Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge.

Forecasting the effects of global warming on biodiversity

The demand for accurate forecasting of the effects of global warming on biodiversity is growing, but current methods for forecasting have limitations. in this article, we compare and discuss the different uses of four forecasting methods: (1) models that consider species individually, (2) niche-theory models that group species by habitat (more specifically, by environmental conditions under which a species can persist or does persist), (3) general circulation models and coupled ocean-atmosphere-biosphere models, and (4) specics-area curve models that consider all species or large aggregates of species. After outlining the different uses and limitations of these methods, we make eight primary suggestions for improving forecasts. We find that greater use of the fossil record and of modern genetic studies would improve forecasting methods. We note a Quaternary conundrum: While current empirical and theoretical ecological results suggest that many species could be at risk from global warming, during the recent ice ages surprisingly few species became extinct. The potential resolution of this conundrum gives insights into the requirements for more accurate and reliable forecasting. Our eight suggestions also point to constructive synergies in the solution to the different problems.

L'assistance au suicide en Suisse dans le contexte de polypathologie invalidante irréversible [Assisted suicide in Switzerland in the context of irreversible illness].

La prise en charge des personnes en fin de vie s'est beaucoup développée en Suisse au cours des dernières décennies, et assure, grâce aux soins gériatriques et palliatifs, dans une grande majorité des cas, une fin de vie digne aux patients. Il arrive toutefois que des malades, motivés notamment par une grande lassitude, aient recours à une association telle qu'EXIT pour les accompagner dans leur désir de mettre fin à leurs jours, même s'ils ne sont pas atteints d'une maladie mettant leur vie en danger. Nous avons étudié ce phénomène chez les 21 personnes, qui ont mis fin à leurs jours avec l'aide de l'association EXIT, sur une période de cinq ans (2001-2005) ; les souffrances physiques de ces malades étaient représentées essentiellement par des douleurs importantes, une asthénie, des troubles respiratoires, neurologiques ou digestifs. A cela, s'ajoutaient les difficultés psychologiques liées à la perte d'autonomie, la solitude, l'angoisse et le sentiment de perte de dignité. Malgré l'absence de maladie mortelle en soi, nous avons pu observer que les critères exigés par l'association EXIT pour envisager un accompagnement étaient respectés dans tous les cas.

The extracellular matrix in multiple sclerosis: an update

Extracellular matrix (ECM) molecules play important roles in the pathobiology of the major human central nervous system (CNS) inflammatory/demyelinating disease multiple sclerosis (MS). This mini-review highlights some recent work on CNS endothelial cell interactions with vascular basement membrane ECM as part of the cellular immune response, and roles for white matter ECM molecules in demyelination and remyelination in MS lesions. Recent basic and clinical investigations of MS emphasize axonal injury, not only in chronic MS plaques, but also in acute lesions; progressive axonal degeneration in normal-appearing white matter also may contribute to brain and spinal cord atrophy in MS patients. Remodeling of the interstitial white matter ECM molecules that affect axon regeneration, however, is incompletely characterized. Our ongoing immunohistochemical studies demonstrate enhanced ECM versican, a neurite and axon growth-inhibiting white matter ECM proteoglycan, and dermatan sulfate proteoglycans at the edges of inflammatory MS lesions. This suggests that enhanced proteoglycan deposition in the ECM and axonal growth inhibition may occur early and are involved in expansion of active lesions. Decreased ECM proteoglycans and their phagocytosis by macrophages along with myelin in plaque centers imply that there is "injury" to the ECM itself. These results indicate that white matter ECM proteoglycan alterations are integral to MS pathology at all disease stages and that they contribute to a CNS ECM that is inhospitable to axon regrowth/regeneration.

L’émission des comportements inadaptés au travail : adaptation ou explication quant à la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail

La présente thèse de doctorat porte sur la relation entre la perception de la justice organisationnelle, l’émission de comportements inadaptés au travail et la santé psychologique des individus au travail. En plus de développer un outil de mesure des comportements inadaptés au travail et d’entreprendre un processus de validation de celui-ci, le présent travail propose que les comportements inadaptés au travail puissent occuper un rôle soit protecteur ou explicatif dans la relation qui unit la perception de la justice organisationnelle avec la santé psychologique des individus au travail. Au sein de cette thèse, le premier article recense la documentation scientifique quant aux variables de la perception de la justice organisationnelle, de l’émission des comportements inadaptés au travail et de la santé psychologique des individus au travail, ainsi que les liens qui unissent ces variables. Aussi, les modèles conceptuels des rôles modérateur et médiateur des comportements inadaptés au travail sont proposés au sein de la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. Le deuxième article a pour objectif de développer un outil de mesure des comportements inadaptés au travail et de tester ses propriétés psychométriques. Ainsi, des analyses statistiques exploratoires et confirmatoires ont été effectuées. Afin d’appuyer la valeur critériée de l’outil proposé, une analyse corrélationnelle a été réalisée avec le critère de l’adaptation. Certaines valeurs psychométriques de l’outil sont validées par les résultats obtenus. Le troisième article examine empiriquement les modèles conceptuels des rôles anticipés des comportements inadaptés au travail dans la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. La perception de la justice organisationnelle a été vue sous les composantes distributive, procédurale, informationnelle et interpersonnelle. De son côté, la santé psychologique des individus a été observée par le biais des éléments du bien-être et de la détresse psychologique au travail. Les différentes analyses de régressions multiples hiérarchiques ont permis d’observer l’absence du rôle modérateur des comportements inadaptés au travail. Pour sa part, l’utilisation du test de Sobel a démontré la présence du rôle médiateur des comportements inadaptés au travail dans certaines relations. Plus exactement, celles-ci sont la relation entre la justice interpersonnelle et le bien-être psychologique au travail, la relation entre la justice interpersonnelle et la détresse psychologique au travail, ainsi que la relation entre la justice distributive et la détresse psychologique au travail. Finalement, la conclusion de la thèse présente une synthèse des résultats et expose les limites et pistes de recherches futures.

Effectiveness Of Feature Detection Operators On The Performance Of Iris Biometric Recognition System

Iris Recognition is a highly efficient biometric identification system with great possibilities for future in the security systems area.Its robustness and unobtrusiveness, as opposed tomost of the currently deployed systems, make it a good candidate to replace most of thesecurity systems around. By making use of the distinctiveness of iris patterns, iris recognition systems obtain a unique mapping for each person. Identification of this person is possible by applying appropriate matching algorithm.In this paper, Daugman’s Rubber Sheet model is employed for irisnormalization and unwrapping, descriptive statistical analysis of different feature detection operators is performed, features extracted is encoded using Haar wavelets and for classification hammingdistance as a matching algorithm is used. The system was tested on the UBIRIS database. The edge detection algorithm, Canny, is found to be the best one to extract most of the iris texture. The success rate of feature detection using canny is 81%, False Accept Rate is 9% and False Reject Rate is 10%.

On blame-freeness and reciprocity: an experimental study

The theory of reciprocity is predicated on the assumption that people are willing to reward nice or kind acts and to punish unkind ones. This assumption raises the question as to how to define kindness. In this paper we offer a new definition of kindness that we call “blame-freeness.” Put most simply, blame-freeness states that in judging whether player i has been kind or unkind to player j in a social situation, player j would have to put himself in the strategic position of player i, while retaining his preferences, and ask if he would have acted in a manner that was worse than i did under identical circumstances. If j would have acted in a more unkind manner than i acted, then we say that j does not blame i for his behavior. If, however, j would have been nicer than i was, then we say that “j blames i” for his actions (i’s actions were blameworthy). We consider this notion a natural, intuitive and empirically relevant way to explain the motives of people engaged in reciprocal behavior. After developing the conceptual framework, we then test this concept in a laboratory experiment involving tournaments and find significant support for the theory.

Changing direction on direction of fit

In this paper, I show that we should understand the direction of fit of beliefs and desires in normative terms. After rehearsing a standard objection to Michael Smith’s analysis of direction of fit, I raise a similar problem for Lloyd Humberstone’s analysis. I go on to offer my own account, according to which the difference between beliefs and desires is determined by the normative relations such states stand in. I argue that beliefs are states which we have reason to change in light of the world, whereas desires are states that give us reason to change the world. After doing this, I show how the view avoids various objections, including two from David Sobel and David Copp. The paper ends by briefly discussing the relevance of the view to the Humean theory of motivation.

Characteristics of tropical cyclones in high-resolution models in the present climate

The global characteristics of tropical cyclones (TCs) simulated by several climate models are analyzed and compared with observations. The global climate models were forced by the same sea surface temperature (SST) fields in two types of experiments, using climatological SST and interannually varying SST. TC tracks and intensities are derived from each model's output fields by the group who ran that model, using their own preferred tracking scheme; the study considers the combination of model and tracking scheme as a single modeling system, and compares the properties derived from the different systems. Overall, the observed geographic distribution of global TC frequency was reasonably well reproduced. As expected, with the exception of one model, intensities of the simulated TC were lower than in observations, to a degree that varies considerably across models.

Hurricanes and climate: the U.S. CLIVAR working group on hurricanes

While a quantitative climate theory of tropical cyclone formation remains elusive, considerable progress has been made recently in our ability to simulate tropical cyclone climatologies and understand the relationship between climate and tropical cyclone formation. Climate models are now able to simulate a realistic rate of global tropical cyclone formation, although simulation of the Atlantic tropical cyclone climatology remains challenging unless horizontal resolutions finer than 50 km are employed. This article summarizes published research from the idealized experiments of the Hurricane Working Group of U.S. CLIVAR (CLImate VARiability and predictability of the ocean-atmosphere system). This work, combined with results from other model simulations, has strengthened relationships between tropical cyclone formation rates and climate variables such as mid-tropospheric vertical velocity, with decreased climatological vertical velocities leading to decreased tropical cyclone formation. Systematic differences are shown between experiments in which only sea surface temperature is increased versus experiments where only atmospheric carbon dioxide is increased, with the carbon dioxide experiments more likely to demonstrate the decrease in tropical cyclone numbers previously shown to be a common response of climate models in a warmer climate. Experiments where the two effects are combined also show decreases in numbers, but these tend to be less for models that demonstrate a strong tropical cyclone response to increased sea surface temperatures. Further experiments are proposed that may improve our understanding of the relationship between climate and tropical cyclone formation, including experiments with two-way interaction between the ocean and the atmosphere and variations in atmospheric aerosols.

Clouds, circulation and climate sensitivity

Fundamental puzzles of climate science remain unsolved because of our limited understanding of how clouds, circulation and climate interact. One example is our inability to provide robust assessments of future global and regional climate changes. However, ongoing advances in our capacity to observe, simulate and conceptualize the climate system now make it possible to fill gaps in our knowledge. We argue that progress can be accelerated by focusing research on a handful of important scientific questions that have become tractable as a result of recent advances. We propose four such questions below; they involve understanding the role of cloud feedbacks and convective organization in climate, and the factors that control the position, the strength and the variability of the tropical rain belts and the extratropical storm tracks.

Intercomparison of methods of coupling between convection and large-scale circulation: 1. Comparison over uniform surface conditions

As part of an international intercomparison project, a set of single column models (SCMs) and cloud-resolving models (CRMs) are run under the weak temperature gradient (WTG) method and the damped gravity wave (DGW) method. For each model, the implementation of the WTG or DGW method involves a simulated column which is coupled to a reference state defined with profiles obtained from the same model in radiative-convective equilibrium. The simulated column has the same surface conditions as the reference state and is initialized with profiles from the reference state. We performed systematic comparison of the behavior of different models under a consistent implementation of the WTG method and the DGW method and systematic comparison of the WTG and DGW methods in models with different physics and numerics. CRMs and SCMs produce a variety of behaviors under both WTG and DGW methods. Some of the models reproduce the reference state while others sustain a large-scale circulation which results in either substantially lower or higher precipitation compared to the value of the reference state. CRMs show a fairly linear relationship between precipitation and circulation strength. SCMs display a wider range of behaviors than CRMs. Some SCMs under the WTG method produce zero precipitation. Within an individual SCM, a DGW simulation and a corresponding WTG simulation can produce different signed circulation. When initialized with a dry troposphere, DGW simulations always result in a precipitating equilibrium state. The greatest sensitivities to the initial moisture conditions occur for multiple stable equilibria in some WTG simulations, corresponding to either a dry equilibrium state when initialized as dry or a precipitating equilibrium state when initialized as moist. Multiple equilibria are seen in more WTG simulations for higher SST. In some models, the existence of multiple equilibria is sensitive to some parameters in the WTG calculations.