Regional-scale vegetation heterogeneity in northeastern Patagonia: Environmental and spatial components

Our aim was to describe vegetation heterogeneity at a regional scale in northeastern Patagonia and to identify the environmental variables associated to it. The study area encompasses 13 144 km2 and is characterized by a mixture of species typical of Patagonian steppes and Monte Desert. We performed 48 vegetation relevés, which were randomly assigned to a training set and to a validation set (32 and 16 relevés, respectively). Training set was subjected to cluster analysis, which allowed the identification of two plant communities one related to Patagonian steppes and another to the Monte desert. We derived 3 attributes of the seasonal curve of the NDVI as indicators of ecosystem function: the seasonal amplitude (SA), the date of the maximum (DOM), and the large seasonal integral (LSI). We explored the relationship between NDVI attributes and communities by classification tree analysis. LSI was the strongest predictor among NDVI attributes, separating both communities without misclassification errors. Patagonian steppes occupy areas with higher LSI. The partial RDA analysis explained 38.1% of total data variation, of which 16.5% was ascribed to environment, 7.9% to space, and 13.7% to spatial component of environment. Patagonian steppes are closer to the coast, in areas exhibiting higher annual precipitation and lower annual temperature range than Monte deserts. Our results indicate the occurrence of two plant communities in the study area and highlight the significance of climatic variables to explain their spatial distribution. As most scenarios of future climate predict greater annual thermal amplitude in the study area, the limit between both communities could be displaced eastward

Role of cephalosporins in the era of Clostridium difficile infection

The incidence of Clostridium difficile infection (CDI) in Europe has increased markedly since 2000. Previous meta-analyses have suggested a strong association between cephalosporin use and CDI, and many national programmes on CDI control have focused on reducing cephalosporin usage. Despite reductions in cephalosporin use, however, rates of CDI have continued to rise. This review examines the potential association of CDI with cephalosporins, and considers other factors that influence CDI risk. EUCLID (the EUropean, multicentre, prospective biannual point prevalence study of CLostridium difficile Infection in hospitalized patients with Diarrhoea) reported an increase in the annual incidence of CDI from 6.6 to 7.3 cases per 10 000 patient bed-days from 2011–12 to 2012–13, respectively. While CDI incidence and cephalosporin usage varied widely across countries studied, there was no clear association between overall cephalosporin prescribing (or the use of any particular cephalosporin) and CDI incidence. Moreover, variations in the pharmacokinetic and pharmacodynamic properties of cephalosporins of the same generation make categorization by generation insufficient for predicting impact on gut microbiota. A multitude of additional factors can affect the risk of CDI. Antibiotic choice is an important consideration; however, CDI risk is associated with a range of antibiotic classes. Prescription of multiple antibiotics and a long duration of treatment are key risk factors for CDI, and risk also differs across patient populations. We propose that all of these are factors that should be taken into account when selecting an antibiotic, rather than focusing on the exclusion of individual drug classes

Catheter Related Bloodstream Infection (CR-BSI) in ICU Patients: Making the Decision to Remove or Not to Remove the Central Venous Catheter

Background Approximately 150 million central venous catheters (CVC) are used each year in the United States. Catheter-related bloodstream infections (CR-BSI) are one of the most important complications of the central venous catheters (CVCs). Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI. Methods We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU) from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (\u3e15 CFU) culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1) differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2) simultaneous quantitative blood culture with 5:1 ratio (CVC versus peripheral). Results 53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method) were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208) in ICU patients. Conclusion In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality

Analysis of observations backing up the existence of VLF and ionospheric TEC anomalies before the Mw6.1 earthquake in Greece, January 26, 2014

The present work integrates ground-based ionosphere measurements using very-low-frequency radio transmissions with satellite measurements of the total electron content to draw common conclusions about the possible impact that the Mw6.1 earthquake that took place in Greece on January 26, 2014, had on the ionosphere. Very-low-frequency radio signals reveal the existence of an ~4-day anomaly in the wavelet spectra of the signals received inside the earthquake preparation zone and a significant increase in the normalized variance of the signals prior to the earthquake (approximately 1 day before). Through total electron content analysis, it was possible to identify a clear anomaly from 15:00 until 20:00 UT on the day before the earthquake that appears again on the day of the earthquake between 07:00 UT and 08:00 UT. The anomalous values reach TEC*Sigma ~4.36 and 3.11, respectively. Their spatial and temporal distributions give grounds to assume a possible link with the earthquake preparation. The geomagnetic, solar and weather conditions during the considered period are presented and taken into account. This work is an initial and original step towards a multi-parameter approach to the problem of the possible earthquake-related effects on the ionosphere joining observations made from both ground stations and satellites. A well-founded knowledge of these phenomena is clearly necessary before dealing with their application to earthquake prediction purposes

Interest representation in the EU: an open and structured dialogue?

Since 1992, the European Commission has sought to build ‘An Open and Structured Dialogue’ with interest groups, and since 2001 a broader ‘Dialogue with Civil Society’. A core feature of this dialogue involves instruments of transparency, and pluralism, with funding to ensure the presence of a wide range of voices. Consultation procedures provide for a ‘marketplace of ideas’ which simulate political competition and contestation, with a ‘voice but not a vote’, and which are supposed to provide for answerability by the European Commission for its policy choices. The European Commission also selects its allies to support its regulatory proposals, with NGOs frequent allies as well as firms and business sectors supporting higher standards. The EU’s fragmented decision-making system helps to provide a naturally pluralist environment, although some recent research suggests that NGOs are more likely to be successful in securing their policy goals than business organizations. NGOs work mostly in coalitions, with the size of coalition a factor in lobbying success. The saliency of issues is another substantial feature of variation in lobbying success and where NGOs can raise the contention of issues they can bring wider participation in EU issues

Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis.

Background Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Methods and Results Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0%) in the ICE-PCS cohort and 342 of 1197 (28.6%) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions Six-month mortality after IE is 25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in I

Characterization of Pseudomonas aeruginosa isolates: Occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global SENTRY Antimicrobial Surveillance Program, 1997-1999

During 1997–1999, a total of 70,067 isolates (6631 Pseudomonas aeruginosa isolates) were analyzed in the SENTRY program by geographic region and body site of infection. The respiratory tract was the most common source of P. aeruginosa. P. aeruginosa isolation rates increased during the study interval. Europe was the only region to show a significant decline in β-lactam and aminoglycoside susceptibility rates. There was a reduction in the rates of susceptibility of Canadian isolates to imipenem and of Latin American isolates to meropenem. A total of 218 multidrug-resistant P. aeruginosa isolates (MDR-PSA; resistant to piperacillin, ceftazidime, imipenem, and gentamicin) were observed; MDR-PSA occurrence rates (percentages of all isolates) ranged from 8.2% (Latin America) to 0.9% (Canada). No antimicrobial inhibited >50% of MDR-PSA strains. Molecular characterization of selected, generally resistant strains was performed. Isolates showing unique ribogroups were found in Europe, Latin America, and the United States, but clonal spread was documented in several medical centers.A. C. Gales, R. N. Jones, J. Turnidge, R. Rennie, and R. Rampha

Use of cultivation-dependent and -independent techniques to assess contamination of central venous catheters: a pilot study

<p>Abstract</p> <p>Background</p> <p>Catheters are the most common cause of nosocomial infections and are associated with increased risk of mortality, length of hospital stay and cost. Prevention of infections and fast and correct diagnosis is highly important.</p> <p>Methods</p> <p>In this study traditional semiquantitative culture-dependent methods for diagnosis of bacteria involved in central venous catheter-related infections as described by Maki were compared with the following culture-independent molecular biological methods: Clone libraries, denaturant gradient gel electrophoresis, phylogeny and fluorescence in situ hybridization.</p> <p>Results</p> <p>In accordance with previous studies, the cultivation of central venous catheters from 18 patients revealed that <it>S. epidermidis </it>and other coagulase-negative staphylococci were most abundant and that a few other microorganisms such as <it>P. aeruginosa </it>and <it>K. pneumoniae </it>occasionally were found on the catheters. The molecular analysis using clone libraries and sequencing, denaturant gradient gel electrophoresis and sequencing provided several important results. The species found by cultivation were confirmed by molecular methods. However, many other bacteria belonging to the phyla <it>Proteobacteria, Firmicutes, Actinobacteria </it>and <it>Bacteroidetes </it>were also found, stressing that only a minor portion of the species present were found by cultivation. Some of these bacteria are known to be pathogens, some have not before been described in relation to human health, and some were not closely related to known pathogens and may represent new pathogenic species. Furthermore, there was a clear difference between the bacterial species found in biofilm on the external (exluminal) and internal (luminal) side of the central venous catheter, which can not be detected by Maki's method. Polymicrobial biofilms were observed on most of the catheters and were much more common than the cultivation-dependent methods indicated.</p> <p>Conclusion</p> <p>The results show that diagnosis based on molecular methods improves the detection of microorganisms involved in central catheter-related infections. The importance of these microorganisms needs to be investigated further, also in relation to contamination risk from improper catheter handling, as only in vivo contaminants are of interest. This information can be used for development of fast and more reliable diagnostic tools, which can be used in combination with traditional methods.</p