Association of lectin pathway proteins with intra-abdominal Candida infection in high-risk surgical intensive-care unit patients. A prospective cohort study within the fungal infection network of Switzerland

OBJECTIVES Human studies on the role of mannose-binding lectin (MBL) in patients with invasive candidiasis have yielded conflicting results. We investigated the influence of MBL and other lectin pathway proteins on Candida colonization and intra-abdominal candidiasis (IAC) in a cohort of high-risk patients. METHODS Prospective observational cohort study of 89 high-risk intensive-care unit (ICU) patients. Levels of lectin pathway proteins at study entry and six MBL2 single-nucleotide polymorphisms were analyzed by sandwich-type immunoassays and genotyping, respectively, and correlated with development of heavy Candida colonization (corrected colonization index (CCI) ≥0.4) and occurrence of IAC during a 4-week period. RESULTS Within 4 weeks after inclusion a CCI ≥0.4 and IAC was observed in 47% and 38% of patients respectively. Neither serum levels of MBL, ficolin-1, -2, -3, MASP-2 or collectin liver 1 nor MBL2 genotypes were associated with a CCI ≥0.4. Similarly, none of the analyzed proteins was found to be associated with IAC with the exception of lower MBL levels (HR 0.74, p = 0.02) at study entry. However, there was no association of MBL deficiency (<0.5 μg/ml), MBL2 haplo- or genotypes with IAC. CONCLUSION Lectin pathway protein levels and MBL2 genotype investigated in this study were not associated with heavy Candida colonization or IAC in a cohort of high-risk ICU patients.

Trajectory mapping of middle atmospheric water vapor by a mini network of NDACC instruments

The important task to observe the global coverage of middle atmospheric trace gases like water vapor or ozone usually is accomplished by satellites. Climate and atmospheric studies rely upon the knowledge of trace gas distributions throughout the stratosphere and mesosphere. Many of these gases are currently measured from satellites, but it is not clear whether this capability will be maintained in the future. This could lead to a significant knowledge gap of the state of the atmosphere. We explore the possibilities of mapping middle atmospheric water vapor in the Northern Hemisphere by using Lagrangian trajectory calculations and water vapor profile data from a small network of five ground-based microwave radiometers. Four of them are operated within the frame of NDACC (Network for the Detection of Atmospheric Composition Change). Keeping in mind that the instruments are based on different hardware and calibration setups, a height-dependent bias of the retrieved water vapor profiles has to be expected among the microwave radiometers. In order to correct and harmonize the different data sets, the Microwave Limb Sounder (MLS) on the Aura satellite is used to serve as a kind of traveling standard. A domain-averaging TM (trajectory mapping) method is applied which simplifies the subsequent validation of the quality of the trajectory-mapped water vapor distribution towards direct satellite observations. Trajectories are calculated forwards and backwards in time for up to 10 days using 6 hourly meteorological wind analysis fields. Overall, a total of four case studies of trajectory mapping in different meteorological regimes are discussed. One of the case studies takes place during a major sudden stratospheric warming (SSW) accompanied by the polar vortex breakdown; a second takes place after the reformation of stable circulation system. TM cases close to the fall equinox and June solstice event from the year 2012 complete the study, showing the high potential of a network of ground-based remote sensing instruments to synthesize hemispheric maps of water vapor.

Length of the Mitral Isthmus But Not Anatomical Location of Ablation Line Predicts Bidirectional Mitral Isthmus Block in Patients Undergoing Catheter Ablation of Persistent Atrial Fibrillation: A Randomized Controlled Trial

INTRODUCTION Mitral isthmus (MI) ablation is an effective option in patients undergoing ablation for persistent atrial fibrillation (AF). Achieving bidirectional conduction block across the MI is challenging, and predictors of MI ablation success remain incompletely understood. We sought to determine the impact of anatomical location of the ablation line on the efficacy of MI ablation. METHODS AND RESULTS A total of 40 consecutive patients (87% male; 54 ± 10 years) undergoing stepwise AF ablation were included. MI ablation was performed in sinus rhythm. MI ablation was performed from the left inferior PV to either the posterior (group 1) or the anterolateral (group 2) mitral annulus depending on randomization. The length of the MI line (measured with the 3D mapping system) and the amplitude of the EGMs at 3 positions on the MI were measured in each patient. MI block was achieved in 14/19 (74%) patients in group 1 and 15/21 (71%) patients in group 2 (P = NS). Total MI radiofrequency time (18 ± 7 min vs. 17 ± 8 min; P = NS) was similar between groups. Patients with incomplete MI block had a longer MI length (34 ± 6 mm vs. 24 ± 5 mm; P < 0.001), a higher bipolar voltage along the MI (1.75 ± 0.74 mV vs. 1.05 ± 0.69 mV; P < 0.01), and a longer history of continuous AF (19 ± 17 months vs. 10 ± 10 months; P < 0.05). In multivariate analysis, decreased length of the MI was an independent predictor of successful MI block (OR 1.5; 95% CI 1.1-2.1; P < 0.05). CONCLUSIONS Increased length but not anatomical location of the MI predicts failure to achieve bidirectional MI block during ablation of persistent AF.

Application of cell line based genomic predictors to predict response to targeted therapies in breast cancer

Cancer cell lines can be treated with a drug and the molecular comparison of responders and non-responders may yield potential predictors that could be tested in the clinic. It is a bioinformatics challenge to apply the cell line-derived multivariable response predictors to patients who respond to therapy. Using the gene expression data from 23 breast cancer cell lines, I developed three predictors of dasatinib sensitivity by selecting differentially expressed genes and applying different classification algorithms. The performance of these predictors on independent cell lines with known dasatinib response was tested. The predictor based on weighted voting method has the best overall performance. It correctly predicted dasatinib sensitivity in 11 out of 12 (92%) breast and 17 out of 23 (74%) lung cancer cell lines. These predictors were then applied to the gene expression data from 133 breast cancer patients in an attempt to predict how the patients might respond to dasatinib therapy. Two predictors identified 13 patients in common to be dasatinib sensitive. Sixty two percent of these cases are triple negative (ER-negative, HER2-negative and PR-negative) and 76% are double negative. The result is consistent with the findings from other studies, which identified a target population for dasatinib treatment to be triple negative or basal breast cancer subtype. In conclusion, we think that the cell line-derived dasatinib classifiers can be applied to the human patients. ^

The cost effective management of Central Line-Associated Bloodstream Infections (CLABSIs) comparing the central line bundle to antimicrobialcoated central venous catheters: A systematic review

Central Line-Associated Bloodstream Infections (CLABSIs) are one of the most costly and preventable cases of morbidity and mortality among intensive care units (ICUs) in health care today. In 2008, the Centers for Medicare and Medicaid Services Medicare Program, under the Deficit Reduction Act, announced it will no longer reimburse hospitals for such adverse events among those related to CLABSIs. This reveals the financial burden shift onto the hospital rather than the health care payer who can now withhold reimbursements. With this weighing more heavily on hospital management, decision makers will need to find a way to completely prevent cases of CLABSI or simply pay for the financial consequences. ^ To reduce the risk of CLABSIs, several clinical, preventive interventions have been studied and even instituted including the Central Line (CL) Bundle and Antimicrobial Coated Central Venous Catheters (AM-CVCs). I carried out a formal systematic review on the topic to compare the cost-effectiveness of the Central Line (CL) Bundle to the commercially available antimicrobial coated central venous catheters (AM-CVCs) in preventing CLABSIs among critically and chronically ill patients in the U.S. Evidence was assessed for inclusion against predefined criteria. I, myself, conducted the data extraction. Ten studies were included in the review. Efficacy in reducing the mean incidence rate of CLABSI by the CL Bundle and AM-CVC interventions were compared with one another including costs. ^ The AM-CVC impregnated with antibiotics, rifampin-minocycline (AI-RM) is more clinically effective than the CL Bundle in reducing the mean rate of CLABSI per 1,000 catheter days. The lowest mean incidence rate of CLABSI per 1,000 catheter days among the AM-CVC studies was as low as zero in favor of the AI-RM. Moreover, the review revealed that the AI-RM appears to be more cost-effective than the CL Bundle. Results showed the adjusted incremental cost of the CL Bundle per ICU patient requiring a CVC to be approximately $196 while the AI-RM at only an additional cost of $48 per ICU patient requiring a CVC. ^ Limited data regarding the cost of the CL Bundle made it difficult to make a true comparison to the direct cost of the AM-CVCs. However, using the result I did have from this review, I concluded that the AM-CVCs do appear to be more cost-effective in decreasing the mean rate of CLABSI while also minimizing incremental costs per CVC than the CL Bundle. This review calls for further research addressing the cost of the CL Bundle and compliance and more effective study designs such as randomized control trials comparing the efficacy and cost of the CL Bundle to the AM-CVCs. Barriers that may face health care managers when implementing the CL Bundle or AM-CVCs include additional costs associated with the intervention, educational training and ongoing reinforcement as well as creating a new culture of understanding.^

Commentary on "Expanded Learning Time in Schools"

As co-founder of KIPP, I know from experience and research that more time in school works. A well-designed extended-time program can help underserved students catch up academically, and prepare them for the rigors of higher education. Implementing extended time more widely poses challenges, but there are also creative solutions to these challenges.

The Aristarchus Proyect on line (www.aristarchus.it) : Electronic Tools for Classical Philology

El artículo está destinado a subrayar el proyecto ARISTARCUS, un conjunto de herramientas de trabajo para la investigación y la enseñanza en temas del área de mundo antiguo Griego y Latino y está disponible en el sitio web www.aristarchus.unige.it. Ha sido llevado a cabo por el grupo de investigación del Dipartimento di Archeologia e Filologia Classica (DARFICLET) de la Universidad de Génova, dirigido por el Profesor Franco Montanari. El sitio web incluye cinco ítems: 1) LGGA - Léxico de los Gramáticos Griegos Antiguos; 2) PAWAG - Palabras escasamente atestadas en Griego Antiguo; 3) CPhCl - Catalogus Philologorum Classicorum; 4) CIAPh - Centro Italiano de l'Année Philologique; 5) Mediaclassica, un conjunto de herramientas para la enseñanza de Griego y Latín.

The Aristarchus Proyect on line (www.aristarchus.it) : Electronic Tools for Classical Philology

El artículo está destinado a subrayar el proyecto ARISTARCUS, un conjunto de herramientas de trabajo para la investigación y la enseñanza en temas del área de mundo antiguo Griego y Latino y está disponible en el sitio web www.aristarchus.unige.it. Ha sido llevado a cabo por el grupo de investigación del Dipartimento di Archeologia e Filologia Classica (DARFICLET) de la Universidad de Génova, dirigido por el Profesor Franco Montanari. El sitio web incluye cinco ítems: 1) LGGA - Léxico de los Gramáticos Griegos Antiguos; 2) PAWAG - Palabras escasamente atestadas en Griego Antiguo; 3) CPhCl - Catalogus Philologorum Classicorum; 4) CIAPh - Centro Italiano de l'Année Philologique; 5) Mediaclassica, un conjunto de herramientas para la enseñanza de Griego y Latín.

The Aristarchus Proyect on line (www.aristarchus.it) : Electronic Tools for Classical Philology

El artículo está destinado a subrayar el proyecto ARISTARCUS, un conjunto de herramientas de trabajo para la investigación y la enseñanza en temas del área de mundo antiguo Griego y Latino y está disponible en el sitio web www.aristarchus.unige.it. Ha sido llevado a cabo por el grupo de investigación del Dipartimento di Archeologia e Filologia Classica (DARFICLET) de la Universidad de Génova, dirigido por el Profesor Franco Montanari. El sitio web incluye cinco ítems: 1) LGGA - Léxico de los Gramáticos Griegos Antiguos; 2) PAWAG - Palabras escasamente atestadas en Griego Antiguo; 3) CPhCl - Catalogus Philologorum Classicorum; 4) CIAPh - Centro Italiano de l'Année Philologique; 5) Mediaclassica, un conjunto de herramientas para la enseñanza de Griego y Latín.

Learning&Information Technologies Cartography

Nowadays, many researches focus their efforts in studies and applications on the Learning area. However, there is a lack of a reference system that permits to know the positioning and the existing links between Learning and Information Technologies. This paper proposes a Cartography where explains the relationships between the elements that compose the Learning Theories and Information Technologies, considering the own features of the learner and the Information Technologies Properties. This intersection will allow us to know what Information Technologies Properties promote Learning Futures.

Wireless Sensor Network based on OCDMA for closed environments

An infrared optical wireless system is presented, consisting on autonomous remote nodes communicating with a central node. The network is designed for telecommand/telemetry purposes, comprising a large number of nodes at a low data rate. Simultaneous access is granted by using CDMA techniques, and an appropriate selection of the code family can also keep power consumption to a minimum

GLMP for automatic assessment of DFS algorithm learning

We describe how to use a Granular Linguistic Model of a Phenomenon (GLMP) to assess e-learning processes. We apply this technique to evaluate algorithm learning using the GRAPHs learning environment.

Scalable software architecture for on-line multi-camera video processing

In this paper we present a scalable software architecture for on-line multi-camera video processing, that guarantees a good trade off between computational power, scalability and flexibility. The software system is modular and its main blocks are the Processing Units (PUs), and the Central Unit. The Central Unit works as a supervisor of the running PUs and each PU manages the acquisition phase and the processing phase. Furthermore, an approach to easily parallelize the desired processing application has been presented. In this paper, as case study, we apply the proposed software architecture to a multi-camera system in order to efficiently manage multiple 2D object detection modules in a real-time scenario. System performance has been evaluated under different load conditions such as number of cameras and image sizes. The results show that the software architecture scales well with the number of camera and can easily works with different image formats respecting the real time constraints. Moreover, the parallelization approach can be used in order to speed up the processing tasks with a low level of overhead

Agile Construction and Evolution of Product-Line Architectures

Software Product Line Engineering (SPLE) has proved to have significant advantages in family-based software development, but also implies the up¬front design of a product-line architecture (PLA) from which individual product applications can be engineered. The big upfront design associated with PLAs is in conflict with the current need of "being open to change". However, the turbulence of the current business climate makes change inevitable in order to stay competitive, and requires PLAs to be open to change even late in the development. The trend of "being open to change" is manifested in the Agile Software Development (ASD) paradigm, but it is spreading to the domain of SPLE. To reduce the big upfront design of PLAs as currently practiced in SPLE, new paradigms are being created, one being Agile Product Line Engineering (APLE). APLE aims to make the development of product-lines more flexible and adaptable to changes as promoted in ASD. To put APLE into practice it is necessary to make mechanisms available to assist and guide the agile construction and evolution of PLAs while complying with the "be open to change" agile principle. This thesis defines a process for "the agile construction and evolution of product-line architectures", which we refer to as Agile Product-Line Archi-tecting (APLA). The APLA process provides agile architects with a set of models for describing, documenting and tracing PLAs, as well as an algorithm to analyze change impact. Both the models and the change impact analysis offer the following capabilities: Flexibility & adaptability at the time of defining software architectures, enabling change during the incremental and iterative design of PLAs (anticipated or planned changes) and their evolution (unanticipated or unforeseen changes). Assistance in checking architectural integrity through change impact analysis in terms of architectural concerns, such as dependencies on earlier design decisions, rationale, constraints, and risks, etc.Guidance in the change decision-making process through change im¬pact analysis in terms of architectural components and connections. Therefore, APLA provides the mechanisms required to construct and evolve PLAs that can easily be refined iteration after iteration during the APLE development process. These mechanisms are provided in a modeling frame¬work called FPLA. The contributions of this thesis have been validated through the conduction of a project regarding a metering management system in electrical power networks. This case study took place in an i-smart software factory and was in collaboration with the Technical University of Madrid and Indra Software Labs. La Ingeniería de Líneas de Producto Software (Software Product Line Engi¬neering, SPLE) ha demostrado tener ventajas significativas en el desarrollo de software basado en familias de productos. SPLE es un paradigma que se basa en la reutilización sistemática de un conjunto de características comunes que comparten los productos de un mismo dominio o familia, y la personalización masiva a través de una variabilidad bien definida que diferencia unos productos de otros. Este tipo de desarrollo requiere el diseño inicial de una arquitectura de línea de productos (Product-Line Architecture, PLA) a partir de la cual los productos individuales de la familia son diseñados e implementados. La inversión inicial que hay que realizar en el diseño de PLAs entra en conflicto con la necesidad actual de estar continuamente "abierto al cam¬bio", siendo este cambio cada vez más frecuente y radical en la industria software. Para ser competitivos es inevitable adaptarse al cambio, incluso en las últimas etapas del desarrollo de productos software. Esta tendencia se manifiesta de forma especial en el paradigma de Desarrollo Ágil de Software (Agile Software Development, ASD) y se está extendiendo también al ámbito de SPLE. Con el objetivo de reducir la inversión inicial en el diseño de PLAs en la manera en que se plantea en SPLE, en los último años han surgido nuevos enfoques como la Ingeniera de Líneas de Producto Software Ágiles (Agile Product Line Engineering, APLE). APLE propone el desarrollo de líneas de producto de forma más flexible y adaptable a los cambios, iterativa e incremental. Para ello, es necesario disponer de mecanismos que ayuden y guíen a los arquitectos de líneas de producto en el diseño y evolución ágil de PLAs, mientras se cumple con el principio ágil de estar abierto al cambio. Esta tesis define un proceso para la "construcción y evolución ágil de las arquitecturas de lineas de producto software". A este proceso se le ha denominado Agile Product-Line Architecting (APLA). El proceso APLA proporciona a los arquitectos software un conjunto de modelos para de¬scribir, documentar y trazar PLAs, así como un algoritmo para analizar vel impacto del cambio. Los modelos y el análisis del impacto del cambio ofrecen: Flexibilidad y adaptabilidad a la hora de definir las arquitecturas software, facilitando el cambio durante el diseño incremental e iterativo de PLAs (cambios esperados o previstos) y su evolución (cambios no previstos). Asistencia en la verificación de la integridad arquitectónica mediante el análisis de impacto de los cambios en términos de dependencias entre decisiones de diseño, justificación de las decisiones de diseño, limitaciones, riesgos, etc. Orientación en la toma de decisiones derivadas del cambio mediante el análisis de impacto de los cambios en términos de componentes y conexiones. De esta manera, APLA se presenta como una solución para la construcción y evolución de PLAs de forma que puedan ser fácilmente refinadas iteración tras iteración de un ciclo de vida de líneas de producto ágiles. Dicha solución se ha implementado en una herramienta llamada FPLA (Flexible Product-Line Architecture) y ha sido validada mediante su aplicación en un proyecto de desarrollo de un sistema de gestión de medición en redes de energía eléctrica. Dicho proyecto ha sido desarrollado en una fábrica de software global en colaboración con la Universidad Politécnica de Madrid e Indra Software Labs.