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Search Results: 1 - 10 of 3434 matches for " Deborah JE Marriott "
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Determinants of mortality in non-neutropenic ICU patients with candidaemia
Deborah JE Marriott, E Geoffrey Playford, Sharon Chen, Monica Slavin, Quoc Nguyen, David Ellis, Tania C Sorrell, the Australian Candidaemia Study
Critical Care , 2009, DOI: 10.1186/cc7964
Abstract: A nationwide prospective clinical and microbiological cohort study of all episodes of ICU-acquired candidaemia occurring in non-neutropenic adults was undertaken in Australian ICUs between 2001 and 2004. Multivariate Cox regression analyses were performed to determine independently significant variables associated with mortality.183 episodes of ICU-acquired candidaemia occurred in 183 patients during the study period. Of the 179 with microbiological data, Candida albicans accounted for 111 (62%) episodes and Candida glabrata, 32 (18%). Outcome data were available for 173: crude hospital mortality at 30 days was 56%. Host factors (older age, ICU admission diagnosis, mechanical ventilation and ICU admission diagnosis) and failure to receive systemic antifungal therapy were significantly associated with mortality on multivariate analysis. Among the subset who received initial fluconazole therapy (n = 93), the crude mortality was 52%. Host factors (increasing age and haemodialysis receipt), but not organism- (Candida species, fluconazole MIC), pharmacokinetic- (fluconazole dose, time to initiation), or pharmacodynamic-related parameters (fluconazole dose:MIC ratio) were associated with mortality. Process of care measures advocated in recent guidelines were implemented inconsistently: follow-up blood cultures were obtained in 68% of patients, central venous catheters removed within five days in 80% and ophthalmological examination performed in 36%.Crude mortality remains high in Australian ICU patients with candidaemia and is overwhelmingly related to host factors but not treatment variables (the time to initiation of antifungals or fluconazole pharmacokinetic and pharmacodynamic factors). The role and timing of early antifungal intervention in critically-ill ICU patients requires further investigation.Candidaemia is a relatively common healthcare-associated infection in critically-ill patients in intensive care units (ICUs) [1-3] that is associated with poor clinical ou
The Internet and Healthcare in Somalia: Knowledge is Power
Owen Marriott
Global Media Journal : African Edition , 2011, DOI: 10.5789/2-1-39
Abstract: The introduction of the eight Millennium Development Goals (MDG’s) by the UN has highlighted the need to improve healthcare conditions across the globe. These goals are particularly pertinent in Somalia, one of the least developed countries in the world. This paper intends to look at the way the burgeoning telecommunications network in Somalia can benefit healthcare professionals by providing access to the internet which in turn provides access to information that can improve healthcare. The paper will argue that although the development of healthcare is commonly associated with the modernization paradigm, the internet can offer a more participatory approach to benefit healthcare professionals in Somalia.
Viral CNS infections: role of glial pattern recognition receptors in neuroinflammation
Ian Marriott
Frontiers in Microbiology , 2012, DOI: 10.3389/fmicb.2012.00201
Abstract: Viruses are the major causative agents of central nervous system (CNS) infection worldwide. RNA and DNA viruses trigger broad activation of glial cells including microglia and astrocytes, eliciting the release of an array of mediators that can promote innate and adaptive immune responses. Such responses can limit viral replication and dissemination leading to infection resolution. However, a defining feature of viral CNS infection is the rapid onset of severe neuroinflammation and overzealous glial responses are associated with significant neurological damage or even death. The mechanisms by which microglia and astrocytes perceive neurotropic RNA and DNA viruses are only now becoming apparent with the discovery of a variety of cell surface and cytosolic molecules that serve as sensors for viral components. In this review we discuss the role played by members of the Toll-like family of pattern recognition receptors (PRRs) in the inflammatory responses of glial cells to the principle causative agents of viral encephalitis. Importantly, we also describe the evidence for the involvement of a number of newly described intracellular PRRs, including retinoic acid-inducible gene I and DNA-dependent activator of IFN regulatory factors, that are thought to function as intracellular sensors of RNA and DNA viruses, respectively. Finally, we explore the possibility that cross-talk exists between these disparate viral sensors and their signaling pathways, and describe how glial cytosolic and cell surface/endosomal PRRs could act in a cooperative manner to promote the fulminant inflammation associated with acute neurotropic viral infection.
Safety and Efficacy of Fingolimod in Treatment-Na ve Multiple Sclerosis Patients
James J. Marriott
Journal of Central Nervous System Disease , 2012, DOI: 10.4137/JCNSD.S5120
Abstract: Fingolimod was recently approved for use in the United States after two phase III trials confirmed its effectiveness in reducing disease activity in relapsing-remitting multiple sclerosis. These positive results, coupled with the important fact that this is the first oral disease-modifying therapy, has lead to considerable enthusiasm amongst physicians and patients. However, fingolimod is associated with rare but serious adverse events. In addition, unlike conventional disease-modifying therapies, cardiopulmonary, ophthalmological and dermatological safety monitoring unfamiliar to both neurologists and patients is required before and during treatment. This paper will discuss these issues from the perspective of using fingolimod as a first-line disease-modifying therapy in treatment-na ve relapsing-remitting multiple sclerosis patients.
Using Adaptive Management to Resolve Uncertainties for Wave and Tidal Energy Projects
Cherise Oram,Chad Marriott
Oceanography , 2010,
Abstract: As the nation clamors for new renewable energy sources, hydrokinetic technologies—including wave, current, tidal, and in-stream energy technologies—offer promising additions to the grid. Placing new technologies in ocean and tidal environments, which contain vast, sometimes sensitive resources but are, surprisingly, relatively unstudied, presents a challenge to agencies and developers alike as the industry strives to move through initial project-permitting stages in an efficient but environmentally responsible manner. “Adaptive management” approaches can allow projects to be permitted and installed while providing agencies and other stakeholders the opportunity to verify their anticipated impacts. Moreover, where actual impacts exceed expectations, an adaptive management approach allows agencies to address such impacts consistent with existing regulatory standards intended to protect marine resources.
Polyethism in a colony of artificial ants
Chris Marriott,Carlos Gershenson
Physics , 2011,
Abstract: We explore self-organizing strategies for role assignment in a foraging task carried out by a colony of artificial agents. Our strategies are inspired by various mechanisms of division of labor (polyethism) observed in eusocial insects like ants, termites, or bees. Specifically we instantiate models of caste polyethism and age or temporal polyethism to evaluated the benefits to foraging in a dynamic environment. Our experiment is directly related to the exploration/exploitation trade of in machine learning.
Quantum Arthur-Merlin Games
Chris Marriott,John Watrous
Computer Science , 2005,
Abstract: This paper studies quantum Arthur-Merlin games, which are Arthur-Merlin games in which Arthur and Merlin can perform quantum computations and Merlin can send Arthur quantum information. As in the classical case, messages from Arthur to Merlin are restricted to be strings of uniformly generated random bits. It is proved that for one-message quantum Arthur-Merlin games, which correspond to the complexity class QMA, completeness and soundness errors can be reduced exponentially without increasing the length of Merlin's message. Previous constructions for reducing error required a polynomial increase in the length of Merlin's message. Applications of this fact include a proof that logarithmic length quantum certificates yield no increase in power over BQP and a simple proof that QMA is contained in PP. Other facts that are proved include the equivalence of three (or more) message quantum Arthur-Merlin games with ordinary quantum interactive proof systems and some basic properties concerning two-message quantum Arthur-Merlin games.
Emergence-focused design in complex system simulation
Chris Marriott,Jobran Chebib
Computer Science , 2015,
Abstract: Emergence is a phenomenon taken for granted in science but also still not well understood. We have developed a model of artificial genetic evolution intended to allow for emergence on genetic, population and social levels. We present the details of the current state of our environment, agent, and reproductive models. In developing our models we have relied on a principle of using non-linear systems to model as many systems as possible including mutation and recombination, gene-environment interaction, agent metabolism, agent survival, resource gathering and sexual reproduction. In this paper we review the genetic dynamics that have emerged in our system including genotype-phenotype divergence, genetic drift, pseudogenes, and gene duplication. We conclude that emergence-focused design in complex system simulation is necessary to reproduce the multilevel emergence seen in the natural world.
The Effect of Social Learning on Individual Learning and Evolution
Chris Marriott,Jobran Chebib
Computer Science , 2014,
Abstract: We consider the effects of social learning on the individual learning and genetic evolution of a colony of artificial agents capable of genetic, individual and social modes of adaptation. We confirm that there is strong selection pressure to acquire traits of individual learning and social learning when these are adaptive traits. We show that selection pressure for learning of either kind can supress selection pressure for reproduction or greater fitness. We show that social learning differs from individual learning in that it can support a second evolutionary system that is decoupled from the biological evolutionary system. This decoupling leads to an emergent interaction where immature agents are more likely to engage in learning activities than mature agents.
Finding a Mate With No Social Skills
Chris Marriott,Jobran Chebib
Quantitative Biology , 2015, DOI: 10.1145/2739480.2754804
Abstract: Sexual reproductive behavior has a necessary social coordination component as willing and capable partners must both be in the right place at the right time. While there are many known social behavioral adaptations to support solutions to this problem, we explore the possibility and likelihood of solutions that rely only on non-social mechanisms. We find three kinds of social organization that help solve this social coordination problem (herding, assortative mating, and natal philopatry) emerge in populations of simulated agents with no social mechanisms available to support these organizations. We conclude that the non-social origins of these social organizations around sexual reproduction may provide the environment for the development of social solutions to the same and different problems.
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