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. r/>r/>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. r/>r/>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. r/>r/>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.r/>

Iron abundances of B-type post-asymptotic giant branch stars in globular clusters: Barnard29 in M13 and ROA5701 in ωCen

High-resolution optical and ultraviolet (UV) spectra of two B-type post-asymptotic giant branch (post-AGB) stars in globular clusters, Barnard29 in M13 and ROA5701 in ?Cen, have been analysed using model atmosphere techniques. The optical spectra have been obtained with FEROS on the ESO 2.2-m telescope and the 2d-Coudé spectrograph on the 2.7-m McDonald telescope, while the UV observations are from the Goddard high-resolution spectrograph on the Hubble Space Telescope (HST). Abundances of light elements (C, N, O, Mg, Al and S) plus Fe have been determined from the optical spectra, while the UV data provide additional Fe abundance estimates from FeIII absorption lines in the 1875-1900 Å wavelength region. A general metal underabundance relative to young B-type stars is found for both Barnard29 and ROA5701. These results are consistent with the metallicities of the respective clusters, as well as with previous studies of the objects. The derived abundance patterns suggest that the stars have not undergone a gas-dust separation, contrary to previous suggestions, although they may have evolved from the AGB before the onset of the third dredge-up. However, the Fe abundances derived from the HST spectra are lower than those expected from the metallicities of the respective clusters, by 0.5 dex for Barnard29 and 0.8 dex for ROA5701. A similar systematic underabundance is also found for other B-type stars in environments of known metallicity, such as the Magellanic Clouds. These results indicate that the FeIII UV lines may yield abundance values which are systematically too low by typically 0.6 dex and hence such estimates should be treated with caution.

Iron abundances from optical FeIII absorption lines in B-type stellar spectra

The role of optical FeIII absorption lines in B-type stars as iron abundance diagnostics is considered. To date, ultraviolet Fe lines have been widely used in B-type stars, although line blending can severely hinder their diagnostic power. Using optical spectra, covering a wavelength range ~3560-9200Å, a sample of Galactic B-type main-sequence and supergiant stars of spectral types B0.5 to B7 are investigated. A comparison of the observed FeIII spectra of supergiants, and those predicted from the model atmosphere codes TLUSTY [plane-parallel, non-local thermodynamic equilibrium (LTE)], with spectra generated using SYNSPEC (LTE), and CMFGEN (spherical, non-LTE), reveal that non-LTE effects appear small. In addition, a sample of main-sequence and supergiant objects, observed with the Fiber-fed Extended Range Optical Spectrograph (FEROS), reveal LTE abundance estimates consistent with the Galactic environment and previous optical studies. Based on the present study, we list a number of FeIII transitions which we recommend for estimating the iron abundance from early B-type stellar spectra.

On solvability of linear differential equations in ${\Bbb R}^{\Bbb N}$

We construct $x^0$ in ${\Bbb R}^{\Bbb N}$ and a row-finite matrix $T=\{T_{i,j}(t)\}_{i,j\in\N}$ of polynomials of one real variable $t$ such that the Cauchy problem $\dot x(t)=T_tx(t)$, $x(0)=x^0$ in the Fr\'echet space $\R^\N$ has no solutions. We also construct a row-finite matrix $A=\{A_{i,j}(t)\}_{i,j\in\N}$ of $C^\infty(\R)$ functions such that the Cauchy problem $\dot x(t)=A_tx(t)$, $x(0)=x^0$ in ${\Bbb R}^{\Bbb N}$ has no solutions for any $x^0\in{\Bbb R}^{\Bbb N}\setminus\{0\}$. We provide some sufficient condition of solvability and of unique solvability for linear ordinary differential equations $\dot x(t)=T_tx(t)$ with matrix elements $T_{i,j}(t)$ analytically dependent on $t$.

Comment on "Electron collisional excitation of argon-like Ni XI using the Breit-Pauli R-matrix method" [Eur. Phys. J. D 42, 235-241 (2007)] - Electron impact excitation of Ni XI

In a recent paper, Verma et al. [Eur. Phys. J. D 42, 235 (2007)] have reported results for energy levels, radiative rates, collision strengths, and effective collision strengths for transitions among the lowest 17 levels of the (1s(2)2s(2)2p(6))3s(2)3p(6), 3s(2)3p(5)3d and 3s3p(6)3d configurations of Ni XI. They adopted the CIV3 and R-matrix codes for the generation of wavefunctions and the scattering process, respectively. In this paper, through two independent calculations performed with the fully relativistic DARC (along with GRASP) and FAC codes, we demonstrate that their results are unreliable. New data are presented and their accuracy is assessed.