Evaluation of a Novel Multiplex PCR Panel Compared to Quantitative Bacterial Culture for Diagnosis of Lower Respiratory Tract Infections.

Quantitative bacterial culture of bronchoalveolar lavage fluids (BALF) is labor-intensive, and the delay involved in performing culture, definitive identification, and susceptibility testing often results in prolonged use of broad-spectrum antibiotics. The Unyvero lower respiratory tract (LRT) panel (Curetis, Holzgerlingen, Germany) allows the multiplexed rapid detection and identification of 20 potential etiologic agents of pneumonia within 5 h of collection. In addition, the assay includes detection of gene sequences that confer antimicrobial resistance. We retrospectively compared the performance of the molecular panel to routine quantitative bacterial culture methods on remnant BALF. Upon testing 175 BALF, we were able to analyze positive agreement of 181 targets from 129 samples, and 46 samples were negative. The positive percent agreement (PPA) among the microbial targets was 96.5%, and the negative percent agreement (NPA) was 99.6%. The targets with a PPA of <100% were Staphylococcus aureus (34/37 [91.9%]), Streptococcus pneumoniae (10/11 [90.9%]), and Enterobacter cloacae complex (2/4 [50%]). For the analyzable resistance targets, concordance with phenotypic susceptibility testing was 79% (14/18). This study found the Unyvero LRT panel largely concordant with culture results; however, no outcome or clinical impact studies were performed.

A comparison of minimum segment models for the estimation of centre of mass position and velocity for slip recovery during a bathtub transfer task.

BACKGROUND: Exploring the use of minimum marker sets is important for balancing the technical quality of motion capture with challenging data collection environments and protocols. While minimum marker sets have been demonstrated to be appropriate for evaluation of some motion patterns, there is limited evidence to support model choices for abrupt, asymmetrical, non-cyclic motion such as balance disturbance during a bathtub exit task. RESEARCH QUESTION: How effective are six models of reduced complexity for the estimation of centre of mass (COM) displacement and velocity, relative to a full-body model. METHODS: Eight participants completed a bathtub exit task. Participants received a balance perturbation as they crossed the bathtub rim, stepping from a soapy wet bathtub to a dry floor. Six reduced models were developed from the full, 72-marker, 12 segment 3D kinematic data set. Peak displacement and velocity of the body COM, and RMSE (relative to the full-body model) for displacement and velocity of the body COM were determined for each model. RESULTS: Main effects were observed for peak right, left, anterior, posterior, upwards and downwards motion, and peak left, anterior, posterior, upwards and downwards velocity. Time-varying (RMSE) was smaller for models including the thighs than models not containing the thighs. In contrast, inclusion of upper arm, forearm, and hand segments did not improve model performance. The model containing the sacrum marker only consistently performed the worst across peak and RMSE metrics. SIGNIFICANCE: Findings suggest a simplified centre of mass model may adequately capture abrupt, asymmetrical, non-cyclic tasks, such as balance disturbance recovery during obstacle crossing. A reduced kinematic model should include the thighs, trunk and pelvis segments, although models that are more complex are recommended, depending on the metrics of interest.

Local Sources of Protein in Low- and Middle-Income Countries: How to Improve the Protein Quality?

Protein inadequacy is a major contributor to nutritional deficiencies and adverse health outcomes of populations in low- and middle-income countries (LMICs). People in LMICs often consume a diet predominantly based on staple crops, such as cereals or starches, and derive most of their daily protein intakes from these sources. However, plant-based sources of protein often contain low levels of indispensable amino acids (IAAs). Inadequate intake of IAA in comparison with daily requirements is a limiting factor that results in protein deficiency, consequently in the long-term stunting and wasting. In addition, plant-based sources contain factors such as antinutrients that can diminish protein digestion and absorption. This review describes factors that affect protein quality, reviews dietary patterns of populations in LMICs and discusses traditional and novel small- and large-scale techniques that can improve the quality of plant protein sources for enhanced protein bioavailability and digestibility as an approach to tackle malnutrition in LMICs. The more accessible small-scale food-processing techniques that can be implemented at home in LMICs include soaking, cooking, and germination, whereas many large-scale techniques must be implemented on an industrial level such as autoclaving and extrusion. Limitations and considerations to implement those techniques locally in LMICs are discussed. For instance, at-home processing techniques can cause loss of nutrients and contamination, whereas limitations with larger scale techniques include high energy requirements, costs, and safety considerations. This review suggests that combining these small- and large-scale approaches could improve the quality of local sources of proteins, and thereby address adverse health outcomes, particularly in vulnerable population groups such as children, adolescents, elderly, and pregnant and lactating women.

Emotion differentiation through features of eye-tracking and pupil diameter for monitoring well-being.

Emotions are an important contributor to human self-expression and well-being. However, many populations express their emotions differently from what is considered "typical". Previous literature has indicated a possible relationship between emotion and eye-movement. The objective of this paper is to further explore this proposed relationship by identifying specific features of eye-movement that relate to six emotion categories: joy, surprise, indifference, disgust, sadness, and fear. Features of eye-movement are extracted from measurements of pupil diameter, saccades, and fixations. These measurements are collected as participants view images from the International Affective Picture System, a validated image deck used to evoke known levels of pleasure, arousal, and dominance. Example features of eye-movement measurements such as pupil diameter include maximum or minimum values, means, and standard deviations. Statistical analyses indicate that the extracted features of eye-tracking in this paper can identify fear and sadness with relative accuracy, while more work is needed to differentiate among joy, indifference, disgust, and surprise. Future work aims to understand differences between typically developing populations such as the individuals included in this analysis, and clinical populations such as individuals with cerebral palsy.Clinical Relevance- This pilot study suggests a link between emotion and features of eye-movement. The information will later be used to develop assistive communication devices that better meet the self-expression needs of individuals with motor and communication challenges.

Targeting CCR5 as a Component of an HIV-1 Therapeutic Strategy.

Globally, human immunodeficiency virus type 1 (HIV-1) infection is a major health burden for which successful therapeutic options are still being investigated. Challenges facing current drugs that are part of the established life-long antiretroviral therapy (ART) include toxicity, development of drug resistant HIV-1 strains, the cost of treatment, and the inability to eradicate the provirus from infected cells. For these reasons, novel anti-HIV-1 therapeutics that can prevent or eliminate disease progression including the onset of the acquired immunodeficiency syndrome (AIDS) are needed. While development of HIV-1 vaccination has also been challenging, recent advancements demonstrate that infection of HIV-1-susceptible cells can be prevented in individuals living with HIV-1, by targeting C-C chemokine receptor type 5 (CCR5). CCR5 serves many functions in the human immune response and is a co-receptor utilized by HIV-1 for entry into immune cells. Therapeutics targeting CCR5 generally involve gene editing techniques including CRISPR, CCR5 blockade using antibodies or antagonists, or combinations of both. Here we review the efficacy of these approaches and discuss the potential of their use in the clinic as novel ART-independent therapies for HIV-1 infection.