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•The gut microbiota in patients with PV is different from that in HCs.•The gut microbiota differs between patients with PV with different treatments.

Moment inequality for quadratic forms of random vectors is of particular interest in covariance matrix testing and estimation problems. In this paper, we prove a Rosenthal-type inequality, which exhibits new features and certain improvement beyond the unstructured Rosenthal inequality of quadratic forms when dimension of the vectors increases without bound. Applications to test the block diagonal structures and detect the sparsity in the high-dimensional covariance matrix are presented. [ABSTRACT FROM AUTHOR]

ABSTRACTNonhemolytic streptococci (NHS) cause serious infections, such as endocarditis and septicemia. Many conventional phenotypic methods are insufficient for the identification of bacteria in this group to the species level. Genetic analysis has revealed that single-gene analysis is insufficient for the identification of all species in this group of bacteria. The aim of the present study was to establish a method based on sequence analysis of the 16S-23S intergenic spacer (ITS) region and the partial gdhgene to identify clinical relevant NHS to the species level. Sequence analysis of the ITS region was performed with 57 NHS reference or clinical strains. Satisfactory identification to the species level was achieved for 14/19 NHS species included in this study on the basis of sequence analysis of the ITS region. Streptococcus salivariusand Streptococcus vestibularisobtained the expected taxon as the best taxon match, but there was a short maximum score distance to the next best match (distance, <10). Streptococcus mitis, Streptococcus oralis, and Streptococcus pneumoniaecould not be unambiguously discriminated by sequence analysis of the ITS region, as was also proven by phylogenetic analysis. These five species could be identified to the group level only by ITS sequence analysis. Partial gdhsequence analysis was applied to the 11 S. oralisstrains, the 11 S. mitisstrains, and the 17 S. pneumoniaestrains. All except one strain achieved a satisfactory identification to the species level. A phylogenetic algorithm based on the analysis of partial gdhgene sequences revealed three distinct clusters. We suggest that sequence analysis of the combination of the ITS region and the partial gdhgene can be used in the reference laboratory for the species-level identification of NHS.

A correct identification of Streptococcus pseudopneumoniaeis a prerequisite for investigating the clinical impact of the bacterium. The identification has traditionally relied on phenotypic methods.

ObjectiveTo determine whether positive expiratory pressure (PEP) by PEP flute self-care is effective in reducing respiratory symptoms among community dwelling adults with SARS-CoV-2 infection and early stage covid-19.DesignNon-drug, open label, randomised controlled trial.SettingCapital Region and Region Zealand in Denmark from 6 October 2020 to 26 February 2021.ParticipantsCommunity dwelling adults, able to perform self-care, with a new SARS-CoV-2 infection (verified by reverse transcription polymerase chain reaction tests) and symptoms of covid-19.InterventionParticipants were randomised to use PEP flute self-care in addition to usual care or have usual care only. Randomisation was based on permuted random blocks in a 1:1 ratio, stratified for sex and age (<60 or ≥60 years). The PEP self-care group was instructed to use a PEP flute three times per day during the 30 day intervention.Main outcome measuresPrimary outcome was a change in symptom severity from baseline to day 30, as assessed by the self-reported COPD (chronic obstructive pulmonary disease) assessment test (CAT), which was adjusted for baseline values and stratification factors. Participants completed the CAT test questionnaire every day online. Secondary outcomes were self-reported urgent care visits due to covid-19, number of covid-19 related symptoms, and change in self-rated health, all within 30-days’ follow-up.Results378 participants were assigned to the PEP flute self-care intervention (n=190) or usual care only (n=188). In the PEP self-care group, the median number of days with PEP flute use was 21 days (interquartile range 13-25). For the intention-to-treat population, a group difference was observed in changes from baseline in CAT scores of −1.2 points (95% confidence interval −2.1 to −0.2; P=0.017) in favour of the PEP flute self-care group. At day 30, the PEP flute self-care group also reported less chest tightness, less dyspnoea, more vigour, and higher level of daily activities, but these differences were small, and no consistent effects were seen on the secondary outcomes. No serious adverse events were reported.ConclusionsIn community dwelling adults with early covid-19, PEP flute self-care had a significant, yet marginal and uncertain clinical effect on respiratory symptom severity, as measured by CAT scores.Trial registrationClinicalTrials.gov NCT04530435.

Two cases of Candida albicansinfections following total hip replacement are presented. The first case describes a patient with bilateral hip prosthesis and peritoneal dialysis. Revision surgery of the left hip, with exchange of a loosened acetabular cup, revealed C. albicansin 5 tissue specimens. This prosthetic infection was probably a result of hematogenous seeding from an infected peritoneal dialysis catheter. The second case describes a patient who had C. albicanssuperinfection after 2 surgical revisions on early deep infection following a primary total hip replacement. Direct inoculation of skin microflora at time of surgery is the most probable explanation. Both patients had predisposing factors as comorbidities and complicated prosthetic surgery. Treatment was a combination of revision surgery and antimicrobial therapy with fluconazole.