Rationale: The CAPTURE tool (Chronic Obstructive Pulmonary Disease [COPD] Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) was developed to identify patients with undiagnosed COPD with an FEV1 <60% predicted or risk of exacerbation as treatment criteria. Objectives: To test the ability of CAPTURE to identify patients requiring treatment because of symptoms or risk of exacerbation or hospitalization. Methods: Data were from COMPASS (Clinical, Radiological and Biological Factors Associated with Disease Progression, Phenotypes and Endotypes of COPD in China), a prospective study of COPD, chronic bronchitis without airflow limitation (postbronchodilator FEV1/FVC ratio ≥0.70), and healthy never-smokers. CAPTURE was tested as questions alone and with peak expiratory flow measurement. Sensitivity, specificity, and positive and negative predicted values (PPV and NPV) were calculated for COPD Assessment Test (CAT) scores ⩾10 versus <10, modified Medical Research Council (mMRC) scores ⩾2 versus <2, and at least one moderate exacerbation or hospitalization in the previous year versus none. Measurements and Main Results: Patients with COPD (n = 1,696) had a mean age of 65 ± 7.5 years, and 90% were male, with a postbronchodilator FEV1 of 66.5 ± 20.1% predicted. Control participants (n = 307) had a mean age of 60.2 ± 7.0 years, and 65% were male, with an FEV1/FVC ratio of 0.78 ± 0.04. CAPTURE using peak expiratory flow showed the best combination of sensitivity and specificity. Sensitivity and specificity were 68.5% and 64.0%, respectively, to detect a CAT score ⩾10; 85.6% and 61.0% to detect an mMRC score ⩾2; 63.5% and 55.6% to detect at least one moderate exacerbation; and 70.2% and 59.4% to detect at least one hospitalization. PPVs ranged from 15.6% (moderate exacerbations) to 47.8% (CAT score). NPVs ranged from 80.8% (CAT score) to 95.6% (mMRC score). Conclusions: CAPTURE has good sensitivity to identify patients with COPD who may require treatment because of increased symptoms or risk of exacerbations or hospitalization, including those with an FEV1 >60% predicted. High NPV values show that CAPTURE can also exclude those who may not require treatment. Clinical trial registered with www.clinicaltrials.gov (NCT04853225).

In this paper, we extend the model of Liu and Zhang (Math Comput Model 54:836-845, 2011) by incorporating three control terms and apply optimal control theory to the resulting model. Optimal control strategies are proposed to minimize both the disease burden and the intervention cost. We prove the existence and uniqueness of optimal control paths and obtain these optimal paths analytically using Pontryagin\'s Maximum Principle. We analyse our results numerically to compare various strategies of proposed controls. It is observed that implementation of three controls is most effective and less expensive among all the strategies. Thus, we conclude that in order to reduce tuberculosis threat all the three controls must be taken into consideration concurrently.

OBJECTIVE: To evaluate the implementation of a FIDELIS (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project in Anhui Province, China.
METHODS: A survey card was designed for students to identify individuals who might have tuberculosis (TB) in their family. Teachers provided health education on TB before distributing the survey cards. Survey cards identifying individuals with respiratory symptoms for ≥3 weeks were sent by the teachers to village doctors who were trained to visit symptomatic individuals and advise them to undergo sputum examination. Data were routinely collected in the implementation of the FIDELIS project, and quarterly reports from the National Tuberculosis Programme were analysed. The detection of new smear-positive TB cases before and after FIDELIS, as well as with and without FIDELIS, were compared.
RESULTS: In the first year, a total of 2 387 405 students were involved and 23 079 symptomatic individuals were examined, among whom 2307 (10.3%) were diagnosed with smear-positive TB. Case detection in FIDELIS counties increased by a factor of 3.5 during the FIDELIS period compared with before FIDELIS, and that in non-FIDELIS counties by a factor of 3.1 (P = 0.001).
CONCLUSIONS: It was feasible to massively mobilise students for TB case finding through collaboration between the health care and education systems.
Evaluer dans le Province d’Anhui, Chine, la mise en œuvre du projet FIDELIS (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB).
Une carte d’enquête a été élaborée pour les étudiants afin d’identifier les individus chez qui une tuberculose (TB) pourrait exister au sein de la famille. Les enseignants ont garanti une éducation-santé sur la TB avant la distribution des cartes de l’enquête. Les cartes de l’enquête identifiant des individus souffrant de symptômes respiratoires depuis ⩾3 semaines ont été envoyées par les enseignants aux médecins du village qui avaient été entrainés à rendre visite et à donner des conseils en matière d’examen des crachats aux individus symptomatiques. Les données colligées en routine dans la mise en œuvre du projet FIDELIS ainsi que les rapports trimestriels du programme national de la tuberculose ont été analysés. Les nouveaux cas de TB à frottis positif détectés avant et après FIDELIS ainsi qu’avec ou sans FIDELIS ont été comparés.
Au cours de la première année, 2 387 405 étudiants ont été impliqués et 23 079 individus symptomatiques ont été examinés, et chez 2307 (10,3%) une tuberculose (TB) à bacilloscopie positive a été diagnostiquée. La détection des cas dans les comtés FIDELIS a augmenté d’un facteur de 3,5 dans la période FIDELIS par comparaison avec la période précédant FIDELIS et d’un facteur de 3,1 par rapport aux comtés sans FIDELIS (P = 0,001).
Il s’avère réalisable de mobiliser de façon massive les étudiants pour le dépistage des cas de TB grâce à une collaboration entre le système des soins de santé et le système éducatif.
Evaluar la introducción de un proyecto FIDELIS (Fondo por la Ampliación Innovadora del DOTS mediante Iniciativas Locales para Detener la Tuberculosis) en Anhui Province, China.
Se elaboró una tarjeta de encuesta destinada a los estudiantes, encaminada a detectar la presencia de casos de tuberculosis (TB) en sus familias. Los profesores suministraron educación sanitaria en materia de TB antes de distribuir las tarjetas de la encuesta. Las tarjetas que detectaron personas con síntomas respiratorios de ⩾3 semanas de evolución se enviaron a los médicos del municipio, los cuales habían recibido instrucciones de visitar a las personas sintomáticas y aconsejarles que aportaran muestras de esputo para examen. Se analizaron los datos recogidos sistemáticamente durante la introducción del proyecto FIDELIS y en los informes trimestrales del Programa Nacional contra la Tuberculosis. Se compararon los datos sobre la detección de casos nuevos de TB con baciloscopia positiva antes y después de la ejecución del proyecto y en entornos donde no se introdujo la iniciativa.
Durante el primer año participaron en el proyecto 2 387 405 estudiantes, se examinaron 23 079 personas sintomáticas y se diagnosticaron 2307 casos de TB con baciloscopia positiva (10,3%). La detección de casos en los condados que aplicaron el proyecto aumentó de 3,5 veces durante el período de aplicación en comparación con los datos previos y fue 3,1 veces superior a la detección observada en los condados que no aplicaron la iniciativa (P = 0,001).
Mediante la colaboración del sistema de atención de salud y el sistema educativo fue posible movilizar a los estudiantes en favor de la detección de casos de TB.

Cognitive impairment creates significant challenges for patients, their families and friends, and clinicians who provide their health care. Early recognition allows for diagnosis and appropriate treatment, education, psychosocial support, and engagement in shared decision-making regarding life planning, health care, involvement in research, and financial matters. An IAGG-GARN consensus panel examined the importance of early recognition of impaired cognitive health. Their major conclusion was that case-finding by physicians and health professionals is an important step toward enhancing brain health for aging populations throughout the world. This conclusion is in keeping with the position of the United States\' Centers for Medicare and Medicaid Services that reimburses for detection of cognitive impairment as part the of Medicare Annual Wellness Visit and with the international call for early detection of cognitive impairment as a patient\'s right. The panel agreed on the following specific findings: (1) validated screening tests are available that take 3 to 7 minutes to administer; (2) a combination of patient- and informant-based screens is the most appropriate approach for identifying early cognitive impairment; (3) early cognitive impairment may have treatable components; and (4) emerging data support a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline.