Measurement of complement receptor 1 on neutrophils in bacterial and viral pneumonia

BACKGROUND: A reliable prediction of the causative agent of community-acquired pneumonia (CAP) is not possible based on clinical features. Our aim was to test, whether the measurement of the expression of complement receptors or Fcγ receptors on neutrophils and monocytes would be a useful preliminary test to differentiate between bacterial and viral pneumonia. METHODS: Sixty-eight patients with CAP were studied prospectively. Thirteen patients had pneumococcal pneumonia; 13 patients, influenza A pneumonia; 5 patients, atypical pneumonia, and 37 patients, aetiologically undefined pneumonia. Leukocyte receptor expression was measured within 2 days of hospital admission. RESULTS: The mean expression of complement receptor 1 (CR1) on neutrophils was significantly higher in the patients with pneumococcal pneumonia than in those with influenza A pneumonia. The mean expression of CR1 was also significantly higher in aetiologically undefined pneumonia than in influenza A pneumonia, but there was no difference between pneumococcal and undefined pneumonia. CONCLUSION: Our results suggest that the expression of CR1 is higher in classical bacterial pneumonia than in viral pneumonia. Determination of the expression of CR1 may be of value as an additional rapid tool in the aetiological diagnosis, bacterial or viral infection, of CAP. These results are preliminary and more research is needed to assess the utility of this new method in the diagnostics of pneumonia

Scedosporium apiospermum as a rare cause of central skull base osteomyelitis.

We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man. The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms. Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction

Mapping Meaning : Critical Cartographies for Participatory Water Management in Taita Hills, Kenya

Participation of local people is often neglected in natural resource management, which leads to failure to understand the social aspects and historical construction of environmental problems. Participatory mapping can enhance the communication of local spatial knowledge for management processes and challenge the official maps and other spatial representations produced by state authorities and scientists. In this study, we analyze what kind of social meanings can be revealed through a multimethod participatory mapping process focusing on water resources in Taita Hills, Kenya. The participatory mapping clearly complicates the simplified image of the physical science mappings, typically depicting natural water supply, by addressing the impacts of contamination, inadequate infrastructure, poverty, distance to the sources, and restrictions in their uses on people's access to water. Moreover, this shared exercise is able to trigger discussion on issues that cannot always be localized but still contribute to place making. Local historical accounts reveal the social and political drivers of the current water-related problems, making explicit the political ecology dynamics in the area.Peer reviewe

IL-6 and other biomarkers as predictors of severity in COVID-19

ObjectiveCytokine release syndrome is suggested to be the most important mechanism triggering acute respiratory distress syndrome and end organ damage in COVID-19. The severity of disease may be measured by different biomarkers.MethodsWe studied markers of inflammation and coagulation as recorded in 29 patients on admission to the hospital in order to identify markers of severe COVID-19 and need of ICU.ResultsPatients who were eventually admitted to ICU displayed significantly higher serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin. No statistical differences were found between the groups in median levels of lymphocytes, D-dimer or ferritin.ConclusionsIL-6 and CRP were the strongest predictors of severity in hospitalized patients with COVID-19.</p

Evaluation of PCR on Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Aspergillosis: A Bivariate Metaanalysis and Systematic Review

BACKGROUND: Nucleic acid detection by polymerase chain reaction (PCR) is emerging as a sensitive and rapid diagnostic tool. PCR assays on serum have the potential to be a practical diagnostic tool. However, PCR on bronchoalveolar lavage fluid (BALF) has not been well established. We performed a systematic review of published studies to evaluate the diagnostic accuracy of PCR assays on BALF for invasive aspergillosis (IA). METHODS: Relevant published studies were shortlisted to evaluate the quality of their methodologies. A bivariate regression approach was used to calculate pooled values of the method sensitivity, specificity, and positive and negative likelihood ratios. Hierarchical summary receiver operating characteristic curves were used to summarize overall performance. We calculated the post-test probability to evaluate clinical usefulness. Potential heterogeneity among studies was explored by subgroup analyses. RESULTS: Seventeen studies comprising 1191 at-risk patients were selected. The summary estimates of the BALF-PCR assay for proven and probable IA were as follows: sensitivity, 0.91 (95% confidence interval (CI), 0.79-0.96); specificity, 0.92 (95% CI, 0.87-0.96); positive likelihood ratio, 11.90 (95% CI, 6.80-20.80); and negative likelihood ratio, 0.10 (95% CI, 0.04-0.24). Subgroup analyses showed that the performance of the PCR assay was influenced by PCR assay methodology, primer design and the methods of cell wall disruption and DNA extraction. CONCLUSIONS: PCR assay on BALF is highly accurate for diagnosing IA in immunocompromised patients and is likely to be a useful diagnostic tool. However, further efforts towards devising a standard protocol are needed to enable formal validation of BALF-PCR

Developing more authentic e-courses: Working life mentoring through social media

Affordances of social media have not yet been fully exploited in the promotion of authentic e-learning in higher education. In this paper, we examine the planning and implementation of social media in five e-Learning of the Future project courses and how these changes support authentic learning. A further focus of interest is the role of working life mentors in the process. The outcomes indicate that the introduction of social media measures strongly supported the strengthening of authentic learning principles (Herrington & Oliver, 2000) on the courses. Revisions to learning tasks centred on establishing connections to expert communities, the use of blogs, and compilation of entrepreneurial narratives. Working life mentors brought a work-oriented perspective to the process and highlighted skills required by workplaces of the future. Developing educational tasks that cross traditional boundaries raises issues of operational culture change and the roles of partners, and these implications are discussed in the paper

Bioturbation on a south-east Australian hillslope : estimating contributions to soil flux

The contribution of bioturbation to downslope soil transport is significant in many situations, particularly in the context of soil formation, erosion and creep. This study explored the direct flux of soil caused by Aphaenogaster ant mounding, vertebrate scraping and tree-throw on a wildfire-affected hillslope in south-east Australia. This included the development of methods previously applied to Californian gopher bioturbation, and an evaluation of methods for estimating the volume of soil displaced by tree-throw events. All three bioturbation types resulted in a net downslope flux, but any influence of hillslope angle on flux rates appeared to be overshadowed by environmental controls over the spatial extent of bioturbation. As a result, the highest flux rates occurred on the footslope and lower slope. The overall contribution of vertebrate scraping (57.0 +/- 89.4 g m(-1) yr(-1)) exceeded that of ant mounding (36.4 +/- 66.0 g m(-1) yr(-1)), although mean rates were subject to considerable uncertainty. Tree-throw events, which individually cause major disturbance, were limited in their importance by their scarcity relative to faunalturbation. However, tree-throw might be the dominant mechanism of biotic soil flux on the mid-slope provided that it occurs at a frequency of at least 2-3 events ha(-1) yr(-1). Although direct biotic soil flux appears to be geomorphologically significant on this hillslope, such transport processes are probably subordinate to other impacts of bioturbation at this site such as the enhancement of infiltration following wildfire.14 page(s

Developing more authentic E-courses by integrating working life mentoring and social media

Studies show that affordances of social media have not yet been fully exploited in the promotion of authentic e-learning in higher education. The e-Learning of the Future project (2009-2011) has met these challenges through working life mentoring using social media. In this paper, we examine the planning and implementation of social media in nine project courses and how these changes support authentic learning. A further focus of interest is the role of working life mentors in the process. The outcomes indicate that the introduction of social media measures strongly supported the strengthening of authentic learning principles (Herrington & Oliver, 2000) on the courses. Revisions to learning tasks centred on establishing connections to expert communities, the use of blogs, and the compilation of recorded entrepreneurial narratives. Working life mentors brought an up-to-date, work-oriented perspective to the process and highlighted skills required by workplaces of the future. Developing educational tasks that cross traditional boundaries raises issues of operational culture change, the roles of partners and transparency of education, and these implications are discussed in the paper