Fungi isolated from the vagina and their susceptibility to antifungals

Introduction: Because of the presence of various fungi and changes in their spectrum in the mycosis of vagina it is necessary to perform periodic overviews including testing their susceptibility to antifungal agents. Objective: The objective of the study was to evaluate susceptibility of the fungi isolated from vaginas to antifungal drugs and to analyse the fungi responsible for vaginal mycosis in patients referred during a 7-year study. Materials and methods: The study was carried out in a group of patients suspected of vaginal mycosis between January 1, 2005 and December 31, 2011. An analysis of the fungi isolated from their vaginas was performed. The susceptibility of the fungi to six antifungals (5-fluorocytosine, amphotericin B, miconazole, ketoconazole, itraconazole and fluconazole) was evaluated using a semiquantitative Fungitest. Results: A total of 4775 mycological test results were evaluated. Fungi were present in 30.6% of the material. C. albicans was the most frequently isolated fungal species (80.2%), followed by C. glabrata (5.8%), and S. cerevisiae (5.5%). Itraconazole turned out to be the least effective drug. C. krusei. was the species most resistant to antifungals, including fluconazole. Conclusions: 1. C. albicans is the species most frequently isolated from a vagina. It is highly susceptible to azoles, the antimycotics generally used in the treatment of vaginal mycosis. 2. Out of the azoles under study, ketoconazole was the most active against fungi in vitro while itraconazole was the least active. 3. The Candida non-albicans species, and particularly C. krusei, are less susceptible to antimycotics. 4. Amphotericin B and 5-fluorocytosine are most effective against Candida strains and S. cerevisiae, however they are not used in the treatment of vaginal mycosis because of their high toxicity

Systematic reviews of qualitative evidence for environmental policy and management: An overview of different methodological options

This is the final version. Available from BMC via the DOI in this record. Qualitative research related to the human dimensions of conservation and environment is growing in quantity. Rigorous syntheses of such studies can help develop understanding and inform decision-making. They can combine findings from studies in varied or similar contexts to address questions relating to, for example, the lived experience of those affected by environmental phenomena or interventions, or to intervention implementation. Researchers in environmental management have adapted methodology for systematic reviews of quantitative research so as to address questions about the magnitude of intervention effects or the impacts of human activities or exposure. However, guidance for the synthesis of qualitative evidence in this field does not yet exist. The objective of this paper is to present a brief overview of different methods for the synthesis of qualitative research and to explore why and how reviewers might select between these. The paper discusses synthesis methods developed in other fields but applicable to environmental management and policy. These methods include thematic synthesis, framework synthesis, realist synthesis, critical interpretive synthesis and meta-ethnography. We briefly describe each of these approaches, give recommendations for the selection between them, and provide a selection of sources for further reading.European UnionSwedish Foundation for Strategic Environmental Research FORMASSweden’s innovation agency VINNOVAAcademy of FinlandNational Centre for Research and Development in Polan

What is the impact on fish recruitment of anthropogenic physical and structural habitat change in shallow nearshore areas in temperate systems? A systematic review protocol

Shallow nearshore marine ecosystems are changing at an increasing rate due to a range of human activities such as urbanisation and commercial development. The growing numbers of constructions and other physical and structural alterations of the shoreline often take place in nursery and spawning habitats of many fish and other aquatic species. Several coastal fish populations have seen marked declines in abundance and diversity during the past two decades. A systematic review on the topic would clarify if anthropogenic physical and structural changes of near-shore areas have effects on fish recruitment and which these effects are. Methods: The review will examine how various physical and structural anthropogenic changes of nearshore fish habitats affect fish recruitment. Relevant studies include small- and large-scale field studies in marine and brackish systems or large lakes in temperate regions of the Northern and Southern hemispheres. Relevant studies may be based on comparisons between undisturbed and disturbed areas, before and after disturbance, or both. Relevant outcomes include measures of recruitment defined as abundance of juveniles of nearshore fish communities. Searches will be made for peer-reviewed and grey literature in English, Dutch, Danish, Finnish, German, Swedish and Spanish. All fish species and species groups will be considered in this review. Included relevant studies will be subject to a critical appraisal that will assess study validity. From relevant included studies, we will extract information on study characteristics, measured outcomes, exposure, comparators, effect modifiers and critical appraisal. Data synthesis will contain narrative and summary findings of each included study of sufficient quality. Meta-analysis may be possible in cases where studies report similar types of outcome

Antagonistic Activities of Sox2 and Brachyury Control the Fate Choice of Neuro-Mesodermal Progenitors

The spinal cord and mesodermal tissues of the trunk such as the vertebral column and skeletal musculature derive from neuro-mesodermal progenitors (NMPs). Sox2, Brachyury (T), and Tbx6 have been correlated with NMP potency and lineage choice; however, their exact role and interaction in these processes have not yet been revealed. Here we present a global analysis of NMPs and their descending lineages performed on purified cells from embryonic day 8.5 wild-type and mutant embryos. We show that T, cooperatively with WNT signaling, controls the progenitor state and the switch toward the mesodermal fate. Sox2 acts antagonistically and promotes neural development. T is also involved in remodeling the chromatin for mesodermal development. Tbx6 reinforces the mesodermal fate choice, represses the progenitor state, and confers paraxial fate commitment. Our findings refine previous models and establish molecular principles underlying mammalian trunk development, comprising NMP maintenance, lineage choice, and mesoderm formation

Structured computer-based training in the interpretation of neuroradiological images

Computer-based systems may be able to address a recognised need throughout the medical profession for a more structured approach to training. We describe a combined training system for neuroradiology, the MR Tutor that differs from previous approaches to computer-assisted training in radiology in that it provides case-based tuition whereby the system and user communicate in terms of a well-founded Image Description Language. The system implements a novel method of visualisation and interaction with a library of fully described cases utilising statistical models of similarity, typicality and disease categorisation of cases. We describe the rationale, knowledge representation and design of the system, and provide a formative evaluation of its usability and effectiveness

Eight problems with literature reviews and how to fix them.

Traditional approaches to reviewing literature may be susceptible to bias and result in incorrect decisions. This is of particular concern when reviews address policy- and practice-relevant questions. Systematic reviews have been introduced as a more rigorous approach to synthesizing evidence across studies; they rely on a suite of evidence-based methods aimed at maximizing rigour and minimizing susceptibility to bias. Despite the increasing popularity of systematic reviews in the environmental field, evidence synthesis methods continue to be poorly applied in practice, resulting in the publication of syntheses that are highly susceptible to bias. Recognizing the constraints that researchers can sometimes feel when attempting to plan, conduct and publish rigorous and comprehensive evidence syntheses, we aim here to identify major pitfalls in the conduct and reporting of systematic reviews, making use of recent examples from across the field. Adopting a 'critical friend' role in supporting would-be systematic reviews and avoiding individual responses to police use of the 'systematic review' label, we go on to identify methodological solutions to mitigate these pitfalls. We then highlight existing support available to avoid these issues and call on the entire community, including systematic review specialists, to work towards better evidence syntheses for better evidence and better decisions

Integrated Multiparametric Radiomics and Informatics System for Characterizing Breast Tumor Characteristics with the OncotypeDX Gene Assay

Optimal use of multiparametric magnetic resonance imaging (mpMRI) can identify key MRI parameters and provide unique tissue signatures defining phenotypes of breast cancer. We have developed and implemented a new machine-learning informatic system, termed Informatics Radiomics Integration System (IRIS) that integrates clinical variables, derived from imaging and electronic medical health records (EHR) with multiparametric radiomics (mpRad) for identifying potential risk of local or systemic recurrence in breast cancer patients. We tested the model in patients (n = 80) who had Estrogen Receptor positive disease and underwent OncotypeDX gene testing, radiomic analysis, and breast mpMRI. The IRIS method was trained using the mpMRI, clinical, pathologic, and radiomic descriptors for prediction of the OncotypeDX risk score. The trained mpRad IRIS model had a 95% and specificity was 83% with an Area Under the Curve (AUC) of 0.89 for classifying low risk patients from the intermediate and high-risk groups. The lesion size was larger for the high-risk group (2.9 ± 1.7 mm) and lower for both low risk (1.9 ± 1.3 mm) and intermediate risk (1.7 ± 1.4 mm) groups. The lesion apparent diffusion coefficient (ADC) map values for high- and intermediate-risk groups were significantly (p \u3c 0.05) lower than the low-risk group (1.14 vs. 1.49 × 10−3 mm2/s). These initial studies provide deeper insight into the clinical, pathological, quantitative imaging, and radiomic features, and provide the foundation to relate these features to the assessment of treatment response for improved personalized medicine

Spatial Segregation of Roma Settlements Within Serbian Cities. Examples from Belgrade, Novi Sad, and Kruševac

This chapter focuses on the spatial segregation of Roma settlements within Serbian cities, shaped by the long-standing ethnic distance and social exclusion. In order to understand the broader context, the historical background against which Roma settlements emerged in Serbia, as well as their current demographic, legislative, and urban characteristics, are briefly presented. Several forms of segregation of Roma settlements are analysed, including segregation as a consequence of racist hostility, institutional discrimination by city administration, and development-based conflicts. Examples of setting up a wall enclosing a Roma settlement in Kruševac, racist pressures that prevent the construction of housing for Roma in Belgrade and the reluctance to improve and legalise Roma settlements in Novi Sad, illustrate the various manifestations of segregation and division of urban space in Serbia.The Urban Book Serie

What are the impacts of within-field farmland management practices on the flux of greenhouse gases from arable cropland in temperate regions? A systematic map protocol

Background: Reducing greenhouse gas emissions is a vital step in limiting climate change and meeting the goals outlined in the COP 21 Paris Agreement of 2015. Studies have suggested that agriculture accounts for around 11% of total greenhouse gas emissions and the industry has a significant role in meeting international and national climate change reduction objectives. However, there is currently little consensus on the mechanisms that regulate the production and assimilation of greenhouse gases in arable land and the practical factors that affect the process. Practical advice for farmers is often overly general, and models based on the amount of nitrogen fertiliser applied, for example, are used despite a lack of knowledge of how local conditions affect the process, such as the importance of humus content and soil types. Here, we propose a systematic map of the evidence relating to the impact on greenhouse gas flux from the agricultural management of arable land in temperate regions. Methods: Using established methods for systematic mapping in environmental sciences we will search for, collate and catalogue research studies relating to the impacts of farming in temperate systems on greenhouse gas emissions. We will search 6 bibliographic databases using a tested search string, and will hand search a web-based search engine and a list of organisational web sites. Furthermore, evidence will be sought from key stakeholders. Search results will then be screened for relevance at title, abstract and full text levels according to a predefined set of eligibility criteria. Consistency checking will be employed to ensure the criteria are being applied accurately and consistently. Relevant studies will then be subjected to coding and meta-data extraction, which will be used to populate a systematic map database describing each relevant study's settings, methods and measured outcomes. The mapping process will help to identify knowledge gaps (subjects lacking in evidence warranting further primary research) and knowledge clusters (subjects with sufficient studies to allow a useful full systematic review), and will highlight best and suboptimal research methods

What evidence exists on ecotechnologies for recycling carbon and nutrients from domestic wastewater? a systematic map

Abstract: Background: Eutrophication of the Baltic Sea, and many other water bodies, is partly the result of point-source emissions of nutrients and carbon from wastewater. At the same time, nitrogen and phosphorus planetary boundaries have been breached. There is a need for more efficient resource management, including the recovery and reuse of nutrients and carbon in waste. The aim of this paper is to collate evidence on ecotechnologies intended for use in the wastewater sector globally to facilitate the recovery or reuse of carbon and/or nutrients. Methods: Searches were performed on literature published between 2013 and 2017 and in 5 bibliographic databases, 1 search engine, and 38 specialist websites. Database searches were performed in English. Searches in specialist websites were also performed in Finnish, Polish and Swedish. There was no geographical limitation. Screening was conducted at title and abstract level, and on full texts. Apart from bibliographical information, we extracted information on ecotechnology type, intervention, details of the recovery or reuse, the type of wastewater stream to which the ecotechnology is applied, the study location, type and design. Prior to screening and coding, we conducted consistency checks amongst reviewers. We generated a searchable database of coded studies. Findings were synthesised narratively and visualised in a geographical information system (i.e. an evidence atlas). We identified a series of knowledge gaps and clusters that warrant further research. Results: The search resulted in 4024 records, out of which 413 articles were retained after the screening process. In addition, 35 pre-screened studies from the specialist website searches were added. Together, these 448 articles contained 474 individual studies of 28 types of ecotechnologies. A combination of ecotechnologies (16.7%), followed by microalgae cultivation (14.1%) were the most frequent ecotechnologies in the evidence base. Ecotechnologies for recovery composed 72.6% of the evidence base. The most common wastewater streams for recovery were mixed wastewater and sludge (73.8%). There was a relative lack of studies on recovery from source-separated wastewater. The most common type of recovery was energy (27.3%), followed by simultaneous recovery of nitrogen and phosphorus (22.1%). Reuse of recovered substances was described in 22.8% of the studies. The most common type of reuse was of nitrogen and phosphorus (57.4%), followed by joint reuse of organic carbon, nitrogen and phosphorus (35.2%). Reuse ecotechnologies were mostly focused on the use of wastewater for irrigation or reuse of biosolids, and not on the nutrients that had been extracted through e.g. precipitation of struvite. In 22 studies both recovery and reuse were described. In total, 60 different study countries were reported in the evidence base, and the most common study location was China