Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either gram negative or gram positive bacteria

<p>Abstract</p> <p>Background</p> <p>In the ICU, bacteremia is a life-threatening infection whose prognosis is highly dependent on early recognition and treatment with appropriate antibiotics. Procalcitonin levels have been shown to distinguish between bacteremia and noninfectious inflammatory states accurately and quickly in critically ill patients. However, we still do not know to what extent the magnitude of PCT elevation at the onset of bacteremia varies according to the Gram stain result.</p> <p>Methods</p> <p>Review of the medical records of every patient treated between May, 2004 and December, 2006 who had bacteremia caused by either Gram positive (GP) or Gram negative (GN) bacteria, and whose PCT dosage at the onset of infection was available.</p> <p>Results</p> <p>97 episodes of either GN bacteremia (<it>n </it>= 52) or GP bacteremia (<it>n </it>= 45) were included. Procalcitonin levels were found to be markedly higher in patients with GN bacteremia than in those with GP bacteremia, whereas the SOFA score value in the two groups was similar. Moreover, in the study population, a high PCT value was found to be independently associated with GN bacteremia. A PCT level of 16.0 ng/mL yielded an 83.0% positive predictive value and a 74.0% negative predictive value for GN-related bacteremia in the study cohort (AUROCC = 0.79; 95% CI, 0.71–0.88).</p> <p>Conclusion</p> <p>In a critically ill patient with clinical sepsis, GN bacteremia could be associated with higher PCT values than those found in GP bacteremia, regardless of the severity of the disease.</p

Hyper-parameter Optimisation by Restrained Stochastic Hill Climbing

Abstract. Machine learning practitioners often refer to hyper-parameter optimisation (HPO) as an art form and a skill that requires intuition and experience; Neuroevolution (NE) typically employs a combination of manual and evolutionary approaches for HPO. This paper explores the integration of a stochastic hill climbing approach for HPO within a NE algorithm. We empirically show that HPO by restrained stochastic hill climbing (HORSHC) is more effective than manual and pure evolutionary HPO. Empirical evidence is derived from a comparison of: (1) a NE algorithm that solely optimises hyper-parameters through evolution and (2) a number of derived algorithms with random search optimisation integration for optimising the hyper-parameters of a Neural Network. Through statistical analysis of the experimental results it has been revealed that random initialisation of hyper-parameters does not significantly affect the final performance of the Neural Networks evolved. However, HORSHC, a novel optimisation approach proposed in this paper has been proven to significantly out-perform the NE control algorithm. HORSHC presents itself as a solution that is computationally comparable in terms of both time and complexity as well as outperforming the control algorithm

Post-transcriptional control during chronic inflammation and cancer: a focus on AU-rich elements

A considerable number of genes that code for AU-rich mRNAs including cytokines, growth factors, transcriptional factors, and certain receptors are involved in both chronic inflammation and cancer. Overexpression of these genes is affected by aberrations or by prolonged activation of several signaling pathways. AU-rich elements (ARE) are important cis-acting short sequences in the 3′UTR that mediate recognition of an array of RNA-binding proteins and affect mRNA stability and translation. This review addresses the cellular and molecular mechanisms that are common between inflammation and cancer and that also govern ARE-mediated post-transcriptional control. The first part examines the role of the ARE-genes in inflammation and cancer and sequence characteristics of AU-rich elements. The second part addresses the common signaling pathways in inflammation and cancer that regulate the ARE-mediated pathways and how their deregulations affect ARE-gene regulation and disease outcome

Association of NRAMP1 polymorphism with leprosy type but not susceptibility to leprosy per se in west Africans.

Twin and family studies indicate that host genetic factors influence susceptibility to leprosy and, possibly, leprosy type. Murine studies have suggested a role for the natural resistance-associated macrophage protein 1 (Nramp1) gene, which can influence cellular immune responses to intracellular pathogens. We evaluated a variation in the human homolog, NRAMP1, recently associated with tuberculosis susceptibility in West Africa. A total of 273 patients with leprosy and 201 controls from Mali were genotyped for NRAMP1 polymorphisms previously associated with tuberculosis. No association was found with leprosy per se (P = 0.83), but the NRAMP1 3'-untranslated region 4-bp insertion/deletion polymorphism was associated with leprosy type (P = 0.007). Heterozygotes were more frequent among multibacillary than paucibacillary leprosy cases. Thus, variation in or near the NRAMP1 gene may exert an influence on the clinical presentation of leprosy, possibly by influencing cellular immune response type

SEARCHING for PLANET NINE with COADDED WISE and NEOWISE-REACTIVATION IMAGES

A distant, as yet unseen ninth planet has been invoked to explain various observations of the outer solar system. While such a "Planet Nine," if it exists, is most likely to be discovered via reflected light in the optical, it may emit much more strongly at 3-5 μm than simple blackbody predictions would suggest, depending on its atmospheric properties. As a result, Planet Nine may be detectable at 3.4 μm with the Wide-field Infrared Survey Explorer, but single exposures are too shallow except at relatively small distances ( au). We develop a method to search for Planet Nine far beyond the W1 single-exposure sensitivity, to distances as large as 800 au, using inertial coadds of W1 exposures binned into ∼1 day intervals. We apply our methodology to a ∼2000 square degree testbed sky region which overlaps a southern segment of Planet Nine's anticipated orbital path. We do not detect a plausible Planet Nine candidate, but are able to derive a detailed completeness curve, ruling out its presence within the parameter space searched at W1 &lt; 16.66 (90% completeness). Our method uses all publicly available W1 imaging, spanning 2010 January to 2015 December, and will become more sensitive with future NEOWISE-Reactivation releases of additional W1 exposures. We anticipate that our method will be applicable to the entire high Galactic latitude sky, and we will extend our search to that full footprint in the near future