Estimated rates of progression to tuberculosis disease for persons infected with Mycobacterium tuberculosis in the United States.

BACKGROUND: In the United States, over 80% of tuberculosis (TB) disease cases are estimated to result from reactivation of latent TB infection (LTBI) acquired more than 2 years previously ("reactivation TB"). We estimated reactivation TB rates for the US population with LTBI, overall, by age, sex, race-ethnicity, and US-born status, and for selected comorbidities (diabetes, end-stage renal disease, and HIV). METHODS: We collated nationally representative data for 2011-2012. Reactivation TB incidence was based on TB cases reported to the National TB Surveillance System that were attributed to LTBI reactivation. Person-years at risk of reactivation TB were calculated using interferon-gamma release assay (IGRA) positivity from the National Health and Nutrition Examination Survey, published values for interferon-gamma release assay sensitivity and specificity, and population estimates from the American Community Survey. RESULTS: For persons aged ≥6 years with LTBI, the overall reactivation rate was estimated as 0.072 (95% uncertainty interval: 0.047, 0.12) per 100 person-years. Estimated reactivation rates declined with age. Compared to the overall population, estimated reactivation rates were higher for persons with diabetes (adjusted rate ratio [aRR] = 1.6 [1.5, 1.7]), end-stage renal disease (aRR = 9.8 [5.4, 19]), and HIV (aRR = 12 [10, 13]). CONCLUSIONS: In our study, individuals with LTBI faced small, non-negligible risks of reactivation TB. Risks were elevated for individuals with medical comorbidities that weaken immune function.

Action Recognition and Movement Direction Discrimination Tasks Are Associated with Different Adaptation Patterns.

The ability to discriminate between different actions is essential for action recognition and social interactions. Surprisingly previous research has often probed action recognition mechanisms with tasks that did not require participants to discriminate between actions, e.g., left-right direction discrimination tasks. It is not known to what degree visual processes in direction discrimination tasks are also involved in the discrimination of actions, e.g., when telling apart a handshake from a high-five. Here, we examined whether action discrimination is influenced by movement direction and whether direction discrimination depends on the type of action. We used an action adaptation paradigm to target action and direction discrimination specific visual processes. In separate conditions participants visually adapted to forward and backward moving handshake and high-five actions. Participants subsequently categorized either the action or the movement direction of an ambiguous action. The results showed that direction discrimination adaptation effects were modulated by the type of action but action discrimination adaptation effects were unaffected by movement direction. These results suggest that action discrimination and direction categorization rely on partly different visual information. We propose that action discrimination tasks should be considered for the exploration of visual action recognition mechanisms.