Infective endocarditis.

Despite improvements in health care, the incidence of infective endocarditis has not decreased over the past decades. This apparent paradox is explained by a progressive evolution in risk factors; while classic predisposing conditions such as rheumatic heart disease have been all but eradicated, new risk factors for infective endocarditis have emerged. These include intravenous drug use, sclerotic valve disease in elderly patients, use of prosthetic valves, and nosocomial disease. Newly identified pathogens, which are difficult to cultivate--eg, Bartonella spp and Tropheryma whipplei--are present in selected individuals, and resistant organisms are challenging conventional antimicrobial therapy. Keeping up with these changes depends on a comprehensive approach, allying understanding of the pathogenesis of disease with the development of new drugs for infective endocarditis. Infection by staphylococci and streptococci is being dissected at the molecular level. New ideas for antimicrobial agents are being developed. These novel insights should help redefine preventive and therapeutic strategies against infective endocarditis.

L'anthropologie face aux demandes du terrain : deux exemples d'implication dans le milieu médical

Cet article présente les implications particulières de deux expériences de terrain faisant émerger la problématique des apports et de l'utilité de l'anthropologie dans le domaine de la santé. Face aux attentes fortes des interlocuteurs de terrain (demandes d'expertise anthropologique dans le domaine de la prévention du suicide et dans celui de la recherche en soins palliatifs), les chercheuses se sont laissé en partie « détourner » en ne travaillant plus seulement « sur », mais « avec » leurs interlocuteurs. Tout en prenant en compte les risques d'instrumentalisation par le domaine médical, la réflexivité du chercheur face à son implication sur le terrain est considérée comme un outil indispensable pour préserver sa distance critique. Par ailleurs, ces expériences de terrain sont l'occasion de réfléchir à la possibilité de créer des échanges discursifs avec les interlocuteurs du terrain et de favoriser ainsi le changement social depuis l'intérieur.

Progress in front propagation research

We review the progress in the field of front propagation in recent years. We survey many physical, biophysical and cross-disciplinary applications, including reduced-variable models of combustion flames, Reid's paradox of rapid forest range expansions, the European colonization of North America during the 19th century, the Neolithic transition in Europe from 13 000 to 5000 years ago, the description of subsistence boundaries, the formation of cultural boundaries, the spread of genetic mutations, theory and experiments on virus infections, models of cancer tumors, etc. Recent theoretical advances are unified in a single framework, encompassing very diverse systems such as those with biased random walks, distributed delays, sequential reaction and dispersion, cohabitation models, age structure and systems with several interacting species. Directions for future progress are outlined

Population genetic structure in the native and introduced range of the Argentine ant/

SUMMARY : The evolution of animal societies, where some individuals forego their own reproductive opportunities to help others to reproduce, poses an evolutionary paradox that can be traced back to Darwin. Altruism may evolve through kin selection when the donor and recipient of altruistic acts are related to each other. In social insects, workers are generally highly related to the brood they rear when colonies are headed by a single queen. Yet some ants have an extraordinary social organization, called unicoloniality, whereby individuals from separate nests mix freely to form large supercolonies, which in some cases extend over hundreds of km. These supercolonies are characterised by a high number of queens (polygyny) and an absence of clear colony boundaries. This type of social organization represents an evolutionary paradox because relatedness between nestmates is effectively zero. In such conditions, kin selection cannot account for the evolution of reproductive altruism. Moreover, unicoloniality is thought to be unstable over time, because workers that can no longer aid close relatives may evolve more selfish strategies. The Argentine ant (Linepithema humile) is a highly invasive species listed among the hundred world's worst invaders by the UICN. Native from South America, L. humile has been accidentally introduced throughout the world. Native populations have been described as noninvasive with a family-based organization. In contrast, within its introduction range, they form unicolonial supercolonies that contain numerous nests without intraspecific aggression. The development of such unicolonial populations has been explained as a direct consequence of the ant's introduction into a new habitat, favouring a transition from family-based to open colonies. To determine if the social structure of the Argentine ant is fundamentally different between the native and the introduced range, we studied genetically and behaviourally native and introduced populations of L. humile over different geographic scales. Our results clearly indicated that there are no fundamental differences in the social organisation of the Argentine ant between the two ranges. Our investigations revealed that, contrary to previous claims, native populations have a unicolonial social organisation very similar to that observed in the introduced range. Consequently, the unicolonial social structure of the Argentine ant does not stem from a shift in social organization associated with introduction into new habitats but evolved in the native range and is likely a stable, evolutionarily ancient adaptation to the local environment. Our study on native populations of L. humile also gave important insight in the comprehension of the evolution of unicoloniality in the Argentine ant. Native supercolonies are relatively small compared to introduced ones and may co-habit in a same population. These supercolonies are genetically highly differentiated leading to a significant relatedness among nestmate workers when the different supercolonies of a population are taken as a reference population. This provides the necessary conditions for loin selection to operate. Furthermore, we examined a native population over time, which revealed a high supercolony extinction rate. If more competitive supercolonies are more likely to survive or replace other supercolonies, a subtle dynamical process between the spread of selfish traits within supercolony and the selective elimination of supercolonies with such traits may allow a stable equilibrium and the persistence of unicoloniality over time. Finally, a worldwide study of the Argentine ant showed that the introduced supercolonies originate from numerous independent introduction events. In conclusion, the success of the Argentine ant does not stem from a shift in social organization associated with its introduction into new habitats, but is most probably explained by the intrinsic characteristics developed in its native range. RESUME : L'altruisme de reproduction où certains individus renoncent à leur propre reproduction pour aider d'autres individus à se reproduire constitue l'un des plus grand paradoxe de l'évolution. En effet, comment expliquer l'évolution de comportements qui tendent à augmenter les chances de survie et le succès reproductif d'autres individus, alors que ces actes diminuent l'aptitude de leurs auteurs ? La théorie de la sélection de parentèle permet de résoudre ce problème. Cette théorie stipule qu'en aidant de proches parents à se reproduire, les individus peuvent promouvoir indirectement la transmission de copies de leurs propres gènes à la génération suivante. Chez les insectes sociaux, l'altruisme des ouvrières s'explique par la théorie de sélection de parentèle lorsque les colonies sont monogynes (constituées d'une seule reine) puisque les ouvrières sont fortement apparentées aux couvains dont elles s'occupent. Par contre, les espèces dites unicoloniales, dont les colonies forment des réseaux de nids appelés supercolonies, représentent toujours un paradoxe pour les théories de l'évolution puisque l'apparentement entre les différents individus d'un nid est nulle. De plus, l'unicolonialité ne devrait pas être stable sur le long terme parce que les ouvrières qui ne s'occupent plus de leur apparentés devraient développer des stratégies plus égoïstes au cours du temps. La fourmi d'Argentine (Linepithema humile) est une espèce invasive ayant un impact considérable sur son environnement. Originaire d'Amérique du Sud, elle a été introduite dans pratiquement toutes les régions du monde dont le climat est de type méditerranéen. Son incroyable succès invasif s'explique par sa structure sociale unicoloniale observée dans chacun des pays où elle a été introduite. Par contre, les rares études effectuées en Argentine ont suggéré que la fourmi d'Argentine n'était pas unicoloniale dans son aire native. L'unicolonialité chez la fourmi d'Argentine était donc considéré comme une conséquence de son introduction dans de nouveaux environnements. Durant cette thèse, nous avons vérifié si la structure sociale de cette espèce différait fondamentalement entre l'aire native et introduite. Pour cela, nous avons étudié, à différentes échelles géographiques, des populations introduites et argentines avec une approche génétique et comportementale. L'ensemble de nos résultats montrent que les différences entre les deux structure sociales ne sont pas aussi importantes que ce que l'on imaginait. Les populations natives sont aussi constituées de réseaux de nids coopérants. La taille de ses supercolonies est toutefois bien moins importante en Argentine et il n'est pas rare de trouver plusieurs supercolonies cohabitantes dans une même population. Nous avons démontré que ces réseaux de nids étaient constitués d'individus qui sont plus apparentés entre eux qu'ils ne le sont avec les individus d'autres supercolonies, ainsi l'unicolonialité dans son aire d'origine ne représente pas un réel paradoxe pour les théories de l'évolution. Finalement nous avons étudié la même population en Argentine à six ans d'intervalle et avons constaté que les supercolonies avaient un taux de survie très faible ce qui pourrait expliquer la stabilité de l'unicolonialité au cours du temps. Si les supercolonies les plus compétitives survivent mieux que les supercolonies dans lesquelles apparaissent des traits égoïstes, on devrait alors observer une dynamique entre l'apparition de traits égoïstes et l'élimination des supercolonies dans lesquelles ces traits égoïstes évolueraient. Finalement, une étude mondiale nous a montré que les supercolonies étaient originaires de nombreux événements d'introductions indépendants. En conclusion, le succès invasif de la fourmi d'Argentine n'est donc pas dû à un changement de comportement associé à son introduction mais est lié aux caractéristiques qu'elle a développées en Argentine.

Extending Learning Objects by Means of Social Networking

Learning objects have been the promise of providing people with high quality learning resources. Initiatives such as MIT Open-CourseWare, MERLOT and others have shown the real possibilities of creating and sharing knowledge through Internet. Thousands of educational resources are available through learning object repositories. We indeed live in an age of content abundance, and content can be considered as infrastructure for building adaptive and personalized learning paths, promoting both formal and informal learning. Nevertheless, although most educational institutions are adopting a more open approach, publishing huge amounts of educational resources, the reality is that these resources are barely used in other educational contexts. This paradox can be partly explained by the dificulties in adapting such resources with respect to language, e-learning standards and specifications and, finally, granularity. Furthermore, if we want our learners to use and take advantage of learning object repositories, we need to provide them with additional services than just browsing and searching for resources. Social networks can be a first step towards creating an open social community of learning around a topic or a subject. In this paper we discuss and analyze the process of using a learning object repository and building a social network on the top of it, with respect to the information architecture needed to capture and store the interaction between learners and resources in form of learning object metadata.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

Quantifying the level of eusociality

The evolution of animal societies in which some individuals forego direct reproduction to help others to reproduce poses an evolutionary paradox. Societies where all individuals reproduce equally and societies where a single individual completely monopolizes reproduction represent the end points of a continuum of variance in the reproductive output among group members. This led Sherman et al. (1995) to propose that cooperative breeding and eusociality (a term originally applied only to insects) are not discrete phenomena. Rather they form a continuum whose main difference is the extent to which individuals forego their own reproductive opportunity to help other members of the group. Here we present a new index: the eusociality index. It quantifies the decrease in direct reproduction of group members as a resut of altruistic acts directed to other members of the group (i.e. a measure of the level of eusociality). The rationale for this index lies in the fundamental duality of the reproductive process, in which organisms supply two distinct elements: (i) genetic material (genes); and (ii) power (energy). In non-eusocial animals, all individuals transmit genes and power in the same ratio (notwithstanding individual variance in offspring size and parental investment). By contrast, amongst eusocial animals some individuals contribute proportionally more to gene transfer, and others more to energy, resulting in high interindividual variation in the ratio of gene to power transfer.

Patent foramen ovale in patients with ischaemic stroke of unknown cause: to close? "pro closure" position

There is ample epidemiological and anecdotal evidence that a PFO increases the risk of stroke both in young and elderly patients, although only in a modest way: PFOs are more prevalent in patients with cryptogenic (unexplained) stroke than in healthy subjects, and are more prevalent in cryptogenic stroke than in strokes of other causes. Furthermore, multiple case series confirm an association of paradoxical embolism across a PFO in patients with deep vein thrombosis and/or pulmonary emboli.2. Is stroke recurrence risk in PFO-patients really not elevated when compared to PFO-free patients, as suggested by traditional observational studies? This finding is an epidemiological artifact called "the paradox of recurrence risk research" (Dahabreh & Kent, JAMA 2011) and is due to one (minor) risk factor, such as PFO, being wiped out by other, stronger risk factors in the control population.3. Having identified PFO as a risk factor for a first stroke and probably also for recurrences, we have to treat it, because treating risk factors always has paid off. No one would nowadays question the aggressive treatment of other risk factors of stroke such as hypertension, atrial fibrillation, smoking, or hyperlipidemia.4. In order to be effective, the preventive treatment has to control the risk factor (i.e. close effectively the PFO), and has to have little or no side effects. Both these conditions are now fulfilled thanks to increasing expertise of cardiologists with technically advanced closure devices and solid back up by multidisciplinary stroke teams.5. Closing a PFO does not dispense us from treating other stroke risk factors aggressively, given that these are cumulative with PFO.6. The most frequent reason why patients have a stroke recurrence after PFO closure is not that closure is ineffective, but that the initial stroke etiology is insufficiently investigated and not PFO related, and that the recurrence is due to another mechanism because of poor risk factor control.7. Similarly, the randomized CLOSURE study was negative because a) patients were included who had a low chance that their initial event was due to the PFO, b) patients were selected with a low chance that a PFO-related recurrence would occur, c) there was an unacceptable high rate of closure-related side effects, and d) the number of randomized patients was too small for a prevention trial.8. It is only a question of time until a sufficiently large randomized clinical trial with true PFO-related stroke patients and a high PFO-related recurrence risk will be performed and show the effectiveness of this closure9. PFO being a rather modest risk factor for stroke does not mean we should prevent our patients from getting the best available prevention by the best physicians in the best stroke centers Therefore, a PFO-closure performed by an excellent cardiologist following the recommendation of an expert neurovascular specialist after a thorough workup in a leading stroke center is one of the most effective stroke prevention treatments available in 2011.

Partial protection and intrathecal invasion of CD8(+) T cells in acute canine distemper virus infection.

Initial non-inflammatory demyelination in canine distemper virus infection (CDV) develops against a background of severe immunosuppression and is therefore, thought to be virus-induced. However, recently we found a marked invasion of T cells throughout the central nervous system (CNS) in dogs with acute distemper despite drastic damage to the immune system. In the present study, this apparent paradox was further investigated by immunophenotyping of lymphocytes, following experimental CDV challenge in vaccinated and non-vaccinated dogs. In contrast to CDV infected, unprotected dogs, vaccinated dogs did not become immunosuppressed and exhibited a strong antiviral immune response following challenge with virulent CDV. In unprotected dogs rapid and drastic lymphopenia was initially due to depletion of T cells. In peripheral blood, CD4(+) T cells were more sensitive and depleted earlier and for a longer time than CD8(+) cells which recovered soon. In the cerebrospinal fluid (CSF) we could observe an increase in the T cell to B cell and CD8(+) to CD4(+) ratios. Thus, partial protection of the CD8(+) cell population could explain why part of the immune function in acute distemper is preserved. As found earlier, T cells invaded the CNS parenchyma in these dogs but also in the protected challenged dogs, which did not develop any CNS disease at all. Since markers of T cell activation were upregulated in both groups of animals, this phenomenon could in part be related to non-specific penetration of activated T cells through the blood brain barrier. However, in diseased animals much larger numbers of T cells were found in the CNS than in the protected dogs, suggesting that massive invasion of T cells in the brain requires CDV expression in the CNS.

Motiivit ja niiden muutos teleoperaattoreiden yrityskaupoissa

Tutkimuksen päätavoite oli tunnistaa tavallisimmat motiivit teleoperaattoreiden yrityskauppojen taustalla sekä motiiveissa mahdollisesti havaittavat muutokset tarkasteluajanjaksolla vuodesta 2000 kesään 2006 asti. Tutkimusmetodologia on case-tutkimus ja casetapauksina analysoitiin Soneran ja Telian fuusiota sekä Elisan toteuttamaa Saunalahden ostoa. Tutkimus perustui aikaisempaan kirjallisuuteen ja varsinkin empiriaosa toimialan yrityskauppoja kuvaaviin lehtiartikkeleihin ja yritysten itsensä yrityskaupan yhteydessä julkaisemaan materiaaliin. Tutkimuksessa ei löydetty uusia motiiveja. Kuitenkin havaittiin, että tarkasteluajanjaksolla tapahtuneet toimialan muutokset vaikuttivat teleoperaattoreiden yrityskauppojen motiiveihin. Vuosituhannen vaihteen imperiuminrakentamiskaupoissatavallisimpia olivat strategiset ja henkilökohtaiset motiivit. Toimialan taloudellisen tilanteen heikennyttyä seurasivat taloudellisten syiden painoarvoa lisänneet selviytymiskaupat. Nyt strategiset syyt ovat nousseet uudelleen taloudellisten syiden rinnalle, kun toimiala etsii uusia mahdollisuuksia lisätuottojen hankkimiseen hintakilpailun kiristämille markkinoilla.

Osaamisen ja yhteistyön kehittäminen oppilaitosten yhteenliittymässä. Case: Espoon seudun koulutuskuntayhtymä

Tutkimuksen tavoitteena on selvittää miten osaamista on hyödynnetty ja yhteistyötä kehitetty ammattioppilaitosten fuusiossa? Tutkielma toteutettiin laadullisenacase-tutkimuksena. Empiirinen osa koostuu seitsemästä haastattelusta ja muusta kirjallisesta aineistosta. Haastatellut henkilöt toimivat Espoon seudun koulutuskuntayhtymän johdossa ja rehtoreina. Osaamisen hyödyntäminen oppilaitosten välillä on vielä vähäistä. Yhteistyötä tehdään lähinnä projekteissa. Monialaisia yhteistyöryhmiä on vielä vähän. Oppilaitokset toimivat edelleen koulutusaloittain itsenäisinä yksikköinä. Näkemykset fuusion syistä ja tavoitteista poikkesivat virallisista fuusiotavoitteista. Yhdistymisen hyötyinä pidettiin ensisijaisesti taloudellisia etuja ja koulutusalan sisäisen kilpailun vähenemistä. Yhteistyöhalukkuudella näyttäisi olevan yhteys sekä osaamisen hyödyntämiseen että integroitumisasteeseen.

Yritys- ja pääomatuloverouudistuksen vaikutus konsernien yritysjärjestelyihin.

Tutkimuksessa selvitetään yritys- ja pääomatuloverouudistuksen vaikutuksia konsernien sisäisiin yritysjärjestelyihin. Päätavoite oli selvittää, onko verouudistuksella todellista vaikutusta konsernirakenteiden muuttamisessa käytettyjen yritysjärjestelykeinojen valintaan. Alatavoitteista merkityksellisimmäksi muodostui verouudistuksen mukanaan tuomien epäkohtien etsiminen. Tytäryhtiöosakkeiden purkuvoiton muuttuminen verotuksessa verovapaaksi ja purkutappion vähennyskelvottomaksi, aiheuttaa houkutuksen pyrkiä yritysjärjestelyjen toteuttamiseen siten, että verotusta voidaan kiertää. Tutkimuksessa osoitettiin epäkohtia uudistuksessa, jotka mahdollistavat veronkiertämisen yritysjärjestelyissä. Tutkimustulos osoittaa verouudistuksella olleen vaikutusta yritysjärjestelykeinon valintaan, sillä uudistuksen jälkeen sekä purkamisen ja fuusion veroseuraamukset ovat emoyhtiön osalta toisiaan vastaavat. Merkitykselliseksi muodostuu uudistuksen jälkeen tytäryhtiön verotuksellinen asema. Se on jatkossa syytä selvittää ennen yritysjärjestelykeinon valintaa.

Yrityskaupat ja fuusiot yrityksen kasvun keinona

Yrityskauppojen sekä fuusioiden määrä sekä niiden merkitys ovat kasvaneet jatkuvasti markkinoiden muuttuessa yhä globaalimmiksi. Tämän vuoksi yrityskauppoja sekä fuusioita toteutettaessa, kaupan eri osapuolten tulee paneutua entistä tarkemmin siihen, onko kauppaa järkevää toteuttaa, mitä hyötyjä siitä seuraa, kuinka itse kauppaprosessi toimii sekä mitkä yrityskaupan sekä fuusion muodotovat osoittautuneet aikaisemmin menestyksekkäimmiksi. Yrityskauppaprosessin alussa ostajan ja myyjän on tärkeätä valmistautua huolellisestikauppaprosessiin. Ostajan tulee suorittaa perinpohjainen myyjän yrityksen taustan tutkiminen eli due diligence. Samassa yhteydessä tulisi suorittaa myynnin kohteena olevan yrityksen arvonmääritys substanssiarvon, tuottoarvon sekä goodwillin mukaisesti, jotta nähdään missä tilassa yritys oikeasti on. Samalla tulee myöspohtia erilaisia toimenpiteitä, joita pitää suorittaa ennen yrityskaupan toteutumista, kuin myös suunnitella neuvottelujen kulkua ja toimenpiteitä, joita yrityskaupan jälkeen on tehtävä. Työssä tarkastellaan myös, millä tavoin yrityskauppaa voidaan rahoittaa sekä mitä veroseuraamuksia myyjä kokee yrityskaupan myötä eri yritysmuodoissa. Tämän lisäksi työssä käsitellään taloudellisten tekijöiden lisäksi myös henkilöstökysymyksiä, joista käy ilmi, kuinka henkilöstö tulisi ottaaosaksi yrityskauppaa tiedottamisen kautta. Työn lopuksi esitetään käytännön tuloksia siitä, miten yrityskauppojen onnistuminen vaihtelee eri yrityskauppamuotojen välillä, onko ostettavan yrityksen koolla vaikutusta yrityskaupan onnistumiseen sekä mitä vaikutuksia yrityskaupoilla ja fuusioilla on yrityksen innovointikykyyn.