Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational study

BackgroundThe PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice.MethodsFebrile children and controls were recruited on presentation to hospital in 9 European countries 2016-2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data. Subsequently, centralised molecular tests (CMTs) for 19 respiratory and 27 blood pathogens were performed.FindingsOf 4611 febrile children, 643 (14%) were classified as definite bacterial infection (DB), 491 (11%) as definite viral infection (DV), and 3477 (75%) had uncertain aetiology. 1061 controls without infection were recruited. CMTs detected blood bacteria more frequently in DB than DV cases for N. meningitidis (OR: 3.37, 95% CI: 1.92-5.99), S. pneumoniae (OR: 3.89, 95% CI: 2.07-7.59), Group A streptococcus (OR 2.73, 95% CI 1.13-6.09) and E. coli (OR 2.7, 95% CI 1.02-6.71). Respiratory viruses were more common in febrile children than controls, but only influenza A (OR 0.24, 95% CI 0.11-0.46), influenza B (OR 0.12, 95% CI 0.02-0.37) and RSV (OR 0.16, 95% CI: 0.06-0.36) were less common in DB than DV cases. Of 16 blood viruses, enterovirus (OR 0.43, 95% CI 0.23-0.72) and EBV (OR 0.71, 95% CI 0.56-0.90) were detected less often in DB than DV cases. Combined local diagnostics and CMTs respectively detected blood viruses and respiratory viruses in 360 (56%) and 161 (25%) of DB cases, and virus detection ruled-out bacterial infection poorly, with predictive values of 0.64 and 0.68 respectively.InterpretationMost febrile children cannot be conclusively defined as having bacterial or viral infection when molecular tests supplement conventional approaches. Viruses are detected in most patients with bacterial infections, and the clinical value of individual pathogen detection in determining treatment is low. New approaches are needed to help determine which febrile children require antibiotics.FundingEU Horizon 2020 grant 668303

Vildagliptin, a dipeptidyl peptidase-IV inhibitor improves model-assessed beta-cell function in patients with type 2 diabetes

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Métabolisme protéique de l'agneau nouveau-né. — I. Conséquences de l'ingestion de colostrum sur la glycémie, la gammaglobulinémie et les teneurs en acides aminés libres des tissus

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Using Big Area Additive Manufacturing to directly manufacture a boat hull mould

Big Area Additive Manufacturing (BAAM) is a large-scale, 3D printing technology developed by Oak Ridge National Laboratory's Manufacturing Demonstration Facility and Cincinnati, Inc. The ability to quickly and cost-effectively manufacture unique moulds and tools is currently one of the most significant applications of BAAM. This work details the application of a BAAM system to fabricate a 10.36 m (34 ft) catamaran boat hull mould. The goal of this project was to explore the feasibility of using BAAM to directly manufacture a mould without the need for thick coatings. The mould was printed in 12 individual sections over a five-day period. After printing, the critical surfaces of the mould were CNC-machined, the sections were assembled, and a final hull was manufactured using the mould. The success of this project illustrates the time and cost savings of BAAM in the fabrication of large moulds

Unidade de observação de cebola (Allium cepa L.) no Estado do Acre.

A pesquisa com cebola, iniciada em 1981, encontra-se com uma tecnologia de produção definida para o Estado do Acre, onde a importação do produto não satisfaz a demanda e onera substancialmente os preços. Com o objetivo de comprovar, junto ao produtor acreano, a técnica de cultivo estabelecida pela pesquisa, instalou-se Unidades de observação em diversos locais do Estado.bitstream/item/166107/1/1064.pd