Urine Flow Cytometry Parameter Cannot Safely Predict Contamination of Urine-A Cohort Study of a Swiss Emergency Department Using Machine Learning Techniques.

BACKGROUND Urine flow cytometry (UFC) analyses urine samples and determines parameter counts. We aimed to predict different types of urine culture growth, including mixed growth indicating urine culture contamination. METHODS A retrospective cohort study (07/2017-09/2020) was performed on pairs of urine samples and urine cultures obtained from adult emergency department patients. The dataset was split into a training (75%) and validation set (25%). Statistical analysis was performed using a machine learning approach with extreme gradient boosting to predict urine culture growth types (i.e., negative, positive, and mixed) using UFC parameters obtained by UF-4000, sex, and age. RESULTS In total, 3835 urine samples were included. Detection of squamous epithelial cells, bacteria, and leukocytes by UFC were associated with the different types of culture growth. We achieved a prediction accuracy of 80% in the three-class approach. Of the n = 126 mixed cultures in the validation set, 11.1% were correctly predicted; positive and negative cultures were correctly predicted in 74.0% and 96.3%. CONCLUSIONS Significant bacterial growth can be safely ruled out using UFC parameters. However, positive urine culture growth (rule in) or even mixed culture growth (suggesting contamination) cannot be adequately predicted using UFC parameters alone. Squamous epithelial cells are associated with mixed culture growth

Diarrheagenic enteroaggregative Escherichia coli causing urinary tract infection and bacteremia leading to sepsis

We report a case of a 55-year-old immunocompromised female who presented to the emergency department with severe diarrhea and vomiting following travel to the Philippines. Stool bacteriology revealed a mixed infection involving an enteropathogenic Escherichia coli and two distinct strains of enteroaggregative Escherichia coli (EAEC). During hospitalization, urine and blood culture tested positive for one of the diarrheagenic EAEC strains, necessitating urinary catheterization, intensive care, and antimicrobial treatment with trimethoprim-sulfamethoxazole, followed by meropenem. Although known to occasionally cause urinary tract infections, EAEC have not been previously associated with sepsis. Our report highlights the potential of EAEC to cause severe extraintestinal infections

The internal structure of handwriting proficiency in beginning writers.

Fluent and automatized handwriting frees cognitive resources for more complex elements of writing (i.e., spelling or text generation) or even math tasks (i.e., operating) and is therefore a central objective in primary school years. Most previous research has focused on the development of handwriting automaticity across the school years and characteristics of handwriting difficulties in advanced writers. However, the relative and absolute predictive power of the different kinematic aspects for typically developing beginning handwriting remains unclear. The purpose of the present study was to investigate whether and to what extent different kinematic aspects contribute to handwriting proficiency in typically developing beginning handwriters. Further, we investigated whether gender, socioeconomic background, or interindividual differences in executive functions and visuomotor integration contribute to children's acquisition of handwriting. Therefore, 853 first-grade children aged seven copied words on a digitized tablet and completed cognitive performance tasks. We used a confirmatory factor analysis to investigate how predefined kinematic aspects of handwriting, specifically the number of inversions in velocity (NIV), pen stops, pen lifts, and pressure on the paper, are linked to an underlying handwriting factor. NIV, pen stops, and pen lifts showed the highest factor loadings and therefore appear to best explain handwriting proficiency in beginning writers. Handwriting proficiency was superior in girls than boys but, surprisingly, did not differ between children from low versus high socioeconomic backgrounds. Handwriting proficiency was related to working memory but unrelated to inhibition, shifting, and visuomotor integration. Overall, these findings highlight the importance of considering different kinematic aspects in children who have not yet automatized pen movements. Results are also important from an applied perspective, as the early detection of handwriting difficulties has not yet received much research attention, although it is the base for tailoring early interventions for children at risk for handwriting difficulties

Detection and isolation of RNA-binding proteins by RNA-ligand screening of a cDNA expression library.

A screening assay for the detection of RNA-binding proteins was developed. It allows the rapid isolation of cDNA clones coding for proteins with sequence-specific binding affinity to a target RNA. For developing the screening protocol, constituents of the human U1 snRNP were utilized as model system. The RNA partner consisted of the U1-RNA stem-loop II and the corresponding protein consisted of the 102 amino acid N-terminal recognition motif of the U1A protein, which was fused to beta-galactosidase and expressed by the recombinant lambda phage LU1A. Following binding of the fusion protein to nitrocellulose membranes, hybridization with a 32P-labeled U1-RNA ligand was carried out to detect specific RNA-protein interaction. Parameters influencing the specificity and the detection limit of binding were systematically investigated with the aid of the model system. Processing the nitrocellulose membranes in the presence of transition metals greatly increased the signal:background ratio. A simple screening protocol involving a single-buffer system was developed. Specific RNA-protein interaction could be detected in the presence of a large excess of recombinant phages from a cDNA library. Only moderate binding affinities (Kd = 10(-8) M) were required. The suitability of the RNA-ligand screening protocol was demonstrated by the identification of new viroid-RNA binding proteins from tomato

Limited open reduction and internal fixation of displaced intra-articular fractures of the calcaneum

The extended lateral L-shaped approach for the treatment of displaced intra-articular fractures of the calcaneum may be complicated by wound infection, haematoma, dehiscence and injury to the sural nerve. In an effort to reduce the risk of problems with wound healing a technique was developed that combined open reduction and fixation of the joint fragments and of the anterior process with percutaneous reduction and screw fixation of the tuberosity. A group of 24 patients with unilateral isolated closed Sanders type II and III fractures was treated using this technique and compared to a similar group of 26 patients managed by the extended approach and lateral plating. The operation was significantly shorter (p < 0.001) in the first group, but more minor secondary procedures and removal of heel screws were necessary. There were no wound complications in this group, whereas four minor complications occurred in the second group. The accuracy and maintenance of reduction, and ultimate function were equivalent

A weighted graph of the projections to mouse auditory cortex

The projections to individual cortical areas from extrinsic sources are a major determinant of the area's function, but we lack comprehensive quantitative input maps even for primary sensory areas in most model species. To quantify all input sources to the mouse primary auditory cortex (Au1), we made localized injections of modified rabies virus (SAD∆G-mCherry) into Au1 of five C57BL/6 mice and identified all the cortical and subcortical areas containing retrogradely labeled cells. Of all neurons projecting to Au1 from extrinsic areas, 27 % were located in the ipsilateral cortex, 14 % in the contralateral cortex, and 58 % in subcortical regions (almost exclusively ipsilateral, predominantly in the medial geniculate nucleus). Although 90 % of the labeled cells in the ipsilateral cortex were located within 1 mm of Au1, most cortical areas projected to Au1, including visual, somatosensory, motor, rhinal, cingulate and piriform cortices. The hierarchical relations of the cortical areas projecting to Au1 were determined based on the proportion of cell bodies in superficial versus deep layers. Feedback projections (from deep layers 5/6) dominated, but temporal association and auditory cortices were on the same hierarchical level, providing input from both superficial and deep layers. Au1 is embedded in a densely connected network that involves a high degree of cross-modal integration

A novel approach for the protein determination in food-relevant microalgae

Microalgae are gaining interest as food ingredient. Assessments of functional and nutritional properties are necessary to forward their implementation. In this study, protein content and composition of eight commercially available microalgae biomasses were determined and compared to conventional food proteins. A novel procedure for the determination of the true protein content was proposed: Multiplication of proteinic nitrogen with a sample-specific nitrogen-to-protein conversion factor kA. The proteinic nitrogen was derived from the difference of total nitrogen minus non-protein nitrogen. The average kA for microalgae was 5.3 and considerable variation between different microalgae biomasses were detected. In addition, the content of non-protein nitrogen varied between 3.4% and 15.4%. The amino acid profiles of Chlorella samples were nutritionally superior to the tested plant proteins but indicated lower protein interaction tendency, potentially limiting their structuring functionality. In contrast, Auxenochlorella contained lower amounts of indispensable amino acids while showing comparable interaction potential to plant proteins.ISSN:1873-2976ISSN:0960-8524ISSN:1873-2976ISSN:0960-852