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Positive ELISpot results predict subsequent development of active tuberculosis in recent tuberculosis contacts. Although tuberculosis contacts with positive ELISpot results have an incidence rate of tuberculosis similar to that of contacts with positive tuberculin skin test results, ELISpot testing could allow more focused targeting of preventive therapy to fewer contacts.

cWe developed and validated a real-time PCR assay consisting of 7 triplexed reactions to identify 11 individual serotypes plus 10 small serogroups representing the majority of disease-causing isolates of Streptococcus pneumoniae. This assay targets the 13 serotypes included within the 13-valent conjugate vaccine and 8 additional key serotypes or serogroups. Advantages over other serotyping assays are described. The assay will be expanded to 40 serotypes/serogroups. We will provide periodic updates at our protocol website.

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Purpose Loss and gain of function (GOF) mutations in human signal transducer and activator of transcription 1 (STAT1) lead to distinct phenotypes. Although recurrent infections are common to both types of STAT1 mutations, GOF mutations are distinguished by chronic mucocutaneous candidiasis and autoimmunity. However, the clinical spectra of STAT1 GOF mutations continue to expand. We here describe two patients with STAT1 GOF mutations presenting early in life with combined immunodeficiency (CID). Methods Clinical data and laboratory findings including immunophenotyping, level of interferon (IFN)-γ/IL-17+ T cells, interferon-induced STAT1 phosphorylation and JAK inhibitor assays were evaluated. Sequencing of STAT1 gene was performed by Sanger sequencer. Results Patient 1 (P1) had persistent oral candidiasis and cytomegalovirus (CMV) infection since 2 months of age, and later developed cavitary lung lesions due to Mycobacterium tuberculosis. Patient 2 (P2) presented with oral candidiasis and recurrent pneumonia at 4 months of age, and subsequently developed CMV pneumonitis. Both patients suffered heterozygous missense mutations in STAT1, leading to deleterious amino acid substitutions in the DNA binding domain (P1: c.1154C>T; p.T385M; P2. c.971G>T; p.C324F). Circulating CD4+ T cells of both patients exhibited increased interferon-γ and decreased IL-17 expression as compared to controls. They also exhibited increased IFN-β and -γ-induced STAT1 phosphorylation that was reversed upon treatment with the JAK kinase inhibitor Ruxolitinib. Conclusion STAT1 GOF mutations may present early in life with CID, consistent with the clinical heterogeneity of the disease. JAK kinase inhibitors may potentially be useful in some patients as adjunct therapy pending definitive treatment with bone marrow transplantation.

Background. The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul. Methods. An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant. Results. A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P = 0.02, OR: 1.504, CI 95%: 1.058–2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P < 0.05]. Conclusion. Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.

Airlines today use e-services extensively for marketing activities and the distribution of services. Monitoring and evaluating e-service quality are essential for customers’ satisfaction and thus the success of airlines. This study aims to evaluate e-service quality in the airline industry from the point of view of the consumers. To achieve this, an integrated Fuzzy Analytical Hierarchy Process (F-AHP) and Fuzzy Measurement Alternatives and Ranking according to Compromise Solution (F-MARCOS) approach was proposed to handle the uncertain and imprecise nature of e-service evaluation. In the first stage, e-service quality criteria were prioritized using the F-AHP method. Then, a real-world case study was carried out on scheduled airlines to demonstrate the applicability of the proposed approach using the F-MARCOS method, utilizing a total sample of 395 airline passengers in Turkey. As a result, the top three e-service criteria were found as reliability, understandability and security. A three-stage sensitivity analysis was also conducted to examine the credibility and stability of the results. This study is the first study to integrate F-AHP and F-MARCOS methods for the first time in literature.

A growing number of business and safety-critical services are delivered by computer systems designed to reconfigure in response to changes in workloads, requirements and internal state. In recent work, we showed how a formal technique called continual verification can be used to ensure that such systems continue to satisfy their reliability and performance requirements as they evolve, and we presented the challenges associated with the new technique. In this paper, we address important instances of two of these challenges, namely the maintenance of up-to-date reliability models and the adoption of continual verification in engineering practice. To address the first challenge, we introduce a new method for learning the parameters of the reliability models from observations of the system behaviour. This method is capable of adapting to variations in the frequency of the available system observations, yielding faster and more accurate learning than existing solutions. To tackle the second challenge, we present a new software engineering tool that enables developers to use our adaptive learning and continual verification in the area of service-based systems, without a formal verification background and with minimal effort.