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ABSTRACTThe prevalence of intrinsic and acquired resistance among colonizing Candidaisolates from patients after candidemia was investigated systematically in a 1-year nationwide study. Patients were treated at the discretion of the treating physician. Oral swabs were obtained after treatment. Species distributions and MIC data were investigated for blood and posttreatment oral isolates from patients exposed to either azoles or echinocandins for <7 or ≥7 days. Species identification was confirmed using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing, susceptibility was examined by EUCAST EDef 7.2 methodology, echinocandin resistance was examined by FKSsequencing, and genetic relatedness was examined by multilocus sequence typing (MLST). One hundred ninety-three episodes provided 205 blood and 220 oral isolates. MLST analysis demonstrated a genetic relationship for 90% of all paired blood and oral isolates. Patients exposed to azoles for ≥7 days (n= 93) had a significantly larger proportion of species intrinsically less susceptible to azoles (particularly Candida glabrata) among oral isolates than among initial blood isolates (36.6% versus 12.9%; P< 0.001). A similar shift toward species less susceptible to echinocandins among 85 patients exposed to echinocandins for ≥7 days was not observed (4.8% of oral isolates versus 3.2% of blood isolates; P> 0.5). Acquired resistance in Candida albicanswas rare (<5%). However, acquired resistance to fluconazole (29.4%; P< 0.05) and anidulafungin (21.6%; P< 0.05) was common in C. glabrataisolates from patients exposed to either azoles or echinocandins. Our findings suggest that the colonizing mucosal microbiota may be an unrecognized reservoir of resistant Candidaspecies, especially C. glabrata, following treatment for candidemia. The resistance rates were high, raising concern in general for patients exposed to antifungal drugs.

Recolonization dynamics from disturbance on a Philippine mixed seagrass meadow, containing species spanning more than 10-fold in rhizome elongation rates and reproductive effort, was examined by following the recovery of a 1,200 m2gap over 2.5 yr. The objective was to assess the contribution of contrasting species to the recovery process and to evaluate the importance of sexual versus vegetative colonization. Large, slow-growing species,Thalassia hemprichiiandEnhalus acoroides, that produce large, broadly-dispersed seeds dominated sexual colonization with a total of 2,643 and 210 seedlings, respectively, recruiting to the area. Despite very rapid turnover of sexual recruits, the high frequency of seedling establishment ensured successful development of new patches in areas devoid of vegetation, leading to a scattered and evenly distributed presence of vegetation inside the gap. The small seagrass speciesCymodocea rotundataandHalodule uninervis, characterized by fast rhizome elongation rates but low reproductive output and limited seed dispersal, were the major contributors to the overall 450 m2increase in vegetation cover through fast lateral extension (144±6 cm yr−1) from meadow edge and surviving patches, forming a compact vegetation cover in one edge of the denuded area. We conclude that contrasting recruitment strategies in the mixed-species seagrass community examined have implications for colonization potential at different spatial scales. Fast clonal growth is only an efficient mechanism for colonization of disturbances within established meadows (small gaps), whereas the large species, which combined high reproductive output with high seed dispersal capacity, may act to accelerate the colonization process in large gaps or distant from established meadows.

During the past few years, biomineralized manganese has been shown to cause ennoblement of various stainless steels to open circuit potentials of 300–400 mV/SCE. We have demonstrated that ennoblement, caused by biologically deposited manganese minerals, along with a relatively low stainless steel pitting potential, caused by the presence of chloride, is sufficient to initiate and drive active pitting corrosion. Stainless steel samples (type 304L), chemically or microbiologically ennobled with manganese dioxide, were exposed to a 0.35% w/v NaCl solution; an environment otherwise not corrosive against the 304L stainless steel. In the first case, steel samples were ennobled by electroplating the sample with a thin film of manganese dioxide, except for a small anodic area. In the latter case, the manganese dioxide was deposited on the steel within biofilms of the manganese oxidizing bacterium Leptothrix discophora SP‐6. After 24 h exposure to the chloride solution the samples were investigated by atomic force microscopy (AFM). Both types of ennobled samples were found severely pitted, whereas reference samples (w/o manganese minerals) had remained intact.

The purpose of this prospective study was to evaluate beta-2-microglobulin (β2m) as a differential diagnostic indicator between hepatic nephropathy (HN) and acute tubulointerstitial nephropathy (ATIN) in patients with reduced renal function and hepatic coma, and to determine whether β2m excretion could be used as a marker of renal impairment before increased serum creatinine (S-Cr) concentration or decreased creatinine clearance (Cr-Cl). Finally, the use of β2m as a prognostic indicator was investigated. Eighteen patients in hepatic coma grade III-IV were entered in the study and were divided into two groups in accordance with their renal function (serum creatinine above/below 180 μmol/l). The fractional excretion of β2m (FE-β2m) was used to monitor β2m elimination. The study failed to show any distinction in FE-β2m between HN and ATIN patients, presumably owing to the small number of patients. FE-β2m could not predict the development of renal failure earlier than the increase in S-Cr or decrease in Cr-Cl. However, a few patients who survived paracetamol intoxication had increased FE-β2M in the beginning of the coma and normal S-Cr and Cr-Cl. Patients who died as a result of paracetamol intoxication had both abnormal FE-β2m and abnormal S-Cr and Cr-Cl, suggesting that if therapy had been initiated earlier, when only FE-β2m was affected, these patients might have survived. All patients who survived, except three paracetamol-and one aminoglycoside-intoxicated patient, had normal FE-β2m in the beginning of the coma. This indicates that β2m is of prognostic value, especially in patients with non-drug-related hepatopathy.

Thirty-two subjects (16 male and 10 female students aged (8-25 yr) performed sedentary work in a climate chamber under two different conditions. The subject wore a light standard clothing (0.6 clo) on one occasion and a heavy clothing ensemble (1.5 clo) on the other. Each subject was exposed singly, for 2-5 hr on each occasion. During the exposures the air temperature was continuously adjusted up or down at the subject's request, as indicated on a dial voting apparatus, so that he remained in thermal comfort. Skin temperatures were measured throughout. Performance measures were obtained on a numerical addition task, a recognition memory task, and on a test of cue-utilization. Subjects rated their effort, arousal and fatigue, and the freshness of the air on semantic differential scales. No significant differences in performance could be shown between the two conditions. Subjective effort, arousal and fatigue did not differ, but subjects considered that the air was fresher in the cool air/heavy clothing condition. Skin temperatures were significantly loss uniform over the body surface in this condition, although the average skin temperature was the same under both conditions, Male subjects maintained a significantly higher mean skin temperature and a significantly higher evaporative weight loss under bath clothing conditions than did female subjects, However, there were no significant differences between the air temperatures preferred by male and female subjects. The average preferred air temperature was 23-2° and 18.7°C for 0.6 and 1.15 clo, respectively,