The Diagnostic Utility of Induced Sputum Microscopy and Culture in Childhood Pneumonia.

BACKGROUND.: Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been widely used in pneumonia etiology studies. METHODS.: We evaluated the diagnostic utility of induced sputum microscopy and culture in patients enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study, a large study of community-acquired pneumonia in children aged 1-59 months. Comparisons were made between induced sputum samples from hospitalized children with radiographically confirmed pneumonia and children categorized as nonpneumonia (due to the absence of prespecified clinical and laboratory signs and absence of infiltrate on chest radiograph). RESULTS.: One induced sputum sample was available for analysis from 3772 (89.1%) of 4232 suspected pneumonia cases enrolled in PERCH. Of these, sputum from 2608 (69.1%) met the quality criterion of <10 squamous epithelial cells per low-power field, and 1162 (44.6%) had radiographic pneumonia. Induced sputum microscopy and culture results were not associated with radiographic pneumonia, regardless of prior antibiotic use, stratification by specific bacteria, or interpretative criteria used. CONCLUSIONS.: The findings of this study do not support the culture of induced sputum specimens as a diagnostic tool for pneumonia in young children as part of routine clinical practice

Strandings as indicators of marine mammal biodiversity and human interactions off the coast of North Carolina

The adjacency of 2 marine biogeographic regions off Cape Hatteras, North Carolina (NC), and the proximity of the Gulf Stream result in a high biodiversity of species from northern and southern provinces and from coastal and pelagic habitats. We examined spatiotemporal patterns of marine mammal strandings and evidence of human interaction for these strandings along NC shorelines and evaluated whether the spatiotemporal patterns and species diversity of the stranded animals reflected published records of populations in NC waters. During the period of 1997–2008, 1847 stranded animals were documented from 1777 reported events. These animals represented 9 families and 34 species that ranged from tropical delphinids to pagophilic seals. This biodiversity is higher than levels observed in other regions. Most strandings were of coastal bottlenose dolphins (Tursiops truncatus) (56%), harbor porpoises (Phocoena phocoena) (14%), and harbor seals (Phoca vitulina) (4%). Overall, strandings of northern species peaked in spring. Bottlenose dolphin strandings peaked in spring and fall. Almost half of the strandings, including southern delphinids, occurred north of Cape Hatteras, on only 30% of NC’s coastline. Most stranded animals that were positive for human interaction showed evidence of having been entangled in fishing gear, particularly bottlenose dolphins, harbor porpoises, short-finned pilot whales (Globicephala macrorhynchus), harbor seals, and humpback whales (Megaptera novaeangliae). Spatiotemporal patterns of bottlenose dolphin strandings were similar to ocean gillnet fishing effort. Biodiversity of the animals stranded on the beaches reflected biodiversity in the waters off NC, albeit not always proportional to the relative abundance of species (e.g., Kogia species). Changes in the spatiotemporal patterns of strandings can serve as indicators of underlying changes due to anthropogenic or naturally occurring events in the source populations

Effect of nanosilica-based activators on the performance of an alkali-activated fly ash

This paper assesses the effect of the use of an alternative activator based on nanosilica/MOH (M = K+ or Na+) blended solutions on the performance of alkali-activated fly ash binders. Binders produced with commercial silicate activators display a greater degree of reaction, associated with increased contents of geopolymer gel; however, mortars produced with the alternative nanosilica-based activators exhibited lower water demand and reduced permeability, independent of the alkali cation used. Na-based activators promote higher compressive strength compared with K-based activators, along with a refined pore structure, although K-activated samples exhibit reduced water demand. Zeolite type products are the major crystalline phases formed within these binders. A wider range of zeolites is formed when using commercial silicate solutions compared with the alternative activators. These results suggest that there are variations in the availability of Si in the system, and consequently in the alkalinity, depending on the silicate source in the activator, which is important in determining the nanostructure of the geopolymer gel.This study was sponsored by the Ministerio de Ciencia e Innovacion of Spain (Project GEORES MAT2010-19934 and research scholarship BES-2008-002440), European regional development fund (FEDER), and the Universitat Politecnica de Valencia (Spain). The participation of SAB and JLP was funded by the Australian Research Council (ARC), including partial funding through the Particulate Fluids Processing Centre, a Special Research Centre of the ARC. A special acknowledgement is also due to the Centre of Electron Microscopy of the Universitat Politecnica de Valencia and Pedro Garces from the Universidad de Alicante for support in some experiments.Rodriguez Martinez, ED.; Bernal, SA.; Provis, JL.; Paya Bernabeu, JJ.; Monzó Balbuena, JM.; Borrachero Rosado, MV. (2013). Effect of nanosilica-based activators on the performance of an alkali-activated fly ash. Cement and Concrete Composites. 35(1):1-11. doi:10.1016/j.cemconcomp.2012.08.025S11135

Being Ready to Treat Ebola Virus Disease Patients

As the outbreak of Ebola virus disease (EVD) in West Africa continues, clinical preparedness is needed in countries at risk for EVD (e.g., United States) and more fully equipped and supported clinical teams in those countries with epidemic spread of EVD in Africa. Clinical staff must approach the patient with a very deliberate focus on providing effective care while assuring personal safety. To do this, both individual health care providers and health systems must improve EVD care. Although formal guidance toward these goals exists from the World Health Organization, Medecin Sans Frontières, the Centers for Disease Control and Prevention, and other groups, some of the most critical lessons come from personal experience. In this narrative, clinicians deployed by the World Health Organization into a wide range of clinical settings in West Africa distill key, practical considerations for working safely and effectively with patients with EVD

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Thermodynamic modelling of alkali-activated slag cements

This paper presents a thermodynamic modelling analysis of alkali-activated slag-based cements, which are high performance and potentially low-CO2 binders relative to Portland cement. The thermodynamic database used here contains a calcium (alkali) aluminosilicate hydrate ideal solid solution model (CNASH_ss), alkali carbonate and zeolite phases, and an ideal solid solution model for a hydrotalcite-like Mg-Al layered double hydroxide phase. Simulated phase diagrams for NaOH- and Na2SiO3-activated slag-based cements demonstrate the high stability of zeolites and other solid phases in these materials. Thermodynamic modelling provides a good description of the chemical compositions and types of phases formed in Na2SiO3-activated slag cements over the most relevant bulk chemical composition range for these cements, and the simulated volumetric properties of the cement paste are consistent with previously measured and estimated values. Experimentally determined and simulated solid phase assemblages for Na2CO3-activated slag cements were also found to be in good agreement. These results can be used to design the chemistry of alkali-activated slag-based cements, to further promote the uptake of this technology and valorisation of metallurgical slags