis of sebaceoma. Case 2 is of a 19-year-old male who presented with a pigmented scalp swelling. Cytomorphological features were suggestive of benign skin adnexal tumor with foci of melanin pigment. The swelling was excised and histopathological examination confirmed the diagnosis of eccrine poroma. To the best of our knowledge, only one previous report of sebaceoma and no report of eccrine poroma describing the cytological findings of these two tumors exist. We report these two cases of benign skin adnexal tumors to discuss the cytological features and the potential diagnostic dilemma that they pose to the cytologist.

Two Step Wittig/Dihydroxylation Synthetic Route to Higher Sugars

DEFF Research Database (Denmark)

Jørgensen, Morten; Madsen, Robert

1999-01-01

Higher carbon sugars are obtained by a two carbon, two step chain elongation of aldoses involving first a Wittig reaction and then an osmium tetroxide catalyzed dihydroxylation......Higher carbon sugars are obtained by a two carbon, two step chain elongation of aldoses involving first a Wittig reaction and then an osmium tetroxide catalyzed dihydroxylation...

Comparison of two-step versus four-step composite finishing/polishing disc systems: evaluation of a new two-step composite polishing disc system.

Science.gov (United States)

da Costa, Juliana B; Goncalves, Flavia; Ferracane, Jack L

2011-01-01

The purpose of this study was to evaluate surface finish and gloss of a two-step composite finishing/polishing (F/P) disc system compared with two multistep systems on five composites. Seventy-five disc-shaped composite specimens (D=10.0 mm, 2 mm thick, n=15 per composite) were made of microfill (Durafill-D), nanofill (Filtek Supreme-FS), nanohybrid (Premise-PR), and microhybrids (Filtek Z250-FZ, Esthet-EX). One side of each specimen was initially finished with a carbide bur. Five specimens of each resin composite were randomly assigned to receive full F/P by each of the disc systems: two-step (Enhance Flex NST-EF) and four-step (Sof-Lex-SL, Super-Snap-SS). Surface gloss was measured with a glossmeter and surface roughness was measured with a profilometer. Results were analyzed by two-way analysis of variance (ANOVA)/Tukey's (αgloss was noted among the three F/P systems when used with D and EX; no difference between SL and EF when used with any composite, except for FS; and no difference between SL and SS when used with any composite. SL and EF showed similar surface roughness when used on all composites, except for EX. EF and SS showed similar surface roughness on PR. SL and SS showed similar surface roughness values on every composite, except for FZ. EF was capable of providing similar gloss and surface roughness to SL on four composites evaluated but was not able to produce as glossy or as smooth a surface as SS for three of the five composites.

Time dependent theory of two-step absorption of two pulses

Energy Technology Data Exchange (ETDEWEB)

Rebane, Inna, E-mail: inna.rebane@ut.ee

2015-09-25

The time dependent theory of two step-absorption of two different light pulses with arbitrary duration in the electronic three-level model is proposed. The probability that the third level is excited at the moment t is found in depending on the time delay between pulses, the spectral widths of the pulses and the energy relaxation constants of the excited electronic levels. The time dependent perturbation theory is applied without using “doorway–window” approach. The time and spectral behavior of the spectrum using in calculations as simple as possible model is analyzed. - Highlights: • Time dependent theory of two-step absorption in the three-level model is proposed. • Two different light pulses with arbitrary duration is observed. • The time dependent perturbation theory is applied without “door–window” approach. • The time and spectral behavior of the spectra is analyzed for several cases.

SU-F-J-66: Anatomy Deformation Based Comparison Between One-Step and Two-Step Optimization for Online ART

International Nuclear Information System (INIS)

Feng, Z; Yu, G; Qin, S; Li, D; Ma, C; Zhu, J; Yin, Y

2016-01-01

Purpose: This study investigated that how the quality of adapted plan was affected by inter-fractional anatomy deformation by using one-step and two-step optimization for on line adaptive radiotherapy (ART) procedure. Methods: 10 lung carcinoma patients were chosen randomly to produce IMRT plan by one-step and two-step algorithms respectively, and the prescribed dose was set as 60 Gy on the planning target volume (PTV) for all patients. To simulate inter-fractional target deformation, four specific cases were created by systematic anatomy variation; including target superior shift 0.5 cm, 0.3cm contraction, 0.3 cm expansion and 45-degree rotation. Based on these four anatomy deformation, adapted plan, regenerated plan and non-adapted plan were created to evaluate quality of adaptation. Adapted plans were generated automatically by using one-step and two-step algorithms respectively to optimize original plans, and regenerated plans were manually created by experience physicists. Non-adapted plans were produced by recalculating the dose distribution based on corresponding original plans. The deviations among these three plans were statistically analyzed by paired T-test. Results: In PTV superior shift case, adapted plans had significantly better PTV coverage by using two-step algorithm compared with one-step one, and meanwhile there was a significant difference of V95 by comparison with adapted and non-adapted plans (p=0.0025). In target contraction deformation, with almost same PTV coverage, the total lung received lower dose using one-step algorithm than two-step algorithm (p=0.0143,0.0126 for V20, Dmean respectively). In other two deformation cases, there were no significant differences observed by both two optimized algorithms. Conclusion: In geometry deformation such as target contraction, with comparable PTV coverage, one-step algorithm gave better OAR sparing than two-step algorithm. Reversely, the adaptation by using two-step algorithm had higher efficiency

SU-F-J-66: Anatomy Deformation Based Comparison Between One-Step and Two-Step Optimization for Online ART

Energy Technology Data Exchange (ETDEWEB)

Feng, Z; Yu, G; Qin, S; Li, D [Shandong Normal University, Jinan, Shandong (China); Ma, C; Zhu, J; Yin, Y [Shandong Cancer Hospital and Institute, Jinan, Shandong (China)

2016-06-15

Purpose: This study investigated that how the quality of adapted plan was affected by inter-fractional anatomy deformation by using one-step and two-step optimization for on line adaptive radiotherapy (ART) procedure. Methods: 10 lung carcinoma patients were chosen randomly to produce IMRT plan by one-step and two-step algorithms respectively, and the prescribed dose was set as 60 Gy on the planning target volume (PTV) for all patients. To simulate inter-fractional target deformation, four specific cases were created by systematic anatomy variation; including target superior shift 0.5 cm, 0.3cm contraction, 0.3 cm expansion and 45-degree rotation. Based on these four anatomy deformation, adapted plan, regenerated plan and non-adapted plan were created to evaluate quality of adaptation. Adapted plans were generated automatically by using one-step and two-step algorithms respectively to optimize original plans, and regenerated plans were manually created by experience physicists. Non-adapted plans were produced by recalculating the dose distribution based on corresponding original plans. The deviations among these three plans were statistically analyzed by paired T-test. Results: In PTV superior shift case, adapted plans had significantly better PTV coverage by using two-step algorithm compared with one-step one, and meanwhile there was a significant difference of V95 by comparison with adapted and non-adapted plans (p=0.0025). In target contraction deformation, with almost same PTV coverage, the total lung received lower dose using one-step algorithm than two-step algorithm (p=0.0143,0.0126 for V20, Dmean respectively). In other two deformation cases, there were no significant differences observed by both two optimized algorithms. Conclusion: In geometry deformation such as target contraction, with comparable PTV coverage, one-step algorithm gave better OAR sparing than two-step algorithm. Reversely, the adaptation by using two-step algorithm had higher efficiency

Calculation of the MSD two-step process with the sudden approximation

Energy Technology Data Exchange (ETDEWEB)

Yoshida, Shiro [Tohoku Univ., Sendai (Japan). Dept. of Physics; Kawano, Toshihiko [Kyushu Univ., Advanced Energy Engineering Science, Kasuga, Fukuoka (Japan)

2000-03-01

A calculation of the two-step process with the sudden approximation is described. The Green's function which connects the one-step matrix element to the two-step one is represented in {gamma}-space to avoid the on-energy-shell approximation. Microscopically calculated two-step cross sections are averaged together with an appropriate level density to give a two-step cross section. The calculated cross sections are compared with the experimental data, however the calculation still contains several simplifications at this moment. (author)

Thermodynamic approach and comparison of two-step and single step DME (dimethyl ether) syntheses with carbon dioxide utilization

International Nuclear Information System (INIS)

Chen, Wei-Hsin; Hsu, Chih-Liang; Wang, Xiao-Dong

2016-01-01

DME (Dimethyl ether) synthesis from syngas with CO_2 utilization through two-step and single step processes is analyzed thermodynamically. The influences of reaction temperature, H_2/CO molar ratio, and CO_2/CO molar ratio on CO and CO_2 conversions, DME selectivity and yield, and thermal behavior are evaluated. Particular attention is paid to the comparison of the performance of DME synthesis between the two different methods. In the two-step method, the addition of CO_2 suppresses the CO conversion during methanol synthesis. An increase in CO_2/CO ratio decreases the CO_2 conversion (negative effect), but increases the total consumption amount of CO_2 (positive effect). At a given reaction temperature with H_2/CO = 4, the maximum DME yield develops at CO_2/CO = 1. In the single step method, over 98% of CO can be converted and the DME yield can be as high as 0.52 mol (mol CO)"−"1 at CO_2/CO = 2. The comparison of the single step and two-step processes indicates that the maximum CO conversion, DME selectivity, and DME yield in the former are higher than those in the latter, whereas an opposite result in the maximum CO_2 conversion is observed. These results reveal that the single step process has lower thermodynamic limitation and is a better option for DME synthesis. From CO_2 utilization point of view, the operation with low temperature, high H_2/CO ratio, and low CO_2/CO ratio results in higher CO_2 conversion, irrespective of two-step or single step DME synthesis. - Highlights: • DME (Dimethyl ether) synthesis with CO_2 utilization is analyzed thermodynamically. • Single step and two-step DME syntheses are studied and compared with each other. • CO_2 addition suppresses CO conversion in MeOH synthesis but increases MeOH yield. • The performance of the single step DME synthesis is better than that of the two-step one. • Increase CO_2/CO ratio decreases CO_2 conversion but increases CO_2 consumption amount.

Two-Step Macrocycle Synthesis by Classical Ugi Reaction

NARCIS (Netherlands)

Abdelraheem, Eman M M; Khaksar, Samad; Kurpiewska, Katarzyna; Kalinowska-Tłuścik, Justyna; Shaabani, Shabnam; Dömling, Alexander

2018-01-01

The direct nonpeptidic macrocycle synthesis of α-isocyano-ω-amines via the classical Ugi four-component reaction (U-4CR) is introduced. Herein an efficient and flexible two-step procedure to complex macrocycles is reported. In the first step, the reaction between unprotected diamines and

Comparison of two fibrin glues in anastomoses and skin closure.

Science.gov (United States)

Park, W; Kim, W H; Lee, C H; Kim, D Y; Choi, J H; Huh, J W; Sung, H M; Kim, I S; Kweon, O K

2002-09-01

To control intra-operative haemorrhage, fibrin glues are preferred by many surgeons because of their biological advantages and convenience of application. Manufacturers have developed a few kinds of fibrin glues with a little difference in their composition. This study was to compare the effectiveness of two commercially available fibrin glues; Greenplast (Green Cross P. D. Company, Yongin, Korea) and Tisseel (Baxter-Immuno AG, Vienna, Austria). They were applied experimentally to several kinds of surgery in dogs - renal vessel anastomosis, partial splenectomy, intestinal anastomosis and incision skin wound - and evaluated for their haemostatic and adhesive effects. When the two glues were applied in renal vessel anastomosis, the amount of haemorrhage in artery and vein decreased significantly. They also decreased the haemorrhage in partial splenectomy. At 10 min after application of the glues to an incision skin wound, the tensile strengths developed were significantly higher than that of control. The present study indicates that two-component fibrin glues have a haemostatic effect as a mechanical barrier in renal vessel anastomosis and an adhesive effect in the early stage of incision skin wound closure, and the two glues have similar effects with no complications.

False-negative reactions to the comparative intradermal tuberculin test for bovine tuberculosis

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Rudielle A. Rodrigues

Full Text Available ABSTRACT: According to the Brazilian National Program for the Control and Eradication of Animal Brucellosis and Tuberculosis (PNCEBT, the routine tests for the diagnosis of bovine tuberculosis in the country are the simple intradermal tuberculin test (SITT of the Ministry of Agriculture, Livestock and Food Supply (MAPA, the caudal fold test and the comparative intradermal tuberculin test (CITT. The latter is also used as a confirmatory test. A group of 53 animals from three dairy herds in a focal area for bovine tuberculosis, that were submitted to depopulation in the state of Rio Grande do Sul, were submitted to the CITT. Tissues were cultured and the resulting colonies were confirmed by PCR and DNA sequencing. Among the 53 animals analyzed using the CITT, 32 (60.4% were negative, 14 (26.4% were positive and seven (13.2% results were inconclusive. The CITT detected 11 of the 39 animals with culture-confirmed M. bovis infection as positive. Among the total of 14 uninfected animals based on cultures, the CBT detected eight as negative. Thus, the CITT demonstrated sensitivity of 28.2% and specificity of 57.1% for the population sampled. A total of 24/32 (75.0% of the animals with negative CITT results were culture positive (confirmed by PCR and were considered false negatives based on the CITT. The maintenance of these false-negative animals in herds has serious implications for the control of the disease, since they can be a source of infection. The addition of complementary tests could help identify such animals and increase the odds of diagnostic success.

Two-Step Plasma Process for Cleaning Indium Bonding Bumps

Science.gov (United States)

Greer, Harold F.; Vasquez, Richard P.; Jones, Todd J.; Hoenk, Michael E.; Dickie, Matthew R.; Nikzad, Shouleh

2009-01-01

A two-step plasma process has been developed as a means of removing surface oxide layers from indium bumps used in flip-chip hybridization (bump bonding) of integrated circuits. The two-step plasma process makes it possible to remove surface indium oxide, without incurring the adverse effects of the acid etching process.

Mixed convection flow and heat transfer over different geometries of backward-facing step

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BADER SHABEEB ALSHURAIAAN

2013-12-01

Full Text Available Mixed convective flow and heat transfer characteristics for two-dimensional laminar flow in a channel with different geometries of a backward-facing step are presented for various Grashof numbers. The wall downstream of the step was maintained at a constant temperature; TH, while the upper wall was considered isothermal at TC. The wall upstream of the step and the backward-facing step were considered as adiabatic surfaces. Navier-Stokes equations were employed to represent the transport phenomena in the channel. Further, the governing equations were solved using a finite element formulation based on the Galerkin method of weighted residuals. The numerical results of the reattachement lengths for recirculation region in a vertical channel with a backward-facing step (Re = 100 were validated by comparing them against documented studies in the literature. The results of this investigation show that the local skin friction coefficient increases with an increase in Grashof numbers. The results of this investigation show that configuration II of the backward-facing step (inclined exhibited an absence of vortices for all values of Grashof numbers and consequently the minimum skin friction coefficient. However, configuration I is found to have the largest local skin friction coefficient.

One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials.

Science.gov (United States)

Saccone, Gabriele; Caissutti, Claudia; Khalifeh, Adeeb; Meltzer, Sara; Scifres, Christina; Simhan, Hyagriv N; Kelekci, Sefa; Sevket, Osman; Berghella, Vincenzo

2017-12-03

To compare both the prevalence of gestational diabetes mellitus (GDM) as well as maternal and neonatal outcomes by either the one-step or the two-step approaches. Electronic databases were searched from their inception until June 2017. We included all randomized controlled trials (RCTs) comparing the one-step with the two-step approaches for the screening and diagnosis of GDM. The primary outcome was the incidence of GDM. Three RCTs (n = 2333 participants) were included in the meta-analysis. 910 were randomized to the one step approach (75 g, 2 hrs), and 1423 to the two step approach. No significant difference in the incidence of GDM was found comparing the one step versus the two step approaches (8.4 versus 4.3%; relative risk (RR) 1.64, 95%CI 0.77-3.48). Women screened with the one step approach had a significantly lower risk of preterm birth (PTB) (3.7 versus 7.6%; RR 0.49, 95%CI 0.27-0.88), cesarean delivery (16.3 versus 22.0%; RR 0.74, 95%CI 0.56-0.99), macrosomia (2.9 versus 6.9%; RR 0.43, 95%CI 0.22-0.82), neonatal hypoglycemia (1.7 versus 4.5%; RR 0.38, 95%CI 0.16-0.90), and admission to neonatal intensive care unit (NICU) (4.4 versus 9.0%; RR 0.49, 95%CI 0.29-0.84), compared to those randomized to screening with the two step approach. The one and the two step approaches were not associated with a significant difference in the incidence of GDM. However, the one step approach was associated with better maternal and perinatal outcomes.

Two-Step Incision for Periarterial Sympathectomy of the Hand

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Seung Bae Jeon

2015-11-01

Full Text Available BackgroundSurgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire.MethodsA total of 40 patients (17 men and 23 women with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS and the Wake Forest University rating scale.ResultsThe total patient score was 8.59 (range, 6-15 in the two-step incision group and 9.62 (range, 7-18 in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034 but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03.ConclusionsCompared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

Decontamination Efficacy and Skin Toxicity of Two Decontaminants against Bacillus anthracis.

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Chad W Stratilo

Full Text Available Decontamination of bacterial endospores such as Bacillus anthracis has traditionally required the use of harsh or caustic chemicals. The aim of this study was to evaluate the efficacy of a chlorine dioxide decontaminant in killing Bacillus anthracis spores in solution and on a human skin simulant (porcine cadaver skin, compared to that of commonly used sodium hypochlorite or soapy water decontamination procedures. In addition, the relative toxicities of these decontaminants were compared in human skin keratinocyte primary cultures. The chlorine dioxide decontaminant was similarly effective to sodium hypochlorite in reducing spore numbers of Bacillus anthracis Ames in liquid suspension after a 10 minute exposure. After five minutes, the chlorine dioxide product was significantly more efficacious. Decontamination of isolated swine skin contaminated with Bacillus anthracis Sterne with the chlorine dioxide product resulted in no viable spores sampled. The toxicity of the chlorine dioxide decontaminant was up to two orders of magnitude less than that of sodium hypochlorite in human skin keratinocyte cultures. In summary, the chlorine dioxide based decontaminant efficiently killed Bacillus anthracis spores in liquid suspension, as well as on isolated swine skin, and was less toxic than sodium hypochlorite in cultures of human skin keratinocytes.

[Comparative study of concordance and costs between tuberculin skin test and QuantiFERON(®)-TB Gold In-Tube in the diagnosis of latent tuberculosis infection among contacts of patients with pulmonary tuberculosis].

Science.gov (United States)

Martinez Lacasa, Xavier; Canals Font, Roser; Jaen Manzanera, Angels; Cuchi Burgos, Eva; Lite Lite, Josep

2015-11-20

Recently diagnosis of latent tuberculosis infection (LTBI) can be made using the tuberculin skin test (TST) or by techniques known as interferon-γ release assays (IGRAS), being QuantiFERON(®)-TB Gold In-Tube (QF-G-IT) the most used. The IGRAS avoid some drawbacks of the TST, especially cross-reaction with bacillus Calmette-Guérin (BCG) vaccine, but also present some problems such as those arising from cost and the need of having an adequate infrastructure and experience. There is no clear consensus on which technique should be preferentially used for the diagnosis of LTBI. This is a comparative study between the TST and QT-G-IT in a cohort of contacts of patients with pulmonary tuberculosis during the study period. An analysis of global agreement and groups was performed according to whether the contacts were vaccinated with BCG or not. A study of costs of both techniques and diagnostic strategies based on these techniques was performed. The agreement between TST and QF-G-IT was acceptable in the whole sample yet it was very good in the unvaccinated group. Few cases of indeterminate values were recorded. The cost study showed that TST was cheaper than QF-G-IT; however when we analyzed the cost of the strategies according to each technique, the QF-G-IT showed a better cost-benefit. We suggest considering QF-G-IT as the only preferred technique for the diagnosis of LTBI in household contacts, based on good overall agreement between the 2 techniques (even if we eliminate the effect of the vaccine) and a cost analysis favorable to QF-G-IT. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

A new piezoelectric energy harvesting design concept: multimodal energy harvesting skin.

Science.gov (United States)

Lee, Soobum; Youn, Byeng D

2011-03-01

This paper presents an advanced design concept for a piezoelectric energy harvesting (EH), referred to as multimodal EH skin. This EH design facilitates the use of multimodal vibration and enhances power harvesting efficiency. The multimodal EH skin is an extension of our previous work, EH skin, which was an innovative design paradigm for a piezoelectric energy harvester: a vibrating skin structure and an additional thin piezoelectric layer in one device. A computational (finite element) model of the multilayered assembly - the vibrating skin structure and piezoelectric layer - is constructed and the optimal topology and/or shape of the piezoelectric layer is found for maximum power generation from multiple vibration modes. A design rationale for the multimodal EH skin was proposed: designing a piezoelectric material distribution and external resistors. In the material design step, the piezoelectric material is segmented by inflection lines from multiple vibration modes of interests to minimize voltage cancellation. The inflection lines are detected using the voltage phase. In the external resistor design step, the resistor values are found for each segment to maximize power output. The presented design concept, which can be applied to any engineering system with multimodal harmonic-vibrating skins, was applied to two case studies: an aircraft skin and a power transformer panel. The excellent performance of multimodal EH skin was demonstrated, showing larger power generation than EH skin without segmentation or unimodal EH skin.

Use of recombinant purified protein derivative (PPD) antigens as specific skin test for tuberculosis.

Science.gov (United States)

Stavri, Henriette; Bucurenci, Nadia; Ulea, Irina; Costache, Adriana; Popa, Loredana; Popa, Mircea Ioan

2012-11-01

Purified protein derivative (PPD) is currently the only available skin test reagent used worldwide for the diagnosis of tuberculosis (TB). The aim of this study was to develop a Mycobacterium tuberculosis specific skin test reagent, without false positive results due to Bacillus Calmette-Guerin (BCG) vaccination using recombinant antigens. Proteins in PPD IC-65 were analyzed by tandem mass spectrometry and compared to proteins in M. tuberculosis culture filtrate; 54 proteins were found in common. Top candidates MPT64, ESAT 6, and CFP 10 were overexpressed in Escherichia coli expression strains and purified as recombinant proteins. To formulate optimal immunodiagnostic PPD cocktails, the antigens were evaluated by skin testing guinea pigs sensitized with M. tuberculosis H37Rv and BCG. For single antigens and a cocktail mixture of these antigens, best results were obtained using 3 μg/0.1 ml, equivalent to 105 TU (tuberculin units). Each animal was simultaneously tested with PPD IC-65, 2 TU/0.1 ml, as reference. Reactivity of the multi-antigen cocktail was greater than that of any single antigen. The skin test results were between 34.3 and 76.6 per cent the level of reactivity compared to that of the reference when single antigens were tested and 124 per cent the level of reactivity compared to the reference for the multi-antigen cocktail. Our results showed that this specific cocktail could represent a potential candidate for a new skin diagnostic test for TB.

Two-step variable selection in quantile regression models

Directory of Open Access Journals (Sweden)

FAN Yali

2015-06-01

Full Text Available We propose a two-step variable selection procedure for high dimensional quantile regressions, in which the dimension of the covariates, pn is much larger than the sample size n. In the first step, we perform ℓ1 penalty, and we demonstrate that the first step penalized estimator with the LASSO penalty can reduce the model from an ultra-high dimensional to a model whose size has the same order as that of the true model, and the selected model can cover the true model. The second step excludes the remained irrelevant covariates by applying the adaptive LASSO penalty to the reduced model obtained from the first step. Under some regularity conditions, we show that our procedure enjoys the model selection consistency. We conduct a simulation study and a real data analysis to evaluate the finite sample performance of the proposed approach.

Acral peeling skin syndrome in two East-African siblings: case report.

Science.gov (United States)

Kiprono, Samson K; Chaula, Baraka M; Naafs, Bernard; Masenga, John E

2012-03-19

Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement

DEFF Research Database (Denmark)

Solovic, I; Sester, M; Gomez-Reino, J J

2010-01-01

risk of reactivating latent infections, especially tuberculosis (TB). Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-¿ release assays or, as an alternative in individuals without a history...... of bacille Calmette-Guérin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis. Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test...

Testing a stepped care model for binge-eating disorder: a two-step randomized controlled trial.

Science.gov (United States)

Tasca, Giorgio A; Koszycki, Diana; Brugnera, Agostino; Chyurlia, Livia; Hammond, Nicole; Francis, Kylie; Ritchie, Kerri; Ivanova, Iryna; Proulx, Genevieve; Wilson, Brian; Beaulac, Julie; Bissada, Hany; Beasley, Erin; Mcquaid, Nancy; Grenon, Renee; Fortin-Langelier, Benjamin; Compare, Angelo; Balfour, Louise

2018-05-24

A stepped care approach involves patients first receiving low-intensity treatment followed by higher intensity treatment. This two-step randomized controlled trial investigated the efficacy of a sequential stepped care approach for the psychological treatment of binge-eating disorder (BED). In the first step, all participants with BED (n = 135) received unguided self-help (USH) based on a cognitive-behavioral therapy model. In the second step, participants who remained in the trial were randomized either to 16 weeks of group psychodynamic-interpersonal psychotherapy (GPIP) (n = 39) or to a no-treatment control condition (n = 46). Outcomes were assessed for USH in step 1, and then for step 2 up to 6-months post-treatment using multilevel regression slope discontinuity models. In the first step, USH resulted in large and statistically significant reductions in the frequency of binge eating. Statistically significant moderate to large reductions in eating disorder cognitions were also noted. In the second step, there was no difference in change in frequency of binge eating between GPIP and the control condition. Compared with controls, GPIP resulted in significant and large improvement in attachment avoidance and interpersonal problems. The findings indicated that a second step of a stepped care approach did not significantly reduce binge-eating symptoms beyond the effects of USH alone. The study provided some evidence for the second step potentially to reduce factors known to maintain binge eating in the long run, such as attachment avoidance and interpersonal problems.

Comparison of the Screening Tests for Gestational Diabetes Mellitus between "One-Step" and "Two-Step" Methods among Thai Pregnant Women.

Science.gov (United States)

Luewan, Suchaya; Bootchaingam, Phenphan; Tongsong, Theera

2018-01-01

To compare the prevalence and pregnancy outcomes of GDM between those screened by the "one-step" (75 gm GTT) and "two-step" (100 gm GTT) methods. A prospective study was conducted on singleton pregnancies at low or average risk of GDM. All were screened between 24 and 28 weeks, using the one-step or two-step method based on patients' preference. The primary outcome was prevalence of GDM, and secondary outcomes included birthweight, gestational age, rates of preterm birth, small/large-for-gestational age, low Apgar scores, cesarean section, and pregnancy-induced hypertension. A total of 648 women were screened: 278 in the one-step group and 370 in the two-step group. The prevalence of GDM was significantly higher in the one-step group; 32.0% versus 10.3%. Baseline characteristics and pregnancy outcomes in both groups were comparable. However, mean birthweight was significantly higher among pregnancies with GDM diagnosed by the two-step approach (3204 ± 555 versus 3009 ± 666 g; p =0.022). Likewise, the rate of large-for-date tended to be higher in the two-step group, but was not significant. The one-step approach is associated with very high prevalence of GDM among Thai population, without clear evidence of better outcomes. Thus, this approach may not be appropriate for screening in a busy antenatal care clinic like our setting or other centers in developing countries.

Acral peeling skin syndrome in two East-African siblings: case report

Directory of Open Access Journals (Sweden)

Kiprono Samson K

2012-03-01

Full Text Available Abstract Background Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. Case presentation We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Conclusions Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

Two-step rocket engine bipropellant valve concept

Science.gov (United States)

Capps, J. E.; Ferguson, R. E.; Pohl, H. O.

1969-01-01

Initiating combustion of altitude control rocket engines in a precombustion chamber of ductile material reduces high pressure surges generated by hypergolic propellants. Two-step bipropellant valve concepts control initial propellant flow into precombustion chamber and subsequent full flow into main chamber.

Age is associated with latent tuberculosis in nurses

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Naesinee Chaiear

2016-12-01

Full Text Available Objective: To evaluate risk factors for developing latent tuberculosis (LTB in Thai nurses. Methods: A comparison study was conducted at Srinagarind Hospital, Khon Kaen, Thailand. Clinical factors were compared between persons with tuberculin conversion and those without tuberculin conversion identified by tuberculin skin test. Results: There were 173 eligible persons with the LTB (34.7%. There were five workplaces where participants worked regularly including the general ward, surgical ward, pediatric ward, medical ward and critical care ward. In a multivariate model, two factors were significantly associated with LTB including age and history of tuberculosis in colleagues. The adjusted odds ratio (95% confidence interval of both variables were 1.056 (1.004–1.104 and 0.202 (0.044– 0.941. Conclusions: Older age is associated with latent tuberculosis in nurses. LTB should be screened routinely and treated if diagnosed for nurses.

Two-step sintering of ultrafine-grained barium cerate proton conducting ceramics

International Nuclear Information System (INIS)

Wang, Siwei; Zhang, Lei; Zhang, Lingling; Brinkman, Kyle; Chen, Fanglin

2013-01-01

Ultra-fine grained dense BaZr 0.1 Ce 0.7 Y 0.1 Yb 0.1 O 3−δ (BZCYYb) ceramics have been successfully prepared via a two-step sintering method. Co-precipitation method has been adopted to prepare nano-sized BZCYYb precursors with an average particle size of 30 nm. By controlling the sintering profile, an average grain size of 184 nm was obtained for dense BZCYYb ceramics via the two-step sintering method, compared to 445 nm for the conventional sintered samples. The two-step sintered BZCYYb samples showed less impurity and an enhanced electrical conductivity compared with the conventional sintered ones. Further, the two-step sintering method was applied to fabricate anode supported solid oxide fuel cells (SOFCs) using BZCYYb as the electrolyte, resulting in dense ultrafine-grained electrolyte membranes and porous anode substrates with fine particles. Due to the reduced ohmic as well as polarization resistances, the maximum power output of the cells fabricated from the two-step sintering method reached 349 mW m −2 at 700 °C, significantly improved from 172 mW cm −2 for the conventional sintered cells, suggesting that two-step sintering method is very promising for optimizing the microstructure and thus enhancing the electrochemical performances for barium cerate based proton-conducting SOFCs.

Maximizing Efficiency in Two-step Solar-thermochemical Fuel Production

Energy Technology Data Exchange (ETDEWEB)

Ermanoski, I. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

2015-05-01

Widespread solar fuel production depends on its economic viability, largely driven by the solar-to-fuel conversion efficiency. In this paper, the material and energy requirements in two-step solar-thermochemical cycles are considered.The need for advanced redox active materials is demonstrated, by considering the oxide mass flow requirements at a large scale. Two approaches are also identified for maximizing the efficiency: optimizing reaction temperatures, and minimizing the pressure in the thermal reduction step by staged thermal reduction. The results show that each approach individually, and especially the two in conjunction, result in significant efficiency gains.

A Two-Step Approach to Uncertainty Quantification of Core Simulators

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Artem Yankov

2012-01-01

Full Text Available For the multiple sources of error introduced into the standard computational regime for simulating reactor cores, rigorous uncertainty analysis methods are available primarily to quantify the effects of cross section uncertainties. Two methods for propagating cross section uncertainties through core simulators are the XSUSA statistical approach and the “two-step” method. The XSUSA approach, which is based on the SUSA code package, is fundamentally a stochastic sampling method. Alternatively, the two-step method utilizes generalized perturbation theory in the first step and stochastic sampling in the second step. The consistency of these two methods in quantifying uncertainties in the multiplication factor and in the core power distribution was examined in the framework of phase I-3 of the OECD Uncertainty Analysis in Modeling benchmark. With the Three Mile Island Unit 1 core as a base model for analysis, the XSUSA and two-step methods were applied with certain limitations, and the results were compared to those produced by other stochastic sampling-based codes. Based on the uncertainty analysis results, conclusions were drawn as to the method that is currently more viable for computing uncertainties in burnup and transient calculations.

Imaging-guided two-photon excitation-emission-matrix measurements of human skin tissues

Science.gov (United States)

Yu, Yingqiu; Lee, Anthony M. D.; Wang, Hequn; Tang, Shuo; Zhao, Jianhua; Lui, Harvey; Zeng, Haishan

2012-07-01

There are increased interests on using multiphoton imaging and spectroscopy for skin tissue characterization and diagnosis. However, most studies have been done with just a few excitation wavelengths. Our objective is to perform a systematic study of the two-photon fluorescence (TPF) properties of skin fluorophores, normal skin, and diseased skin tissues. A nonlinear excitation-emission-matrix (EEM) spectroscopy system with multiphoton imaging guidance was constructed. A tunable femtosecond laser was used to vary excitation wavelengths from 730 to 920 nm for EEM data acquisition. EEM measurements were performed on excised fresh normal skin tissues, seborrheic keratosis tissue samples, and skin fluorophores including: NADH, FAD, keratin, melanin, collagen, and elastin. We found that in the stratum corneum and upper epidermis of normal skin, the cells have large sizes and the TPF originates from keratin. In the lower epidermis, cells are smaller and TPF is dominated by NADH contributions. In the dermis, TPF is dominated by elastin components. The depth resolved EEM measurements also demonstrated that keratin structure has intruded into the middle sublayers of the epidermal part of the seborrheic keratosis lesion. These results suggest that the imaging guided TPF EEM spectroscopy provides useful information for the development of multiphoton clinical devices for skin disease diagnosis.

Skin banking at a regional burns centre-The way forward.

Science.gov (United States)

Keswani, Sunil Manohar; Mishra, Mukesh Gopinath; Karnik, Shilpa; Dutta, Shruti; Mishra, Mamata; Panda, Sangita; Varghese, Reshmi; Virkar, Tanvi; Upendran, Vaishna

2018-04-13

In India approximately 1 million people get burnt every year and most of them are from the lower or middle income strata. Therefore it is obligatory to find out an economic way of treatment for the affected populace. Since use of human skin allograft is the gold standard for the treatment of burn wound, in-house skin banking for a burn unit hospital is prerequisite to make the treatment procedure affordable. Although, there was one skin bank at India till 2009, but it was difficult for a single bank to cover the entire country's need. Looking at the necessities, National Burns Centre (a tertiary burn care centre) along with Rotary International and Euro Skin Bank collaborated and developed an effective cadaveric skin banking model in Mumbai, Maharashtra in 2009. Initial two to three years were formation phase; by the year 2013 the entire system was organized and started running full fledged. The model has also been replicated in other states of India to accommodate the large burn population of the country. This paper therefore, gives a step by step account of how the bank evolved and its present status. Copyright © 2017. Published by Elsevier Ltd.

Tuberculosis. Lung and extrapulmonary compromise (cutaneous and ganglionar)

International Nuclear Information System (INIS)

Paez Mildred; Neira, Myriam Consuelo; Latorre Pablo; Faisal, Michel

2000-01-01

We present the case or a male, 28 year old that consulted for fever, weight loss and axillary ulcer. Clinically had two skin lesions where cutaneous tuberculosis was proven (lupus vulgaris-scrofuloderma). The skin lesions led to the diagnosis of lung tuberculosis and tuberculous adenitis. In this case all the diagnostic criteria for cutaneous tuberculosis were completed: active presence of tuberculosis in another place, positive reaction to tuberculin test, physical signs and appropriate answer to the treatment

A two-step Hilbert transform method for 2D image reconstruction

International Nuclear Information System (INIS)

Noo, Frederic; Clackdoyle, Rolf; Pack, Jed D

2004-01-01

The paper describes a new accurate two-dimensional (2D) image reconstruction method consisting of two steps. In the first step, the backprojected image is formed after taking the derivative of the parallel projection data. In the second step, a Hilbert filtering is applied along certain lines in the differentiated backprojection (DBP) image. Formulae for performing the DBP step in fan-beam geometry are also presented. The advantage of this two-step Hilbert transform approach is that in certain situations, regions of interest (ROIs) can be reconstructed from truncated projection data. Simulation results are presented that illustrate very similar reconstructed image quality using the new method compared to standard filtered backprojection, and that show the capability to correctly handle truncated projections. In particular, a simulation is presented of a wide patient whose projections are truncated laterally yet for which highly accurate ROI reconstruction is obtained

Evidence-based treatments for the asymptomatic HIV- positive ...

African Journals Online (AJOL)

banzi

ty of the women attending antenatal clin- ics are healthy and therefore ... a decrease in the patient's risk of falling ill from opportunistic .... 10% risk in those who are tuberculin-. n e g a t i v e . In summary. • There is grade-A evidence that. HIV-positive patients who are tuberculin skin-positive benefit from anti-TB prophylaxis.

[Ladder step strategy for surgical repair of congenital concealed penis in children].

Science.gov (United States)

Wang, Fu-Ran; Zhong, Hong-Ji; Chen, Yi; Zhao, Jun-Feng; Li, Yan

2016-11-01

To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children. This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described. Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature). The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.

Performance enhancement of a heterojunction bipolar transistor (HBT) by two-step passivation

International Nuclear Information System (INIS)

Fu, S.-I.; Lai, P.-H.; Tsai, Y.-Y.; Hung, C.-W.; Yen, C.-H.; Cheng, S.-Y.; Liu, W.-C.

2006-01-01

An interesting two-step passivation (with ledge structure and sulphide based chemical treatment) on base surface, for the first time, is demonstrated to study the temperature-dependent DC characteristics and noise performance of an InGaP/GaAs heterojunction bipolar transistor (HBT). Improved transistor behaviors on maximum current gain β max , offset voltage ΔV CE , and emitter size effect are obtained by using the two-step passivation. Moreover, the device with the two-step passivation exhibits relatively temperature-independent and improved thermal stable performances as the temperature is increased. Therefore, the two-step passivationed device can be used for high-temperature and low-power electronics applications

Two-Step Classification of Unemployed People in the Czech Republic

OpenAIRE

Zdeněk Šulc; Marina Stecenková; Jiří Vild

2015-01-01

The paper analyzes structure and behavior of unemployed people in the Czech Republic by means of latent class analysis (LCA) and CHAID analysis where the output of LCA serves as the input for CHAID. The unemployed are classified in two steps; for each step different characteristics are used. In the first step, respondents are split into latent classes according to their answers to questions concerning ways of searching for a new job. In the second step, CHAID analysis is performed with result...

QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting

DEFF Research Database (Denmark)

Rose, Michala Vaaben; Kimaro, Godfather; Nissen, Thomas N

2012-01-01

To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults with confi......To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults...

Comparison between two race/skin color classifications in relation to health-related outcomes in Brazil

Directory of Open Access Journals (Sweden)

Szwarcwald Celia L

2011-08-01

Full Text Available Abstract Background This paper aims to compare the classification of race/skin color based on the discrete categories used by the Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE and a skin color scale with values ranging from 1 (lighter skin to 10 (darker skin, examining whether choosing one alternative or the other can influence measures of self-evaluation of health status, health care service utilization and discrimination in the health services. Methods This is a cross-sectional study based on data from the World Health Survey carried out in Brazil in 2003 with a sample of 5000 individuals older than 18 years. Similarities between the two classifications were evaluated by means of correspondence analysis. The effect of the two classifications on health outcomes was tested through logistic regression models for each sex, using age, educational level and ownership of consumer goods as covariables. Results Both measures of race/skin color represent the same race/skin color construct. The results show a tendency among Brazilians to classify their skin color in shades closer to the center of the color gradient. Women tend to classify their race/skin color as a little lighter than men in the skin color scale, an effect not observed when IBGE categories are used. With regard to health and health care utilization, race/skin color was not relevant in explaining any of them, regardless of the race/skin color classification. Lack of money and social class were the most prevalent reasons for discrimination in healthcare reported in the survey, suggesting that in Brazil the discussion about discrimination in the health care must not be restricted to racial discrimination and should also consider class-based discrimination. The study shows that the differences of the two classifications of race/skin color are small. However, the interval scale measure appeared to increase the freedom of choice of the respondent.

Acral peeling skin syndrome in two East-African siblings: case report

OpenAIRE

Kiprono, Samson K; Chaula, Baraka M; Naafs, Bernard; Masenga, John E

2012-01-01

Abstract Background Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. Case presentation We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occl...

A Two-Step Approach for Analytical Optimal Hedging with Two Triggers

Directory of Open Access Journals (Sweden)

Tiesong Hu

2016-02-01

Full Text Available Hedging is widely used to mitigate severe water shortages in the operation of reservoirs during droughts. Rationing is usually instituted with one hedging policy, which is based only on one trigger, i.e., initial storage level or current water availability. It may perform poorly in balancing the benefits of a release during the current period versus those of carryover storage during future droughts. This study proposes a novel hedging rule to improve the efficiency of a reservoir operated to supply water, in which, based on two triggers, hedging is initiated with three different hedging sub-rules through a two-step approach. In the first step, the sub-rule is triggered based on the relationship between the initial reservoir storage level and the level of the target rule curve or the firm rule curve at the end of the current period. This step is mainly concerned with increasing the water level or not in the current period. Hedging is then triggered under the sub-rule based on current water availability in the second step, in which the trigger implicitly considers both initial and ending reservoir storage levels in the current period. Moreover, the amount of hedging is analytically derived based on the Karush–Kuhn–Tucker (KKT conditions. In addition, the hedging parameters are optimized using the improved particle swarm optimization (IPSO algorithm coupled with a rule-based simulation. A single water-supply reservoir located in Hubei Province in central China is selected as a case study. The operation results show that the proposed rule is reasonable and significantly improves the reservoir operation performance for both long-term and critical periods relative to other operation policies, such as the standard operating policy (SOP and the most commonly used hedging rules.

Prevalence of Tuberculosis Infection Among Health-Care Workers in Hamadan, West of Iran

Directory of Open Access Journals (Sweden)

Hashemi

2014-04-01

Full Text Available Background The risk of occupationally acquired tuberculosis (TB remains a concern, even now that the infection has been under control to a great extent. Objectives The aim of this study was to ascertain the prevalence of latent TB infection and pulmonary TB, and to assess the risk factors for TB, among health care workers in Hamadan. Patients and Methods Tuberculin skin test was performed on 245 health care workers, in two educational hospitals. The reaction was considered as "positive" if the induration diameter was ≥ 10 mm. Individuals with a positive test > than 15 mm were encouraged to seek further medical evaluation, including a chest-x-ray and a smear and sputum culture of the sputum for acid-fast bacilli, in those with radiographic changes indicating TB. Results Out of 245 health-care workers included in this study, 92 (38% had positive tuberculin test. There was a significant association between aging and tuberculin positivity. There was also a significant association between the length of employment and tuberculin positivity. Ward attendants had higher rates of positive test results, compared with other occupational groups. Conclusions It was concluded that latent TB infection is common among health-care workers in the studied region. Age, occupational group and employment length were found to be strongly associated with tuberculin positivity.

Two-level image authentication by two-step phase-shifting interferometry and compressive sensing

Science.gov (United States)

Zhang, Xue; Meng, Xiangfeng; Yin, Yongkai; Yang, Xiulun; Wang, Yurong; Li, Xianye; Peng, Xiang; He, Wenqi; Dong, Guoyan; Chen, Hongyi

2018-01-01

A two-level image authentication method is proposed; the method is based on two-step phase-shifting interferometry, double random phase encoding, and compressive sensing (CS) theory, by which the certification image can be encoded into two interferograms. Through discrete wavelet transform (DWT), sparseness processing, Arnold transform, and data compression, two compressed signals can be generated and delivered to two different participants of the authentication system. Only the participant who possesses the first compressed signal attempts to pass the low-level authentication. The application of Orthogonal Match Pursuit CS algorithm reconstruction, inverse Arnold transform, inverse DWT, two-step phase-shifting wavefront reconstruction, and inverse Fresnel transform can result in the output of a remarkable peak in the central location of the nonlinear correlation coefficient distributions of the recovered image and the standard certification image. Then, the other participant, who possesses the second compressed signal, is authorized to carry out the high-level authentication. Therefore, both compressed signals are collected to reconstruct the original meaningful certification image with a high correlation coefficient. Theoretical analysis and numerical simulations verify the feasibility of the proposed method.

Mouse Models of the Skin: Models to Define Mechanisms of Skin Carcinogenesis

International Nuclear Information System (INIS)

Wheeler, D. L.; Verma, A. K.; Denning, M. F.

2013-01-01

The multistep model of mouse skin carcinogenesis has facilitated identification of irreversible genetic events of initiation and progression, and epigenetic events of tumor promotion. Mouse skin tumor initiation can be accomplished by a single exposure to a sufficiently small dose of a carcinogen, and this step is rapid and irreversible. However, promotion of skin tumor formation requires a repeated and prolonged exposure to a promoter, and that tumor promotion is reversible. Investigations focused on the mechanisms of mouse carcinogenesis have resulted in the identifications of potential molecular targets of cancer induction and progression useful in planning strategies for human cancer prevention trials. This special issue contains eight papers that focus on mouse models used to study individual proteins expressed in the mouse skin and the role they play in differentiation, tissue homeostasis, skin carcinogenesis, and chemo prevention of skin cancer.

Efficacy of two antiseptic regimens on skin colonization of insertion sites for two different catheter types: a randomized, clinical trial.

Science.gov (United States)

Lutz, Juergen Thomas; Diener, Isabel Victoria; Freiberg, Kerstin; Zillmann, Robert; Shah-Hosseini, Kija; Seifert, Harald; Berger-Schreck, Bettina; Wisplinghoff, Hilmar

2016-12-01

Catheter-related bloodstream infections affect patients in surgical and intensive care settings worldwide, causing complications, aggravation of existing symptoms and increased length of stay. The trial aimed at comparing two registered skin antiseptics with respect to their residual and therefore infection-preventing effects. In a parallel, monocentric, prospective, triple-blind, randomized trial the difference in bacterial recolonization of catheter skin sites in central venous (CVC) and epidural catheters (EC) was investigated by comparing two alcoholic-based skin disinfectants. Patients receiving planned surgeries or intensive care were eligible for the trial. Those in the trial group received skin disinfection with the additive octenidine dihydrochloride (OCT) (n = 51), those in the control group were treated with benzalkonium chloride as additive (BAC) (n = 59) prior to catheter insertion. Randomization was carried out by assigning patients to groups week-wise. Endpoints of the investigation were skin colonization of the catheter site counted in colony forming units per swab at three time points: (1) prior to catheter insertion, on untreated skin; (2) directly after catheter insertion, prior to sterile coverage; (3) 48 h after catheter insertion. The hypothesis was tested by a Wilcoxon test with a two-sided alpha = 5 %. From second to third swab, recolonization of the catheter-surrounding skin was significantly lower in the trial group for both sorts of catheters: delta 2-3 OCT group: 0.72 (95 % CI: 0.42; 1.02); delta 2-3 BAC group: 1.97 (95 % CI: 1.45; 2.50); p < 0.001. None of the patients enrolled developed a catheter-related blood stream infection (CRBSI) during follow-up. Previous studies have shown that skin colonization is strongly associated with the occurrence of CRBSI. This randomized controlled trial supports the observations made in previous trials that octenidine dihydrochloride in disinfectants is more effective than agents

Investigation to biodiesel production by the two-step homogeneous base-catalyzed transesterification.

Science.gov (United States)

Ye, Jianchu; Tu, Song; Sha, Yong

2010-10-01

For the two-step transesterification biodiesel production made from the sunflower oil, based on the kinetics model of the homogeneous base-catalyzed transesterification and the liquid-liquid phase equilibrium of the transesterification product, the total methanol/oil mole ratio, the total reaction time, and the split ratios of methanol and reaction time between the two reactors in the stage of the two-step reaction are determined quantitatively. In consideration of the transesterification intermediate product, both the traditional distillation separation process and the improved separation process of the two-step reaction product are investigated in detail by means of the rigorous process simulation. In comparison with the traditional distillation process, the improved separation process of the two-step reaction product has distinct advantage in the energy duty and equipment requirement due to replacement of the costly methanol-biodiesel distillation column. Copyright 2010 Elsevier Ltd. All rights reserved.

Effect of the Backward-Facing Step Location on the Aerodynamics of a Morphing Wing

Directory of Open Access Journals (Sweden)

Fadi Mishriky

2016-08-01

Full Text Available Over the last decade, aircraft morphing technology has drawn a lot of attention in the aerospace community, because it is likely to improve the aerodynamic performance and the versatility of aircraft at different flight regimes. With the fast paced advancements in this field, a parallel stream of research is studying different materials and designs to develop reliable morphing skins. A promising candidate for a viable morphing skin is the sliding skin, where two or more rigid surfaces remain in contact and slide against each other during morphing. The overlapping between each two panels create a backward-facing step on the airfoil surface which has a critical effect on the aerodynamics of the wing. This paper presents a numerical study of the effect of employing a backward-facing step on the suction side of a National Advisory Committee for Aeronautics (NACA 2412 airfoil at a high Reynolds number of 5.9 × 106. The effects of the step location on the lift coefficient, drag coefficient and critical angle of attack are studied to find a favorable location for the step along the chord-wise direction. Results showed that employing a step on the suction side of the NACA 2412 airfoil can adversely affect the aforementioned aerodynamic properties. A drop of 21.1% in value of the lift coefficient and an increase of 120.8% in the drag coefficient were observed in case of a step located at 25% of the chord length. However, these effects are mitigated by shifting the step location towards the trailing edge. Introducing a step on the airfoil caused the airfoil’s thickness to change, which in turn has affected the transition point of the viscous boundary layer from laminar to turbulent. The location of the step, prior or post the transition point, has a noteworthy effect on the pressure and shear stress distribution, and consequently on the values of the lift and drag coefficients.

A Two-Step Resume Information Extraction Algorithm

Directory of Open Access Journals (Sweden)

Jie Chen

2018-01-01

Full Text Available With the rapid growth of Internet-based recruiting, there are a great number of personal resumes among recruiting systems. To gain more attention from the recruiters, most resumes are written in diverse formats, including varying font size, font colour, and table cells. However, the diversity of format is harmful to data mining, such as resume information extraction, automatic job matching, and candidates ranking. Supervised methods and rule-based methods have been proposed to extract facts from resumes, but they strongly rely on hierarchical structure information and large amounts of labelled data, which are hard to collect in reality. In this paper, we propose a two-step resume information extraction approach. In the first step, raw text of resume is identified as different resume blocks. To achieve the goal, we design a novel feature, Writing Style, to model sentence syntax information. Besides word index and punctuation index, word lexical attribute and prediction results of classifiers are included in Writing Style. In the second step, multiple classifiers are employed to identify different attributes of fact information in resumes. Experimental results on a real-world dataset show that the algorithm is feasible and effective.

Effectiveness of Brucella abortus lipopolysaccharide as an adjuvant for tuberculin PPD.

Science.gov (United States)

Jamalan, Mostafa; Ardestani, Susan Kaboudanian; Zeinali, Majid; Mosaveri, Nader; Mohammad Taheri, Mohammad

2011-01-01

Bacterial lipopolysaccharide (LPS) has T-helper 1 (Th1) immunostimulatory activities but because of toxicity and pyrogenicity cannot be used as an adjuvant. Brucella abortus LPS has less toxicity and no pyrogenic properties in comparison to other bacterial LPS. In the current study, the immunostimulatory properties of B. abortus LPS were evaluated for its adjuvant activity. Tuberculin purified protein derivative (PPD) from Mycobacterium tuberculosis was extracted and after anion-exchange chromatography on Q-sepharose column, two fractions (17 and 23), which dominantly contained 30- and 70-kDa antigens, were collected for immunological studies. BALB/c mice were immunized with four different antigen preparations (BCG, PPD, 17th and 23rd PPD fractions) along with complete Freund's adjuvant or B. abortus LPS. The T-cell immune response of mice was assessed by measurement of Th1-type cytokine (IFN-γ) and Th2-type cytokines (IL-5 and IL-10) levels. Also, the humoral immunity was evaluated by measuring the specific IgG levels. Our results showed that immunization of mice with 17th PPD fraction along with B. abortus LPS can induce a Th1-type cytokine response characterized with a high IFN-γ/IL-5 ratio, while immunization with PPD or 23rd PPD fraction along with the same adjuvant resulted to a mixed Th1/Th2-type cytokine response. Copyright © 2010 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.

Two-step evolution of endosymbiosis between hydra and algae.

Science.gov (United States)

Ishikawa, Masakazu; Shimizu, Hiroshi; Nozawa, Masafumi; Ikeo, Kazuho; Gojobori, Takashi

2016-10-01

In the Hydra vulgaris group, only 2 of the 25 strains in the collection of the National Institute of Genetics in Japan currently show endosymbiosis with green algae. However, whether the other non-symbiotic strains also have the potential to harbor algae remains unknown. The endosymbiotic potential of non-symbiotic strains that can harbor algae may have been acquired before or during divergence of the strains. With the aim of understanding the evolutionary process of endosymbiosis in the H. vulgaris group, we examined the endosymbiotic potential of non-symbiotic strains of the H. vulgaris group by artificially introducing endosymbiotic algae. We found that 12 of the 23 non-symbiotic strains were able to harbor the algae until reaching the grand-offspring through the asexual reproduction by budding. Moreover, a phylogenetic analysis of mitochondrial genome sequences showed that all the strains with endosymbiotic potential grouped into a single cluster (cluster γ). This cluster contained two strains (J7 and J10) that currently harbor algae; however, these strains were not the closest relatives. These results suggest that evolution of endosymbiosis occurred in two steps; first, endosymbiotic potential was gained once in the ancestor of the cluster γ lineage; second, strains J7 and J10 obtained algae independently after the divergence of the strains. By demonstrating the evolution of the endosymbiotic potential in non-symbiotic H. vulgaris group strains, we have clearly distinguished two evolutionary steps. The step-by-step evolutionary process provides significant insight into the evolution of endosymbiosis in cnidarians. Copyright © 2016 Elsevier Inc. All rights reserved.

Two-Step Evolution of Endosymbiosis between Hydra and Algae

KAUST Repository

Ishikawa, Masakazu

2016-07-09

In the Hydra vulgaris group, only 2 of the 25 strains in the collection of the National Institute of Genetics in Japan currently show endosymbiosis with green algae. However, whether the other non-symbiotic strains also have the potential to harbor algae remains unknown. The endosymbiotic potential of non-symbiotic strains that can harbor algae may have been acquired before or during divergence of the strains. With the aim of understanding the evolutionary process of endosymbiosis in the H. vulgaris group, we examined the endosymbiotic potential of non-symbiotic strains of the H. vulgaris group by artificially introducing endosymbiotic algae. We found that 12 of the 23 non-symbiotic strains were able to harbor the algae until reaching the grand-offspring through the asexual reproduction by budding. Moreover, a phylogenetic analysis of mitochondrial genome sequences showed that all the strains with endosymbiotic potential grouped into a single cluster (cluster γ). This cluster contained two strains (J7 and J10) that currently harbor algae; however, these strains were not the closest relatives. These results suggest that evolution of endosymbiosis occurred in two steps; first, endosymbiotic potential was gained once in the ancestor of the cluster γ lineage; second, strains J7 and J10 obtained algae independently after the divergence of the strains. By demonstrating the evolution of the endosymbiotic potential in non-symbiotic H. vulgaris group strains, we have clearly distinguished two evolutionary steps. The step-by-step evolutionary process provides significant insight into the evolution of endosymbiosis in cnidarians.

Intermediate surface structure between step bunching and step flow in SrRuO3 thin film growth

Science.gov (United States)

Bertino, Giulia; Gura, Anna; Dawber, Matthew

We performed a systematic study of SrRuO3 thin films grown on TiO2 terminated SrTiO3 substrates using off-axis magnetron sputtering. We investigated the step bunching formation and the evolution of the SRO film morphology by varying the step size of the substrate, the growth temperature and the film thickness. The thin films were characterized using Atomic Force Microscopy and X-Ray Diffraction. We identified single and multiple step bunching and step flow growth regimes as a function of the growth parameters. Also, we clearly observe a stronger influence of the step size of the substrate on the evolution of the SRO film surface with respect to the other growth parameters. Remarkably, we observe the formation of a smooth, regular and uniform ``fish skin'' structure at the transition between one regime and another. We believe that the fish skin structure results from the merging of 2D flat islands predicted by previous models. The direct observation of this transition structure allows us to better understand how and when step bunching develops in the growth of SrRuO3 thin films.

Two-Step Condensation of the Ideal Bose Gas in Highly Anisotropic Traps

International Nuclear Information System (INIS)

van Druten, N.J.; Ketterle, W.

1997-01-01

The ideal Bose gas in a highly anisotropic harmonic potential is studied. It is found that Bose-Einstein condensation occurs in two distinct steps as the temperature is lowered. In the first step the specific heat shows a sharp feature, but the system still occupies many one-dimensional quantum states. In the second step, at a significantly lower temperature, the ground state becomes macroscopically occupied. It should be possible to verify these predictions using present-day atom traps. The two-step behavior can occur in a rather general class of anisotropic traps, including the box potential. copyright 1997 The American Physical Society

Two-step impression/ injection, an alternative putty/ wash impression technique: case report.

Science.gov (United States)

Caputi, S; Murmura, G; Sinjari, B; Varvara, G

2012-01-01

We here describe a new technique for making a definitive impression that we refer to as the two-step impression/injection technique. This technique initially follows the classical one-step putty/ light-body impression technique with the polymerization of the putty and the light-body compound. This is then followed by the second step: injection of extra-light-body compound into the preparation through a hole in the metal stock tray. The aim of this additional step is to control the wash bulk and minimize the changes that can produce unfavorable impression results. This new two-step impression/injection technique allows displacement of soft tissues, such as the tongue, during the first seating of the putty and wash materials, while in the second step, the extra-light-body compound records all of the finer details without being compressed.

Thickness measurement by two-sided step-heating thermal imaging

Science.gov (United States)

Li, Xiaoli; Tao, Ning; Sun, J. G.; Zhang, Cunlin; Zhao, Yuejin

2018-01-01

Infrared thermal imaging is a promising nondestructive technique for thickness prediction. However, it is usually thought to be only appropriate for testing the thickness of thin objects or near-surface structures. In this study, we present a new two-sided step-heating thermal imaging method which employed a low-cost portable halogen lamp as the heating source and verified it with two stainless steel step wedges with thicknesses ranging from 5 mm to 24 mm. We first derived the one-dimensional step-heating thermography theory with the consideration of warm-up time of the lamp, and then applied the nonlinear regression method to fit the experimental data by the derived function to determine the thickness. After evaluating the reliability and accuracy of the experimental results, we concluded that this method is capable of testing thick objects. In addition, we provided the criterions for both the required data length and the applicable thickness range of the testing material. It is evident that this method will broaden the thermal imaging application for thickness measurement.

Modified Two-Step Dimethyl Ether (DME Synthesis Simulation from Indonesian Brown Coal

Directory of Open Access Journals (Sweden)

Dwiwahju Sasongko

2016-08-01

Full Text Available A theoretical study was conducted to investigate the performance of dimethyl ether (DME synthesis from coal. This paper presents a model for two-step DME synthesis from brown coal represented by the following processes: drying, gasification, water-gas reaction, acid gas removal, and DME synthesis reactions. The results of the simulation suggest that a feedstock ratio of coal : oxygen : steam of 1 : 0.13 : 0.821 produces the highest DME concentration. The water-gas reactor simulation at a temperature of 400°C and a pressure of 20 bar gave the ratio of H2/CO closest to 2, the optimal value for two-step DME synthesis. As for the DME synthesis reactor simulation, high pressure and low temperature promote a high DME concentration. It is predicted that a temperature of 300°C and a pressure of 140 bar are the optimum conditions for the DME synthesis reaction. This study also showed that the DME concentration produced by the two-step route is higher than that produced by one-step DME synthesis, implying that further improvement and research are needed to apply two-step DME synthesis to production of this liquid fuel.

Examine Your Skin

Medline Plus

Full Text Available ... Store In Memory Melanoma Info Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding ... Biopsy: The First Step Sentinel Node Biopsy Melanoma Treatment: Stages I & II Melanoma Treatment: Stage III Melanoma ...

Theory of two-step two-proton decays of nuclei

International Nuclear Information System (INIS)

Kadmensky, S. G.; Ivankov, Yu. V.

2014-01-01

A general theory of many-body diagonal and nondiagonal one-proton decays of spherical and deformed nuclei is developed on the basis of an approach not employing R-matrix theory in describing deep-subbarrier alpha and one-proton decays of nuclei but relying on integral formulas for the widths with respect to these decays. With the aid of this theory and by means of a diagram technique, a formalism is developed for describing two-step two-proton decays of a (Z, A) parent nucleus, which proceed as two successive time-separated one-proton decays of the parent and intermediate [(Z − 1, A − 1)] nuclei, these decays being related by the Green’s function for the intermediate nucleus, G(Z − 1, A − 1). It is shown that, upon taking into account, in this Green’s function, intermediate-nucleus states that are on- and off-shell states for the decaying system, there arise, respectively, sequential and virtual two-proton decays of parent nuclei. Expressions for the widths with respect to sequential and virtual two-proton decays from the ground and excited states of spherical and deformed nuclei and for the angular and energy distributions of emitted protons are obtained

Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

Directory of Open Access Journals (Sweden)

Menzies Dick

2008-06-01

Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

Railgun-type two step accelerator

International Nuclear Information System (INIS)

Kasai, Satoshi; Maeda, Hikosuke; Onozuka, Masanori; Oda, Yasutsugu; Azuma, Kingo.

1995-01-01

In the two step-type railgun accelerator used in an experimental nuclear fusion device of the present invention, energy of laser beams to be irradiated in an acceleration gas behind a flying object can be reduced, and the voltage applied between the rails can be lowered. Charged particles are generated and supplied to the acceleration gas behind the flying object by a charged particle generating and supplying device so as to promote generation of plasmas caused by irradiation of laser beams. As a result, dielectric break down is caused between the rails by a Paschen's law by application of voltage lower than dielectric breakdown voltage, thereby enabling to generate plasmas easily. Accordingly, the energy of laser beams can be suppressed and the voltage applied between the rails can be lowered. (I.S.)

Railgun-type two step accelerator

Energy Technology Data Exchange (ETDEWEB)

Kasai, Satoshi; Maeda, Hikosuke [Japan Atomic Energy Research Inst., Tokyo (Japan); Onozuka, Masanori; Oda, Yasutsugu; Azuma, Kingo

1995-10-13

In the two step-type railgun accelerator used in an experimental nuclear fusion device of the present invention, energy of laser beams to be irradiated in an acceleration gas behind a flying object can be reduced, and the voltage applied between the rails can be lowered. Charged particles are generated and supplied to the acceleration gas behind the flying object by a charged particle generating and supplying device so as to promote generation of plasmas caused by irradiation of laser beams. As a result, dielectric break down is caused between the rails by a Paschen`s law by application of voltage lower than dielectric breakdown voltage, thereby enabling to generate plasmas easily. Accordingly, the energy of laser beams can be suppressed and the voltage applied between the rails can be lowered. (I.S.).

A Two-Step Approach to Analyze Satisfaction Data

Science.gov (United States)

Ferrari, Pier Alda; Pagani, Laura; Fiorio, Carlo V.

2011-01-01

In this paper a two-step procedure based on Nonlinear Principal Component Analysis (NLPCA) and Multilevel models (MLM) for the analysis of satisfaction data is proposed. The basic hypothesis is that observed ordinal variables describe different aspects of a latent continuous variable, which depends on covariates connected with individual and…

A two-step quantum secure direct communication protocol with hyperentanglement

International Nuclear Information System (INIS)

Gu Bin; Zhang Cheng-Yi; Huang Yu-Gai; Fang Xia

2011-01-01

We propose a two-step quantum secure direct communication (QSDC) protocol with hyperentanglement in both the spatial-mode and the polarization degrees of freedom of photon pairs which can in principle be produced with a beta barium borate crystal. The secret message can be encoded on the photon pairs with unitary operations in these two degrees of freedom independently. This QSDC protocol has a higher capacity than the original two-step QSDC protocol as each photon pair can carry 4 bits of information. Compared with the QSDC protocol based on hyperdense coding, this QSDC protocol has the immunity to Trojan horse attack strategies with the process for determining the number of the photons in each quantum signal as it is a one-way quantum communication protocol. (general)

Specificiteit van de Mantoux-reactie op het nieuwe tuberculine RT23 ten opzichte van de reactie op het oude PPD-RIVM; vergelijkend onderzoek onder ziekenhuispersoneel

NARCIS (Netherlands)

Cobelens, F. G.; de Boer, H. E.

1999-01-01

OBJECTIVE: In the Netherlands, an increase in prevalence of tuberculin positivity has been noted since the replacement of the Dutch PPD-RIVM preparation by RT23. This investigation was carried out to assess the specificity of RT23 compared with PPD-RIVM. DESIGN: Comparative. METHOD: In 90 hospital

Coupling of Spinosad Fermentation and Separation Process via Two-Step Macroporous Resin Adsorption Method.

Science.gov (United States)

Zhao, Fanglong; Zhang, Chuanbo; Yin, Jing; Shen, Yueqi; Lu, Wenyu

2015-08-01

In this paper, a two-step resin adsorption technology was investigated for spinosad production and separation as follows: the first step resin addition into the fermentor at early cultivation period to decrease the timely product concentration in the broth; the second step of resin addition was used after fermentation to adsorb and extract the spinosad. Based on this, a two-step macroporous resin adsorption-membrane separation process for spinosad fermentation, separation, and purification was established. Spinosad concentration in 5-L fermentor increased by 14.45 % after adding 50 g/L macroporous at the beginning of fermentation. The established two-step macroporous resin adsorption-membrane separation process got the 95.43 % purity and 87 % yield for spinosad, which were both higher than that of the conventional crystallization of spinosad from aqueous phase that were 93.23 and 79.15 % separately. The two-step macroporous resin adsorption method has not only carried out the coupling of spinosad fermentation and separation but also increased spinosad productivity. In addition, the two-step macroporous resin adsorption-membrane separation process performs better in spinosad yield and purity.

Two-Step Amyloid Aggregation: Sequential Lag Phase Intermediates

Science.gov (United States)

Castello, Fabio; Paredes, Jose M.; Ruedas-Rama, Maria J.; Martin, Miguel; Roldan, Mar; Casares, Salvador; Orte, Angel

2017-01-01

The self-assembly of proteins into fibrillar structures called amyloid fibrils underlies the onset and symptoms of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s. However, the molecular basis and mechanism of amyloid aggregation are not completely understood. For many amyloidogenic proteins, certain oligomeric intermediates that form in the early aggregation phase appear to be the principal cause of cellular toxicity. Recent computational studies have suggested the importance of nonspecific interactions for the initiation of the oligomerization process prior to the structural conversion steps and template seeding, particularly at low protein concentrations. Here, using advanced single-molecule fluorescence spectroscopy and imaging of a model SH3 domain, we obtained direct evidence that nonspecific aggregates are required in a two-step nucleation mechanism of amyloid aggregation. We identified three different oligomeric types according to their sizes and compactness and performed a full mechanistic study that revealed a mandatory rate-limiting conformational conversion step. We also identified the most cytotoxic species, which may be possible targets for inhibiting and preventing amyloid aggregation.

Proof-of-concept: 3D bioprinting of pigmented human skin constructs.

Science.gov (United States)

Ng, Wei Long; Qi, Jovina Tan Zhi; Yeong, Wai Yee; Naing, May Win

2018-01-23

Three-dimensional (3D) pigmented human skin constructs have been fabricated using a 3D bioprinting approach. The 3D pigmented human skin constructs are obtained from using three different types of skin cells (keratinocytes, melanocytes and fibroblasts from three different skin donors) and they exhibit similar constitutive pigmentation (pale pigmentation) as the skin donors. A two-step drop-on-demand bioprinting strategy facilitates the deposition of cell droplets to emulate the epidermal melanin units (pre-defined patterning of keratinocytes and melanocytes at the desired positions) and manipulation of the microenvironment to fabricate 3D biomimetic hierarchical porous structures found in native skin tissue. The 3D bioprinted pigmented skin constructs are compared to the pigmented skin constructs fabricated by conventional a manual-casting approach; in-depth characterization of both the 3D pigmented skin constructs has indicated that the 3D bioprinted skin constructs have a higher degree of resemblance to native skin tissue in term of the presence of well-developed stratified epidermal layers and the presence of a continuous layer of basement membrane proteins as compared to the manually-cast samples. The 3D bioprinting approach facilitates the development of 3D in vitro pigmented human skin constructs for potential toxicology testing and fundamental cell biology research.

MIDPOINT TWO- STEPS RULE FOR THE SQUARE ROOT METHOD

African Journals Online (AJOL)

DR S.E UWAMUSI

Aberth third order method for finding zeros of a polynomial in interval ... KEY WORDS: Square root iteration, midpoint two steps Method, ...... A New set of Methods for the simultaneous determination of zeros of polynomial equation and iterative ...

Super-Cavitating Flow Around Two-Dimensional Conical, Spherical, Disc and Stepped Disc Cavitators

Science.gov (United States)

Sooraj, S.; Chandrasekharan, Vaishakh; Robson, Rony S.; Bhanu Prakash, S.

2017-08-01

A super-cavitating object is a high speed submerged object that is designed to initiate a cavitation bubble at the nose which extends past the aft end of the object, substantially reducing the skin friction drag that would be present if the sides of the object were in contact with the liquid in which the object is submerged. By reducing the drag force the thermal energy consumption to move faster can also be minimised. The super-cavitation behavioural changes with respect to Cavitators of various geometries have been studied by varying the inlet velocity. Two-dimensional computational fluid dynamics analysis has been carried out by applying k-ε turbulence model. The variation of drag coefficient, cavity length with respect to cavitation number and inlet velocity are analyzed. Results showed conical Cavitator with wedge angle of 30° has lesser drag coefficient and cavity length when compared to conical Cavitators with wedge angles 45° and 60°, spherical, disc and stepped disc Cavitators. Conical cavitator 60° and disc cavitator have the maximum cavity length but with higher drag coefficient. Also there is significant variation of supercavitation effect observed between inlet velocities of 32 m/s to 40 m/s.

Two-Step Oxidation of Refractory Gold Concentrates with Different Microbial Communities.

Science.gov (United States)

Wang, Guo-Hua; Xie, Jian-Ping; Li, Shou-Peng; Guo, Yu-Jie; Pan, Ying; Wu, Haiyan; Liu, Xin-Xing

2016-11-28

Bio-oxidation is an effective technology for treatment of refractory gold concentrates. However, the unsatisfactory oxidation rate and long residence time, which cause a lower cyanide leaching rate and gold recovery, are key factors that restrict the application of traditional bio-oxidation technology. In this study, the oxidation rate of refractory gold concentrates and the adaption of microorganisms were analyzed to evaluate a newly developed two-step pretreatment process, which includes a high temperature chemical oxidation step and a subsequent bio-oxidation step. The oxidation rate and recovery rate of gold were improved significantly after the two-step process. The results showed that the highest oxidation rate of sulfide sulfur could reach to 99.01 % with an extreme thermophile microbial community when the pulp density was 5%. Accordingly, the recovery rate of gold was elevated to 92.51%. Meanwhile, the results revealed that moderate thermophiles performed better than acidophilic mesophiles and extreme thermophiles, whose oxidation rates declined drastically when the pulp density was increased to 10% and 15%. The oxidation rates of sulfide sulfur with moderate thermophiles were 93.94% and 65.73% when the pulp density was increased to 10% and 15%, respectively. All these results indicated that the two-step pretreatment increased the oxidation rate of refractory gold concentrates and is a potential technology to pretreat the refractory sample. Meanwhile, owing to the sensitivity of the microbial community under different pulp density levels, the optimization of microbial community in bio-oxidation is necessary in industry.

Efficient One-Step Fusion PCR Based on Dual-Asymmetric Primers and Two-Step Annealing

DEFF Research Database (Denmark)

Liu, Yilan; Chen, Jinjin; Thygesen, Anders

2018-01-01

Gene splicing by fusion PCR is a versatile and widely used methodology, especially in synthetic biology. We here describe a rapid method for splicing two fragments by one-round fusion PCR with a dual-asymmetric primers and two-step annealing (ODT) method. During the process, the asymmetric...... intermediate fragments were generated in the early stage. Thereafter, they were hybridized in the subsequent cycles to serve as template for the target full-length product. The process parameters such as primer ratio, elongation temperature and cycle numbers were optimized. In addition, the fusion products...

Prostate ultrasound imaging: evaluation of a two-step scoring system in the diagnosis of prostate cancer.

Science.gov (United States)

Gao, Yong; Liao, Xin-Hong; Ma, Yan; Lu, Lu; Wei, Li-Yan; Yan, Xue

2017-12-01

This study aims to investigate the feasibility and performance of a two-step scoring system of ultrasound imaging in the diagnosis of prostate cancer. 75 patients with 888 consecutive histopathologically verified lesions were included in this study. Step 1, an initial 5-point scoring system was developed based on conventional transrectal ultrasound (TRUS). Step 2, a final scoring system was evaluated according to contrast-enhanced transrectal ultrasound (CE-TRUS). Each lesion was evaluated using the two-step scoring system (step 1 + step 2) and compared with only using conventional TRUS (step 1). 888 lesions were histologically verified: 315 of them were prostate cancer from 46 patients and 573 were benign prostatic hypertrophy (BPH) from 29 patients. According to the two-step scoring system, 284 lesions were upgraded and 130 lesions were downgraded from step 1 to step 2 (this means using step 2 to assess the results by step 1). However, 96 cases were improperly upgraded after step 2 and 48 malignant lesions were still missed after step 2 as score-1. For the two-step scoring system, the sensitivity, specificity, and accuracy were 84.7%, 83.2%, and 83.7%, respectively, versus 22.8%, 96.6%, and 70.4%, respectively, for conventional TRUS. The area under the ROC curve (AUC) for lesion diagnosis was 0.799-0.952 for the two-step scoring system, versus 0.479-0.712 for conventional TRUS. The difference in the diagnostic accuracy of the two-step scoring system and conventional TRUS was statistically significant (Pstep scoring system was straightforward to use and achieved a considerably accurate diagnostic performance for prostate cancer. The application of the two-step scoring system for prostate cancer is promising.

Two-Step Classification of Unemployed People in the Czech Republic

Directory of Open Access Journals (Sweden)

Zdeněk Šulc

2015-03-01

Full Text Available The paper analyzes structure and behavior of unemployed people in the Czech Republic by means of latent class analysis (LCA and CHAID analysis where the output of LCA serves as the input for CHAID. The unemployed are classified in two steps; for each step different characteristics are used. In the first step, respondents are split into latent classes according to their answers to questions concerning ways of searching for a new job. In the second step, CHAID analysis is performed with results obtained from LCA as a dependent variable. In the paper, data from periodical Labor Force Survey conducted in Czech Republic in spring 2011 are used. The results indicate that unemployed people in the Czech Republic can be divided into four segments: Active, Passive, Typical and Specific. A special attention is paid to extreme segments Active and Passive.

Fractional laser therapy – the next step in alleviating the symptoms of skin aging (own observations

Directory of Open Access Journals (Sweden)

Adam Halbina

2014-05-01

Full Text Available Skin aging is a natural process of the skin, which accelerates in menopause and is additionally intensified by accumulating effects of repeated exposure to solar UV radiation and other external factors. Anti-aging skin treatment and constant improvement of its methods have become an important area of current research. The need to apply effective skin anti-aging methods that minimize traumatization resulted in the development of fractional laser technology delivering a laser beam to microscopic column skin zones in order to achieve skin photo-remodeling.

[Educational practices in accordance with the "Ten steps to successful breastfeeding" in a Human Milk Bank].

Science.gov (United States)

Silva, Cristianny Miranda E; Pellegrinelli, Ana Luiza Rodrigues; Pereira, Simone Cardoso Lisboa; Passos, Ieda Ribeiro; Santos, Luana Caroline Dos

2017-05-01

This article sought to evaluate educational practices in line with the "Ten Steps to Successful Breastfeeding" in a Human Milk Bank. It involved a retrospective study using sociodemographic data about the pregnancy and the baby, obtained from a nursing mothers care protocol (2009-2012). These data were associated to steps related to educational practices from the "Ten Steps." Descriptive analysis, chi-square test and Poisson regression were performed. 12,283 mothers, with a median of 29 (12-54) years old, were evaluated. The guidelines about breastfeeding received during prenatal care (step 3) prevailed among mothers aged 30-39 years and the skin to skin contact (step 4) prevailed among oriented mothers. Breastfeeding training (step 5) predominated among those who breastfed exclusively. Higher prevalence of exclusive breastfeeding (step 6), breastfeeding on demand (step 8) and use of artificial nipples (step 9) were noted among infants whose mothers were oriented. These findings indicate the important role of health professionals on mother/child training about breastfeeding, on encouragement of the skin/skin contact, exclusive breastfeeding and breastfeeding on demand. The guidelines indicated the need to improve in order to reduce the use of artificial nipples and enhance exclusive breastfeeding.

Nonvolatile two-step, two-color holography with continuous-wave lights for both congruent and near-stoichiometric LiNbO3:Fe

International Nuclear Information System (INIS)

Shen Yan; Zhang Guoquan; Fu Bo; Xu Qingjun; Xu Jingjun

2004-01-01

We have studied theoretically the steady-state nonvolatile two-step, two-color holographic recording performance for both the congruent and the near-stoichiometric LiNbO 3 :Fe based on the two-center model (the deep-trap and the shallow-trap centers are Fe 2+ /Fe 3+ and Nb Li 4+ /Nb Li 5+ , respectively). The results show that the direct electron exchange between the Fe 2+ /Fe 3+ centers and the Nb Li 4+ /Nb Li 5+ centers due to the tunneling effect dominates the charge-transfer process during the nonvolatile two-step, two-color holography and determines the two-step, two-color holography performance in LiNbO 3 :Fe. We have further studied the effects of the crystal stoichiometry on the performance of the two-step, two-color holography. It is shown that, as far as the total space-charge field is considered, the nonvolatile two-step, two-color holography performance in the near-stoichiometric LiNbO 3 :Fe is much better than that in the congruent LiNbO 3 :Fe within the intensity range reachable by the continuous-wave lights

Lateral stability of the spring-mass hopper suggests a two-step control strategy for running.

Science.gov (United States)

Carver, Sean G; Cowan, Noah J; Guckenheimer, John M

2009-06-01

This paper investigates the control of running gaits in the context of a spring loaded inverted pendulum model in three dimensions. Specifically, it determines the minimal number of steps required for an animal to recover from a perturbation to a specified gait. The model has four control inputs per step: two touchdown angles (azimuth and elevation) and two spring constants (compression and decompression). By representing the locomotor movement as a discrete-time return map and using the implicit function theorem we show that the number of recovery steps needed following a perturbation depends upon the goals of the control mechanism. When the goal is to follow a straight line, two steps are necessary and sufficient for small lateral perturbations. Multistep control laws have a larger number of control inputs than outputs, so solutions of the control problem are not unique. Additional constraints, referred to here as synergies, are imposed to determine unique control inputs for perturbations. For some choices of synergies, two-step control can be expressed as two iterations of its first step policy and designed so that recovery occurs in just one step for all perturbations for which one-step recovery is possible.

Novel strategy for immunomodulation: Dissolving microneedle array encapsulating thymopentin fabricated by modified two-step molding technology.

Science.gov (United States)

Lin, Shiqi; Cai, Bingzhen; Quan, Guilan; Peng, Tingting; Yao, Gangtao; Zhu, Chune; Wu, Qiaoli; Ran, Hao; Pan, Xin; Wu, Chuanbin

2018-01-01

Thymopentin (TP5) is commonly used in the treatment for autoimmune diseases, with a short plasma half-life (30s) and a long treatment period (7 days to 6 months). It is usually administrated by syringe injection, resulting in compromised patient compliance. Dissolving microneedle array (DMNA) offers a superior approach for transdermal delivery of biological macromolecules, as it allows painless penetration through the stratum corneum and generates minimal biohazardous waste after dissolving in the skin. Despite recent advances in DMNA as a novel approach for transdermal drug delivery, problem of insufficient mechanical strength remains to be solved. In this study, TP5-loaded DMNA (TP5-DMNA) was uniquely developed using a modified two-step molding technology. The higher mechanical strength was furnished by employing bovine serum albumin (BSA) as a co-material to fabricate the needles. The obtained TP5-DMNA containing BSA displayed better skin penetration and higher drug loading efficiency than that without BSA. The in vivo pharmacodynamics study demonstrated that TP5-DMNA had comparative effect on immunomodulation to intravenous injection of TP5, in terms of ameliorating the CD4+/CD8+ ratio, SOD activity and MDA value to the basal level. Only mild irritation was observed at the site of administration. These results suggest that the novel TP5-DMNA utilizing BSA provides an alternative approach for convenient and safe transdermal delivery of TP5, which is a promising administration strategy for future clinical application. Copyright © 2017 Elsevier B.V. All rights reserved.

Morphology-photovoltaic property correlation in perovskite solar cells: One-step versus two-step deposition of CH3NH3PbI3

Directory of Open Access Journals (Sweden)

Jeong-Hyeok Im

2014-08-01

Full Text Available Perovskite CH3NH3PbI3 light absorber is deposited on the mesoporous TiO2 layer via one-step and two-step coating methods and their photovoltaic performances are compared. One-step coating using a solution containing CH3NH3I and PbI2 shows average power conversion efficiency (PCE of 7.5%, while higher average PCE of 13.9% is obtained from two-step coating method, mainly due to higher voltage and fill factor. The coverage, pore-filling, and morphology of the deposited perovskite are found to be critical in photovoltaic performance of the mesoporous TiO2 based perovskite solar cells.

A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin.

Science.gov (United States)

Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

2017-09-01

Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve™ gel (DELP) and a cheaper alternative, Zerobase Emollient™ cream (ZBC). This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) comparison in 18 females with atopic eczema and dry skin on their lower legs. DELP gel and ZBC cream were each applied to one lower leg twice daily for 4 days and on the morning only on day 5. The efficacy of both products was assessed by hydration measurements using a Corneometer CM825 probe (Courage-Khazaka Electronic). The measurements were made three times daily on days 1 to 5. The primary efficacy variable was the area under the curve (AUC) of the change from baseline corneometer readings over the 5 days. Skin hydration using DELP gel was significantly higher than using ZBC cream (p skin hydration observed for DELP gel was substantial and long lasting. In contrast, for ZBC cream, there was no significant improvement of the cumulative skin hydration as measured by the AUC (p = 0.22). DELP gel achieved substantial, long-lasting and cumulative skin hydration, whilst ZBC cream achieved no measurable improvement in skin hydration compared to before treatment. Healthcare professionals should be aware that different emollients can perform differently. Dermal Laboratories Ltd. EudraCT number:2014-001026-16.

Two-centre interference effects on the Thomas two-step scattering mechanisms

International Nuclear Information System (INIS)

Adivi, E Ghanbari

2010-01-01

The charge transfer process in the collision of fast protons with hydrogen molecules is theoretically investigated using the second-order Born approximation with correct boundary conditions. In addition to two first-order terms, the present calculations include the three second-order terms which correspond to the Thomas two-step scattering mechanisms. The interference effects, due to the scattering of the particles from two atomic centres, on the electron capture differential cross sections vary significantly with the orientation of the molecule and with the impact energy. After the averaging over all molecular orientations the interference patterns disappear but the Thomas peak becomes more pronounced. These patterns are also apparent in the differential cross sections as a function of the angle between the molecular axis and the incident beam direction. The integrated cross sections are calculated and the results are compared with available experimental data.

Influence of two different IR radiators on the antioxidative potential of the human skin

International Nuclear Information System (INIS)

Darvin, M E; Patzelt, A; Meinke, M; Sterry, W; Lademann, J

2009-01-01

Resonance Raman spectroscopy was used for the fast in vivo detection of the concentration of carotenoid antioxidant substances such as beta-carotene and lycopene in human skin and for the measurement of their degradation dynamics, subsequent to infrared (IR) irradiation emitted by two different IR radiators applied at the same power density. One of the radiators was equipped with a water filter in front of the radiation source (WIRA) and the other was a usual broadband system without a water filter (standard IR radiator – SIR). It was found that the SIR exerted a higher influence on the degradation of carotenoids in the skin than the WIRA. Furthermore, all twelve volunteers who participated in the study felt that the irradiation with the SIR was disagreeably warmer on the skin surface compared to the WIRA, in spite of the same power density values for both radiators on the skin surface. The average degradation magnitude of the carotenoids in the skin of all volunteers after an IR irradiation was determined at 23% for WIRA and 33% for the SIR. A correlation (R 2 ∼ 0.6) was found between the individual level of carotenoids in the skin of the volunteers and the magnitude of degradation of the carotenoids for both IR radiators. Taking the previous investigations into consideration, which clearly showed production of free radicals in the skin subsequent to IR irradiation, it can be concluded that during the application of WIRA irradiation on the skin, fewer radicals are produced in comparison to the SIR

Strong Stability Preserving Two-step Runge–Kutta Methods

KAUST Repository

Ketcheson, David I.; Gottlieb, Sigal; Macdonald, Colin B.

2011-01-01

We investigate the strong stability preserving (SSP) property of two-step Runge–Kutta (TSRK) methods. We prove that all SSP TSRK methods belong to a particularly simple subclass of TSRK methods, in which stages from the previous step are not used. We derive simple order conditions for this subclass. Whereas explicit SSP Runge–Kutta methods have order at most four, we prove that explicit SSP TSRK methods have order at most eight. We present explicit TSRK methods of up to eighth order that were found by numerical search. These methods have larger SSP coefficients than any known methods of the same order of accuracy and may be implemented in a form with relatively modest storage requirements. The usefulness of the TSRK methods is demonstrated through numerical examples, including integration of very high order weighted essentially non-oscillatory discretizations.

Strong Stability Preserving Two-step Runge–Kutta Methods

KAUST Repository

Ketcheson, David I.

2011-12-22

We investigate the strong stability preserving (SSP) property of two-step Runge–Kutta (TSRK) methods. We prove that all SSP TSRK methods belong to a particularly simple subclass of TSRK methods, in which stages from the previous step are not used. We derive simple order conditions for this subclass. Whereas explicit SSP Runge–Kutta methods have order at most four, we prove that explicit SSP TSRK methods have order at most eight. We present explicit TSRK methods of up to eighth order that were found by numerical search. These methods have larger SSP coefficients than any known methods of the same order of accuracy and may be implemented in a form with relatively modest storage requirements. The usefulness of the TSRK methods is demonstrated through numerical examples, including integration of very high order weighted essentially non-oscillatory discretizations.

Effect of two-step and one-step surface conditioning of glass ceramic on adhesion strength of orthodontic bracket and effect of thermo-cycling on adhesion strength.

Science.gov (United States)

Asiry, Moshabab A; AlShahrani, Ibrahim; Alaqeel, Samer M; Durgesh, Bangalore H; Ramakrishnaiah, Ravikumar

2018-08-01

The adhesion strength of orthodontic brackets bonded to dental glass ceramics was evaluated after ceramic surface was treated with two-step and one-step surface conditioning systems, and subjecting to thermo-cycling. A total of forty specimens were fabricated from silica based glass ceramic (lithium disilicate) by duplicating the buccal surface of maxillary first premolar. The specimens were randomly assigned to two experimental groups (n = 20), group one specimens were treated with two-step surface conditioning system (IPS ceramic etching gel™ and Monobond plus™) and group two specimens were treated with one-step surface conditioning system (Monobond etch and prime™). The surface roughness of the specimens after treatment with two-step and one-step surface conditioning system was measured using non-contact surface profilometer. Ten randomly selected specimens from each group were subjected to thermo-cycling and the remaining ten served as baseline. The shear bond strength of the specimens was measured using universal material testing machine. The adhesive remnant index score was calculated, and the results of surface roughness and bond strength were tabulated and subjected to analysis of variance and post hoc tukey's test at a significance level of p step conditioning system had higher surface roughness and bond strength than one-step conditioning system. The majority of the specimens treated with both two-step and one-step conditioned specimens showed adhesive failure after subjecting thermo-cycling. Traditional two-step conditioning provides better bond strength. The clinical importance of the study is that, the silane promoted adhesion significantly reduces on exposure to thermo-cycling. Copyright © 2018 Elsevier Ltd. All rights reserved.

Zinc hexacyanoferrate film as an effective protecting layer in two-step and one-step electropolymerization of pyrrole on zinc substrate

Energy Technology Data Exchange (ETDEWEB)

Pournaghi-Azar, M.H. [Electroanalytical Chemistry Laboratory, Faculty of Chemistry, University of Tabriz, Tabriz (Iran, Islamic Republic of)]. E-mail: pournaghiazar@tabrizu.ac.ir; Nahalparvari, H. [Electroanalytical Chemistry Laboratory, Faculty of Chemistry, University of Tabriz, Tabriz (Iran, Islamic Republic of)

2005-03-15

The two-step and one-step electrosynthesis processes of polypyrrole (PPy) films on the zinc substrate are described. The two-step process includes (i) the zinc surface pretreatment with hexacyanoferrate ion in the aqueous medium in order to form a zinc hexacyanoferrate (ZnHCF) film non-blocking passive layer on the surface and with the view to prevent its reactivity and (ii) electropolymerization of pyrrole on the ZnHCF vertical bar Zn-modified electrode in aqueous pyrrole solution. In this context, both the non-electrolytic and electrolytic procedures were adapted, and the effect of some experimental conditions such as supporting electrolyte, pH and temperature of the solution at the zinc surface pretreatment step as well as pyrrole concentration and electrochemical techniques at the polymerization step was investigated. By optimizing the experimental conditions in both steps, we have obtained a homogeneous and strongly adherent PPy films on the zinc substrate. The one-step process is based on the use of an aqueous medium containing Fe(CN){sub 6}{sup 4-} and pyrrole. The ferrocyanide ion passivates the substrate by formation of ZnHCF film during the electropolymerization process of pyrrole and therefore makes it possible to obtain strongly adherent PPy films, with controlled thickness, either by cyclic voltammetry or by electrolysis at constant current or constant potential without any previously treatment of the zinc electrode surface. The polypyrrole films deposited on the zinc electrode were characterized by cyclic voltammetry and scanning electron microscopic (SEM) measurement.

Zinc hexacyanoferrate film as an effective protecting layer in two-step and one-step electropolymerization of pyrrole on zinc substrate

International Nuclear Information System (INIS)

Pournaghi-Azar, M.H.; Nahalparvari, H.

2005-01-01

The two-step and one-step electrosynthesis processes of polypyrrole (PPy) films on the zinc substrate are described. The two-step process includes (i) the zinc surface pretreatment with hexacyanoferrate ion in the aqueous medium in order to form a zinc hexacyanoferrate (ZnHCF) film non-blocking passive layer on the surface and with the view to prevent its reactivity and (ii) electropolymerization of pyrrole on the ZnHCF vertical bar Zn-modified electrode in aqueous pyrrole solution. In this context, both the non-electrolytic and electrolytic procedures were adapted, and the effect of some experimental conditions such as supporting electrolyte, pH and temperature of the solution at the zinc surface pretreatment step as well as pyrrole concentration and electrochemical techniques at the polymerization step was investigated. By optimizing the experimental conditions in both steps, we have obtained a homogeneous and strongly adherent PPy films on the zinc substrate. The one-step process is based on the use of an aqueous medium containing Fe(CN) 6 4- and pyrrole. The ferrocyanide ion passivates the substrate by formation of ZnHCF film during the electropolymerization process of pyrrole and therefore makes it possible to obtain strongly adherent PPy films, with controlled thickness, either by cyclic voltammetry or by electrolysis at constant current or constant potential without any previously treatment of the zinc electrode surface. The polypyrrole films deposited on the zinc electrode were characterized by cyclic voltammetry and scanning electron microscopic (SEM) measurement

The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement

DEFF Research Database (Denmark)

Solovic, I.; Sester, M.; Gomez-Reino, J.J.

2010-01-01

risk of reactivating latent infections, especially tuberculosis (TB). Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-gamma release assays or, as an alternative in individuals without...... a history of bacille Calmette-Guerin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis. Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test...... and an interferon-gamma release assay, as there are insufficient data in children to recommend one test over the other. Consequently, targeted preventive chemotherapy is highly recommended for all individuals with persistent M. tuberculosis-specific immune responses undergoing TNF antagonist therapy...

Two Step Synthesis of a Non-symmetric Acetylcholinesterase Reactivator

Directory of Open Access Journals (Sweden)

Vit Koleckar

2007-08-01

Full Text Available The newly developed and very promising acetylcholinesterase reactivator (E-1- (2-hydroxyiminomethylpyridinium-4-(4-hydroxyiminomethylpyridinium-but-2-ene dibromide was prepared using two different pathways via a two-step synthesis involving the appropriate (E-1-(4-bromobut-2-enyl-2- or 4-hydroxyiminomethyl-pyridinium bromides. Afterwards, purities and yields of the desired product prepared by both routes were compared. Finally, its potency to reactivate several nerve agent-inhibited acetylcholinesterases was tested.

A novel two-step ultrasound post-assisted lye peeling regime for tomatoes: Reducing pollution while improving product yield and quality.

Science.gov (United States)

Gao, Ruiping; Ye, Fayin; Lu, Zhiqiang; Wang, Jiajia; Li Shen, Xiao; Zhao, Guohua

2018-07-01

In this paper, the effects and mechanisms of a novel two-step tomato peeling method, hot lye with a post-assistance of ultrasound, were investigated. The present work aims to improve the environmental friendliness of the conventional hot lye tomato peeling method (10% w/v, 97 °C, 45 s). The results showed that 4% (w/v) lye treatment at 97 °C for 30 s with a post-assistance of a 31.97 W/L ultrasound treatment at 70 °C for 50 s achieved a 100% peelability. In this scenario, the peeling yield and lycopene content in the peeled product were significantly higher than the peeling yield and lycopene content with the conventional hot lye peeling method. The present two-step peeling method was concluded with a mechanism of chemico-mechanical synergism, in which the hot lye functions mainly in a chemical way while the ultrasound is a mechanical process. Especially from the lye side, this work first demonstrated that the lye penetrated across the tomato skin via a pitting model rather than evenly. The findings reported in this paper not only provide a novel tomato peeling method with significant environmental benefits but also discover new clues to the peeling mechanism using hot lye. Copyright © 2018 Elsevier B.V. All rights reserved.

Thermal sensation and thermophysiological responses with metabolic step-changes

DEFF Research Database (Denmark)

Goto, Tomonobu; Toftum, Jørn; deDear, Richard

2006-01-01

at sedentary activity. In a second experimental series, subjects alternated between rest and exercise as well as between exercise at different intensities at two temperature levels. Measurements comprised skin and oesophageal temperatures, heart rate and subjective responses. Thermal sensation started to rise....... The sensitivity of thermal sensation to changes in core temperature was higher for activity down-steps than for up-steps. A model was proposed that estimates transient thermal sensation after metabolic step-changes. Based on predictions by the model, weighting factors were suggested to estimate a representative...... average metabolic rate with varying activity levels, e.g. for the prediction of thermal sensation by steady-state comfort models. The activity during the most recent 5 min should be weighted 65%, during the prior 10-5 min 25% and during the prior 20-10 min 10%....

Preparation of three-dimensional shaped aluminum alloy foam by two-step foaming

International Nuclear Information System (INIS)

Shang, J.T.; Xuming, Chu; Deping, He

2008-01-01

A novel method, named two-step foaming, was investigated to prepare three-dimensional shaped aluminum alloy foam used in car industry, spaceflight, packaging and related areas. Calculations of thermal decomposition kinetics of titanium hydride showed that there is a considerable amount of hydrogen releasing when the titanium hydride is heated at a relatively high temperature after heated at a lower temperature. The hydrogen mass to sustain aluminum alloy foam, having a high porosity, was also estimated by calculations. Calculations indicated that as-received titanium hydride without any pre-treatment can be used as foaming agents in two-step foaming. The processes of two-step foaming, including preparing precursors and baking, were also studied by experiments. Results showed that, low titanium hydride dispersion temperature, long titanium hydride dispersion time and low precursors porosity are beneficial to prepare three-dimensional shaped aluminum alloy foams with uniform pores

Patient experiences with oily skin: the qualitative development of content for two new patient reported outcome questionnaires.

Science.gov (United States)

Arbuckle, Robert; Atkinson, Mark J; Clark, Marci; Abetz, Linda; Lohs, Jan; Kuhagen, Ilka; Harness, Jane; Draelos, Zoe; Thiboutot, Diane; Blume-Peytavi, Ulrike; Copley-Merriman, Kati

2008-10-16

To develop the content for two new patient reported outcome (PRO) measures to: a) assess the severity of symptoms; and b) the impact of facial skin oiliness on emotional wellbeing using qualitative data from face to face, and internet focus groups in Germany and the US. Using input from initial treatment satisfaction focus groups (n = 42), a review of relevant literature and expert clinicians (n = 3), a discussion guide was developed to guide qualitative inquiry using Internet focus groups (IFGs). IFGs were conducted with German (n = 26) and US (n = 28) sufferers of oily skin. Questionnaire items were generated using coded transcript data from the focus groups. Cognitive debriefing was conducted online with 42 participants and face to face with an additional five participants to assess the comprehension of the items. There were equal numbers of male and female participants; mean age was 35.4 (SD 9.3) years. On average, participants had had oily skin for 15.2 years, and 74% (n = 40) reported having mild-moderate acne. Participants reported using visual, tactile and sensory (feel without touching their face) methods to evaluate the severity of facial oiliness. Oily facial skin had both an emotional and social impact, and was associated with feelings of unattractiveness, self-consciousness, embarrassment, irritation and frustration. Items were generated for a measure of oily skin severity (Oily Skin Self-Assessment Scale) and a measure of the impact of oily skin on emotional well-being (Oily Skin Impact Scale). Cognitive debriefing resulted in minor changes to the draft items and confirmed their face and content validity. The research provides insight into the experience of having oily skin and illustrates significant difficulties associated with the condition. Item content was developed for early versions of two PRO measures of the symptoms and emotional impact of oily facial skin. The psychometric validation of these measures reported elsewhere.

Two-step approach to the dynamics of coupled anharmonic oscillators

International Nuclear Information System (INIS)

Chung, N. N.; Chew, L. Y.

2009-01-01

We have further extended the two-step approach developed by Chung and Chew [N. N. Chung and L. Y. Chew, Phys. Rev. A 76, 032113 (2007)] to the solution of the quantum dynamics of general systems of N-coupled anharmonic oscillators. The idea is to employ an optimized basis set to represent the dynamical quantum states of these oscillator systems. The set is generated via the action of the optimized Bogoliubov transformed bosonic operators on the optimal squeezed vacuum product state. The procedure requires (i) applying the two-step approach to the eigendecomposition of the time evolution operator and (ii) transforming the representation of the initial state from the original to the optimal bases. We have applied the formalism to examine the dynamics of squeezing and entanglement of several anharmonic oscillator systems.

Dynamic masquerade with morphing three-dimensional skin in cuttlefish.

Science.gov (United States)

Panetta, Deanna; Buresch, Kendra; Hanlon, Roger T

2017-03-01

Masquerade is a defence tactic in which a prey resembles an inedible or inanimate object thus causing predators to misclassify it. Most masquerade colour patterns are static although some species adopt postures or behaviours to enhance the effect. Dynamic masquerade in which the colour pattern can be changed is rare. Here we report a two-step sensory process that enables an additional novel capability known only in cuttlefish and octopus: morphing three-dimensional physical skin texture that further enhances the optical illusions created by coloured skin patterns. Our experimental design incorporated sequential sensory processes: addition of a three-dimensional rock to the testing arena, which attracted the cuttlefish to settle next to it; then visual processing by the cuttlefish of physical textures on the rock to guide expression of the skin papillae, which can range from fully relaxed (smooth skin) to fully expressed (bumpy skin). When a uniformly white smooth rock was presented, cuttlefish moved to the rock and deployed a uniform body pattern with mostly smooth skin. When a rock with small-scale fragments of contrasting shells was presented, the cuttlefish deployed mottled body patterns with strong papillae expression. These robust and reversible responses indicate a sophisticated visual sensorimotor system for dynamic masquerade. © 2017 The Author(s).

Ultrasonic transesterification of Jatrophacurcas L. oil to biodiesel by a two-step process

International Nuclear Information System (INIS)

Deng Xin; Fang Zhen; Liu Yunhu

2010-01-01

Transesterification of high free fatty acid content Jatropha oil with methanol to biodiesel catalyzed directly by NaOH and high-concentrated H 2 SO 4 or by two-step process were studied in an ultrasonic reactor at 60 deg. C. If NaOH was used as catalyst, biodiesel yield was only 47.2% with saponification problem. With H 2 SO 4 as catalyst, biodiesel yield was increased to 92.8%. However, longer reaction time (4 h) was needed and the biodiesel was not stable. A two-step, acid-esterification and base-transesterification process was further used for biodiesel production. It was found that after the first-step pretreatment with H 2 SO 4 for 1 h, the acid value of Jatropha oil was reduced from 10.45 to 1.2 mg KOH/g, and subsequently, NaOH was used for the second-step transesterification. Stable and clear yellowish biodiesel was obtained with 96.4% yield after reaction for 0.5 h. The total production time was only 1.5 h that is just half of the previous reported. The two-step process with ultrasonic radiation is effective and time-saving for biodiesel production from Jatropha oil.

Two-step condensation of the ideal Bose gas in highly anisotropic traps

NARCIS (Netherlands)

van Druten, N.J.; Ketterle, W.

1997-01-01

The ideal Bose gas in a highly anisotropic harmonic potential is studied. It is found that Bose-Einstein condensation occurs in two distinct steps as the temperature is lowered. In the first step the specific heat shows a sharp feature, but the system still occupies many one-dimensional quantum

A tale of two tails: Not just skin deep

Directory of Open Access Journals (Sweden)

Abhijit Dutta

2015-01-01

Full Text Available The dorsal cutaneous appendage or the so called human tail is a rare congenital anomaly protruding from the lumbo-sacro-coccygeal area. These caudal appendages are divided into true-tails and pseudo-tails. We report here two cases of congenital pseudo-tail with underlying spina bifida and lipo-meningocele. In this article we seek to emphasize that, as the skin and nervous systems are intimately linked by their similar ectodermal origin, a dorsal appendage may be regarded as a cutaneous marker of the underlying spinal dysraphism.

Comparative Effectiveness of Two Walking Interventions on Participation, Step Counts, and Health.

Science.gov (United States)

Smith-McLallen, Aaron; Heller, Debbie; Vernisi, Kristin; Gulick, Diana; Cruz, Samantha; Snyder, Richard L

2017-03-01

To (1) compare the effects of two worksite-based walking interventions on employee participation rates; (2) compare average daily step counts between conditions, and; (3) examine the effects of increases in average daily step counts on biometric and psychologic outcomes. We conducted a cluster-randomized trial in which six employer groups were randomly selected and randomly assigned to condition. Four manufacturing worksites and two office-based worksite served as the setting. A total of 474 employees from six employer groups were included. A standard walking program was compared to an enhanced program that included incentives, feedback, competitive challenges, and monthly wellness workshops. Walking was measured by self-reported daily step counts. Survey measures and biometric screenings were administered at baseline and 3, 6, and 9 months after baseline. Analysis used linear mixed models with repeated measures. During 9 months, participants in the enhanced condition averaged 726 more steps per day compared with those in the standard condition (p women (-2.1 lbs.), and reductions in body mass index (-0.41 men, -0.31 women). Higher step counts were also associated with improvements in mood, having more energy, and higher ratings of overall health. An enhanced walking program significantly increases participation rates and daily step counts, which were associated with weight loss and reductions in body mass index.

Systematic skin cancer screening in Northern Germany.

Science.gov (United States)

Breitbart, Eckhard W; Waldmann, Annika; Nolte, Sandra; Capellaro, Marcus; Greinert, Ruediger; Volkmer, Beate; Katalinic, Alexander

2012-02-01

The incidence of skin cancer is increasing worldwide. For decades, opportunistic melanoma screening has been carried out to respond to this burden. However, despite potential positive effects such as reduced morbidity and mortality, there is still a lack of evidence for feasibility and effectiveness of organized skin cancer screening. The main aim of the project was to evaluate the feasibility of systematic skin cancer screening. In 2003, the Association of Dermatological Prevention was contracted to implement the population-based SCREEN project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany) in the German state of Schleswig-Holstein. A two-step program addressing malignant melanoma and nonmelanocytic skin cancer was implemented. Citizens (aged ≥ 20 years) with statutory health insurance were eligible for a standardized whole-body examination during the 12-month study period. Cancer registry and mortality data were used to assess first effects. Of 1.88 million eligible citizens, 360,288 participated in SCREEN. The overall population-based participation rate was 19%. A total of 3103 malignant skin tumors were found. On the population level, invasive melanoma incidence increased by 34% during SCREEN. Five years after SCREEN a substantial decrease in melanoma mortality was seen (men: observed 0.79/100,000 and expected 2.00/100,000; women: observed 0.66/100,000 and expected 1.30/100,000). Because of political reasons (resistance as well as lack of support from major German health care stakeholders), it was not possible to conduct a randomized controlled trial. The project showed that large-scale systematic skin cancer screening is feasible and has the potential to reduce skin cancer burden, including mortality. Based on the results of SCREEN, a national statutory skin cancer early detection program was implemented in Germany in 2008. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All

Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

Science.gov (United States)

Caissutti, Claudia; Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

2018-02-01

The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus (GDM) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM-negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM-positive by the One Step, but not the Two Step. Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM-negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Ehrenfest's theorem and the validity of the two-step model for strong-field ionization

DEFF Research Database (Denmark)

Shvetsov-Shilovskiy, Nikolay; Dimitrovski, Darko; Madsen, Lars Bojer

By comparison with the solution of the time-dependent Schrodinger equation we explore the validity of the two-step semiclassical model for strong-field ionization in elliptically polarized laser pulses. We find that the discrepancy between the two-step model and the quantum theory correlates...

Cyclic deformation behaviour of quenched and tempered AISI 4140 at two-step tensile-compressive-loading

Energy Technology Data Exchange (ETDEWEB)

Schulze, V.; Lang, K.-H.; Voehringer, O.; Macherauch, E. [Karlsruhe Univ. (T.H.) (Germany). Inst. fuer Werkstoffkunde 1

1997-08-30

The cyclic deformation behaviour in stress-controlled two-step experiments with one or more changes between two blocks of certain lengths and amplitudes was investigated at the technically important steel AISI 4140 (German grade 42 CrMo 4). In all two-step experiments cyclic worksoftening behaviour is found. The degree of work softening is discussed in comparison to single-step experiments. In several cases effects of static strain-ageing can be found. (orig.) 10 refs.

Adiabatic tapered optical fiber fabrication in two step etching

Science.gov (United States)

Chenari, Z.; Latifi, H.; Ghamari, S.; Hashemi, R. S.; Doroodmand, F.

2016-01-01

A two-step etching method using HF acid and Buffered HF is proposed to fabricate adiabatic biconical optical fiber tapers. Due to the fact that the etching rate in second step is almost 3 times slower than the previous droplet etching method, terminating the fabrication process is controllable enough to achieve a desirable fiber diameter. By monitoring transmitted spectrum, final diameter and adiabaticity of tapers are deduced. Tapers with losses about 0.3 dB in air and 4.2 dB in water are produced. The biconical fiber taper fabricated using this method is used to excite whispering gallery modes (WGMs) on a microsphere surface in an aquatic environment. So that they are suitable to be used in applications like WGM biosensors.

THERAPEUTIC EFFECT OF SOLASODINE RHAMNOSYL GLYCOSIDES FOR LARGE SKIN CANCERS: TWO CLINICAL CASES

Directory of Open Access Journals (Sweden)

Bill E. Cham

2012-01-01

Full Text Available Solasodine rhamnosyl glycosides (BEC are a new class of antineoplastics, the efficiency of which administered via intravenous, intraperitoneal, and intratumoral routes is higher than that of many other antitumor agents. Early investigations have established the efficiency of topical BEC applications as a treatment option for non-melanoma skin cancers. There have recently been two clinical cases that count in favor of the fact that the cream formulation Curaderm containing BEC has a very high efficacy in the treatment of large non-melanoma skin cancers that are incurable by other existing methods. Also, Curaderm treatment shows a splendid cosmetic effect. 

Step patterns on vicinal reconstructed surfaces

Science.gov (United States)

Vilfan, Igor

1996-04-01

Step patterns on vicinal (2 × 1) reconstructed surfaces of noble metals Au(110) and Pt(110), miscut towards the (100) orientation, are investigated. The free energy of the reconstructed surface with a network of crossing opposite steps is calculated in the strong chirality regime when the steps cannot make overhangs. It is explained why the steps are not perpendicular to the direction of the miscut but form in equilibrium a network of crossing steps which make the surface to look like a fish skin. The network formation is the consequence of competition between the — predominantly elastic — energy loss and entropy gain. It is in agreement with recent scanning tunnelling microscopy observations on vicinal Au(110) and Pt(110) surfaces.

Ultrasonic transesterification of Jatrophacurcas L. oil to biodiesel by a two-step process

Energy Technology Data Exchange (ETDEWEB)

Deng, Xin; Fang, Zhen; Liu, Yun-hu [Biomass Group, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, 88 Xuefulu, Kunming, Yunnan Province 650223 (China)

2010-12-15

Transesterification of high free fatty acid content Jatropha oil with methanol to biodiesel catalyzed directly by NaOH and high-concentrated H{sub 2}SO{sub 4} or by two-step process were studied in an ultrasonic reactor at 60 C. If NaOH was used as catalyst, biodiesel yield was only 47.2% with saponification problem. With H{sub 2}SO{sub 4} as catalyst, biodiesel yield was increased to 92.8%. However, longer reaction time (4 h) was needed and the biodiesel was not stable. A two-step, acid-esterification and base-transesterification process was further used for biodiesel production. It was found that after the first-step pretreatment with H{sub 2}SO{sub 4} for 1 h, the acid value of Jatropha oil was reduced from 10.45 to 1.2 mg KOH/g, and subsequently, NaOH was used for the second-step transesterification. Stable and clear yellowish biodiesel was obtained with 96.4% yield after reaction for 0.5 h. The total production time was only 1.5 h that is just half of the previous reported. The two-step process with ultrasonic radiation is effective and time-saving for biodiesel production from Jatropha oil. (author)

Ultrasonic transesterification of Jatrophacurcas L. oil to biodiesel by a two-step process

Energy Technology Data Exchange (ETDEWEB)

Deng Xin [Biomass Group, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, 88 Xuefulu, Kunming, Yunnan Province 650223 (China); Fang Zhen, E-mail: zhenfang@xtbg.ac.c [Biomass Group, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, 88 Xuefulu, Kunming, Yunnan Province 650223 (China); Liu Yunhu [Biomass Group, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, 88 Xuefulu, Kunming, Yunnan Province 650223 (China)

2010-12-15

Transesterification of high free fatty acid content Jatropha oil with methanol to biodiesel catalyzed directly by NaOH and high-concentrated H{sub 2}SO{sub 4} or by two-step process were studied in an ultrasonic reactor at 60 deg. C. If NaOH was used as catalyst, biodiesel yield was only 47.2% with saponification problem. With H{sub 2}SO{sub 4} as catalyst, biodiesel yield was increased to 92.8%. However, longer reaction time (4 h) was needed and the biodiesel was not stable. A two-step, acid-esterification and base-transesterification process was further used for biodiesel production. It was found that after the first-step pretreatment with H{sub 2}SO{sub 4} for 1 h, the acid value of Jatropha oil was reduced from 10.45 to 1.2 mg KOH/g, and subsequently, NaOH was used for the second-step transesterification. Stable and clear yellowish biodiesel was obtained with 96.4% yield after reaction for 0.5 h. The total production time was only 1.5 h that is just half of the previous reported. The two-step process with ultrasonic radiation is effective and time-saving for biodiesel production from Jatropha oil.

Two-step flash light sintering process for crack-free inkjet-printed Ag films

International Nuclear Information System (INIS)

Park, Sung-Hyeon; Kim, Hak-Sung; Jang, Shin; Lee, Dong-Jun; Oh, Jehoon

2013-01-01

In this paper, a two-step flash light sintering process for inkjet-printed Ag films is investigated with the aim of improving the quality of sintered Ag films. The flash light sintering process is divided into two steps: a preheating step and a main sintering step. The preheating step is used to remove the organic binder without abrupt vaporization. The main sintering step is used to complete the necking connections among the silver nanoparticles and achieve high electrical conductivity. The process minimizes the damage on the polymer substrate and the interface between the sintered Ag film and polymer substrate. The electrical conductivity is calculated by measuring the resistance and cross-sectional area with an LCR meter and 3D optical profiler, respectively. It is found that the resistivity of the optimal flash light-sintered Ag films (36.32 nΩ m), which is 228.86% of that of bulk silver, is lower than that of thermally sintered ones (40.84 nΩ m). Additionally, the polyimide film used as the substrate is preserved with the inkjet-printed pattern shape during the flash light sintering process without delamination or defects. (paper)

Two-step estimation procedures for inhomogeneous shot-noise Cox processes

DEFF Research Database (Denmark)

Prokesová, Michaela; Dvorák, Jirí; Jensen, Eva B. Vedel

In the present paper we develop several two-step estimation procedures for inhomogeneous shot-noise Cox processes. The intensity function is parametrized by the inhomogeneity parameters while the pair-correlation function is parametrized by the interaction parameters. The suggested procedures...

Effect of bur-cut dentin on bond strength using two all-in-one and one two-step adhesive systems.

Science.gov (United States)

Koase, Kaori; Inoue, Satoshi; Noda, Mamoru; Tanaka, Toru; Kawamoto, Chiharu; Takahashi, Akiko; Nakaoki, Yasuko; Sano, Hidehiko

2004-01-01

To compare the microtensile bond strength (MTBS) of two all-in-one adhesive systems and one experimental two-step self-etching adhesive system to two types of bur-cut dentin. Using one of the three adhesives, Xeno CF Bond (Xeno), Prompt L-Pop (PL), or the experimental two-step system ABF (ABF), resin composite was bonded to flat buccal and root dentin surfaces of eight extracted human premolars. These surfaces were produced using either regular-grit or superfine-grit diamond burs. After storage overnight in 37 degrees C water, the bonded specimens were sectioned into six or seven slices approximately 0.7 mm thick perpendicular to the bonded surface. They were then subjected to microtensile testing. The surfaces of the fractured specimens were observed microscopically to determine the failure mode. In addition, to observe the effect of conditioning, the two types of bur-cut dentin surfaces were conditioned with the adhesives, rinsed with acetone, and observed with SEM. When Xeno and PL were bonded to dentin cut with a regular-grit diamond bur, MTBS values were lower than to superfine bur-cut dentin, and failures occurred adhesively at the interface, whereas the experimental two-step adhesive showed no significant difference in microtensile bond strength between two differently cut surfaces. The all-in-one adhesives tested here improved bond strengths when bonded to superfine bur-cut dentin as a substrate, whereas the experimental two-step adhesive system showed unchanged bonding to both regular and superfine bur-cut dentin surfaces.

The Relative Utility of Skin Resistance and Skin Conductance

National Research Council Canada - National Science Library

Barland, Gordon

1990-01-01

The effectiveness of two circuits (constant current = skin resistance; constant voltage = skin conductance) used for measuring electrodermal activity during a psychophysiological detection of deception...

The response of human thermal sensation and its prediction to temperature step-change (cool-neutral-cool.

Directory of Open Access Journals (Sweden)

Xiuyuan Du

Full Text Available This paper reports on studies of the effect of temperature step-change (between a cool and a neutral environment on human thermal sensation and skin temperature. Experiments with three temperature conditions were carried out in a climate chamber during the period in winter. Twelve subjects participated in the experiments simulating moving inside and outside of rooms or cabins with air conditioning. Skin temperatures and thermal sensation were recorded. Results showed overshoot and asymmetry of TSV due to the step-change. Skin temperature changed immediately when subjects entered a new environment. When moving into a neutral environment from cool, dynamic thermal sensation was in the thermal comfort zone and overshoot was not obvious. Air-conditioning in a transitional area should be considered to limit temperature difference to not more than 5°C to decrease the unacceptability of temperature step-change. The linear relationship between thermal sensation and skin temperature or gradient of skin temperature does not apply in a step-change environment. There is a significant linear correlation between TSV and Qloss in the transient environment. Heat loss from the human skin surface can be used to predict dynamic thermal sensation instead of the heat transfer of the whole human body.

The Response of Human Thermal Sensation and Its Prediction to Temperature Step-Change (Cool-Neutral-Cool)

Science.gov (United States)

Du, Xiuyuan; Li, Baizhan; Liu, Hong; Yang, Dong; Yu, Wei; Liao, Jianke; Huang, Zhichao; Xia, Kechao

2014-01-01

This paper reports on studies of the effect of temperature step-change (between a cool and a neutral environment) on human thermal sensation and skin temperature. Experiments with three temperature conditions were carried out in a climate chamber during the period in winter. Twelve subjects participated in the experiments simulating moving inside and outside of rooms or cabins with air conditioning. Skin temperatures and thermal sensation were recorded. Results showed overshoot and asymmetry of TSV due to the step-change. Skin temperature changed immediately when subjects entered a new environment. When moving into a neutral environment from cool, dynamic thermal sensation was in the thermal comfort zone and overshoot was not obvious. Air-conditioning in a transitional area should be considered to limit temperature difference to not more than 5°C to decrease the unacceptability of temperature step-change. The linear relationship between thermal sensation and skin temperature or gradient of skin temperature does not apply in a step-change environment. There is a significant linear correlation between TSV and Qloss in the transient environment. Heat loss from the human skin surface can be used to predict dynamic thermal sensation instead of the heat transfer of the whole human body. PMID:25136808

Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

Science.gov (United States)

Cunningham, Emilie M; Doyle, Eva I; Bowden, Rodney G

The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

Core-shell polymer nanorods by a two-step template wetting process

International Nuclear Information System (INIS)

Dougherty, S; Liang, J

2009-01-01

One-dimensional core-shell polymer nanowires offer many advantages and great potential for many different applications. In this paper we introduce a highly versatile two-step template wetting process to fabricate two-component core-shell polymer nanowires with controllable shell thickness. PLLA and PMMA were chosen as model polymers to demonstrate the feasibility of this process. Solution wetting with different concentrations of polymer solutions was used to fabricate the shell layer and melt wetting was used to fill the shell with the core polymer. The shell thickness was analyzed as a function of the polymer solution concentration and viscosity, and the core-shell morphology was observed with TEM. This paper demonstrates the feasibility of fabricating polymer core-shell nanostructures using our two-step template wetting process and opens the arena for optimization and future experiments with polymers that are desirable for specific applications.

Patient experiences with oily skin: The qualitative development of content for two new patient reported outcome questionnaires

Directory of Open Access Journals (Sweden)

Draelos Zoe

2008-10-01

Full Text Available Abstract Objective To develop the content for two new patient reported outcome (PRO measures to: a assess the severity of symptoms; and b the impact of facial skin oiliness on emotional wellbeing using qualitative data from face to face, and internet focus groups in Germany and the US. Methods Using input from initial treatment satisfaction focus groups (n = 42, a review of relevant literature and expert clinicians (n = 3, a discussion guide was developed to guide qualitative inquiry using Internet focus groups (IFGs. IFGs were conducted with German (n = 26 and US (n = 28 sufferers of oily skin. Questionnaire items were generated using coded transcript data from the focus groups. Cognitive debriefing was conducted online with 42 participants and face to face with an additional five participants to assess the comprehension of the items. Results There were equal numbers of male and female participants; mean age was 35.4 (SD 9.3 years. On average, participants had had oily skin for 15.2 years, and 74% (n = 40 reported having mild-moderate acne. Participants reported using visual, tactile and sensory (feel without touching their face methods to evaluate the severity of facial oiliness. Oily facial skin had both an emotional and social impact, and was associated with feelings of unattractiveness, self-consciousness, embarrassment, irritation and frustration. Items were generated for a measure of oily skin severity (Oily Skin Self-Assessment Scale and a measure of the impact of oily skin on emotional well-being (Oily Skin Impact Scale. Cognitive debriefing resulted in minor changes to the draft items and confirmed their face and content validity. Conclusion The research provides insight into the experience of having oily skin and illustrates significant difficulties associated with the condition. Item content was developed for early versions of two PRO measures of the symptoms and emotional impact of oily facial skin. The psychometric validation of

Incidence, risk factors, and pregnancy outcomes of gestational diabetes mellitus using one-step versus two-step diagnostic approaches: A population-based cohort study in Isfahan, Iran.

Science.gov (United States)

Hosseini, Elham; Janghorbani, Mohsen; Aminorroaya, Ashraf

2018-06-01

To study the incidence, risk factors, and pregnancy outcomes associated with gestational diabetes mellitus (GDM) diagnosed with one-step and two-step screening approaches. 1000 pregnant women who were eligible and consented to participate underwent fasting plasma glucose testing at the first prenatal visit (6-14 weeks). The women free from GDM or overt diabetes were screened at 24-28 weeks using the 50-g glucose challenge test (GCT) followed by 100-g, 3-h oral glucose tolerance test (OGTT) (two-step method). Regardless of the GCT result, all women underwent a 75-g, 2-h OGTT within one-week interval (one-step method). GDM incidence using the one-step and two-step methods was 9.3% (95% CI: 7.4-11.2) and 4.2% (95% CI: 2.9-5.5). GDM significantly increased the risk of macrosomia, gestational hypertension, preeclampsia, and cesarean section and older age and family history of diabetes significantly increased the risk of developing GDM in both approaches. In two-step method, higher pre-pregnancy body mass index and lower physical activity during pregnancy along with higher earlier cesarean section also increased significantly the risk of developing GDM. Despite a higher incidence of GDM using the one-step approach, more risk factors for and a stronger effect of GDM on adverse pregnancy outcomes were found when using the two-step approach. Longer follow-up of women with and without GDM may change the results using both approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

Low Cost Skin Segmentation Scheme in Videos Using Two Alternative Methods for Dynamic Hand Gesture Detection Method

Directory of Open Access Journals (Sweden)

Eman Thabet

2017-01-01

Full Text Available Recent years have witnessed renewed interest in developing skin segmentation approaches. Skin feature segmentation has been widely employed in different aspects of computer vision applications including face detection and hand gestures recognition systems. This is mostly due to the attractive characteristics of skin colour and its effectiveness to object segmentation. On the contrary, there are certain challenges in using human skin colour as a feature to segment dynamic hand gesture, due to various illumination conditions, complicated environment, and computation time or real-time method. These challenges have led to the insufficiency of many of the skin color segmentation approaches. Therefore, to produce simple, effective, and cost efficient skin segmentation, this paper has proposed a skin segmentation scheme. This scheme includes two procedures for calculating generic threshold ranges in Cb-Cr colour space. The first procedure uses threshold values trained online from nose pixels of the face region. Meanwhile, the second procedure known as the offline training procedure uses thresholds trained out of skin samples and weighted equation. The experimental results showed that the proposed scheme achieved good performance in terms of efficiency and computation time.

BCG (Bacille Calmette-Guerin) Vaccine

Science.gov (United States)

... Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

TB in Children in the United States

Science.gov (United States)

... Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

Tuberculosis: The Connection between TB and HIV (the AIDS Virus)

Science.gov (United States)

... Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

Two-step flash light sintering of copper nanoparticle ink to remove substrate warping

Energy Technology Data Exchange (ETDEWEB)

Ryu, Chung-Hyeon; Joo, Sung-Jun [Department of Mechanical Convergence Engineering, Hanyang University, Haengdang-dong, Seongdong-gu, Seoul 133-791 (Korea, Republic of); Kim, Hak-Sung, E-mail: kima@hanyang.ac.kr [Department of Mechanical Convergence Engineering, Hanyang University, Haengdang-dong, Seongdong-gu, Seoul 133-791 (Korea, Republic of); Institute of Nano Science and Technology, Hanyang University, Seoul, 133-791 (Korea, Republic of)

2016-10-30

Highlights: • We performed the two-step flash light sintering for copper nanoparticle ink to remove substrate warping. • 12 J/cm{sup 2} of preheating and 7 J/cm{sup 2} of main sintering energies were determined as optimum conditions to sinter the copper nanoparticle ink. • The resistivity of two-step sintered copper nanoparticle ink was 3.81 μΩ cm with 5B adhesion level, 2.3 times greater than that of bulk copper. • The two-step sintered case showed a high conductivity without any substrate warping. - Abstract: A two-step flash light sintering process was devised to reduce the warping of polymer substrates during the sintering of copper nanoparticle ink. To determine the optimum sintering conditions of the copper nanoparticle ink, the flash light irradiation conditions (pulse power, pulse number, on-time, and off-time) were varied and optimized. In order to monitor the flash light sintering process, in situ resistance and temperature monitoring of copper nanoink were conducted during the flash light sintering process. Also, a transient heat transfer analysis was performed by using the finite-element program ABAQUS to predict the temperature changes of copper nanoink and polymer substrate. The microstructures of the sintered copper nanoink films were analyzed by scanning electron microscopy. Additionally, an X-ray diffraction and Fourier transform infrared spectroscopy were used to characterize the crystal phase change of the sintered copper nanoparticles. The resulting two-step flash light sintered copper nanoink films exhibited a low resistivity (3.81 μΩ cm, 2.3 times of that of bulk copper) and 5B level of adhesion strength without warping of the polymer substrate.

48 CFR 52.214-23 - Late submissions, modifications, revisions, and withdrawals of technical proposals under two-step...

Science.gov (United States)

2010-10-01

..., modifications, revisions, and withdrawals of technical proposals under two-step sealed bidding. 52.214-23... Late submissions, modifications, revisions, and withdrawals of technical proposals under two-step..., Modifications, Revisions, and Withdrawals of Technical Proposals Under Two-Step Sealed Bidding (NOV 1999) (a...

[Comparison of annual risk for tuberculosis infection (1994-2001) in school children in Djibouti: methodological limitations and epidemiological value in a hyperendemic context].

Science.gov (United States)

Bernatas, J J; Mohamed Ali, I; Ali Ismaël, H; Barreh Matan, A

2008-12-01

The purpose of this report was to describe a tuberculin survey conducted in 2001 to assess the trend in the annual risk for tuberculosis infection in Djibouti and compare resulting data with those obtained in a previous survey conducted in 1994. In 2001 cluster sampling allowed selection of 5599 school children between the ages of 6 and 10 years including 31.2% (1747/5599) without BCG vaccination scar. In this sample the annual risk of infection (ARI) estimated using cutoff points of 6 mm, 10 mm, and 14 mm corrected by a factor of 1/0.82 and a mode value (18 mm) determined according to the "mirror" method were 4.67%, 3.64%, 3.19% and 2.66% respectively. The distribution of positive tuberculin skin reaction size was significantly different from the normal law. In 1994 a total of 5257 children were selected using the same method. The distribution of positive reactions was not significantly different from the gaussian distribution and 28.6% (1505/5257) did not have a BCG scar. The ARI estimated using cutoff points of 6 mm, 10 mm, and 14 mm corrected by a factor of 1/0.82 and a mode value (17 mm) determined according to the "mirror" method were 2.68%, 2.52%, 2.75% and 3.32 respectively. Tuberculin skin reaction size among positive skin test reactors was correlated with the presence of a BCG scar, and its mean was significantly higher among children with BCG scar. The proportion of positive skin test reactors was also higher in the BCG scar group regardless of the cutoff point selected. Comparison of prevalence rates and ARI values did not allow any clear conclusion to be drawn, mainly because of a drastic difference in the positive reaction distribution profiles between the two studies. The distribution of the skin test reaction's size 1994 study could be modelized by a gaussian distribution while it could not in 2001. A partial explanation for the positive reaction distribution observed in the 2001 study might be the existence of cross-reactions with environmental

Skin Microvascular Thrombosis in Fusarium Infection in Two Early Biopsied Cases

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Yang Fan

2010-05-01

Full Text Available Fusarium species cause rare and severe infections. Their incidence is increasing in immunocompromised patients but they are also observed in healthy hosts. Because of the rapid dissemination of infection and the frequent resistance of Fusarium species to antifungal drugs, histopathologic evidence of hyphae is very helpful to obtain the diagnosis rapidly. We report the clinical and pathological features of two patients with initial cutaneous lesions. Cutaneous early biopsies showed microvessel involvement with hyphae and thrombosis. Fusarium infection was confirmed by skin culture. Hyphae within a microvessel thrombus in the skin were highly suggestive of disseminated fungal infection. These pathological features enabled to establish an early diagnosis and to start efficient antifungal treatment. In early cutaneous biopsies of immunocompromised patients, the presence of cutaneous vessel thrombosis can suggest a fungal infection and may help to start specific therapy without delay for these life-threatening infections.

First-step nucleation growth dependence of InAs/InGaAs/InP quantum dot formation in two-step growth

International Nuclear Information System (INIS)

Yin Zongyou; Tang Xiaohong; Deny, Sentosa; Chin, Mee Koy; Zhang Jixuan; Teng Jinghua; Du Anyan

2008-01-01

First-step nucleation growth has an important impact on the two-step growth of high-quality mid-infrared emissive InAs/InGaAs/InP quantum dots (QDs). It has been found that an optimized growth rate for first-step nucleation is critical for forming QDs with narrow size distribution, high dot density and high crystal quality. High growth temperature has an advantage in removing defects in the QDs formed, but the dot density will be reduced. Contrasting behavior in forming InAs QDs using metal-organic vapor phase epitaxy (MOVPE) by varying the input flux ratio of group-V versus group-III source (V/III ratio) in the first-step nucleation growth has been observed and investigated. High-density, 2.5 x 10 10 cm -2 , InAs QDs emitting at>2.15 μm have been formed with narrow size distribution, ∼1 nm standard deviation, by reducing the V/III ratio to zero in first-step nucleation growth

Ultralow-density SiO2 aerogels prepared by a two-step sol-gel process

International Nuclear Information System (INIS)

Wang Jue; Li Qing; Shen Jun; Zhou Bin; Chen Lingyan; Jiang; Weiyang

1996-01-01

Low density SiO 2 gels are prepared by a two-step sol-gel process from TEOS. The influence of various solution ratios on the gelation process is investigated. The comparative characterization of gels using different solvent, such as ethanol, acetone and methyl cyanide, is also given. The ultralow-density SiO 2 aerogels with density less than 10 kg/m 3 are prepared by CO 2 supercritical drying technique. The structure difference between SiO 2 aerogels prepared by conventional single-step process and the two-step process is also presented

Draft Genome Sequences of Two Propionibacterium acnes Strains Isolated from Progressive Macular Hypomelanosis Lesions of Human Skin

DEFF Research Database (Denmark)

Petersen, Rolf; Lomholt, Hans B.; Scholz, Christian F. P.

2015-01-01

Propionibacterium acnes is a Gram-positive bacterium that is prevalent on human skin. It has been associated with skin disorders such as acne vulgaris and progressive macular hypomelanosis (PMH). Here, we report draft genome sequences of two type III P. acnes strains, PMH5 and PMH7, isolated from...

Two step continuous method to synthesize colloidal spheroid gold nanorods.

Science.gov (United States)

Chandra, S; Doran, J; McCormack, S J

2015-12-01

This research investigated a two-step continuous process to synthesize colloidal suspension of spheroid gold nanorods. In the first step; gold precursor was reduced to seed-like particles in the presence of polyvinylpyrrolidone and ascorbic acid. In continuous second step; silver nitrate and alkaline sodium hydroxide produced various shape and size Au nanoparticles. The shape was manipulated through weight ratio of ascorbic acid to silver nitrate by varying silver nitrate concentration. The specific weight ratio of 1.35-1.75 grew spheroid gold nanorods of aspect ratio ∼1.85 to ∼2.2. Lower weight ratio of 0.5-1.1 formed spherical nanoparticle. The alkaline medium increased the yield of gold nanorods and reduced reaction time at room temperature. The synthesized gold nanorods retained their shape and size in ethanol. The surface plasmon resonance was red shifted by ∼5 nm due to higher refractive index of ethanol than water. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of transdermal delivery of nanoemulsions in ex vivo porcine skin using two-photon microscopy and confocal laser-scanning microscopy

Science.gov (United States)

Choi, Sanghoon; Kim, Jin Woong; Lee, Yong Joong; Delmas, Thomas; Kim, Changhwan; Park, Soyeun; Lee, Ho

2014-10-01

This study experimentally evaluates the self-targeting ability of asiaticoside-loaded nanoemulsions compared with nontargeted nanoemulsions in ex vivo experiments with porcine skin samples. Homebuilt two-photon and confocal laser-scanning microscopes were employed to noninvasively examine the transdermal delivery of two distinct nanoemulsions. Prior to the application of nanoemulsions, we noninvasively observed the morphology of porcine skin using two-photon microscopy. We have successfully visualized the distributions of the targeted and nontargeted nanoemulsions absorbed into the porcine skin samples. Asiaticoside-loaded nanoemulsions showed an improved ex vivo transdermal delivery through the stratum corneum compared with nonloaded nanoemulsions. As a secondary measure, nanoemulsions-applied samples were sliced in the depth direction with a surgical knife in order to obtain the complete depth-direction distribution profile of Nile red fluorescence. XZ images demonstrated that asiaticoside-loaded nanoemulsion penetrated deeper into the skin compared with nontargeted nanoemulsions. The basal layer boundary is clearly visible in the case of the asiaticoside-loaded skin sample. These results reaffirm the feasibility of using self-targeting ligands to improve permeation through the skin barrier for cosmetics and topical drug applications.

Impact of first-step potential and time on the vertical growth of ZnO nanorods on ITO substrate by two-step electrochemical deposition

International Nuclear Information System (INIS)

Kim, Tae Gyoum; Jang, Jin-Tak; Ryu, Hyukhyun; Lee, Won-Jae

2013-01-01

Highlights: •We grew vertical ZnO nanorods on ITO substrate using a two-step continuous potential process. •The nucleation for the ZnO nanorods growth was changed by first-step potential and duration. •The vertical ZnO nanorods were well grown when first-step potential was −1.2 V and 10 s. -- Abstract: In this study, we analyzed the growth of ZnO nanorods on an ITO (indium doped tin oxide) substrate by electrochemical deposition using a two-step, continuous potential process. We examined the effect of changing the first-step potential as well as the first-step duration on the morphological, structural and optical properties of ZnO nanorods, measured via using field emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD) and photoluminescence (PL), respectively. As a result, vertical ZnO nanorods were grown on ITO substrate without the need for a template when the first-step potential was set to −1.2 V for a duration of 10 s, and the second-step potential was set to −0.7 V for a duration of 1190 s. The ZnO nanorods on this sample showed the highest XRD (0 0 2)/(1 0 0) peak intensity ratio and the highest PL near band edge emission to deep level emission peak intensity ratio (NBE/DLE). In this study, the nucleation for vertical ZnO nanorod growth on an ITO substrate was found to be affected by changes in the first-step potential and first-step duration

some generalized two-step block hybrid numerov method for solving ...

African Journals Online (AJOL)

Nwokem et al.

ABSTRACT. This paper proposes a class of generalized two-step Numerov methods, a block hybrid type for the direct solution of general second order ordinary differential equations. Both the main method and additional methods were derived via interpolation and collocation procedures. The basic properties of zero ...

Two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy.

Science.gov (United States)

Liu, Yu; Li, Ji-Jia; Zu, Peng; Liu, Hong-Xu; Yu, Zhan-Wu; Ren, Yi

2017-12-07

To introduce a two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy and assess its clinical application. One hundred and twenty-two patients with middle or lower esophageal cancer who underwent laparoscopic-thoracoscopic Ivor-Lewis esophagectomy at Liaoning Cancer Hospital and Institute from March 2014 to March 2016 were included in this study, and divided into two groups based on the procedure used for creating a gastric tube. One group used a two-step method for creating a gastric tube, and the other group used the conventional method. The two groups were compared regarding the operating time, surgical complications, and number of stapler cartridges used. The mean operating time was significantly shorter in the two-step method group than in the conventional method group [238 (179-293) min vs 272 (189-347) min, P creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy has the advantages of simple operation, minimal damage to the tubular stomach, and reduced use of stapler cartridges.

Skin absorption through atopic dermatitis skin

DEFF Research Database (Denmark)

Halling-Overgaard, A-S; Kezic, S; Jakasa, I

2017-01-01

Patients with atopic dermatitis have skin barrier impairment in both lesional and non-lesional skin. They are typically exposed to emollients daily and topical anti-inflammatory medicaments intermittently, hereby increasing the risk of developing contact allergy and systemic exposed to chemicals...... ingredients found in these topical preparations. We systematically searched for studies that investigated skin absorption of various penetrants, including medicaments, in atopic dermatitis patients, but also animals with experimentally induced dermatitis. We identified 40 articles, i.e. 11 human studies...... examining model penetrants, 26 human studies examining atopic dermatitis drugs and 3 animal studies. We conclude that atopic dermatitis patients have nearly two-fold increased skin absorption when compared to healthy controls. There is a need for well-designed epidemiological and dermato...

Clinical Assessment of Immediate and Long-Term Effects of a Two-Step Topical Hyaluronic Acid Lip Treatment.

Science.gov (United States)

Makino, Elizabeth T; Tan, Priscilla; Qian, Kun; Babcock, Michael; Mehta, Rahul C

2017-04-01

Key features of lip aging include loss of volume, color, and definition as well as increases in lines/wrinkles and uneven skin texture. A single-center, open-label clinical study was conducted to assess the efficacy and tolerability of a novel, topical two-step lip treatment (HA5 LS) in female subjects presenting with mild to moderate lip dryness and mild to severe lip condition. Subjects were instructed to apply HA5 LS at least three times a day to ensure coverage 8 hours a day for four weeks. Clinical assessments for efficacy and tolerability were conducted at baseline, baseline post-application, week 2, and week 4. Standardized digital photography, subject self-assessment questionnaires, and instrumentation measurements for skin hydration (corneometer) and lip plumpness (digital caliper) were also conducted. Thirty-six female subjects aged 22-40 years enrolled in the study. HA5 LS provided instant and long term effects, achieving significant improvements in all clinical grading parameters including lip texture, color, definition/contour, scaling, cupping, lines/wrinkles, lip plumpness, and overall lip condition from baseline post-application to week 4 (all P less than equal to .001; Wilcoxon signed-rank test). Instrumentation measurements for hydration and digital caliper at weeks 2 and 4 were also significant (all P less than equal to .032; paired t-test). HA5 LS was also well-tolerated and highly-rated by subjects throughout the study duration. Results from this study suggest that HA5 LS addresses the key features of lip aging, providing both instant and long-term benefits. J Drugs Dermatol. 2017;16(4):366-371..

Immunotherapy in viral warts with intradermal Bacillus Calmette–Guerin vaccine versus intradermal tuberculin purified protein derivative: A double-blind, randomized controlled trial comparing effectiveness and safety in a tertiary care center in Eastern India

Directory of Open Access Journals (Sweden)

Indrashis Podder

2017-01-01

Conclusion: Both intradermal Bacillus Calmette–Guerin and tuberculin purified protein derivative hold promise in the treatment of viral warts. Bacillus Calmette–Guerin may be more effective, though it had more adverse events in our study.

The roles of knitted mesh-reinforced collagen-chitosan hybrid scaffold in the one-step repair of full-thickness skin defects in rats.

Science.gov (United States)

Wang, Xingang; You, Chuangang; Hu, Xinlei; Zheng, Yurong; Li, Qiyin; Feng, Zhanzeng; Sun, Huafeng; Gao, Changyou; Han, Chunmao

2013-08-01

Full-thickness skin defects represent a significant and urgent clinical problem. Dermal substitutes serving as a regenerative template to induce dermal reconstruction provide a promising method to treat serious skin defects. Although collagen-chitosan dermal scaffolds display good biocompatibility and a suitable porous structure for angiogenesis and tissue regeneration, their poor mechanical properties compromise their application. To develop a well-supported dermal substitute, a poly(l-lactide-co-glycolide) (PLGA) knitted mesh was fabricated and integrated with collagen-chitosan scaffold (CCS) to obtain a PLGA knitted mesh-reinforced CCS (PLGAm/CCS). The morphology of this PLGAm/CCS was investigated in vitro. To characterize the tissue response, specifically angiogenesis and tissue regeneration, the PLGAm/CCS was transplanted in combination with thin split-thickness autografts to repair full-thickness skin wounds using a one-step surgical procedure in Sprague-Dawley rats. These results were then compared with CCSs. At weeks 2, 4 and 8 after the operation, the healing wounds were imaged to analyse wound changes, and tissue specimens were harvested for histology, immunohistochemistry, real-time quantitative polymerase chain reaction and Western blot analysis. The results demonstrated that collagen-chitosan sponge in the PLGAm/CCS remained porous, interconnected and occupied the openings of PLGA mesh, and the incorporation of the PLGA knitted mesh into CCS improved the mechanical strength with little influence on its mean pore size and porosity. Following transplantation, PLGAm/CCS inhibited wound contraction, and effectively promoted neotissue formation and blood vessel ingrowth. In conclusion, the mechanical strength of the scaffolds plays an important role in the process of tissue regeneration and vascularization. The ability of PLGAm/CCS to promote angiogenesis and induce in situ tissue regeneration demonstrates its potential in skin tissue engineering. Copyright

A Two-Step Theory of the Evolution of Human Thinking

Directory of Open Access Journals (Sweden)

Satne Glenda

2016-03-01

Full Text Available Social accounts of objective content, like the one advanced by Tomasello (2014, are traditionally challenged by an ‘essential tension’ (Hutto and Satne 2015. The tension is the following: while sociality is deemed to be at the basis of thinking, in order to explain sociality, some form of thinking seems to be necessarily presupposed. In this contribution I analyse Tomasello’s two-step theory of the evolution of human thinking vis-à-vis this challenge. While his theory is in principle suited to address it, I claim that the specifics of the first step and the notion of perspective that infuse it are problematic in this regard. I end by briefly sketching an alternative.

Using an isomorphic problem pair to learn introductory physics: Transferring from a two-step problem to a three-step problem

Directory of Open Access Journals (Sweden)

Shih-Yin Lin

2013-10-01

Full Text Available In this study, we examine introductory physics students’ ability to perform analogical reasoning between two isomorphic problems which employ the same underlying physics principles but have different surface features. 382 students from a calculus-based and an algebra-based introductory physics course were administered a quiz in the recitation in which they had to learn from a solved problem provided and take advantage of what they learned from it to solve another isomorphic problem (which we call the quiz problem. The solved problem provided has two subproblems while the quiz problem has three subproblems, which is known from previous research to be challenging for introductory students. In addition to the solved problem, students also received extra scaffolding supports that were intended to help them discern and exploit the underlying similarities of the isomorphic solved and quiz problems. The data analysis suggests that students had great difficulty in transferring what they learned from a two-step problem to a three-step problem. Although most students were able to learn from the solved problem to some extent with the scaffolding provided and invoke the relevant principles in the quiz problem, they were not necessarily able to apply the principles correctly. We also conducted think-aloud interviews with six introductory students in order to understand in depth the difficulties they had and explore strategies to provide better scaffolding. The interviews suggest that students often superficially mapped the principles employed in the solved problem to the quiz problem without necessarily understanding the governing conditions underlying each principle and examining the applicability of the principle in the new situation in an in-depth manner. Findings suggest that more scaffolding is needed to help students in transferring from a two-step problem to a three-step problem and applying the physics principles appropriately. We outline a few

Using an isomorphic problem pair to learn introductory physics: Transferring from a two-step problem to a three-step problem

Science.gov (United States)

Lin, Shih-Yin; Singh, Chandralekha

2013-12-01

In this study, we examine introductory physics students’ ability to perform analogical reasoning between two isomorphic problems which employ the same underlying physics principles but have different surface features. 382 students from a calculus-based and an algebra-based introductory physics course were administered a quiz in the recitation in which they had to learn from a solved problem provided and take advantage of what they learned from it to solve another isomorphic problem (which we call the quiz problem). The solved problem provided has two subproblems while the quiz problem has three subproblems, which is known from previous research to be challenging for introductory students. In addition to the solved problem, students also received extra scaffolding supports that were intended to help them discern and exploit the underlying similarities of the isomorphic solved and quiz problems. The data analysis suggests that students had great difficulty in transferring what they learned from a two-step problem to a three-step problem. Although most students were able to learn from the solved problem to some extent with the scaffolding provided and invoke the relevant principles in the quiz problem, they were not necessarily able to apply the principles correctly. We also conducted think-aloud interviews with six introductory students in order to understand in depth the difficulties they had and explore strategies to provide better scaffolding. The interviews suggest that students often superficially mapped the principles employed in the solved problem to the quiz problem without necessarily understanding the governing conditions underlying each principle and examining the applicability of the principle in the new situation in an in-depth manner. Findings suggest that more scaffolding is needed to help students in transferring from a two-step problem to a three-step problem and applying the physics principles appropriately. We outline a few possible strategies

Stress corrosion cracking resistance of aluminum alloy 7000 series after two-step aging

Directory of Open Access Journals (Sweden)

Jegdić Bore V.

2015-01-01

Full Text Available The effect of one step-and a new (short two-step aging on the resistance to stress corrosion cracking of an aluminum alloy 7000 series was investigated, using slow strain rate test and fracture mechanics method. Aging level in the tested alloy was evaluated by means of scanning electron microscopy and measurements of electrical resistivity. It was shown that the alloy after the new two-step aging is significantly more resistant to stress corrosion cracking. Values of tensile properties and fracture toughness are similar for both thermal states. Processes that take place at the crack tip have been considered. The effect of the testing solution temperature on the crack growth rate on the plateau was determined. Two values of the apparent activation energy were obtained. These values correspond to different processes that control crack growth rate on the plateau at higher and lower temperatures. [Projekat Ministarstva nauke Republike Srbije, br. TR 34028 i br. TR 34016

Delayed-type hypersensitivity skin test responses to PPD and other antigens among BCG-vaccinated HIV-1-infected and healthy children and adolescents.

Science.gov (United States)

Costa, Natalia Moriya Xavierda; Albuquerque, Maly de; Lins, Janaína Bacelar Acioli; Alvares-Junior, João Teixeira; Stefani, Mariane Martins de Araújo

2011-10-01

Among HIV-1-infected patients, CD4+ T cell counts are well-established markers of cell-mediated immunity. Delayed-type hypersensitivity (DTH) skin tests can be used to evaluate in vivo cell-mediated immunity to common antigens. DTH responses to tuberculin purified protein derivative (PPD), sporotrichin, trichophytin, candidin and streptokinase/streptodornase antigens were assessed. Thirty-six HIV-1-infected children/adolescents and 56 age- and sex-matched HIV-1/HIV-2-seronegative participants were tested. All participants had a BCG scar. Fisher's exact test was used to evaluate significant differences between groups (pPPD positivity prevailed among healthy participants (40/56, 71.4%). PPD reactivity in the HIV-1-positive group was 8.3% (pPPD induration was 2.5mm (range: 2-5mm) in the HIV-1 group and 6.0 mm among healthy participants (range: 3-15 mm). There was no correlation between PPD positivity and age. No correlation between CD4+ T cell counts and DTH reactivity was observed among HIV-1-infected patients. DTH skin test responses, including PPD reactivity, were significantly lower among HIV-1-infected participants compared to healthy controls, which likely reflects advanced disease and T cell depletion.

Effect of two-step aging on the mechanical properties of AA2219 DC cast alloy

Energy Technology Data Exchange (ETDEWEB)

Elgallad, E.M., E-mail: eelgalla@uqac.ca; Zhang, Z.; Chen, X.-G.

2015-02-11

With its combination of high specific strength, good machinability and excellent weldability, AA2219 direct chill (DC) cast alloy has become a new category of materials for manufacturing large molds for the plastics and automotive industries. The effect of two-step aging on the microstructural evolution and mechanical properties of AA2219 DC cast alloy was investigated. The precipitate microstructure was characterized under different heat treatment conditions using differential scanning calorimetry (DSC) and transmission electron microscopy (TEM). The poor mechanical properties of the air-quenched alloy were attributed to the presence of quench-induced coarse θ′ and θ precipitates, which had very limited contribution to the precipitation hardening during the aging treatment. The two-step aging treatment of the air-quenched AA2219 alloy involved the precipitation of GP zones in the first step followed by their transformation into fine θ″ strengthening precipitates in the second step, which considerably improved the mechanical properties. After undergoing 120 °C/36 h+190 °C/8 h two-step aging, the hardness, YS and UTS of the air-quenched alloy were increased by 27%, 46% and 15%, respectively, compared with 190 °C/8 h one-step aging.

Effectiveness of en masse versus two-step retraction: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Mumen Z. Rizk

2018-01-01

Full Text Available Abstract Background This review aims to compare the effectiveness of en masse and two-step retraction methods during orthodontic space closure regarding anchorage preservation and anterior segment retraction and to assess their effect on the duration of treatment and root resorption. Methods An electronic search for potentially eligible randomized controlled trials and prospective controlled trials was performed in five electronic databases up to July 2017. The process of study selection, data extraction, and quality assessment was performed by two reviewers independently. A narrative review is presented in addition to a quantitative synthesis of the pooled results where possible. The Cochrane risk of bias tool and the Newcastle-Ottawa Scale were used for the methodological quality assessment of the included studies. Results Eight studies were included in the qualitative synthesis in this review. Four studies were included in the quantitative synthesis. En masse/miniscrew combination showed a statistically significant standard mean difference regarding anchorage preservation − 2.55 mm (95% CI − 2.99 to − 2.11 and the amount of upper incisor retraction − 0.38 mm (95% CI − 0.70 to − 0.06 when compared to a two-step/conventional anchorage combination. Qualitative synthesis suggested that en masse retraction requires less time than two-step retraction with no difference in the amount of root resorption. Conclusions Both en masse and two-step retraction methods are effective during the space closure phase. The en masse/miniscrew combination is superior to the two-step/conventional anchorage combination with regard to anchorage preservation and amount of retraction. Limited evidence suggests that anchorage reinforcement with a headgear produces similar results with both retraction methods. Limited evidence also suggests that en masse retraction may require less time and that no significant differences exist in the amount of root

Microstructure and superconducting properties of Bi-2223/Ag tapes fabricated in the two-step sintering process

International Nuclear Information System (INIS)

Lu, X.Y.; Nagata, A.; Sugawara, K.

2008-01-01

The microstructure and superconducting properties of Bi-2223/Ag tapes fabricated in the two-step sintering process were investigated. The tapes were then subjected to two heat treatments with an intermediate rolling. All the tapes were sintered at 835 deg. C for 24 h at initial sintering stage. A two-step sintering procedure was then used in the final sintering stage. In the first step, the tapes are sintered at 840-865 deg. C for 1 h. In the second step, they were sintered at 835 deg. C for 120 h. The results show that the first step sintering temperature has significant influence on the microstructure and the critical current density J c . The observed microstructures are consistent well with the different J c performances of the tapes first-step-sintered at different temperatures. The tape first-step-sintered at 850 deg. C, which has small secondary phases, stronger c-axis grain alignment, higher proportion of Bi-2223 phase, and no cracks, exhibits the highest J c value

Skin Cancer

Science.gov (United States)

Skin cancer is the most common form of cancer in the United States. The two most common types ... face, neck, hands, and arms. Another type of skin cancer, melanoma, is more dangerous but less common. Anyone ...

Comparison of two kinds of skin imaging analysis software: VISIA® from Canfield and IPP® from Media Cybernetics.

Science.gov (United States)

Wang, X; Shu, X; Li, Z; Huo, W; Zou, L; Tang, Y; Li, L

2018-01-27

Skin imaging analysis, acting as a supplement to noninvasive bioengineering devices, has been widely used in medical cosmetology and cosmetic product evaluation. The main aim of this study is to assess the differences and correlations in measuring skin spots, wrinkles, vascular features, porphyrin, and pore between two commercially available image analysis software. Seventy healthy women were included in the study. Before taking pictures, the dermatologist evaluated subjects' skin conditions. Test sites included the forehead, cheek, and periorbital skin. A 2 × 2 cm cardboard was used to make a mark on the skin surface. Pictures were taken using VISIA ® under three kinds light conditions and analyzed using VISIA ® and IPP ® respectively. (1) Skin pore, red area, ultraviolet spot, brown spot, porphyrin, and wrinkle measured with VISIA ® were correlated with those measured with IPP ® (P < .01). (2) Spot, wrinkle, fine line, brown spot, and red area analyzed with VISIA ® were correlated with age on the forehead and periorbital skin (P < .05). L-value, Crow's feet, ultraviolet spot, brown spot, and red area analyzed with IPP ® were correlated with age on the periorbital skin (P < .05). (3) L-value, spot, wrinkle, fine line, porphyrin, red area, and pore analyzed with VISIA ® and IPP ® showed correlations with the subjective evaluation scores (P < .05). VISIA ® and IPP ® showed acceptable correlation in measuring various skin conditions. VISIA ® showed a high sensibility when measured on the forehead skin. IPP ® is available as an alternative software program to evaluate skin features. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Resistance of germfree athymic nude mice to two-stage skin carcinogenesis

Energy Technology Data Exchange (ETDEWEB)

Holland, J.M.; Perkins, E.H.

1979-01-01

Germfree athymic and normal littermate mice were compared with respect to their relative sensitivity to single skin application of dimethylbenzanthacine followed either by croton oil or TPA applied as a co-carcinogen. In separate experiments the acute response of both phenotypes to TPA was assessed by histologic examination of skin as well as the incorporttion of tritiated thymidine into acid insoluble material obtained from the isolated epidermis. Nude mice were observed to be less, equal, or more sensitive than normal littermate to topical skin carcinogenesis depending upon experimental variables. The tendency of solvent to spread rapidly on the skin of nude mice appeared to have the greatest influence on susceptibility to papilloma induction. Other factors of potential, although unproven importance, include differences in skin structure, possibly associated with accelerated activity of hair follicles as well as resistance to both the inflammatory and hyperplasiogenic effects of TPA.

Comparison of single-entry and double-entry two-step couple screening for cystic fibrosis carriers

NARCIS (Netherlands)

tenKate, LP; Verheij, JBGM; Wildhagen, MF; Hilderink, HBM; Kooij, L; Verzijl, JG; Habbema, JDF

1996-01-01

Both single-entry two-step (SETS) couple screening and double-entry two-step (DETS) couple screening have been recommended as methods to screen for cystic fibrosis gene carriers. In this paper we compare the expected results from both types of screening. In general, DETS results in a higher

Efficient Hydrolysis of Rice Straw into Xylose and Glucose by a Two-step Process

Directory of Open Access Journals (Sweden)

YAN Lu-lu

2016-07-01

Full Text Available The hydrolysis of rice straw into xylose and glucose in dilute sulfuric acid aqueous solution was studied with a two-step process in batch autoclave reactor. The results showed that compared with the traditional one-step acid hydrolysis, both xylose and glucose could be produced in high yields from rice straw by using the two-step acid hydrolysis process. The effects of reaction temperature, reaction time, the amount of rice straw and acid concentration on the hydrolysis of rice straw were systematically studied, and showed that except initial rice straw loading amount, the other parameters had remarkable influence on the products distribution and yields. In the first-step of the hydrolysis process, a high xylose yield of 162.6 g·kg-1 was obtained at 140℃ after 120 min reaction time. When the solid residues from the first step were subjected to a second-step hydrolysis, a glucose yield as high as 216.5 g·kg-1 could be achieved at 180℃ after 120 min. This work provides a promising strategy for the efficient and value-added utilization of agricultural wastes such as rice straw.

a Two-Step Classification Approach to Distinguishing Similar Objects in Mobile LIDAR Point Clouds

Science.gov (United States)

He, H.; Khoshelham, K.; Fraser, C.

2017-09-01

Nowadays, lidar is widely used in cultural heritage documentation, urban modeling, and driverless car technology for its fast and accurate 3D scanning ability. However, full exploitation of the potential of point cloud data for efficient and automatic object recognition remains elusive. Recently, feature-based methods have become very popular in object recognition on account of their good performance in capturing object details. Compared with global features describing the whole shape of the object, local features recording the fractional details are more discriminative and are applicable for object classes with considerable similarity. In this paper, we propose a two-step classification approach based on point feature histograms and the bag-of-features method for automatic recognition of similar objects in mobile lidar point clouds. Lamp post, street light and traffic sign are grouped as one category in the first-step classification for their inter similarity compared with tree and vehicle. A finer classification of the lamp post, street light and traffic sign based on the result of the first-step classification is implemented in the second step. The proposed two-step classification approach is shown to yield a considerable improvement over the conventional one-step classification approach.

Smoke regions extraction based on two steps segmentation and motion detection in early fire

Science.gov (United States)

Jian, Wenlin; Wu, Kaizhi; Yu, Zirong; Chen, Lijuan

2018-03-01

Aiming at the early problems of video-based smoke detection in fire video, this paper proposes a method to extract smoke suspected regions by combining two steps segmentation and motion characteristics. Early smoldering smoke can be seen as gray or gray-white regions. In the first stage, regions of interests (ROIs) with smoke are obtained by using two step segmentation methods. Then, suspected smoke regions are detected by combining the two step segmentation and motion detection. Finally, morphological processing is used for smoke regions extracting. The Otsu algorithm is used as segmentation method and the ViBe algorithm is used to detect the motion of smoke. The proposed method was tested on 6 test videos with smoke. The experimental results show the effectiveness of our proposed method over visual observation.

Association between the gait pattern characteristics of older people and their two-step test scores.

Science.gov (United States)

Kobayashi, Yoshiyuki; Ogata, Toru

2018-04-27

The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). It has been reported that the Two-Step test score has a good correlation with one's walking ability; however, its association with the gait pattern of older people during normal walking is still unknown. Therefore, this study aims to clarify the associations between the gait patterns of older people observed during normal walking and their Two-Step test scores. We analyzed the whole waveforms obtained from the lower-extremity joint angles and joint moments of 26 older people in various stages of locomotive syndrome using principal component analysis (PCA). The PCA was conducted using a 260 × 2424 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (ten trials of 26 participants, 101 time points, 4 angles, 3 axes, and 2 variable types per trial). The Pearson product-moment correlation coefficient between the scores of the principal component vectors (PCVs) and the scores of the Two-Step test revealed that only one PCV (PCV 2) among the 61 obtained relevant PCVs is significantly related to the score of the Two-Step test. We therefore concluded that the joint angles and joint moments related to PCV 2-ankle plantar-flexion, ankle plantar-flexor moments during the late stance phase, ranges of motion and moments on the hip, knee, and ankle joints in the sagittal plane during the entire stance phase-are the motions associated with the Two-Step test.

Identification and characterization of two dermorphins from skin extracts of the Amazonian frog Phyllomedusa bicolor.

Science.gov (United States)

Mignogna, G; Severini, C; Simmaco, M; Negri, L; Erspamer, G F; Kreil, G; Barra, D

1992-05-11

Skin extracts of South American hylid frogs of the subfamily Phyllomedusinae contain dermorphins and deltorphins, opioid heptapeptides highly selective for either mu or delta receptors. In all these peptides, a D-amino acid is present in the second position. The structure of the precursors for Ala-deltorphins was recently deduced from cloned cDNAs derived from skin of Phyllomedusa bicolor (Richter et al. (1990) Proc. Natl. Acad. Sci. USA 87, 4836-4839). From the amino acid sequence of these precursors, the existence of three peptides related to dermorphin could be predicted. From methanol extracts of skin of Ph. bicolor we have isolated two of these peptides, [Lys7]dermorphin-OH and [Trp4,Asn7]dermorphin-OH. The biological activity of these new dermorphins and their amidated counterparts is presented.

A two-step annealing process for enhancing the ferroelectric properties of poly(vinylidene fluoride) (PVDF) devices

KAUST Repository

Park, Jihoon; Kurra, Narendra; AlMadhoun, M. N.; Odeh, Ihab N.; Alshareef, Husam N.

2015-01-01

We report a simple two-step annealing scheme for the fabrication of stable non-volatile memory devices employing poly(vinylidene fluoride) (PVDF) polymer thin-films. The proposed two-step annealing scheme comprises the crystallization

Two-step bioleaching of copper and gold from discarded printed circuit boards (PCB).

Science.gov (United States)

Işıldar, Arda; van de Vossenberg, Jack; Rene, Eldon R; van Hullebusch, Eric D; Lens, Piet N L

2016-11-01

An effective strategy for environmentally sound biological recovery of copper and gold from discarded printed circuit boards (PCB) in a two-step bioleaching process was experimented. In the first step, chemolithotrophic acidophilic Acidithiobacillus ferrivorans and Acidithiobacillus thiooxidans were used. In the second step, cyanide-producing heterotrophic Pseudomonas fluorescens and Pseudomonas putida were used. Results showed that at a 1% pulp density (10g/L PCB concentration), 98.4% of the copper was bioleached by a mixture of A. ferrivorans and A. thiooxidans at pH 1.0-1.6 and ambient temperature (23±2°C) in 7days. A pure culture of P. putida (strain WCS361) produced 21.5 (±1.5)mg/L cyanide with 10g/L glycine as the substrate. This gold complexing agent was used in the subsequent bioleaching step using the Cu-leached (by A. ferrivorans and A. thiooxidans) PCB material, 44.0% of the gold was mobilized in alkaline conditions at pH 7.3-8.6, and 30°C in 2days. This study provided a proof-of-concept of a two-step approach in metal bioleaching from PCB, by bacterially produced lixiviants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Novel nanocarriers for topical drug delivery: investigating delivery efficiency and distribution in skin using two-photon microscopy

Science.gov (United States)

Kirejev, Vladimir; Guldbrand, Stina; Bauer, Brigitte; Smedh, Maria; Ericson, Marica B.

2011-03-01

The complex structure of skin represents an effective barrier against external environmental factors, as for example, different chemical and biochemical compounds, yeast, bacterial and viral infections. However, this impermeability prevents efficient transdermal drug delivery which limits the number of drugs that are able to penetrate the skin efficiently. Current trends in drug application through skin focus on the design and use of nanocarriers for transport of active compounds. The transport systems applied so far have several drawbacks, as they often have low payload, high toxicity, a limited variability of inclusion molecules, or long degradation times. The aim of these current studies is to investigate novel topical drug delivery systems, e.g. nanocarriers based on cyclic oligosaccharides - cyclodextrins (CD) or iron (III)-based metal-organic frameworks (MOF). Earlier studies on cell cultures imply that these drug nanocarriers show promising characteristics compared to other drug delivery systems. In our studies, we use two-photon microscopy to investigate the ability of the nanocarriers to deliver compounds through ex-vivo skin samples. Using near infrared light for excitation in the so called optical window of skin allows deep-tissue visualization of drug distribution and localization. In addition, it is possible to employ two-photon based fluorescence correlation spectroscopy for quantitative analysis of drug distribution and concentrations in different cell layers.

Study of CdTe quantum dots grown using a two-step annealing method

Science.gov (United States)

Sharma, Kriti; Pandey, Praveen K.; Nagpal, Swati; Bhatnagar, P. K.; Mathur, P. C.

2006-02-01

High size dispersion, large average radius of quantum dot and low-volume ratio has been a major hurdle in the development of quantum dot based devices. In the present paper, we have grown CdTe quantum dots in a borosilicate glass matrix using a two-step annealing method. Results of optical characterization and the theoretical model of absorption spectra have shown that quantum dots grown using two-step annealing have lower average radius, lesser size dispersion, higher volume ratio and higher decrease in bulk free energy as compared to quantum dots grown conventionally.

A two-step method for rapid characterization of electroosmotic flows in capillary electrophoresis.

Science.gov (United States)

Zhang, Wenjing; He, Muyi; Yuan, Tao; Xu, Wei

2017-12-01

The measurement of electroosmotic flow (EOF) is important in a capillary electrophoresis (CE) experiment in terms of performance optimization and stability improvement. Although several methods exist, there are demanding needs to accurately characterize ultra-low electroosmotic flow rates (EOF rates), such as in coated capillaries used in protein separations. In this work, a new method, called the two-step method, was developed to accurately and rapidly measure EOF rates in a capillary, especially for measuring the ultra-low EOF rates in coated capillaries. In this two-step method, the EOF rates were calculated by measuring the migration time difference of a neutral marker in two consecutive experiments, in which a pressure driven was introduced to accelerate the migration and the DC voltage was reversed to switch the EOF direction. Uncoated capillaries were first characterized by both this two-step method and a conventional method to confirm the validity of this new method. Then this new method was applied in the study of coated capillaries. Results show that this new method is not only fast in speed, but also better in accuracy. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Subciliary skin-muscle flap approach in patients with orbital fractures

Directory of Open Access Journals (Sweden)

Seyed Esmail Hassanpour

2008-06-01

Full Text Available Background: Selection of a suitable incision for orbital floor and medial wall fractures is one of the challenging problems in plastic surgery. The most frequently used is the subciliary step skin muscle incision with advantages including: adequate exposure and acceptable cosmetic result and disadvantages such as ectropion and skin necrosis.In this article we have tried to determine the rate of complications of this incision in a series of patients with orbital trauma that have been operated by the authors in 15khordad hospital during a three years period  (September 2000-september 2003.Methods: This retrospective review includes 52consecuative cases of orbital trauma (61 eye referred to our center who have been operated by authors. Step skin-muscle incision approach was used for reduction and fixation of orbital rim and floor fractures .These patients have been evaluated according to causes of fractures, kind and number of incisions, hospital stay, and complications of step skin-muscle incision. The mean duration of postoperative follow-up was two years.Results: Among the 52 patients reviewed, there were 48 males and 4 females; their mean age was 29 years (range: 15-67 years. Injuries were on the left side in 25 (49% patients, on the right side in 18(35% patients and both sides in 9 (16% patients. The main cause of trauma was car accident (50%. Six patients had scleral show 1-2 mm, five of them were managed by non