Lack of effect of combination antibiotic therapy on mortality in patients with pneumococcal sepsis

In order to determine whether combination antibiotic therapy decreases mortality after severe pneumococcal infection, a retrospective study of a cohort of 1,840 adult patients with severe sepsis or septic shock enrolled in two multicenter clinical trials between 1994 and 1999 was conducted. Among 107 patients with monobacterial pneumococcal sepsis, the case-fatality rate was 20% (five of 25) for patients who received antibiotic monotherapy compared with 19.5% (16 of 82) for patients who received combination therapy (adjusted hazard ratio, 1.1; 95% CI, 0.4-3.1). Similarly, monotherapy did not increase the risk of death (adjusted hazard ratio, 1.0; 95% CI, 0.2-4.8) among bacteremic patients (n=75). However, the latter analysis may have been underpowered (power, 58%) to detect a difference in mortality. Overall, in contrast to recently published reports, these results suggest that combination antibiotic therapy does not decrease mortality after severe pneumococcal sepsi

Infants ask for help when they know they don’t know

Uncertainty monitoring is a core property of metacognition, allowing individuals to adapt their decision-making strategies depending on the state of their knowledge. Although it has been argued that other animals share these metacognitive abilities, only humans seem to possess the ability to explicitly communicate their own uncertainty to others. It remains unknown whether this capacity is present early in development, or whether it emerges later with the ability to verbally report one’s own mental states. Here, using a nonverbal memory-monitoring paradigm, we show that 20-month-olds can monitor and report their own uncertainty. Infants had to remember the location of a hidden toy before pointing to indicate where they wanted to recover it. In an experimental group, infants were given the possibility to ask for help through nonverbal communication when they had forgotten the toy location. Compared with a control group in which infants had no other option but to decide by themselves, infants given the opportunity to ask for help used this option strategically to improve their performance. Asking for help was used selectively to avoid making errors and to decline difficult choices. These results demonstrate that infants are able to successfully monitor their own uncertainty and share this information with others to fulfill their goals

The Pragmatic Vision of Visionary Pragmatism: The Challenge of Radical Democracy in a Neoliberal World Order

Visionary Pragmatism is a project formulated in the face of a hyper-malignant mode of capitalism that is provoking and entangled with ecological collapse, dedemocratization, unfathomable inequality, destruction of the commons, intensifying xenophobia, and racism. In the book, I seek modes of radical and ecological democracy that advance beyond both modest resistance and radical posturing that is largely empty and formulaic. I explore possibilities for generating new political modes in a variety of locations, and especially at the intersections where democratic initiatives in higher education engage with myriad publics to intensify alternative processes of knowledge production, political practice, and power that are sufficiently game-transformative in their own right to stand a chance of generating radical change. Beyond myopic pragmatism and hyper-professionalized scholarship, ‘visionary pragmatism’ offers a path along which we might refashion more imaginative theory through modes of creatively engaged practice and, in turn, more radical politics in conjunction with theory thus generated and critical theory broadly construed. Stylistically, the book moves between theoretical reflection and ethnography

Culture change in elite sport performance teams: Examining and advancing effectiveness in the new era

Reflecting the importance of optimizing culture for elite teams, Fletcher and Arnold (2011) recently suggested the need for expertise in culture change. Acknowledging the dearth of literature on the specific process, however, the potential effectiveness of practitioners in this area is unknown. The present paper examines the activity's precise demands and the validity of understanding in sport psychology and organizational research to support its delivery. Recognizing that sport psychologists are being increasingly utilized by elite team management, initial evidence-based guidelines are presented. Finally, to stimulate the development of ecologically valid, practically meaningful knowledge, the paper identifies a number of future research directions

Comparison of two DNA targets for the diagnosis of Toxoplasmosis by real-time PCR using fluorescence resonance energy transfer hybridization probes

BACKGROUND: Toxoplasmosis is an infectious disease caused by the parasitic protozoan Toxoplasma gondii. It is endemic worldwide and, depending on the geographic location, 15 to 85% of the human population are asymptomatically infected. Routine diagnosis is based on serology. The parasite has emerged as a major opportunistic pathogen for immunocompromised patients, in whom it can cause life-threatening disease. Moreover, when a pregnant woman develops a primary Toxoplasma gondii infection, the parasite may be transmitted to the fetus and cause serious damnage. For these two subpopulations, a rapid and accurate diagnosis is required to initiate treatment. Serological diagnosis of active infection is unreliable because reactivation is not always accompanied by changes in antibody levels, and the presence of IgM does not necessarily indicate recent infection. Application of quantitative PCR has evolved as a sensitive, specific, and rapid method for the detection of Toxoplasma gondii DNA in amniotic fluid, blood, tissue samples, and cerebrospinal fluid. METHODS: Two separate, real-time fluorescence PCR assays were designed and evaluated with clinical samples. The first, targeting the 35-fold repeated B1 gene, and a second, targeting a newly described multicopy genomic fragment of Toxoplasma gondii. Amplicons of different intragenic copies were analyzed for sequence heterogeneity. RESULTS: Comparative LightCycler experiments were conducted with a dilution series of Toxoplasma gondii genomic DNA, 5 reference strains, and 51 Toxoplasma gondii-positive amniotic fluid samples revealing a 10 to 100-fold higher sensitivity for the PCR assay targeting the newly described 529-bp repeat element of Toxoplasma gondii. CONCLUSION: We have developed a quantitative LightCycler PCR protocol which offer rapid cycling with real-time, sequence-specific detection of amplicons. Results of quantitative PCR demonstrate that the 529-bp repeat element is repeated more than 300-fold in the genome of Toxoplasma gondii. Since individual intragenic copies of the target are conserved on sequence level, the high copy number leads to an ultimate level of analytical sensitivity in routine practice. This newly described 529-bp repeat element should be preferred to less repeated or more divergent target sequences in order to improve the sensitivity of PCR tests for the diagnosis of toxoplasmosis

Seroprevalence of Toxoplasma gondii and Neospora spp. Infections in Arab Horses, Southwest of Iran

Background: Because of the economic importance of the Arab race horses and also the role of Toxoplasma gondii and Neospora spp. in abortion and reproductive failure of these animals, we decided to perform this study. Objectives: We designed this study to investigate the seroprevalence of anti-Toxoplasma gondii and anti-Neospora spp. antibodies in Arab horses from 12 cities of Khuzestan province in southwest of Iran. Materials and Methods: From October 2009 to March 2011, a total of 235 blood samples were collected from jugular veins of Arab horses of different ages and genders from 12 cities of Khuzestan province. All the sera were tested for anti-Toxoplasma antibodies using the modified agglutination test (MAT) and the existence of anti-Neospora antibodies were tested using N-MAT for Neospora spp. Results: According to the MAT results, antibodies to T. gondii were found in 114 (48.5%) of 235 sera with titers of 1:20 in 84, 1:40 in 19, 1:80 in four, 1:160 in four, and 1:320 in three horses. According to the N-MAT results, antibodies to Neospora spp. were found in 47 (20%) of 235 sera with titers of 1:40 in 39, 1:80 in five, and 1:160 in three horses. We did not observe any statistically significant differences regarding age groups and genders between seropositive and seronegative horses for Neospora spp. using chi-square (chi(2)) test, but it seemed that anti-Toxoplasma antibodies were more prevalent in older horses ( >= 10 years old). Conclusions: The results indicated that Arab horses are exposed to these parasites in southwest of Iran. Further research is required to determine the genomic structures of these parasites in Arab horses in southwest of Iran

SIRTA, a ground-based atmospheric observatory for cloud and aerosol research

Ground-based remote sensing observatories have a crucial role to play in providing data to improve our understanding of atmospheric processes, to test the performance of atmospheric models, and to develop new methods for future space-borne observations. Institut Pierre Simon Laplace, a French research institute in environmental sciences, created the Site Instrumental de Recherche par Télédétection Atmosphérique (SIRTA), an atmospheric observatory with these goals in mind. Today SIRTA, located 20km south of Paris, operates a suite a state-of-the-art active and passive remote sensing instruments dedicated to routine monitoring of cloud and aerosol properties, and key atmospheric parameters. Detailed description of the state of the atmospheric column is progressively archived and made accessible to the scientific community. This paper describes the SIRTA infrastructure and database, and provides an overview of the scientific research associated with the observatory. Researchers using SIRTA data conduct research on atmospheric processes involving complex interactions between clouds, aerosols and radiative and dynamic processes in the atmospheric column. Atmospheric modellers working with SIRTA observations develop new methods to test their models and innovative analyses to improve parametric representations of sub-grid processes that must be accounted for in the model. SIRTA provides the means to develop data interpretation tools for future active remote sensing missions in space (e.g. CloudSat and CALIPSO). SIRTA observation and research activities take place in networks of atmospheric observatories that allow scientists to access consistent data sets from diverse regions on the globe

Epidemiology and outcome of acute lung injury in European intensive care units

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