Discovery of a new azole resistance mechanism in Aspergillus fumigatus through whole genome sequencing and sexual crossing.

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Recent Experiments at Big Karl

Friendship is sometimes assumed to denote a very separate set of concerns to those which have traditionally been thought central to International Relations: sovereignty, states, and nations. Brought into relation to these themes the concern of friendship might appear at best novel or marginal – if it is to be considered pertinent at all. Yet there might be pause to reconsider this conclusion. In recent decades a body of literature has emerged which challenges this view (King and Smith (2007), Devere and Smith (2010), Oelsner and Vion (2011)). Could it be that this literature indicates something about the structure and implications of International Relations which might otherwise be overlooked? Moreover, does ‘friendship’ encourage a re-engagement and restructuring within the ontology of International Relations itself (cf. Berenskoetter 2007)? To pose this question is to consider the ways that friendship offers a challenge and alternative to both how International Relations is understood (its conceptualisation), and the kinds of things that it takes as its basic objects of study and concern (its ontology). This essay suggests that friendship does in fact offer such a challenge. Friendship is not so much an object or identifiable state, but a way of conceptualising relations. Friendship suggests that the focus for understanding both the state and the nation should be to see them as specialised friendship groups. Such a framework also alerts us to the numerous bonds of friendship which are left in more nebulous and fluid states. This remainder makes a reformation of the political possible, and forms one of the bases of change in the international order. This essay is analytical in character. It intends to provide an outline of the role of friendship in International Relations, and to illustrate this with reference to the state and nation. In the first part the conceptualisation of friendship will be explored (which also leads to comment on the more generic problem of conceptualisation itself). Here it is argued that rather than being understood to denote a specific and restricted relationship between discrete entities, friendship is a concept which helps to identify and understand a wider problematic. This problematic is the nature of the bonds between person and person, group and group, and the substantial affects and phenomena that these produce. As such friendship should not be thought to indicate an ‘ideal type’ against which the success of a ‘search’ for friendship in International Relations can be measured. Instead friendship can be thought of as indicating a set of concerns which are focused on identification and reciprocation within a framework of shared values. The concern here is not so much to define friendship, but to identify and analyse its dynamics and consequences. In this sense, friendship is not something ‘possessed’ but something that ‘is happening’. It is not something that can be detailed, but something that helps to structure and explain. The second part the essay proceeds to bring this conceptual framework to bear on two important concepts in International Relations; the state and the nation. By extending the analysis of friendship offered in the first part, here it is argued that both the state and the nation should not be taken to indicate defined (let alone discrete) entities, but are better understood to indicate a complex of concerns centred around the possibilities and affects of bonding. In short, both state and nation are specialised and highly effective instances of friendship. As such, both take pre-existing bonds of friendship and transform them into something new. The state and the nation are therefore significant crystallisations of friendship which emerge from, and transform, existing bonds. Importantly, in so doing they leave a remainder, and it is this underdeveloped friendship which provides the material for future change. The essay concludes that far from being irrelevant to an understanding of International Relations, friendship is central to it. Without an understanding and theorisation of the possibility of relations, both within and between states and nations, there can be no ‘international’. Indeed, it might not only offer a complement to existing approaches, but perhaps ultimately to dislodge the traditional lens shaped by the foci of sovereignty and power, replacing them instead with a focus on a more complex order of identifications, reciprocations, and shared values

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use