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This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

The team observed viruses as they evolved over hundreds of generations to infect bacteria. They found that when the bacteria could evolve defences, the viruses evolved at a quicker rate and generated greater diversity, compared to situations where the bacteria were unable to adapt to the viral infection. The study shows, for the first time, that the American evolutionary biologist Leigh Van Valen was correct in his 'Red Queen Hypothesis'. The theory, first put forward in the 1970s, was named after a passage in Lewis Carroll's Through the Looking Glass in which the Red Queen tells Alice, 'It takes all the running you can do to keep in the same place'. This suggested that species were in a constant race for survival and have to continue to evolve new ways of defending themselves throughout time. Dr Steve Paterson, from the University's School of Biosciences, explains: "Historically, it was assumed that most evolution was driven by a need to adapt to the environment or habitat. The Red Queen Hypothesis challenged this by pointing out that actually most natural selection will arise from co-evolutionary interactions with other species, not from interactions with the environment. "This suggested that evolutionary change was created by 'tit-for-tat' adaptations by species in constant combat. This theory is widely accepted in the science community, but this is the first time we have been able to show evidence of it in an experiment with living things." Dr Michael Brockhurst said: "We used fast-evolving viruses so that we could observe hundreds of generations of evolution. We found that for every viral strategy of attack, the bacteria would adapt to defend itself, which triggered an endless cycle of co-evolutionary change. We compared this with evolution against a fixed target, by disabling the bacteria's ability to adapt to the virus. "These experiments showed us that co-evolutionary interactions between species result in more genetically diverse populations, compared to instances where the host was not able to adapt to the parasite. The virus was also able to evolve twice as quickly when the bacteria were allowed to evolve alongside it."

To explore how such memories are recorded, the researchers showed ten volunteers three short films and asked them to memorise what they saw. The films were very simple, sharing a number of similar features - all included a woman carrying out an everyday task in a typical urban street, and each film was the same length, seven seconds long. For example, one film showed a woman drinking coffee from a paper cup in the street before discarding the cup in a litter bin; another film showed a (different) woman posting a letter. The volunteers were then asked to recall each of the films in turn whilst inside an fMRI scanner, which records brain activity by measuring changes in blood flow within the brain. A computer algorithm then studied the patterns and had to identify which film the volunteer was recalling purely by looking at the pattern of their brain activity. The results are published in the journal Current Biology. "The algorithm was able to predict correctly which of the three films the volunteer was recalling significantly above what would be expected by chance," explains Martin Chadwick, lead author of the study. "This suggests that our memories are recorded in a regular pattern." Although a whole network of brain areas support memory, the researchers focused their study on the medial temporal lobe, an area deep within the brain believed to be most heavily involved in episodic memory. It includes the hippocampus - an area which Professor Maguire and colleagues have studied extensively in the past. They found that the key areas involved in recording the memories were the hippocampus and its immediate neighbours. However, the computer algorithm performed best when analysing activity in the hippocampus itself, suggesting that this is the most important region for recording episodic memories. In particular, three areas of the hippocampus - the rear right and the front left and front right areas - seemed to be involved consistently across all participants. The rear right area had been implicated in the earlier study, further enforcing the idea that this is where spatial information is recorded. However, it is still not clear what role the front two regions play.