Aerococcus urinae: a rare pathogen in urinary tract infections, associated with patients with underlying urinary pathology

Introducción: Aerococcus urinae es un patógeno urinario poco frecuente que ha sido asociado en la bibliografía a pacientes en la tercera edad, con patología urinaria subyacente. La mala identificación mediante pruebas bioquímicas convencionales, su baja tasa de aislamiento y la similar morfología con otros microorganismos considerados como flora normal en el tracto urinario, hacen de este microorganismo un gran desconocido. El objetivo de este trabajo fue determinar la implicación clínica de Aerococcus urinae en pacientes con infección urinaria, estudiando la relación existente descrita en la bibliografía con pacientes en la tercera edad, con patología urinaria subyacente. Asimismo, debido a su infradiagnóstico en infección urinaria (ITU), se evaluó la utilidad de la espectrometría de masas MALDI-TOF (Bruker) como modelo diagnóstico confiable en el laboratorio de microbiología. Material y métodos: Se realizó un estudio prospectivo en pacientes con infección urinaria desde mayo a septiembre de 2014. Se estudiaron los perfiles de sensibilidad a los antimicrobianos frecuentemente utilizados en infección urinaria. Se registraron los datos clínicos más importantes de los pacientes con un recuento positivo para A. urinae. Resultados: De las 9261 muestras de orina analizadas, 1513 muestras resultaron tener un recuento mayor a 100.000 UFC/mL. A. urinae fue aislado en 3 casos, y la identificación por MALDI-TOF fue fiable a nivel de género y especie ( score ≥ 2) , siendo contrastada mediante secuenciación ARNr 16S. Todos los pacientes que desarrollaron infección urinaria por A. urinae, fueron pacientes en la tercera edad con una patología subyacente, siendo en todos los casos este microorganismo resistente a trimetropim/sulfametoxazol. Conclusiones: La implicación de A. urinae como patógeno urinario, en pacientes con patología urinaria de base, la dificultad en su diagnóstico, y la alta tasa de resistencia de este microorganismo a trimetropim/sulfametoxazol, hacen recomendable establecer una especial atención en los métodos diagnósticos utilizados.Introduction: Aerococcus urinae is an uncommon urinary tract pathogen that has been associated in the literature for older patients with underlying urinary pathology. Misidentification by conventional biochemical tests, their low rate of isolation and similar morphology to other microorganisms considered as normal flora in the urinary tract, makes this organism a great unknown. The aim of this investigation is to determine the implication of Aerococcus urinae as the cause of urinary tract infections, studying the relationship described in literature in elderly patients with underlying urinary pathology. Material and methods: A prospective study on patients with urinary infection, from May to September 2014 was performed. Urine-cultures with a significant bacteria and suspicious of A. urinae, were identified by means of MALDI-TOF system, and contrasted with ARNr 16S sequencing. Profiles of antimicrobial susceptibility frequently used in urinary tract infection were studied. Clinical data for patients with positive urine cultures for A. urinae were registered. Result: 9261 urine samples were analyzed, 1513 samples had counts greater than 100,000 CFU / mL. A. urinae was isolated in 3 cases, and identification by MALDI-TOF was reliable genus and species level (score ≥ 2), being proven by sequencing 16S rRNA. All patients who developed urinary infection by A. urinae were elderly patients with underlying pathology, and this microorganism resistant to trimethoprim / sulfamethoxazole. Conclusions: The A. urinae overt implication as urinary pathogen, the high rate of resistance of this organism to trimethoprim / sulfamethoxazole, and its difficulty to diagnose, urge to pay special attention to the diagnostic methods applied

Classes of Multiple Decision Functions Strongly Controlling FWER and FDR

This paper provides two general classes of multiple decision functions where each member of the first class strongly controls the family-wise error rate (FWER), while each member of the second class strongly controls the false discovery rate (FDR). These classes offer the possibility that an optimal multiple decision function with respect to a pre-specified criterion, such as the missed discovery rate (MDR), could be found within these classes. Such multiple decision functions can be utilized in multiple testing, specifically, but not limited to, the analysis of high-dimensional microarray data sets.Comment: 19 page

Antibodies from rabbits immunized with HIV-1 clade B SOSIP trimers can neutralize multiple clade B viruses by destabilizing the envelope glycoprotein

The high HIV-1 viral diversity is a formidable hurdle for the development of an HIV-1 vaccine. Elicitation of broadly neutralizing antibodies (bNAbs) would offer a solution, but so far immunization strategies have failed to elicit bNAbs efficiently. To overcome the obstacles, it is important to understand the immune responses elicited by current HIV-1 envelope glycoprotein (Env) immunogens. To gain more insight, we characterized monoclonal antibodies (mAbs) isolated from rabbits immunized with Env SOSIP trimers based on the clade B isolate AMC008. Four rabbits that were immunized three times with AMC008 trimer developed robust autologous and sporadic low-titer heterologous neutralizing responses. Seventeen AMC008 trimer-reactive mAbs were isolated using antigen-specific single B cell sorting. Four of these mAbs neutralized the autologous AMC008 virus and several other clade B viruses. When visualized by electron microscopy, the complex of the neutralizing mAbs with the AMC008 trimer showed binding to the gp41 subunit with unusual approach angles and we observed that their neutralization ability depended on their capacity to induce Env trimer dissociation. Thus, AMC008 SOSIP trimer immunization induced clade B neutralizing mAbs with unusual approach angles with neutralizing effects that involve trimer destabilization. Optimizing these responses might provide an avenue to the induction of trimer dissociating bNAbs. IMPORTANCE Roughly 32 million people have died as a consequence of HIV-1 infection since the start of the epidemic and still 1.7 million people get infected with HIV-1 annually. Therefore, a vaccine to prevent HIV-1 infection is urgently needed. Current HIV-1 immunogens are not able to elicit the broad immune responses needed to provide protection against the large variation of HIV-1 strains circulating globally. A better understanding of the humoral immune responses elicited by immunization with state-of-the-art HIV-1 immunogens should facilitate the design of improved HIV-1 vaccine candidates. We identified antibodies with the ability to neutralize multiple HIV-1 viruses by destabilization of the envelope glycoprotein. Their weak but consistent cross-neutralization ability indicates the potential of this epitope to elicit broad responses. The trimer-destabilizing effect of the neutralizing mAbs combined with detailed characterization of the neutralization epitope can be used to shape the next generation of HIV-1 immunogens to elicit improved humoral responses after vaccination

A new initialization procedure for the distributed estimation of distribution algorithms

Estimation of distribution algorithms (EDAs) are one of the most promising paradigms in today’s evolutionary computation. In this field, there has been an incipient activity in the so-called parallel estimation of distribution algorithms (pEDAs). One of these approaches is the distributed estimation of distribution algorithms (dEDAs). This paper introduces a new initialization mechanism for each of the populations of the islands based on the Voronoi cells. To analyze the results, a series of different experiments using the benchmark suite for the special session on Real-parameter Optimization of the IEEE CEC 2005 conference has been carried out. The results obtained suggest that the Voronoi initialization method considerably improves the performance obtained from a traditional uniform initialization

Fístula completa de la 2º hendidura branquial. A propósito de 1 caso y revisión de la literatura

Las anomalías de los remanentes branquiales constituyenpatologías poco frecuentes siendo las de la 2dahendidura las mas frecuentes. Las fístulas completas sonextremadamente raras y comunican la región lateral delcuello a la orofaringe. Se presentan como un orificio en laregión lateral del cuello que ocasionalmente drena liquido,pudiendo este ser persistente. El tratamiento de elecciónes la resección quirúrgica. Presentamos un caso de fístulabranquial completa analizando su presentación clínica y sutratamiento así como una revisión de la literatur

Sublittoral soft bottom communities and diversity of Mejillones Bay in northern Chile (Humboldt Current upwelling system)

The macrozoobenthos of Mejillones Bay (23°S; Humboldt Current) was quantitatively investigated over a 7-year period from austral summer 1995/1996 to winter 2002. About 78 van Veen grab samples taken at six stations (5, 10, 20 m depth) provided the basis for the analysis of the distribution of 60 species and 28 families of benthic invertebrates, as well as of their abundance and biomass. Mean abundance (2,119 individuals m-2) was in the same order compared to a previous investigation; mean biomass (966 g formalin wet mass m-2), however, exceeded prior estimations mainly due to the dominance of the bivalve Aulacomya ater. About 43% of the taxa inhabited the complete depth range. Mean taxonomic Shannon diversity (H', Log e) was 1.54 ± 0.58 with a maximum at 20 m (1.95 ± 0.33); evenness increased with depth. The fauna was numerically dominated by carnivorous gastropods, polychaetes and crustaceans (48%). About 15% of the species were suspensivorous, 13% sedimentivorous, 11% detritivorous, 7% omnivorous and 6% herbivorous. Cluster analyses showed a significant difference between the shallow and the deeper stations. Gammarid amphipods and the polychaete family Nephtyidae characterized the 5-mzone, the molluscs Aulacomya ater, Mitrella unifasciata and gammarids the intermediate zone, while the gastropod Nassarius gayi and the polychaete family Nereidae were most prominent at the deeper stations. The communities of the three depth zones did not appear to be limited by hypoxia during non-El Niño conditions. Therefore, no typical change in community structure occurred during El Niño 1997–1998, in contrast to what was observed for deeper faunal assemblages and hypoxic bays elsewhere in the coastal Humboldt Current system

Syntactic learning by mere exposure - An ERP study in adult learners

<p>Abstract</p> <p>Background</p> <p>Artificial language studies have revealed the remarkable ability of humans to extract syntactic structures from a continuous sound stream by mere exposure. However, it remains unclear whether the processes acquired in such tasks are comparable to those applied during normal language processing. The present study compares the ERPs to auditory processing of simple Italian sentences in native and non-native speakers after brief exposure to Italian sentences of a similar structure. The sentences contained a non-adjacent dependency between an auxiliary and the morphologically marked suffix of the verb. Participants were presented four alternating learning and testing phases. During learning phases only correct sentences were presented while during testing phases 50 percent of the sentences contained a grammatical violation.</p> <p>Results</p> <p>The non-native speakers successfully learned the dependency and displayed an N400-like negativity and a subsequent anteriorily distributed positivity in response to rule violations. The native Italian group showed an N400 followed by a P600 effect.</p> <p>Conclusion</p> <p>The presence of the P600 suggests that native speakers applied a grammatical rule. In contrast, non-native speakers appeared to use a lexical form-based processing strategy. Thus, the processing mechanisms acquired in the language learning task were only partly comparable to those applied by competent native speakers.</p

The Surgical Infection Society revised guidelines on the management of intra-abdominal infection

Background: Previous evidence-based guidelines on the management of intra-abdominal infection (IAI) were published by the Surgical Infection Society (SIS) in 1992, 2002, and 2010. At the time the most recent guideline was released, the plan was to update the guideline every five years to ensure the timeliness and appropriateness of the recommendations. Methods: Based on the previous guidelines, the task force outlined a number of topics related to the treatment of patients with IAI and then developed key questions on these various topics. All questions were approached using general and specific literature searches, focusing on articles and other information published since 2008. These publications and additional materials published before 2008 were reviewed by the task force as a whole or by individual subgroups as to relevance to individual questions. Recommendations were developed by a process of iterative consensus, with all task force members voting to accept or reject each recommendation. Grading was based on the GRADE (Grades of Recommendation Assessment, Development, and Evaluation) system; the quality of the evidence was graded as high, moderate, or weak, and the strength of the recommendation was graded as strong or weak. Review of the document was performed by members of the SIS who were not on the task force. After responses were made to all critiques, the document was approved as an official guideline of the SIS by the Executive Council. Results: This guideline summarizes the current recommendations developed by the task force on the treatment of patients who have IAI. Evidence-based recommendations have been made regarding risk assessment in individual patients; source control; the timing, selection, and duration of antimicrobial therapy; and suggested approaches to patients who fail initial therapy. Additional recommendations related to the treatment of pediatric patients with IAI have been included. Summary: The current recommendations of the SIS regarding the treatment of patients with IAI are provided in this guideline

Decision making under uncertainty in environmental projects using mathematical simulation modeling

The final publication is available at Springer via http://dx.doi.org/10.1007/s12665-016-6135-yIn decision-making processes, reliability and risk aversion play a decisive role. The aim of this study is to perform an uncertainty assessment of the effects of future scenarios of sustainable groundwater pumping strategies on the quantitative and chemical status of an aquifer. The good status of the aquifer is defined according to the terms established by the EU Water Framework Directive (WFD). A decision support systems (DSS) is presented, which makes use of a stochastic inverse model (GC method) and geostatistical approaches to calibrate equally likely realizations of hydraulic conductivity (K) fields for a particular case study. These K fields are conditional to available field data, including hard and soft information. Then, different future scenarios of groundwater pumping strategies are generated, based on historical information and WFD standards, and simulated for each one of the equally likely K fields. The future scenarios lead to different environmental impacts and levels of socioeconomic development of the region and, hence, to a different degree of acceptance among stakeholders. We have identified the different stakeholders implied in the decision-making process, the objectives pursued and the alternative actions that should be considered by stakeholders in a public participation project (PPP). The MonteCarlo simulation provides a highly effective way for uncertainty assessment and allows presenting the results in a simple and understandable way even for non-experts stakeholders. The methodology has been successfully applied to a real case study and lays the foundations to performa PPP and stakeholders' involvement in a decisionmaking process as required by the WFD. 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