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Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.

This paper deals with a new design of a thermo-magnetically activated piezoelectric generator. This proposed generator exploits the temperature-dependent magnetization of a ferromagnetic material, which is exposed to temporary change of temperature cycles. To promote a better understanding of the operation of this mechanism, a global coupled numerical model is presented, which is able to predict the static and dynamic behavior of the generator. It is shown that with some modifications to the physical design, the generator can be tuned for different activation temperatures. Energy densities of 280 and 67 µJcm−3 were achieved by the proposed model of the generator for its opening and closing commutation, respectively.

Background. Invasive fungal diseases (IFD) caused by Cryptococcus and dimorphic fungi are associated with significant morbidity and mortality. Isavuconazole (ISAV) is a novel, broad-spectrum, triazole antifungal agent (IV and by mouth [PO]) developed for the treatment of IFD. It displays potent activity in vitro against these pathogens and in this report we examine outcomes of patients with cryptococcosis or dimorphic fungal infections treated with ISAV. Methods. The VITAL study was an open-label nonrandomized phase 3 trial conducted to evaluate the efficacy and safety of ISAV treatment in management of rare IFD. Patients received ISAV 200 mg 3 times daily for 2 days followed by 200 mg once-daily (IV or PO). Proven IFD and overall response at end of treatment (EOT) were determined by an independent, data-review committee. Mortality and safety were also assessed. Results. Thirty-eight patients received ISAV for IFD caused by Cryptococcus spp. (n = 9), Paracoccidioides spp. (n = 10), Coccidioides spp. (n = 9), Histoplasma spp. (n = 7) and Blastomyces spp. (n = 3). The median length of therapy was 180 days (range 2–331 days). At EOT 24/38 (63%) patients exhibited a successful overall response. Furthermore, 8 of 38 (21%) had stable IFD at the end of therapy without progression of disease, and 6 (16%) patients had progressive IFD despite this antifungal therapy. Thirty-three (87%) patients experienced adverse events. Conclusions. ISAV was well tolerated and demonstrated clinical activity against these endemic fungi with a safety profile similar to that observed in larger studies, validating its broad-spectrum in vitro activity and suggesting it may be a valuable alternative to currently available agents. Clinical Trials Registration. NCT00634049.

Tuberculosis (TB), considered an ancient disease, is still killing one person every 21 seconds. Diagnosis of Mycobacterium tuberculosis (M.tb) still has many challenges, especially in low and middle-income countries with high burden disease rates. Over the last two decades, the amount of drug-resistant (DR)-TB cases has been increasing, from mono-resistant (mainly for isoniazid or rifampicin resistance) to extremely drug resistant TB. DR-TB is problematic to diagnose and treat, and thus, needs more resources to manage it. Together with+ TB clinical symptoms, phenotypic and genotypic diagnosis of TB includes a series of tests that can be used on different specimens to determine if a person has TB, as well as if the M.tb strain+ causing the disease is drug susceptible or resistant. Here, we review and discuss advantages and disadvantages of phenotypic vs . genotypic drug susceptibility testing for DR-TB, advances in TB immunodiagnostics, and propose a call to improve deployable and low-cost TB diagnostic tests to control the DR-TB burden, especially in light of the increase of the global burden of bacterial antimicrobial resistance, and the potentially long term impact of the coronavirus disease 2019 (COVID-19) disruption on TB programs.

Exacerbations of chronic obstructive pulmonary disease (COPD) continue to place a considerable disease and financial burden on both patients and healthcare systems, particularly in low- and middle-income countries (LMICs). Therefore, preventing future exacerbations remains a key treatment goal. However, gaps remain in the standard of COPD care following exacerbations, despite the availability of evidence-based recommendations providing guidance on discharging patients from hospital or emergency department (ED) after a COPD exacerbation. To better understand these gaps in clinical practice, an advisory board meeting of 13 international pulmonologists was convened in September 2022, with the principal objective to formulate and recommend an evidence-based hospital discharge protocol following a COPD exacerbation, with a particular focus on LMICs. Based on identified gaps in COPD care, recommendations for alleviating the burden of exacerbations were proposed, which could be delivered as a discharge protocol for implementation in hospitals and/or ED. Following a review of the available clinical evidence, including an online survey of 11 pre-meeting questions and 5 additional questions discussed during the meeting, the key unmet needs identified by the experts included poor integration of standardized protocols in routine clinical practice, failure to ensure consistent delivery of post-discharge care, and lack of efficiently functioning healthcare systems. A protocol was formulated for delivery as part of a disease management program involving an interdisciplinary approach and a care bundle, aiming to address gaps in discharge-related care by determining the likelihood of readmission and optimizing maintenance treatment plans based on assessment of symptoms and future exacerbation risk. This can provide holistic care following hospital/ED discharge and personalized treatment plans by advocating referral to a specialist. To ensure wide-ranging uptake, implementation of a discharge protocol will need to be tailored to local healthcare settings by conducting feasibility studies, standardizing clinical pathways and healthcare policies, and engaging relevant stakeholders.

This article deals with modeling and characterization of a thermo-magnetically activated piezoelectric generator, we provide breakthrough in addressing the modeling issue of such power generators by reporting equivalent electrical circuit and its characterization. The circuit is based on the standard Butterworth van Dyke model. It includes mechanical, dielectric, and piezoelectric losses by using complex elastic, dielectric and piezoelectric constants that are obtained through fitting measured admittance of piezoelectric transducer. The model is developed of lumped circuits elements and it is valid under both parallel and series wired bimorph connection. Experimental and simulation results show good agreement, within 10.2% (for maximum output voltage), on the generator behavior for both the rectifier circuits implemented.

We report the design, fabrication, and characterization of a prototype that meets the form, fit, and function of a household 1.5 V AA battery, but which can be wirelessly recharged without removal from the host device. The prototype system comprises a low-frequency electrodynamic wireless power transmission (EWPT) receiver, a lithium polymer energy storage cell, and a power management circuit (PMC), all contained within a 3D-printed package. The EWPT receiver and overall system are experimentally characterized using a 238 Hz sinusoidal magnetic charging field and either a 1000 µF electrolytic capacitor or a lithium polymer (LiPo) cell as the storage cell. The system demonstrates a minimal operating field as low as 50 µTrms (similar in magnitude to Earth’s magnetic field). At this minimum charging field, the prototype transfers a maximum dc current of 50 µA to the capacitor, corresponding to a power delivery of 118 µW. The power effectiveness of the power management system is approximately 49%; with power effectiveness defined as the ratio between actual output power and the maximum possible power the EWPT receiver can transfer to a pure resistive load at a given field strength.

Background Community-acquired pneumonia (CAP) is considered the most important cause of death from infectious disease in developed countries. Severity assessment scores partially address the difficulties in identifying high-risk patients. A lack of specific and valid pathophysiologic severity markers affect early and effective sepsis therapy. HMGB-1, sRAGE and RAGE have been involved in sepsis and their potential as severity markers has been proposed. The aim of this study was to evaluate HMGB-1, RAGE and sRAGE levels in patients with CAP-associated sepsis and determine their possible association with clinical outcome. Method We evaluated 33 patients with CAP-associated sepsis admitted to the emergency room and followed in the medical wards. Severity assessment scores (CURB-65, PSI, APACHE II, SOFA) and serologic markers (HMGB-1, RAGE, sRAGE) were evaluated on admission. Results Thirty patients with a diagnosis of CAP-associated sepsis were enrolled in the study within 24 hours after admission. Fourteen (46.6%) had pandemic (H1N1) influenza A virus, 2 (6.6%) had seasonal influenza A and 14 other diagnoses. Of the patients in the study group, 16 (53.3%) had a fatal outcome. ARDS was observed in 17 (56.6%) and a total of 22 patients had severe sepsis on admission (73%). The SOFA score showed the greatest difference between surviving and non-surviving groups ( P = .003) with similar results in ARDS patients ( P = .005). sRAGE levels tended to be higher in non-surviving ( P = .058) and ARDS patients ( P = .058). Logistic regression modeling demonstrated that SOFA ( P = .013) and sRAGE ( P = .05) were the only variables that modified the probability of a fatal outcome. Conclusion The association of elevated sRAGE with a fatal outcome suggests that it may have an independent causal effect in CAP. SOFA scores were the only clinical factor with the ability to identify surviving and ARDS patients.

Is there a CD4+ and CD8+ immunity alteration in patients with pulmonary tuberculosis (TB) and diabetes (DM) that does not recover after antituberculosis treatment? This prospective comparative study evaluated CD4+ and CD8+ lymphocytic subpopulations and antituberculosis antibodies in patients with diabetes and tuberculosis (TB-DM), before and after antituberculosis treatment. CD4+ T cell counts were lower in patients with TB-DM compared to those with only TB or only DM, and these levels remained low even after two months of anti-TB treatment. Regarding the CD8+ T cell analysis, we identified higher blood values in the DM-only group, which may be explained by the high prevalence of latent tuberculosis (LTBI) in patients with DM. IgM antituberculosis antibodies levels were elevated in patients with only TB at baseline, and 2 months post-anti-TB treatment, IgG did not express any relevant alterations. Our results suggest an alteration in CD4+ immunity in patients with TB-DM that did not normalize after antituberculosis treatment.

This paper presents a hybrid electromechanical transformer that passively transfers electrical power between galvanically isolated ports by coupling electrodynamic and piezoelectric transducers. The use of these two complementary electromechanical transduction methods along with a high-Q mechanical resonance affords very large transformations of voltage, current, or impedance at particular electrical frequencies. A chip-size prototype is designed, simulated, fabricated, and experimentally characterized. The 7.6 mm × 7.6 mm × 1.65 mm device achieves an open-circuit voltage gain of 31.4 and 48.7 when operating as a step-up transformer at 729.5 Hz and 1015 Hz resonance frequencies, respectively. When operating as a step-down transformer, the resonance frequencies and the corresponding voltage gains are 728 Hz, 1002 Hz, and 0.0097, 0.0128, respectively. In one operational mode, the system shows a minimum power dissipation of only 0.9 µW corresponding to a power conversion efficiency of 11.8%.