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Abstract Introduction Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality. Case presentation A 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably. Conclusion This report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.

A new and high performance polytetrafluoroethylene (PTFE) digestor was designed and fabricated in-house for the total dissolution of granite samples for the determination of technology-critical elements (TCEs) by inductively coupled plasma optical emission spectrometry (ICP-OES). Initially, the granite sample (∼0.25 g) was placed in the PTFE digestor and added 8 mL(v/v) of 20%HF+40%HCl+10%HNO 3 acid mixture. After closing, the digestor was directly heated on a hotplate at ∼250 °C for about 2 h (hotplate digestion step (HDS)). Subsequently, the sample mixture was transferred to a graphite-bottom Teflon beaker for evaporation step (ES) at ∼180 °C to remove silica matrix followed by aqua regia treatment step (ATS) to the sample residue for the transformation of highly insoluble metal-fluoro complexes in to soluble chloro-complexes. After ATS, the sample residue was reconstituted in 3 mL of 60 % (v/v) aqua regia. The final sample digests were very clear and stable with no apparently visible fluoride precipitates indicating complete decomposition of different phases present in the granite matrix. The clear sample digests were analysed for REEs (La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Yb, Sc and Y), high field strength elements HFSEs (Ta, Ti, Zr, Nb, Hf and Th) by ICP-OES. The key parameters of the proposed digestion protocol were optimized for achieving quantitative recovery (>95 %). The proposed procedure was validated using granite based reference materials viz., NCSDC-73376, SARM-1 and JG-2. Various novelty aspects are involved in the present work which include (a) utilization of in-house PTFE digestor (b) hotplate heating with dilute acid mixtures (c) complete elimination of metal-fluoride precipitates (d) no need of expensive commercial bomb digestion systems and (e) total dissolution of granite sample for the determination of elements of highly technological relevance in ∼3 h which is much faster than what is achievable using prevailing conventional methods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In recent years, Attribute-Based Access Control (ABAC) has become quite popular and effective for enforcing access control in dynamic and collaborative environments. Implementation of ABAC requires the creation of a set of attribute-based rules which cumulatively form a policy. Designing an ABAC policy ab initio demands a substantial amount of effort from the system administrator. Moreover, organizational changes may necessitate the inclusion of new rules in an already deployed policy. In such a case, re-mining the entire ABAC policy requires a considerable amount of time and administrative effort. Instead, it is better to incrementally augment the policy. In this paper, we propose PAMMELA, a Policy Administration Methodology using Machine Learning to assist system administrators in creating new ABAC policies as well as augmenting existing policies. PAMMELA can generate a new policy for an organization by learning the rules of a policy currently enforced in a similar organization. For policy augmentation, new rules are inferred based on the knowledge gathered from the existing rules. A detailed experimental evaluation shows that the proposed approach is both efficient and effective.

Objectives: Early diagnosis of tuberculosis (TB) and multidrug-resistant TB (MDR-TB) is a priority for Viet Nam's National TB Control Programme. In many laboratories, quality systems are weak; few have attained accreditation. We implemented a structured training and mentoring program for TB laboratories and measured impact on quality., Methods: Six TB culture laboratories implemented the Strengthening TB Laboratory Management Towards Accreditation (TB SLMTA) program, consisting of three training workshops and on-site mentoring between workshops to support improvement projects. Periodic audits, using standardized checklists, monitored laboratories' progress toward accreditation readiness., Results: At baseline, all six laboratories achieved a zero-star level. At exit, five laboratories attained three stars and another one star. Overall checklist scores increased by 44.2% on average, from 29.8% to 74.0%; improvements occurred across all quality system essentials., Conclusions: The program led to improved quality systems. Sites should be monitored to ensure sustainability of improvements and country capacity expanded for national scaleup., (© American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Following the endorsement of the Xpert MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) by the World Health Organization (WHO) in 2010, Viet Nam's National Tuberculosis Control Program (NTP) began using GeneXpert instruments in NTP laboratories. In 2013, Viet Nam's NTP implemented an Xpert MTB/RIF external quality assurance (EQA) program in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and the Foundation for Innovative New Diagnostics (FIND). Proficiency-testing (PT) panels comprising five dried tube specimens (DTS) were sent to participating sites approximately twice a year from October 2013 to July 2016. The number of enrolled laboratories increased from 22 to 39 during the study period. Testing accuracy was assessed by comparing reported and expected results; percentage scores were assigned; and feedback reports were provided to sites. On-site evaluation (OSE) was conducted for underperforming laboratories. The results from the first five rounds demonstrate the positive impact of PT and targeted OSE visits on testing quality. On average, for every additional round of feedback, the odds of achieving PT scores of ≥80% increased 2.04-fold (95% confidence interval, 1.39- to 3.00-fold). Future work will include scaling up PT to all sites and maintaining the performance of participating laboratories while developing local panel production capacity.

Rapid diagnosis of tuberculous meningitis (TBM) is crucial as the disease outcome depends on the stage at which the treatment is initiated. The reliability of the available tests has not been established; thus, the present study was conducted to evaluate the conventional diagnostic tests as compared to the newer methods. Cerebrospinal fluid was collected from 100 children, and analyzed for various biochemical and cytological tests. The samples were subjected to Ziehl-Neelsen (Z-N) staining, Lowenstein-Jensen (L-J) culture, BACTEC culture and polymerase chain reaction (PCR). Twenty-two patients could be identified as definitive TBM based on the demonstration of Mycobacterium tuberculosis by BACTEC culture and PCR. Of these 22 cases, Z-N staining was positive in only two and L-J culture in six cases. Both the BACTEC culture and PCR had 100% agreement in the diagnosis of TBM. However, BACTEC culture could be a better diagnostic test as drug sensitivity can also be performed by this method.