Digital Commons Network^™

Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez

Dissertations and Theses (Open Access)

Sickle cell anemia contributes substantially to childhood morbidity and mortality in sub-Saharan Africa, where there are scarce health resources and inadequate awareness among healthcare providers and the community. Without early diagnosis and initiation of preventive treatments, most infants will die of acute complications before their fifth birthday. Information on the mortality associated with sickle cell anemia is excluded from global statistical summaries due to the lack of accurate data, making sickle cell anemia an invisible killer of children on the African continent. Information from long-term large-scale sickle cell screening efforts is not yet available in Africa; therefore, a mixed-methods study …

The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin

Dissertations and Theses (Open Access)

Higher dietary fat intake and alterations in fatty acid metabolism may affect cancer development and progression. This dissertation conducted a series of studies examining whether dietary fat intake and genetic variants in fatty acid metabolism genes have an impact on clinical outcomes among non-Hispanic whites newly diagnosed with non-small cell lung cancer (NSCLC). First, a cohort of 2,262 NSCLC patients was prospectively examined for intakes of total, saturated, monounsaturated, and polyunsaturated fat in relation to overall survival and recurrence. Dietary fat intake at diagnosis was assessed with a previously validated food frequency questionnaire and categorized by Dietary Reference Intakes. Multivariable …

Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson

Dissertations and Theses (Open Access)

The overall decline in physical activity levels during adolescence supports the examination of intrapersonal-, interpersonal-, and behavior-level factors that may influence physical activity behavior among this population. The three papers within this dissertation aimed to examine associations of socio-demographics and socio-environmental factors with physical activity among U.S. adolescents. Papers 1 and 3 used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Paper 1 examined differences in adolescent physical activity by gender and race/ethnicity, and examined modification by grade and socioeconomic status (SES). Paper 3 examined the association of parent- and adolescent-reported parental social support with adolescent …

Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin

Dissertations and Theses (Open Access)

PURPOSE: Cancer survivors have complex journeys following the completion of active treatment. The Institute of Medicine and other high-profile organizations have recommended and mandated the use of a survivorship care plan (SCP) despite mixed evidence supporting the impact of SCPs on key survivor-level outcomes. The purpose of this dissertation was to understand the complex relationship linking the delivery of SCPs and to relevant survivorlevel outcomes. STUDY GROUP: This dissertation focuses on breast and colorectal cancer survivors because they comprise nearly 30% of the entire cancer survivor population in the US and are the two most prevalent cancers in men and …

Structural Basis Of Amino Acid Surveillance By Higher-Order Trna-Mrna Interactions, Shuang Li, Zhaoming Su, Jean Lehmann, Vassiliki Stamatopoulou, Nikoleta Giarimoglou, Frances E Henderson, Lixin Fan, Grigore D Pintilie, Kaiming Zhang, Muyuan Chen, Steven J Ludtke, Yun-Xing Wang, Constantinos Stathopoulos, Wah Chiu, Jinwei Zhang

Faculty, Staff and Students Publications

Amino acid availability in Gram-positive bacteria is monitored by T-box riboswitches. T-boxes directly bind tRNAs, assess their aminoacylation state, and regulate the transcription or translation of downstream genes to maintain nutritional homeostasis. Here, we report cocrystal and cryo-EM structures of Geobacillus kaustophilus and Bacillus subtilis T-box-tRNA complexes, detailing their multivalent, exquisitely selective interactions. The T-box forms a U-shaped molecular vise that clamps the tRNA, captures its 3' end using an elaborate 'discriminator' structure, and interrogates its aminoacylation state using a steric filter fashioned from a wobble base pair. In the absence of aminoacylation, T-boxes clutch tRNAs and form a continuously …

Deconvolute Brain Tumor Genomic Alterations Based On Dna Methylation, Jie Yang

Dissertations and Theses (Open Access)

Molecular classification based on mutations, expression subtypes, and copy number variants has improved diagnosis and treatment decision-making for patients with brain tumors, particularly malignant gliomas. However, the association between epigenetic signature and genetic alterations is poorly understood. For example, mutation of isocitrate dehydrogenase (IDH) is associated with genome-wide hypermethylation of CpG islands in gliomas. But other subtype-associated alterations, including telomerase reverse transcriptase (TERT) promoter mutation, alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation, chromosome 1p19q co-deletion (chr1p19q codel), and gene expression subtypes, have yet to be associated with any epigenetic signature. Therefore, we hypothesized that …

Integrating Primary Care Into Community Mental Health Centres In Texas, Usa: Results Of A Case Study Investigation, Rebecca Wells, Ellen D Breckenridge, Sasha Ajaz, Aman Narayan, Daniel Brossart, James H Zahniser, Jolene Rasmussen

Faculty, Staff and Student Publications

INTRODUCTION: Despite evidence that people with serious mental illness benefit from receiving primary care within mental health care settings, there is little research on this type of integration. The objective of this study was to characterize how providers and patients experienced implementation of primary care into specialty mental health services.

METHODS: During site visits, study team members interviewed staff and conducted focus groups with patients at 10 United States community mental health centres then beginning to integrate primary into their practices. One year later, follow up phone interviews with key centre staff informants validated and updated findings. Data analysis included …

Tinnitus And Self-Perceived Hearing Handicap In Firefighters: A Cross-Sectional Study, Samson Jamesdaniel, Kareem G Elhage, Rita Rosati, Samiran Ghosh, Bengt Arnetz, James Blessman

Faculty, Staff and Student Publications

Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. …

Energy Balance Related Lifestyle Factors And Risk Of Endometrial And Colorectal Cancer Among Individuals With Lynch Syndrome: A Systematic Review, Adriana M Coletta, Susan K Peterson, Leticia A Gatus, Kate J Krause, Susan M Schembre, Susan C Gilchrist, Mala Pande, Eduardo Vilar, Y Nancy You, Miguel A Rodriguez-Bigas, Larkin L Strong, Patrick M Lynch, Karen H Lu, Karen Basen-Engquist

Faculty, Staff and Student Publications

Lifestyle factors related to energy balance, such as excess body weight, poor diet, and physical inactivity, are associated with risk of sporadic endometrial cancer (EC) and colorectal cancer (CRC). There are limited data on energy balance-related lifestyle factors and EC or CRC risk among individuals with lynch syndrome, who are at extraordinarily higher risk of developing EC or CRC. We conducted a systematic review of evidence related to weight status, weight change, dietary habits, and physical activity on EC and CRC risk among individuals with lynch syndrome. Findings are reported narratively. We searched Medline, EMBASE, CENTRAL, PubMed, and clinicaltrials.gov up …

9th Annual Postdoctoral Science Symposium, University Of Texas Md Anderson Cancer Center Postdoctoral Association

Annual Postdoctoral Science Symposium Abstracts

The mission of the Annual Postdoctoral Science Symposium (APSS) is to provide a platform for talented postdoctoral fellows throughout the Texas Medical Center to present their work to a wider audience. The MD Anderson Postdoctoral Association convened its inaugural Annual Postdoctoral Science Symposium (APSS) on August 4, 2011.

The APSS provides a professional venue for postdoctoral scientists to develop, clarify, and refine their research as a result of formal reviews and critiques of faculty and other postdoctoral scientists. Additionally, attendees discuss current research on a broad range of subjects while promoting academic interactions and enrichment and developing new collaborations.

First Foods Nutrition Curriculum For New Immigrant Families: A Pilot Study, Elizabeth E. Dawson-Hahn M.D., Mph, Lorren Koceja Rd, Cd, Abigail R. Grant M.D., Anisa Ibrahim M.D., Beth Farmer Lcsw, H. Mollie Grow M.D., Mph, Sarah Lowry Phd, Mph, Suzinne Pak-Gorstein Phd, Mph

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Immigrant families arrive in the US from a variety of nutritional landscapes and educational experiences. Early childhood is a key time to intervene to set children on a healthy path. Creating nutritional education programs tailored for immigrant families may improve nutrition and health outcomes.

Objective: To evaluate the First Foods curriculum as a tool for knowledge and behavior change for new immigrant families of young children.

Methods: Immigrant caregivers of children less than 2 years old were invited to attend First Foods, a 4-class series. Each series was offered in 1 of 5 different languages (Arabic, Dari, Somali, Burmese, …

Discrimination Against Mixed-Status Families And Its Health Impact On Latino Children, Margaret A. Singer Ba, Manuela Gutierrez Velez Bs, Scott D. Rhodes Phd, Mph, Julie M. Linton M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background and Objective: Restrictive immigration policies and discrimination are associated with negative health outcomes for immigrant and Latino families. Mixed-status families represent a unique subpopulation of Latinos affected by restrictive immigration policies. This qualitative study explored discrimination against mixed-status families and its potential health impact on Latino children from the perspective of Latina mothers.

Methods: In 2017, twenty in-depth interviews with Latina mothers of mixed-status families living in northwestern North Carolina were conducted, transcribed, and analyzed. Constant comparison, an approach to grounded theory development, was used.

Results: Nine themes emerged that reflected experiences with discrimination and its …

Implications For Immigrant Child Health: Creating Evidence-Based Practice In A Changing Environment, Robert Sanborn Edd, Christopher Greeley

Journal of Applied Research on Children: Informing Policy for Children at Risk

Executive Editors, Dr. Robert Sanborn and Dr. Christopher Greeley, discuss the implications of research presented in the Journal of Applied Research on Children 10 (1) regarding the well being of immigrant children.

Infant With Protein C Deficiency And Stroke In The Setting Of Iron Deficiency Anemia, Tahseen Jalal Karim, Dustin J Paul, Regina M Troxell, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

We report an 18-month-old infant with ischemic stroke, neurocognitive impairment, and psychomotor retardation in the setting of severe iron deficiency anemia. Although an uncommon outcome in anemic children, stroke is important to consider as a cause for developmental delay in children with iron deficiency anemia.

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Indications For Lung Transplant Referral And Listing, Omar Shweish, Goutham Dronavalli

Faculty, Staff and Student Publications

Lung transplantation is a valuable therapeutic option for many patients with severe lung disease who have exhausted other medical or surgical therapies. However, since lungs are not a manufacturable organ like artificial heart valves or left ventricular assist devices, and since they are a limited resource compared to number of patients requiring the organs, the Department of Health and Human Services set the Final Rule of organ allocation in 1998. This led to development and implementation of Lung Allocation Score (LAS) in 2005. The score broadly divides lung diseases into 4 diagnostic criteria with a coefficient factor given to each …

Utilizing Temporal Information In The Ehr For Developing A Novel Continuous Prediction Model, Kang Lin Hsieh

Dissertations and Theses (Open Access)

Type 2 diabetes mellitus (T2DM) is a nation-wide prevalent chronic condition, which includes direct and indirect healthcare costs. T2DM, however, is a preventable chronic condition based on previous clinical research. Many prediction models were based on the risk factors identified by clinical trials. One of the major tasks of the T2DM prediction models is to estimate the risks for further testing by HbA1c or fasting plasma glucose to determine whether the patient has or does not have T2DM because nation-wide screening is not cost-effective.

Those models had substantial limitations on data quality, such as missing values. In this dissertation, I …

Children As Pawns Of Us Immigration Policy, Sarah Polk M.D., Scm, Mhs, Shamelle Richards, Mary Ann Hernando, Margaret Moon M.D., Joshua Sharfstein M.D.

Journal of Applied Research on Children: Informing Policy for Children at Risk

The highly publicized imposition and retraction of the “family separation” border policy by the current U.S. Administration was not an anomaly in U.S. history. In this manuscript, we place these troubling recent events in the context of decades of U.S. immigration policies and politics. We then describe the consequences of family separation and other current immigration policies on child health. We end with a call to action: Pediatricians and other advocates for child health should demand a new direction in immigration policy that stops the use of children as pawns. Instead, the United States should adopt as a fundamental guiding …

Mhealth Childhood Obesity Prevention: A Look Into The Hispanic Mother’S Perspective, Veronica Isabel Gonzalez

Dissertations and Theses (Open Access)

Along with increasing physical activity, improving nutrition is an important behavior to target to reduce the risk of obesity in children and adolescents. To date, a nutrition-focused mHealth intervention used to promote obesity prevention and healthy living among Hispanic children and adolescents has not been specifically developed for Hispanic mothers. The purpose of this study was to provide information on feasibility and acceptability of a mHealth child nutrition intervention among Hispanic mothers. The data was collected from an online survey and telephone interviews from 30 mothers of 8-12-year-old Hispanic girls. Most mothers were 40 years old or younger (70%), identified …

The Impact Of Food Security Status On The Food Shopping Behavior And Patterns Of 2018 Brighter Bites Participants At Baseline, Sarah A. Crulcich

Dissertations and Theses (Open Access)

Households with children continue to have a greater prevalence of food insecurity compared to the national average. While the national food security rates have improved in recent years, it remains stagnant among children. The purpose of this study was to conduct a cross-sectional regression analysis on food shopping patterns and behavior among Brighter Bites participants stratified by food security status to offer more insight into how these households obtain fresh produce. We used baseline survey data from Brighter Bites participants completed during fall 2018. The results indicate that food insecure Brighter Bites households shop more frequently for produce at locations …

Tuberculosis Among Dairy Workers In Bailey County, Texas, Anabel Rodriguez

Dissertations and Theses (Open Access)

On January 2016, Texas State Department of Health Services (DSHS) Public Health Region 1 (PHR 1) conducted T-SPOT.TB tests in response to two requests to screen dairy workers potentially exposed to cattle infected with Mycobacterium bovis or bovine tuberculosis (bTB) in Bailey County, Texas. Out of 140 workers tested, 14 had confirmed latent tuberculosis infection (LTBI)—prevalence of 10.0%. This first study gave rise to questions concerning tuberculosis (TB) knowledge and exposure history among dairy workers in this same county. The second study focused on determining TB knowledge among dairy workers through a series of questions administered by research personnel on …

Evaluation Of Food Journal Application Validity In Comparison With Dhq Iii, Michael Roa

Dissertations and Theses (Open Access)

As chronic conditions associated with the high prevalence of obesity/overweight in the United States continue to rise, research focusing on nutrition has grown in recent years. The gold standard for collecting detailed nutritional information on individuals is food journals, mostly via pen and paper. Alternatively, smartphone food journal applications have become more popular and widely accessible in recent years. These applications allow the user to quickly make meal entries, often taking advantage of the application’s food and servings database.

This study compared the results of the third iteration of the Diet History Questionnaire (DHQ III) with a dietary journal data …

Oxidative Phosphorylation: A Critical Feature And Novel Therapeutic Target In Melanoma Brain Metastases, Grant Fischer

Dissertations and Theses (Open Access)

We recently showed via RNA-sequencing (RNA-seq) analysis of clinical samples that melanoma brain metastases (MBMs) have higher expression of oxidative phosphorylation (OXPHOS) genes (including PPARGC1A or PGC1α) than patient-matched extracranial metastases (ECMs). Thus, the central hypothesis of this dissertation is that OXPHOS plays a critical role in the pathogenesis of MBMs.

RNA-seq analysis identified increased expression of OXPHOS genes in intracranial (ICr) vs. subcutaneous (SQ) xenografts of 4 different human melanoma cell lines. Increased OXPHOS in the ICr xenografts was confirmed by direct metabolite analysis and [U-¹³C]-glucose tracing analysis. Together, these studies indicate that the brain TME …

Fasting Reduces Intestinal Radiotoxicity Enabling Dose-Escalated Radiotherapy For Pancreatic Cancer, Marimar De La Cruz Bonilla

Dissertations and Theses (Open Access)

Surgical resection is the only potentially curative treatment for pancreatic cancer, but only 15-20% of patients have resectable tumors. In unresectable cases, stereotactic body radiotherapy (SBRT) may be used to give tumor-directed radiotherapy (RT). Unfortunately, this can cause severe gastrointestinal (GI) toxicity due to proximity of the pancreatic head to the duodenum. Protecting the intestine from the toxic side-effects of radiation may enable dose-escalation that could achieve more effective local control of disease. We and others have previously shown that a fast of 24 hours protects mice from lethal doses of the DNA-damaging agent etoposide. In this study, we demonstrate …

Health Coaching To Encourage Obese Adults To Enroll In Commercially-Available Weight Management Programs: The Path To Health Study, Natalia I Heredia, Minjae Lee, Kevin O Hwang, Belinda M Reininger, Maria E Fernandez, Lorna H Mcneill

Faculty, Staff and Student Publications

Physicians are recommended to screen and refer obese patients to weight management programs (WMPs). There are often limited referral options for physicians, though commercially-available WMPs could be a potential solution. The purpose of this study (Path to Health) was to evaluate the efficacy of health coaching to promote enrollment in commercially-available WMPs through a two-arm, RCT with obese patients (n = 168) randomly assigned to intervention (n = 84) or control groups (n = 84). Intervention participants received phone health coaching to help them select and enroll in WMPs. We collected data on program enrollment, weight, self-reported physical activity (PA), …

The Society Of Abdominal Radiology At 10 Years: Reflections, Status Report, And Look To The Future, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes

Faculty, Staff and Student Publications

CONTEXT.—: Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV.

OBJECTIVES.—: To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies.

DESIGN.—: Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history.

RESULTS.—: Fifty-two cases (24% of all tested, …

The Influence Of Vitamin D Supplementation On Local And Systemic Inflammatory Markers In Periodontitis Patients: A Pilot Study, Mohamed M Meghil, Lance Hutchens, Anas Raed, Neha A Multani, Mythilypriya Rajendran, Haidong Zhu, Stephen Looney, Mahmoud Elashiry, Roger M Arce, Mark E Peacock, Yanbin Dong, Christopher W Cutler

Faculty, Staff and Student Publications

OBJECTIVES: Vitamin D deficiency/insufficiency is a worldwide public health issue that has been linked to numerous inflammatory disorders, including periodontitis. There is increasing support for a role for adequate vitamin D levels in overall health. Populations with darker skin color have a higher prevalence of vitamin D deficiency/insufficiency and periodontitis. The purpose of this small pilot study was to investigate the influence of 12 weeks of 25(OH)D vitamin D supplementation (VDS) on mediators of systemic inflammation in dark-skinned, periodontitis patients.

MATERIALS AND METHODS: A total of 23 patients with moderate to severe periodontitis were randomly assigned to the vitamin D …

Performance Measures For Small-Bowel Endoscopy: A European Society Of Gastrointestinal Endoscopy (Esge) Quality Improvement Initiative, Cristiano Spada, Deirdre Mcnamara, Edward J Despott, Samuel Adler, Brooks D Cash, Ignacio Fernández-Urién, Hrvoje Ivekovic, Martin Keuchel, Mark Mcalindon, Jean-Christophe Saurin, Simon Panter, Cristina Bellisario, Silvia Minozzi, Carlo Senore, Cathy Bennett, Michael Bretthauer, Mario Dinis-Ribeiro, Dirk Domagk, Cesare Hassan, Michal F Kaminski, Colin J Rees, Roland Valori, Raf Bisschops, Matthew D Rutter

Faculty, Staff and Student Publications

The European Society of Gastrointestinal Endoscopy (ESGE) together with the United European Gastroenterology (UEG) recently developed a short list of performance measures for small-bowel endoscopy (i.e. small-bowel capsule endoscopy and device-assisted enteroscopy) with the final goal of providing endoscopy services across Europe with a tool for quality improvement. Six key performance measures both for small-bowel capsule endoscopy and for device-assisted enteroscopy were selected for inclusion, with the intention being that practice at both a service and endoscopist level should be evaluated against them. Other performance measures were considered to be less relevant, based on an assessment of their overall importance, …

Use Of Best Practice Alerts To Improve Adherence To Evidence-Based Screening In Pediatric Diabetes Care, Daniel Desalvo, Sara K. Bartz, Blair Mockler, Rona Y. Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Youth with type 1 diabetes (T1D) are at increased risk for comorbid autoimmune conditions and long-term complications. To help with early identification of these complications, the American Diabetes Association (ADA) has published evidence-based screening guidelines. The aim of our quality improvement intervention was to improve and sustain adherence to the ADA recommended screening guidelines to >90% for youth with T1D in the Texas Children’s Hospital (TCH) Diabetes Center by utilizing best practice alerts (BPA) within the electronic medical record (EMR).

Methods: In accordance with the ADA Standards of Care screening guidelines for youth with T1D, we analyzed the database …

Epidemiology Of Tuberculosis In Internationally Displaced Children Resettling In Harris County, Gabriella S. Lamb

Dissertations and Theses (Open Access)

Background More than 300,000 refugees arrived in the United States (U.S.) from 2010-2015, and Texas accepts the 2nd highest number of refugees. Texas also accepts large numbers of asylees, parolees, and special immigrant visa holders. Additionally, a large proportion of trafficked persons in the U.S. live in or pass through Texas. Foreign-born children are disproportionately affected by tuberculosis (TB) and account for two-thirds of U.S. childhood TB cases. Children are at greater risk for progression from TB infection to disease and experience greater morbidity and mortality from TB disease. This makes screening for and treatment of TB infection in children …