A prospective clinical trial of a real-time polymerase chain reaction assay for the diagnosis of candidemia in nonneutropenic, critically ill adults

Background. Invasive Candida infection among nonneutropenic, critically ill adults is a clinical problem that has received increasing attention in recent years. Poor performance of extant diagnostic modalities has promoted risk-based, preemptive prescribing in view of the poor outcomes associated with inadequate or delayed antifungal therapy; this risks unnecessary overtreatment. A rapid, reliable diagnostic test could have a substantial impact on therapeutic practice in this patient population.

Methods. Three TaqMan-based real-time polymerase chain reaction assays were developed that are capable of detecting the main medically important Candida species, categorized according to the likelihood of fluconazole susceptibility. Assay 1 detected Candida albicans, Candida parapsilosis, Candida tropicalis, and Candida dubliniensis. Assays 2 and 3 detected Candida glabrata and Candida krusei, respectively. The clinical performance of these assays, applied to serum, was evaluated in a prospective trial of nonneutropenic adults in a single intensive care unit.

Results. In all, 527 specimens were obtained from 157 participants. All 3 assays were run in parallel for each specimen; they could be completed within 1 working day. Of these, 23 specimens were obtained from 23 participants categorized as having proven Candida infection at the time of sampling. If a single episode of Candida famata candidemia was excluded, the estimated clinical sensitivity, specificity, and positive and negative predictive values of the assays in this trial were 90.9%, 100%, 100% and 99.8%, respectively.

Conclusions. These data suggest that the described assays perform well in this population for enhancing the diagnosis of candidemia. The extent to which they may affect clinical outcomes, prescribing practice, and cost-effectiveness of care remains to be ascertained.

Linear indicator for voltage collapse in power systems

A new linear indicator is presented together with a comparative study with other published works. The salient advantage of the linear characteristic is emphasised. The new index is tested utilising the IEEE 30 bus test power system

Making sustainability ‘real’: using group-enquiry to promote education

Sustainable development is now widely held as a transcendental ideal of town and country planning, yet the way in which it is taught in planning schools remains problematic. This arises from a range of factors, including the all-persuasive nature of sustainability and the lack of solid examples of success through implementation. The issue of how best to promote learning for sustainable development in planning has arguably intensified in the last two years in the case of the Royal Town Planning Institute- sponsored ‘fast track’ one-year Masters, which has reduced the opportunities for students to engage in wider (and perhaps even deeper) concepts, including that of sustainable development. This paper explores this through discussion of a specific project developed at Queen’s University Belfast, facilitated by a grant from the UK Higher Education Academy. Working with a local community, this entailed a group of students working on their Masters thesis collectively addressing issues of sustainable regeneration in a small Irish market town. The design of the project draws heavily on the concepts of enquiry based learning, experiential learning and action competence, whichare seen as being central to improving education for sustainable development (ESD). The paper explores the benefits of such an approach and discusses the ways in which this experience can help enhance student’s experience of ESD.

A Novel Packet Marking Function for Real-Time Interactive MPEG-4 Video Applications in a Differentiated Services Network

The future convergence of voice, video and data applications on the Internet requires that next generation technology provides bandwidth and delay guarantees. Current technology trends are moving towards scalable aggregate-based systems where applications are grouped together and guarantees are provided at the aggregate level only. This solution alone is not enough for interactive video applications with sub-second delay bounds. This paper introduces a novel packet marking scheme that controls the end-to-end delay of an individual flow as it traverses a network enabled to supply aggregate- granularity Quality of Service (QoS). IPv6 Hop-by-Hop extension header fields are used to track the packet delay encountered at each network node and autonomous decisions are made on the best queuing strategy to employ. The results of network simulations are presented and it is shown that when the proposed mechanism is employed the requested delay bound is met with a 20% reduction in resource reservation and no packet loss in the network.

Suitability of Crangonyx pseudogracilis (Crustacea : Amphipoda) as an early warning indicator in the multispecies freshwater biomonitor

Background. Biological monitors are increasingly important in 'Biological Early Warning Systems' (BEWS) for monitoring water quality. This study examines the freshwater amphipod Crangonyx pseudogracilis as a potential new indicator species when used in the Multispecies Freshwater Biomonitor (MFB). The MFB is an online continuous biomonitor which uses impedance conversion to record behavioural responses of vertebrates and invertebrates.

Validation of urinary cortisol as an indicator of hypothalamic-pituitary-adrenal function in the bearded emperor Tamarin (Saguinus imperator subgrisescens)

The use of cortisol levels as a measure of stress is often complicated by the use of invasive techniques that may increase hypothalamic-pituitary-adrenal (HPA) axis activity during sample collection. The goal of this study was to collect samples noninvasively and validate an enzyme-immunoassay (EIA) for the measurement of cortisol in urine to quantify HPA axis activity in the bearded emperor tamarin (Saguinus imperator subgrisescens). Urine samples were collected from trained subjects between 0700 and 0730 hr during a 1-month period, and were pooled for immunological validation. We validated the assay immunologically by demonstrating specificity, accuracy, precision, and sensitivity. For biological validation of the assay, we showed that levels of urinary cortisol (in samples collected between 0700 and 1700 hr) varied significantly across the day. Cortisol concentration was lowest at 0700 hr, increased to a mid-morning peak (0900 hr), and declined across the remainder of the day in a typical mammalian circadian pattern. We thus demonstrate that urinary cortisol can be used to quantify HPA activity in S. i. subgrisescens. (C) 2004 Wiley-Liss, Inc.

Anal redness in European eels as an indicator of infection by the swimbladder nematode, Anguillicola crassus

Anal redness in European eels Anguilla anguilla is related to the prevalence and mean abundance of the swimbladder nematode Anguillicola crassus and may provide a simple. non-invasive diagnostic tool for A. crassus infection. (C) 2003 The Fisheries Society of the British Isles.