The potential of a portable, point-of-care electronic nose to diagnose tuberculosis.

INTRODUCTION: Tuberculosis (TB) is the leading cause of death due to an infectious disease worldwide. Especially in low-income countries, new diagnostic techniques that are accessible, inexpensive and easy-to-use, are needed to shorten transmission time and initiate treatment earlier. OBJECTIVE: We conducted a study with a handheld, point-of-care electronic nose (eNose) device to diagnose TB through exhaled breath. SETTING: This study includes a total of 110 patients and visitors of an expert centre of respiratory diseases in Asunción, Paraguay. TB diagnosis was established by culture of Mycobacterium tuberculosis complex and compared with the eNose results in two phases. RESULTS: The calibration phase, including only culture confirmed TB cases versus healthy people, demonstrated a sensitivity and specificity of 91% and 93% respectively. The confirmation phase, including all participants, showed a sensitivity of 88% and a specificity of 92%. The eNose showed high acceptance rate among participants, and was easy to operate. CONCLUSION: The eNose resulted in a powerful technique to differentiate between healthy people and TB patients. Its comfort, speed and usability promise great potential in vulnerable groups, in remote areas and hospital settings to triage patients with suspicion of TB.

Time-integrated position error accounts for sensorimotor behavior in time-constrained tasks.

Several studies have shown that human motor behavior can be successfully described using optimal control theory, which describes behavior by optimizing the trade-off between the subject's effort and performance. This approach predicts that subjects reach the goal exactly at the final time. However, another strategy might be that subjects try to reach the target position well before the final time to avoid the risk of missing the target. To test this, we have investigated whether minimizing the control effort and maximizing the performance is sufficient to describe human motor behavior in time-constrained motor tasks. In addition to the standard model, we postulate a new model which includes an additional cost criterion which penalizes deviations between the position of the effector and the target throughout the trial, forcing arrival on target before the final time. To investigate which model gives the best fit to the data and to see whether that model is generic, we tested both models in two different tasks where subjects used a joystick to steer a ball on a screen to hit a target (first task) or one of two targets (second task) before a final time. Noise of different amplitudes was superimposed on the ball position to investigate the ability of the models to predict motor behavior for different levels of uncertainty. The results show that a cost function representing only a trade-off between effort and accuracy at the end time is insufficient to describe the observed behavior. The new model correctly predicts that subjects steer the ball to the target position well before the final time is reached, which is in agreement with the observed behavior. This result is consistent for all noise amplitudes and for both tasks.