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Table 74.

Summary of Tests for Trypanosomes

Abbreviations: EDTA, ethylenediaminetetraacetic acid; GI, gastrointestinal; HE, hematoxylin eosin; NAAT, nucleic acid amplification test; NNN, Novy-MacNeal-Nicolle; TAT, turnaround time.

Transportation time and nucleic acid extraction time are not included in this estimate.

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Table 74.

Summary of Tests for Trypanosomes

Abbreviations: EDTA, ethylenediaminetetraacetic acid; GI, gastrointestinal; HE, hematoxylin eosin; NAAT, nucleic acid amplification test; NNN, Novy-MacNeal-Nicolle; TAT, turnaround time.

Transportation time and nucleic acid extraction time are not included in this estimate.

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Microscopy is less useful during the latent and chronic stages of infection when rates of parasitemia are very low. The diagnosis in these stages may be established serologically or by microscopic examination of tissue aspirates or biopsies. The nonmotile (amastigote) intracellular form of T. cruzi predominates during this phase of the infection. Culture in easily prepared Novy-MacNeal-Nicolle medium or similar media of any appropriate blood or tissue specimen during the acute and chronic stages will add to the sensitivity of laboratory diagnosis and may be available through the CDC or specialized reference laboratories. Live trypanosomes are highly infectious and specimens must be handled with care using “standard precautions” for the handling of blood and body fluids.

Serology by commercially available enzyme-linked immunoassay (ELISA) kits is of greatest use during the latent and chronic stages of disease when parasites are no longer easily detected in peripheral blood preparations by microscopy. Positive ELISA results are considered evidence of active infection and would exclude potential blood/tissue donors who test positive from acting as donors, as the infection has been shown to be transmitted by transfusion and transplantation.

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It is important to realize that this guide cannot account for individual variation among patients. This guide is not intended to supplant physician judgment with respect to particular patients or special clinical situations. The Infectious Diseases Society of America (IDSA) considers adherence to the recommendations in this guide to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances. While IDSA makes every effort to present accurate and reliable information, the information provided in this guide is presented “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. This guide should be applied in a manner consistent with all applicable laws, rules, and regulations. Neither IDSA nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this guide or reliance on the information presented. This guide represents the proprietary and copyrighted property of IDSA. Copyright 2018 Infectious Diseases Society of America. All rights reserved. No part of this guide may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of IDSA. Permission is granted to physicians and healthcare providers solely to copy and use the guide in their professional practices and clinical decision-making. No license or permission is granted to any person or entity, and prior written authorization by IDSA is required, to sell, distribute, or modify the guide, or to make derivative works of or incorporate the guide into any product, including but not limited to clinical decision support software or any other software product. Any person or entity desiring to use this guide in any way must contact IDSA for approval in accordance with IDSA’s terms and conditions of third party use, in particular any use of the guide in any software product.

Acknowledgments.  We acknowledge the contributions and leadership provided by Dr Ellen Jo Baron in the 2013 version of this document. We appreciate the contributions of the Pediatric Clinical Microbiology Consortium to the document. Participants included Jennifer Dien Bard, Christopher Doern, James Dunn, Karen Sue Kehl, Amy Leber, Alex McAdams, Joel Mortensen, Xuang Qin, Paula Revell, Rangaraj Selvarangan, and Xiotian Zheng. The panel is grateful to Thomas F. Smith, PhD and Donna J. Hata, PhD, for their contributions to the development of this guidance, and to Marilyn August for her assistance with the formatting of the tables. We especially appreciate the careful review and suggestions of members of the American Society for Microbiology (ASM) and the Infectious Diseases Society of America (IDSA).

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Computation in R consists of sequentially evaluating statements . Statements, such as x<-1:10 or mean(y) , can be separated by either a semi-colon or a new line. Whenever the evaluator is presented with a syntactically complete statement that statement is evaluated and the value returned. The result of evaluating a statement can be referred to as the value of the statement 2 The value can always be assigned to a symbol.

Both semicolons and new lines can be used to separate statements. A semicolon always indicates the end of a statement while a new line may indicate the end of a statement. If the current statement is not syntactically complete new lines are simply ignored by the evaluator. If the session is interactive the prompt changes from ‘ > ’ to ‘ + ’.

Statements can be grouped together using braces ‘ { ’ and ‘ } ’. A group of statements is sometimes called a block . Single statements are evaluated when a new line is typed at the end of the syntactically complete statement. Blocks are not evaluated until a new line is entered after the closing brace. In the remainder of this section, statement refers to either a single statement or a block.

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The if / else statement conditionally evaluates two statements. There is a condition which is evaluated and if the value is TRUE then the first statement is evaluated; otherwise the second statement will be evaluated. The if / else statement returns, as its value, the value of the statement that was selected. The formal syntax is

First, statement1 is evaluated to yield value1 . If value1 is a logical vector with first element TRUE then statement2 is evaluated. If the first element of value1 is FALSE then statement3 is evaluated. If value1 is a numeric vector then statement3 is evaluated when the first element of value1 is zero and otherwise statement2 is evaluated. Only the first element of value1 is used. All other elements are ignored. If value1 has any type other than a logical or a numeric vector an error is signalled.

Latest image

False color unfiltered image of comet C/2015 O1 (PANSTARRS), obtained on 2018 Apr. 8 (1h13-1h23UT) with 60-cm, f/3.3 Deltagraph. Exposure time was 8x60s. Copyright © 2018 by H. Mikuz, Črni Vrh Observatory.

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. It is a free and unique service for comet observers worldwide which allows submission, display and analysis of comet data in a single location.

Amateur astronomers can make valuable contributions to comet science by observing comets and submitting their observations to COBS as professional astronomers typically do not have telescope time required to acquire regular observations. We therefore encourage comet observers worldwide to submit their observations and contribute to the COBS database.

Registered observers may submit observations using a web based form which which stores the observations in an SQL database and stores them in ICQ format . Observations may be queried and plotted in the web site or exported for further processing, analysis and publication. The database currently contains more than 234000 comet observations of more than 1200 different comets and represents the largest available database of comet observations.

The data stored in COBS is freely available to everyone who honors our data usage policy . Please cite COBS as the reference if you use it for comet studies.

Latest lightcurve

Light-curve of C/2016 M1 (PANSTARRS) (Jul 02, 2018).

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Current comet magnitudes and observable region

The observable region is an approximate indication of the latitude at which the comet may be seen. The period when visible is calculated for latitude 45°N and 45°S.

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Jun. 29, 2018

The interstellar object 'Oumuamua perplexed scientists in October 2017 as it whipped past Earth at an unusually high speed. This mysterious visitor is the first object ever seen in our solar system that is known to have originated elsewhere.

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Jun. 29, 2018

Using observations from NASA's Hubble Space Telescope and ground-based observatories, an international team of scientists has confirmed 'Oumuamua (oh-MOO-ah-MOO-ah), the first known interstellar object to travel through our solar system, got an unexpected boost in speed and shift in trajectory as it passed through the inner solar system last year.

Jun. 29, 2018

`Oumuamua, the first interstellar object discovered in the Solar System, is moving away from the Sun faster than expected. This anomalous behavior was detected by a worldwide astronomical collaboration. The new results suggest that `Oumuamua is most likely an interstellar comet and not an asteroid.

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