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Abstract Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons. Methods A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses. Results Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63–0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant. Conclusion In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis.

A description of modern telecommunications devices which can be useful in inter-library communications, including their capacities, types of signals and carriers. Described are telephone lines, radio broadcasting, coaxial cable, microwave and communications satellites. This article, and the one following, were presented as tutorials by the author's to participants at the American Library Association's Atlantic City Convention on June 25, 1969.

Testing is the gateway to HIV care and support services, and efforts to broaden treatment must include a proactive and inclusive approach to testing. Provider Initiated Testing and Counseling (PITC) for HIV utilizes the opportunity afforded by the clinical encounter for the care provider to make a clinical recommendation that the patient have a voluntary HIV test. It is hoped that by broadening testing by such strategies as PITC more patients may be identified and linked to treatment and support. However, there exist multiple challenges and questions regarding the provision of routine HIV testing and counseling in clinical facilities. In order to support further PITC efforts and scale up of current testing programs, a research agenda that addresses the ethical, social and operational components of PITC programming in health facilities, is critically needed to further guide its expansion.

Among the 20 known ancient dental prostheses from Etruscan archaeological contexts in an unusual example that was recovered for Poggio Gaiella, Italy. The form and construction technique used in making the Poggio Gaiella piece suggests that it was used as a restraining band to hold loose teeth in place within a maxilla. The possibility that these appliances provide evidence for early cases of leprosy rather than tooth evulsion is discussed.

In addition to the various copies of ancient dental appliances, enormous numbers of reports deal with fanciful and unverifiable examples. These spurious dental bridges (or fake ancient crowns, inlays, or fillings) have been traced to their sources. While most of these spurious examples, such as the "stone" implant from Turkey (Atilla, 1993), discussed below, are found in the secondary literature, a few are accepted by scholars who were well versed in ancient dentistry (Guerini, 1909:68, n1). In most cases, these spurious examples are the result of wishful thinking combined with poor referencing of earlier secondary sources, ignorance of the technology involved in the construction of dental appliances, and a lack of scholarly communication.

The ancient Etruscans invented the dental bridge over 2,500 years ago. The earliest known example, made from pure gold, was excavated from the ancient site of Satricum in central Italy. it has been dated to ca. 630 BC. At that time this village was within the Etruscan realm. All of the earliest examples of these dental prostheses derive from Etruscan contexts. Study of all of the known dental appliances from this part of the ancient world suggests that their use faded as central Italy came under Roman influence. Among the 19 known prostheses from Etruscan archaeological contexts (Becker, nda) is an outstanding example, believed to be from Orvieto, now in the Danish National Museum in Copenhagen (Figs. 1, 2) (Becker, 1992). A detailed description of the Copenhagen example allows it to be compared with other known pieces. We now have a clear understanding of the various ways in which prostheses were made and used. A significant discovery is that these Etruscan bridges were worn only by females, suggesting that cosmetics and vanity were important dental concerns. The unusual construction technique of the Copenhagen piece and its place within the typology of examples reflects the evolution of this technology over more than 400 years.