Urine D-arabinitol/L-arabinitol ratio in diagnosing Candida infection in patients with haematological malignancy

Adult patients with hematologic malignancies along with HIV infected patients were prospectively studied to determine the performance of urine D-arabinitol/L-arabinitol (DA/LA) ratio in diagnosing invasive candidiasis. Ten evaluable febrile neutropenic patients had proven invasive candidiasis and elevated DA/LA ratios were found in 5. Invasive candidiasis with normal DA/LA ratios was most frequently due to Candida krusei infection. This Candida species is a non-producer of arabinitol. Only 4 of 81 febrile neutropenic patients given either antifungal prophylaxis or empiric antifungal treatment had elevated DA/LA ratios. Only 1 of 15 HIV positive patients with either oropharyngeal or esophageal candidiasis had elevated DA/LA ratios. Widespread use of fluconazole prophylaxis in bone marrow transplantation patients at the study hospital has led to an increased prevalence of C. krusei infection. This is the likely reason for the low sensitivity of the test in proven and suspected invasive Candida infections reported here. (C) 2002 Elsevier Science Inc. All rights reserved.

The bright and dark sides of individual and group innovation:A Special Issue introduction

This introduction essay proposes a challenging program for researchers eager to explore factors and process mechanisms contributing to the benefits and costs individuals and groups incur from pursuing innovative approaches. With respect to individual innovation, such moderating factors might be found in the characteristics of the innovative idea, the innovator, co-workers, supervisors, the broader organizational context, and in national culture. Examples of factors that are likely to shape the beneficial and detrimental outcomes of group innovation include knowledge, skills and ability of group members, group tenure, diversity among group members, group processes (clarifying group objectives, participation, constructive management of competing perspectives), and external demands on groups. This Special Issue contains a state-of-the-science paper, three articles dealing with the benefits and costs of individual innovation, and three articles addressing the bright and dark sides of group innovation. Copyright © 2004 John Wiley & Sons, Ltd.

Seeing light vs dark lines: psychophysical performance is based on separate channels, limited by noise and uncertainty

Visual detection performance (d') is usually an accelerating function of stimulus contrast, which could imply a smooth, threshold-like nonlinearity in the sensory response. Alternatively, Pelli (1985 Journal of the Optical Society of America A 2 1508 - 1532) developed the 'uncertainty model' in which responses were linear with contrast, but the observer was uncertain about which of many noisy channels contained the signal. Such internal uncertainty effectively adds noise to weak signals, and predicts the nonlinear psychometric function. We re-examined these ideas by plotting psychometric functions (as z-scores) for two observers (SAW, PRM) with high precision. The task was to detect a single, vertical, blurred line at the fixation point, or identify its polarity (light vs dark). Detection of a known polarity was nearly linear for SAW but very nonlinear for PRM. Randomly interleaving light and dark trials reduced performance and rendered it non-linear for SAW, but had little effect for PRM. This occurred for both single-interval and 2AFC procedures. The whole pattern of results was well predicted by our Monte Carlo simulation of Pelli's model, with only two free parameters. SAW (highly practised) had very low uncertainty. PRM (with little prior practice) had much greater uncertainty, resulting in lower contrast sensitivity, nonlinear performance, and no effect of external (polarity) uncertainty. For SAW, identification was about v2 better than detection, implying statistically independent channels for stimuli of opposite polarity, rather than an opponent (light - dark) channel. These findings strongly suggest that noise and uncertainty, rather than sensory nonlinearity, limit visual detection.

Dark solitons in optical communication systems

This thesis presents experimental and theoretical work on the use of dark optical solitons as data carriers in communications systems. The background chapters provide an introduction to nonlinear optics, and to dark solitons, described as intensity dips in a bright background, with an asymmetrical phase profile. The motivation for the work is explained, considering both the superior stability of dark solitons and the need for a soliton solution suitable for the normal, rather than the anomalous (bright soliton) dispersion regime. The first chapters present two generation techniques, producing packets of dark solitons via bright pulse interaction, and generating continuous trains of dark pulses using a fibre laser. The latter were not dark solitons, but were suitable for imposition of the required phase shift by virtue of their extreme stability. The later chapters focus on the propagation and control of dark solitons. Their response to periodic loss and gain is shown to result in the exponential growth of spectral sidebands. This may be suppressed by reducing the periodicity of the loss/gain cycle or using periodic filtering. A general study of the response of dark solitons to spectral filtering is undertaken, showing dramatic differences in the behaviour of black and 99.9% grey solitons. The importance of this result is highlighted by simulations of propagation in noisy systems, where the timing jitter resulting from random noise is actually enhanced by filtering. The results of using sinusoidal phase modulation to control pulse position are presented, showing that the control is at the expense of serious modulation of the bright background. It is concluded that in almost every case, dark and bright solitons have very different properties, and to continue to make comparisons would not be so productive as to develop a deeper understanding of the interactions between the dark soliton and its bright background.

'Urine testing is a waste of time': newly diagnosed Type 2 diabetes patients' perceptions of self-monitoring

Aims To date, there is no convincing evidence that non-insulin treated patients who undertake self-blood glucose monitoring (SBGM) have better glycaemic control than those who test their urine. This has led to a recommendation that non-insulin dependent patients undertake urine testing, which is the cheaper option. This recommendation does not take account of patients' experiences and views. This study explores the respective merits of urine testing and SBGM from the perspectives of newly diagnosed patients with Type 2 diabetes. Methods Qualitative study using repeat in-depth interviews with 40 patients. Patients were interviewed three times at 6-monthly intervals over 1 year. Patients were recruited from hospital clinics and general practices in Lothian, Scotland. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results Patients reported strongly negative views of urine testing, particularly when they compared it with SBGM. Patients perceived urine testing as less convenient, less hygienic and less accurate than SBGM. Most patients assumed that blood glucose meters were given to those with a more advanced or serious form of diabetes. This could have implications for how they thought about their own disease. Patients often interpreted negative urine results as indicating that they could not have diabetes. Conclusions Professionals should be aware of the meanings and understandings patients attach to the receipt and use of different types of self-monitoring equipment. Guidelines that promote the use of consistent criteria for equipment allocation are required. The manner in which negative urine results are conveyed needs to be reconsidered.