Male Sex Is Associated With Worse Microbiological and Clinical Outcomes Following Tuberculosis Treatment: A Retrospective Cohort Study, a Systematic Review of the Literature, and Meta-analysis.

BACKGROUND: Although the incidence of tuberculosis is higher in men than in women, the relationship of sex with tuberculosis treatment outcomes has not been adequately studied. METHODS: We performed a retrospective cohort study and a systematic review and meta-analysis of observational studies during the last 10 years to assess sex differences in clinical and microbiological outcomes in tuberculosis. RESULTS: In our cohort of 2894 Taiwanese patients with drug-susceptible pulmonary tuberculosis (1975 male and 919 female), male patients had higher adjusted hazards of 9-month mortality due to all causes (hazard ratio, 1.43 [95% confidence interval (CI), 1.03-1.98]) and infections (1.70 [1.09-2.64]) and higher adjusted odds of 2-month sputum culture positivity (odds ratio [OR], 1.56 [95% CI, 1.05-2.33]) compared with female patients. Smear positivity at 2 months did not differ significantly (OR, 1.27 [95% CI, .71-2.27]) between the sexes. Among 7896 articles retrieved, 398 were included in our systematic review describing a total of 3 957 216 patients. The odds of all-cause mortality were higher in men than in women in the pooled unadjusted (OR, 1.26 [95% CI, 1.19-1.34]) and adjusted (1.31 [1.18-1.45]) analyses. Men had higher pooled odds of sputum culture (OR, 1.44 [95% CI, 1.14-1.81]) and sputum smear (1.58 [1.41-1.77]) positivity, both at the end of the intensive phase and on completion of treatment. CONCLUSIONS: Our retrospective cohort showed that male patients with tuberculosis have higher 9-month all-cause and infection-related mortality, with higher 2-month sputum culture positivity after adjustment for confounding factors. In our meta-analysis, male patients showed higher all-cause and tuberculosis-related mortality and higher sputum culture and smear positivity rates during and after tuberculosis treatment.

Observations of new particle formation, modal growth rates, and direct emissions of sub-10 nm particles in an urban environment.

Ultrafine particles with diameters less than 100 nm suspended in the air are a topic of interest in air quality and climate sciences. Sub-10 nm particles are of additional interest due to their health effects and contribution to particle growth processes. Ambient measurements were carried out at North Carolina State University in Raleigh, NC between April to June 2019 and November 2019 to May 2020 to investigate the temporal variability of size distribution and number concentration of ultrafine particles. A mobile lab was deployed between March and May 2020 to characterize the spatial distribution of sub-10 nm particle number concentration. New particle formation and growth events were observed regularly. Also observed were direct emissions of sub-10 nm particles. Analysis against meteorological variables, gas-phase species, and particle concentrations show that the sub-10nm particles dominated number concentration during periods of low planetary boundary layer height, low solar radiation, and northeast winds. The spatial patterns observed during mobile deployments suggest that multiple temporally stable and spatially confined point sources of sub-10 nm particles are present within the city. These sources likely include the campus utility plants and the Raleigh-Durham International Airport. Additionally, the timing of data collection allowed for investigation of variations in the urban aerosol number size distribution due to reduced economic activity during the COVID-19 pandemic.