Utility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults.

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn To access publisher's full text version of this article click on the hyperlink at the bottom of the pageor click on the hyperlink at the To access publisher's full text version of this article, please click on the hyperlink in Additional Links field top of the page marked FilesA lack of sensitive tests and difficulties obtaining representative samples contribute to the challenge in identifying etiology in pneumonia. Upper respiratory tract swabs can be easily collected and analyzed with real-time PCR (rtPCR). Common pathogens such as S. pneumoniae and H. influenzae can both colonize and infect the respiratory tract, complicating the interpretation of positive results. Oropharyngeal swabs were collected (n = 239) prospectively from adults admitted to hospital with pneumonia. Analysis with rtPCR targeting S. pneumoniae and H. influenzae was performed and results compared with sputum cultures, blood cultures, and urine antigen testing for S. pneumoniae. Different Ct cutoff values were applied to positive tests to discern colonization from infection. Comparing rtPCR with conventional testing for S. pneumoniae in patients with all tests available (n = 57) resulted in: sensitivity 87 %, specificity 79 %, PPV 59 % and NPV 94 %, and for H. influenzae (n = 67): sensitivity 75 %, specificity 80 %, PPV 45 % and NPV 94 %. When patients with prior antimicrobial exposure were excluded sensitivity improved: 92 % for S. pneumoniae and 80 % for H. influenzae. Receiver operating characteristic curve analysis demonstrated for S. pneumoniae: AUC = 0.65 (95 % CI 0.51-0.80) and for H. influenzae: AUC = 0.86 (95 % CI 0.72-1.00). Analysis of oropharyngeal swabs using rtPCR proved both reasonably sensitive and specific for diagnosing pneumonia caused by S. pneumoniae and H. influenzae. This method may be a useful diagnostic adjunct to other methods and of special value in patients unable to provide representative lower airway samples.Icelandic Center for Research Rannis Landspitali University Hospital Science Fund University of Iceland Research Fun

A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment

A Declarative Framework for Specifying and Enforcing Purpose-aware Policies

Purpose is crucial for privacy protection as it makes users confident that their personal data are processed as intended. Available proposals for the specification and enforcement of purpose-aware policies are unsatisfactory for their ambiguous semantics of purposes and/or lack of support to the run-time enforcement of policies. In this paper, we propose a declarative framework based on a first-order temporal logic that allows us to give a precise semantics to purpose-aware policies and to reuse algorithms for the design of a run-time monitor enforcing purpose-aware policies. We also show the complexity of the generation and use of the monitor which, to the best of our knowledge, is the first such a result in literature on purpose-aware policies.Comment: Extended version of the paper accepted at the 11th International Workshop on Security and Trust Management (STM 2015

A GLIMPSE into the Nature of Galactic Mid-IR Excesses

We investigate the nature of the mid-IR excess for 31 intermediate-mass stars that exhibit an 8 micron excess in either the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire or the Mid-Course Space Experiment using high resolution optical spectra to identify stars surrounded by warm circumstellar dust. From these data we determine projected stellar rotational velocities and estimate stellar effective temperatures for the sample. We estimate stellar ages from these temperatures, parallactic distances, and evolutionary models. Using MIPS [24] measurements and stellar parameters we determine the nature of the infrared excess for 19 GLIMPSE stars. We find that 15 stars exhibit Halpha emission and four exhibit Halpha absorption. Assuming that the mid-IR excesses arise in circumstellar disks, we use the Halpha fluxes to model and estimate the relative contributions of dust and free-free emission. Six stars exhibit Halpha fluxes that imply free-free emission can plausibly explain the infrared excess at [24]. These stars are candidate classical Be stars. Nine stars exhibit Halpha emission, but their Halpha fluxes are insufficient to explain the infrared excesses at [24], suggesting the presence of a circumstellar dust component. After the removal of the free-free component in these sources, we determine probable disk dust temperatures of Tdisk~300-800 K and fractional infrared luminosities of L(IR)/L(*)~10^-3. These nine stars may be pre-main-sequence stars with transitional disks undergoing disk clearing. Three of the four sources showing Halpha absorption exhibit circumstellar disk temperatures ~300-400 K, L(IR)/L(*)~10^-3, IR colors K-[24]< 3.3, and are warm debris disk candidates. One of the four Halpha absorption sources has K-[24]> 3.3 implying an optically thick outer disk and is a transition disk candidate.Comment: 17 figures. Accepted for publication in Ap

Welding fume nanoparticles from solid and flux-cored wires: Solubility, toxicity, and role of fluorides

Welding fume particles are hazardous. Their toxicity likely depends on their composition and reactivity. This study aimed at exploring the role of sodium or other fluorides (NaF), which are intentionally added to flux-cored wire electrodes for stainless steel welding, on the solubility (in phosphate buffered saline) and toxicity of the generated welding fume particles. A multi-analytical particle characterization approach along with in-vitro cell assays was undertaken. The release of Cr(VI) and Mn from the particles was tested as a function of fluoride solution concentration. The welding fume particles containing NaF released significantly higher amounts of Cr(VI) compared with solid wire reference fumes, which was associated with increased cytotoxicity and genotoxicity in-vitro. No crystalline Na or potassium (K) containing chromates were observed. Cr(VI) was incorporated in an amorphous mixed oxide. Solution-added fluorides did not increase the solubility of Cr(VI), but contributed to a reduced Mn release from both solid and flux-cored wire fume particles and the reduction of Cr(VI) release from solid wire fume particles. Chemical speciation modeling suggested that metal fluoride complexes were not formed. The presence of NaF in the welding electrodes did not have any direct, but possibly an indirect, role in the Cr(VI) solubility of welding fumes

Debris Disk Evolution Around A Stars

We report 24 and/or 70 um measurements of ~160 A-type main-sequence stars using the Multiband Imaging Photometer for Spitzer (MIPS). Their ages range from 5 to 850 Myr based on estimates from the literature (cluster or moving group associations) or from the H-R diagram and isochrones. The thermal infrared excess is identified by comparing the deviation (~3% and ~15% at the 1-\sigma level at 24 and 70 um, respectively) between the measurements and the synthetic Kurucz photospheric predictions. Stars showing excess infrared emission due to strong emission lines or extended nebulosity seen at 24 um are excluded from our sample; therefore, the remaining infrared excesses are likely to arise from circumstellar debris disks. At the 3-sigma confidence level, the excess rate at 24 and 70 um is 32% and >=33% (with an uncertainty of 5%), considerably higher than has been found for old solar analogs and M dwarfs. Our measurements place constraints on the fractional dust luminosities and temperatures in the disks. We find that older stars tend to have lower fractional dust luminosity than younger ones. While the fractional luminosity from the excess infrared emission follows a general 1/t relationship, the values at a given stellar age vary by at least two orders of magnitude. We also find that (1) older stars possess a narrow range of temperature distribution peaking at colder temperatures, and (2) the disk emission at 70 um persists longer than that at 24 um. Both results suggest that the debris-disk clearing process is more effective in the inner regions.Comment: 17 pages, accepted for publication in Ap

Phase 1b Study of Batiraxcept in Combination With Durvalumab in Patients With Platinum-Resistant Ovarian Cancer

Combining an immune checkpoint inhibitor with batiraxcept (AVB-S6-500), an AXL inhibitor that acts via selective binding to growth arrest-specific protein 6 (GAS6), may improve anti-tumor immunity in platinum-resistant ovarian cancer (PROC). This phase 1b trial of durvalumab in combination with escalating doses of batiraxcept enrolled patients with recurrent PROC (NCT04019288). The primary objective was to determine the toxicity profile of the combination. Eleven patients were enrolled on the trial. No dose-limiting toxicities were observed, and no objective responses were noted. Median progression free survival (PFS) was 1.81 months (95% confidence interval (CI) 1.71–2.40), and median overall survival (OS) was 4.53 months (95% CI 2.10–24.74). Batiraxcept effectively reduced serum GAS6 levels at 1-h post-treatment, resulting in trough levels below the limit of detection in all cases but one. In conclusion, the combination of batiraxcept and durvalumab was safe and tolerable but did not demonstrate anti-tumor activity in a heterogenous population of patients with recurrent PROC

A qualitative study of stakeholders' perspectives on the social network service environment

Over two billion people are using the Internet at present, assisted by the mediating activities of software agents which deal with the diversity and complexity of information. There are, however, ethical issues due to the monitoring-and-surveillance, data mining and autonomous nature of software agents. Considering the context, this study aims to comprehend stakeholders' perspectives on the social network service environment in order to identify the main considerations for the design of software agents in social network services in the near future. Twenty-one stakeholders, belonging to three key stakeholder groups, were recruited using a purposive sampling strategy for unstandardised semi-structured e-mail interviews. The interview data were analysed using a qualitative content analysis method. It was possible to identify three main considerations for the design of software agents in social network services, which were classified into the following categories: comprehensive understanding of users' perception of privacy, user type recognition algorithms for software agent development and existing software agents enhancement

Development of the initial certification and technology roadmap for the FUTPRINT50 framework

The main goal of the research project FUTPRINT50 is the acceleration of the introduction of a hybrid-electric regional aircraft. One essential part of this project is to develop a roadmap which couples the technological development with its associated research infrastructure and regulatory aspects. This aims at maximizing the likelihood of a successful hybrid-electric 50-seat regional aircraft with a projected entry-into-service by 2035/2040. This article presents the roadmap framework and methodology worked out by FUTPRINT50. Additionally, it shows the findings of the consortium about key enabling technologies and testing infrastructures necessary to achieve the final integrated demonstrators that provide evidence for lowering the risk of adoption and for bridging mapped regulatory gaps in regard to hybrid-electric propulsion. Furthermore, links to other complementary roadmaps are highlighted. Detail is given on the status of work and follow-up actions towards its completion.European Union funding: 87555

CCL2 Is Associated with a Faster Rate of Cognitive Decline during Early Stages of Alzheimer's Disease

Chemokine (C-C motif) receptor 2 (CCR2)-signaling can mediate accumulation of microglia at sites affected by neuroinflammation. CCR2 and its main ligand CCL2 (MCP-1) might also be involved in the altered metabolism of beta-amyloid (Aβ) underlying Alzheimer's disease (AD). We therefore measured the levels of CCL2 and three other CCR2 ligands, i.e. CCL11 (eotaxin), CCL13 (MCP-4) and CCL26 (eotaxin-3), in the cerebrospinal fluid (CSF) and plasma of 30 controls and 119 patients with mild cognitive impairment (MCI) at baseline. During clinical follow-up 52 MCI patients were clinically stable for five years, 47 developed AD (i.e. cases with prodromal AD at baseline) and 20 developed other dementias. Only CSF CCL26 was statistically significantly elevated in patients with prodromal AD when compared to controls (p = 0.002). However, in patients with prodromal AD, the CCL2 levels in CSF at baseline correlated with a faster cognitive decline during follow-up (rs = 0.42, p = 0.004). Furthermore, prodromal AD patients in the highest tertile of CSF CCL2 exhibited a significantly faster cognitive decline (p<0.001) and developed AD dementia within a shorter time period (p<0.003) compared to those in the lowest tertile. Finally, in the entire MCI cohort, CSF CCL2 could be combined with CSF Tau, P-tau and Aβ42 to predict both future conversion to AD and the rate of cognitive decline. If these results are corroborated in future studies, CCL2 in CSF could be a candidate biomarker for prediction of future disease progression rate in prodromal AD. Moreover, CCR2-related signaling pathways might be new therapeutic targets for therapies aiming at slowing down the disease progression rate of AD