The Sensitivity of Diagnostic Criteria of Marais S, et al. in Confirmed Childhood Tuberculous Meningitis

Wang, Mao‐Shui; Wang, Junli; Liu, Xin-Jie; Zhang, Yanan

doi:10.3389/fped.2022.832694

Cited by 7 publications

(9 citation statements)

References 24 publications

(29 reference statements)

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“…However, in this study, most CSF features were insensitive for the diagnosis of infant TBM, and all variables had an equal positivity of approximately 70%. Similarly, in a previous report, we found that there is a significant difference in the score for CSF features between children with probable and possible TBM who were confirmed by microbiological methods [ 22 ]. This finding confirms that childhood TBM has non-specific symptoms and that more CSF items should be introduced in the revised Marais criteria to improve its diagnostic accuracy for childhood TBM.…”

Section: Discussionsupporting

confidence: 80%

Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review

Hou

Liu

et al. 2022

Annals of Medicine

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Background Cerebrospinal fluid (CSF) examinations play an important role in the diagnosis of tuberculous meningitis (TBM). However, their yield in the diagnosis of infant TBM remains unclear. This scoping review aims to detail the role of CSF examination for the diagnosis of infant TBM. Methods A comprehensive literature search of PubMed, EBSCO, Embase, Scopus, Web of Science, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials was performed to identify articles published prior to October 14th, 2021. Articles describing the results of CSF exanimations among infant TBM were eligible for inclusion. Data extracted from each study included age, sex, CSF microbiological evidence (such as AFB smear, TB PCR, and TB culture), and routine CSF examinations (such as appearance, red blood cell count, white blood cell count, protein, and glucose). Results A total of 98 cases were included in the final analysis. The yield of microbiological methods was listed as follows: CSF AFB smear, 20.5% (9/44); CSF TB culture 47.5% (29/61); CSF TB PCR, 65.0% (26/40); the combination of them, 57.3% (47/82). According to Marais criteria, the positivities of CSF examinations were calculated as follows: WBC count (ref, 50–500/μL), 65.5% (55/84); lymphocyte predominance (ref, >0.5), 75.4% (49/65); total protein (ref, >100 mg/dL), 67.8% (59/87); glucose (ref, <2.2 mmol/L, or CSF/serum ratio < 0.5), 68.2% (58/85). Conclusions Our data demonstrated that routine microbiological tools for infant TBM diagnosis have a sensitivity ranging from 20.5% to 65.0%, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis. Key messages: Routine microbiological tools (such as acid-fast bacilli smear, PCR, and culture) have an unsatisfactory sensitivity for infant TBM diagnosis, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis.

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Section: Discussionsupporting

confidence: 80%

Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review

Hou

Liu

et al. 2022

Annals of Medicine

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“…Additionally, other bright FRBs were seen from SGR 1935+2154 without corresponding X-ray flares (Good & Chime/Frb Collaboration 2020;Kirsten et al 2021), though the X-ray upper limits are insufficient to be interesting. In 2022 another FRB from SGR 1935+2154 (Dong et al 2022) was seen in coincidence with an X-ray short burst (Wang et al 2022;. Continued monitoring of the high-energy sky is necessary to determine active and quiescent times of the Galactic magnetars and to provide contemporaneous observations of FRBs.…”

Section: The Origin and Physical Mechanism Of Fast Radio Burstsmentioning

confidence: 99%

Gamma-Ray Transient Network Science Analysis Group Report

Burns,

Fryer

2023

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The Interplanetary Network (IPN) is a detection, localization and alert system that utilizes the arrival time of transient signals in gamma-ray detectors on spacecraft separated by planetary baselines to geometrically locate the origin of these transients. Due to the changing astrophysical landscape and the new emphasis on time domain and multimessenger astrophysics (TDAMM) from the Pathways to Discovery in Astronomy and Astrophysics for the 2020s, this Gamma-ray Transient Network Science Analysis Group was tasked to understand the role of the IPN and high-energy monitors in this new era. The charge includes describing the science made possible with these facilities, tracing the corresponding requirements and capabilities, and highlighting where improved operations of existing instruments and the IPN would enhance TDAMM science. While this study considers the full multiwavelength and multimessenger context, the findings are specific to space-based high-energy monitors. These facilities are important both for full characterization of these transients as well as facilitating follow-up observations through discovery and localization. The full document reports the history of this field in Section 1, followed by our detailed analyses and findings in some 68 pages, providing a holistic overview of the role of the IPN and high-energy monitors in the coming decades.We here summarize our core conclusions. Scientific breakthroughs which require capable high-energy monitors are fully detailed in Section 2. Specific questions of interest include: unique example of NASA's Transform to Open Science initiative. Adding the numerous gamma-ray smallsats to the collaboration would allow for greater inclusion of the international community, ensure maximum gain of their data, act to facilitate inclusion of private data towards productive TDAMM results, and allow the United States to support the developing space capabilities in other countries.We identify a number of specific actions that could be taken by NASA to increase the TDAMM return of current, forthcoming, and future facilities, discussed in Section 4. These include:• Enhanced space-based communications: Providing additional communication contacts for gamma-ray burst monitors will lead to faster retrieval of data and data of higher quality (e.g. high resolution time-tagged event data). The immediate allocation of additional contacts for the Neil Gehrels Swift Observatory is important to discovery in the on-going gravitational-wave observing run (the capability was requested in the latest Senior Review round but not mentioned in the report). Similar improvements can be made to forthcoming Astrophysics missions like StarBurst and the Compton Spectrometer and Imager (COSI). This finding also applies to assets in NASA Planetary and Heliophysics, as well as missions led by other space agencies, where additional or more frequent contacts would boost the scientific return of the IPN and other TDAMM facilities. This provides an avenue for a TDAMM program built with international partn...

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“…Organic matter is one of the primary parameters controlling Hg sorption and mobility in natural aquatic systems due to the formation of extremely strong ionic bonding between Hg and reduced sulfur (S) or thiol groups (-SH) commonly present in aquatic organic matter (Ravichandran, 2004;Skyllberg et al, 2006;Wang et al, 2022). Mercury exfiltrating as inorganic Hg(II) with contaminated groundwater is expected to rapidly bind to organic sorption sites in the bottom sediments as well as algae and biofilms.…”

Section: Isotope Fractionation Mechanismsmentioning

confidence: 99%

Large extent of mercury stable isotope fractionation in contaminated stream sediments induced by changes of mercury binding forms

Schwab¹,

Rothe²,

McLagan³

et al. 2022

Front. Environ. Chem.

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Mercury (Hg) release from contaminated legacy sites is a large contributor to riverine ecosystems and can represent a significant local and regional environmental issue even long after the initial site contamination. Understanding processes of in-stream species transformation is therefore important to assess the fate and bioavailability of the released Hg. In this study, we investigated in-stream Hg transformation processes with analyses of Hg binding forms and Hg stable isotopes. Stream sediments were collected downstream of a former kyanization facility (Black Forest, SW Germany), where highly soluble Hg(II)-chloride (HgCl2) was used as an anti-fouling agent to treat timber. Exfiltration of partly anoxic, contaminated groundwater with Hg concentrations of up to 700 μg L−1 into the adjacent Gutach stream is the main source of Hg to sediments. Total Hg concentrations in the stream bottom sediments (<2 mm) ranged from background values of 6.3 µg kg−1 upstream of the contaminated site to 77 mg kg−1 near the location of exfiltration of contaminated groundwater. A five-step sequential extraction procedure and Hg pyrolytic thermal desorption (PTD) analyses indicated changes in Hg binding forms in the sediments along the flow path towards a higher proportion of organically bound Hg. A large shift towards negative δ202Hg values was observed downstream of the contaminated site (change of ≈2‰) along with a minor offset in mass-independent fractionation. Binary mixing models based on Hg isotope ratios using one industrial and different natural background endmembers were tested to estimate their respective contribution of Hg to the sediments but failed to produce plausible allocations. Based on the observed changes in isotopic composition, total Hg concentrations and Hg binding forms, we propose that the large extent of fractionation observed in downstream sediments is the result of a combination of kinetic isotope effects during sorption, redistribution of Hg within the sediment and the preferential transport of Hg associated with the sediment fine fraction. These results highlight the importance of transformation processes when assessing the sources and fate of Hg in environmental systems and show limitations of using simple mixing models based on Hg stable isotopes.

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The Sensitivity of Diagnostic Criteria of Marais S, et al. in Confirmed Childhood Tuberculous Meningitis

Cited by 7 publications

References 24 publications

Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review

Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review

Gamma-Ray Transient Network Science Analysis Group Report

Large extent of mercury stable isotope fractionation in contaminated stream sediments induced by changes of mercury binding forms

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