Detection of pneumonia associated pathogens using a prototype multiplexed pneumonia test in hospitalized patients with severe pneumonia

Severe pneumonia remains an important cause of morbidity and mortality. Polymerase chain reaction (PCR) has been shown to be more sensitive than current standard microbiological methods--particularly in patients with prior antibiotic treatment--and therefore, may improve the accuracy of microbiological diagnosis for hospitalized patients with pneumonia. Conventional detection techniques and multiplex PCR for 14 typical bacterial pneumonia-associated pathogens were performed on respiratory samples collected from adult hospitalized patients enrolled in a prospective multi-center study. Patients were enrolled from March until September 2012. A total of 739 fresh, native samples were eligible for analysis, of which 75 were sputa, 421 aspirates, and 234 bronchial lavages. 276 pathogens were detected by microbiology for which a valid PCR result was generated (positive or negative detection result by Curetis prototype system). Among these, 120 were identified by the prototype assay, 50 pathogens were not detected. Overall performance of the prototype for pathogen identification was 70.6% sensitivity (95% confidence interval (CI) lower bound: 63.3%, upper bound: 76.9%) and 95.2% specificity (95% CI lower bound: 94.6%, upper bound: 95.7%). Based on the study results, device cut-off settings were adjusted for future series production. The overall performance with the settings of the CE series production devices was 78.7% sensitivity (95% CI lower bound: 72.1%) and 96.6% specificity (95% CI lower bound: 96.1%). Time to result was 5.2 hours (median) for the prototype test and 43.5 h for standard-of-care. The Pneumonia Application provides a rapid and moderately sensitive assay for the detection of pneumonia-causing pathogens with minimal hands-on time

Measurement of the Nucleon Structure Function F2 in the Nuclear Medium and Evaluation of its Moments

We report on the measurement of inclusive electron scattering off a carbon target performed with CLAS at Jefferson Laboratory. A combination of three different beam energies 1.161, 2.261 and 4.461 GeV allowed us to reach an invariant mass of the final-state hadronic system W~2.4 GeV with four-momentum transfers Q2 ranging from 0.2 to 5 GeV2. These data, together with previous measurements of the inclusive electron scattering off proton and deuteron, which cover a similar continuous two-dimensional region of Q2 and Bjorken variable x, permit the study of nuclear modifications of the nucleon structure. By using these, as well as other world data, we evaluated the F2 structure function and its moments. Using an OPE-based twist expansion, we studied the Q2-evolution of the moments, obtaining a separation of the leading-twist and the total higher-twist terms. The carbon-to-deuteron ratio of the leading-twist contributions to the F2 moments exhibits the well known EMC effect, compatible with that discovered previously in x-space. The total higher-twist term in the carbon nucleus appears, although with large systematic uncertainites, to be smaller with respect to the deuteron case for n<7, suggesting partial parton deconfinement in nuclear matter. We speculate that the spatial extension of the nucleon is changed when it is immersed in the nuclear medium.Comment: 37 pages, 15 figure

Family Management Practices and Positive Youth Development in Stepfamilies and Single‐Mother Families

Objective To determine how engagement in family management practices (i.e., parent–youth closeness, knowledge of youth\u27s friends, shared family meals, and media monitoring) is associated with positive developmental outcomes for youth living in diverse family structures. Background As patterns of unmarried childbearing, cohabitation, divorce, and remarriage have changed in the United States, youth increasingly live in diverse family structures. Limited research, however, addresses positive youth development in these families. Specific family tasks and caregiver constellations in the home may mean that youth in different family structures benefit differently from family management practices. Method Using data from 9,131 households with a 12- to 17-year-old child in the 2011–2012 National Survey of Children\u27s Health, structural equation modeling was used to test whether four family management practices were associated with two positive youth developmental outcomes (flourishing and extracurricular activity participation). Multigroup analyses tested for differences in the associations across family structures. Results Family management practices were generally positively associated with positive youth development. The strength of associations between specific family management practices and positive youth developmental outcomes, however, varied across family structures, suggesting that practices may have differing effectiveness depending on family context. Conclusion Understanding mechanisms that promote positive youth developmental outcomes in diverse family structures and how mechanisms may function differently across family contexts can broaden the sophistication of family theories and interventions

Multicystic Dysplastic Kidney

Multicysticdysplastickidney(MCDK)isthemost common cystic renal anomaly found in children and the second cause of palpable mass in neonates after hydronephrosis. The kidney is characterized by the presence of multiple non-communicating cysts in absence of normal parenchyma

Diffractive production of the charmed baryon LAMBDAc+_{c}^{+} at the CERN ISR

In a sample of diffractive events of high multiplicity a sharp five standard deviation signal is observed at M=2255 MeV/c/sup 2/ in the K /sup -/p pi /sup +/ mass distribution and, although with less statistical strength, at the same mass in the lambda /sup 0/ pi /sup + / pi /sup +/ pi /sup -/ channel. These signals are identified as being due to the decay of the charmed baryon Lambda /sub c//sup +/ which is produced with a cross section times branching ratio sigma /sub C/B in the range 0.7-1.8 mu b for the K/sup -/ pi /sup +/p decay and 0.3-0.7 mu b for the Lambda /sup 0/ pi /sup +/ pi /sup +/ pi /sup -/ system. (8 refs)

Detection of pneumonia associated pathogens using a prototype multiplexed pneumonia test in hospitalized patients with severe pneumonia

Severe pneumonia remains an important cause of morbidity and mortality. Polymerase chain reaction (PCR) has been shown to be more sensitive than current standard microbiological methods--particularly in patients with prior antibiotic treatment--and therefore, may improve the accuracy of microbiological diagnosis for hospitalized patients with pneumonia. Conventional detection techniques and multiplex PCR for 14 typical bacterial pneumonia-associated pathogens were performed on respiratory samples collected from adult hospitalized patients enrolled in a prospective multi-center study. Patients were enrolled from March until September 2012. A total of 739 fresh, native samples were eligible for analysis, of which 75 were sputa, 421 aspirates, and 234 bronchial lavages. 276 pathogens were detected by microbiology for which a valid PCR result was generated (positive or negative detection result by Curetis prototype system). Among these, 120 were identified by the prototype assay, 50 pathogens were not detected. Overall performance of the prototype for pathogen identification was 70.6% sensitivity (95% confidence interval (CI) lower bound: 63.3%, upper bound: 76.9%) and 95.2% specificity (95% CI lower bound: 94.6%, upper bound: 95.7%). Based on the study results, device cut-off settings were adjusted for future series production. The overall performance with the settings of the CE series production devices was 78.7% sensitivity (95% CI lower bound: 72.1%) and 96.6% specificity (95% CI lower bound: 96.1%). Time to result was 5.2 hours (median) for the prototype test and 43.5 h for standard-of-care. The Pneumonia Application provides a rapid and moderately sensitive assay for the detection of pneumonia-causing pathogens with minimal hands-on time