Miracle-dz/UniFAR-FTUs huggingface dataset:
Etiology, Antibiotic Resistance and Risk Factors for Neonatal Sepsis in a Large Referral Center in Zambia

Background: In sub-Saharan Africa, there is scanty data on the causes of neonatal sepsis and antimicrobial resistance among common invasive pathogens that might guide policy and practice. Methods: A cross-sectional observational prevalence and etiology study of neonates with suspected sepsis admitted to the neonatal intensive care unit, University Teaching Hospital, Lusaka, Zambia, between October 2013 and May 2014. Data from blood cultures and phenotypic antibiotic susceptibility testing were compared with multivariate analysis of risk factors for neonatal sepsis. Results: Of 313 neonates with suspected sepsis, 54% (170/313) were male; 20% (62/313) were born to HIV-positive mothers; 33% (103/313) had positive blood cultures, of which 85% (88/103) were early-onset sepsis. Klebsiella species was the most prevalent isolate, accounting for 75% (77/103) of cases, followed by coagulase-negative staphylococci [6% (7/103)], Staphylococcus aureus [6% (6/103)], Escherichia coli [5% (5/103)] and Candida species [5% (5/103)]. For Klebsiella species, antibiotic resistance ranged from 96%–99% for World Health Organization-recommended first-line therapy (gentamicin and ampicillin/penicillin) to 94%–97% for third-generation cephalosporins. The prevalence of culture-confirmed sepsis increased from 0 to 39% during the period December 2013 to March 2014, during which time mortality increased 29%–47%; 93% (14/15) of late-onset sepsis and 82% (37/45) of early-onset sepsis aged 4–7 days were admitted >2 days before the onset of symptoms. Culture results for only 25% (26/103) of cases were available before discharge or death. Maternal HIV infection was associated with a reduced risk of neonatal sepsis [odds ratio, 0.46 (0.23–0.93); P = 0.029]. Conclusions: Outbreaks of nosocomial multiantibiotic-resistant infections are an important cause of neonatal sepsis and associated mortality. Reduced risk of neonatal sepsis associated with maternal HIV infection is counterintuitive and requires further investigation.
Financial structures and economic development

The author constructs a model that captures the two-way nature of the relationship between financial and economic development - and allows societies at different levels of economic development and with different policies to choose different financial services. In this model, various types of financial contracts and institutions arise in response to the economic environment. Incentives for financial structures to emerge are generated by liquidity and productivity risk, the costs of gathering information and mobilizing resources, and the costs of financial transactions. The emergence and development of financial arrangements in response to the economic environment can alter investment decisions and per capita growth rates - while the level of per capita income helps determine the types of financial services a particular society chooses to develop and use. The author not only reconciles more empirical regularities than past theoretical studies have done, but highlights the role of public policies on financial activities. Policy has important implications for the rate of economic growth, the level of financial development, and the types of institutions providing financial services. The model also predicts that per capita growth rates should be related to the types of financial services provided by the financial sector. Thus, the most common empirical measure of financial development may not appropriately capture fundamental features of financial development.
Market Reaction to Intended Use of Proceeds Disclosure: Evidence from Australian SEO's

We study a sample of 568 Australian rights offerings made during 2003-08 to examine the market response to the reasons stated by the firm for the use of capital on announcements. We also examine the impact of the extent of disclosure of use of proceeds on market response. Using event study methodology and cross sectional regressions, we find that the market response to offerings for capital expenditure purposes is significantly less adverse than to offerings for other purposes. However, the study does not find an association between the extent of disclosure of use of proceeds and the market response. Our findings suggest that the market appears to be interested in the broad classification of the intended use of proceeds on announcement and specifying a dollar amount for each of the intended use listed on announcement is not value relevant.
Incidence of Nephropathy in HIV Infected Patients Receiving Highly Active Antiretroviral Therapy at Newlands Clinic: A Retrospective Study

Introduction: HIV infected patients on antiretroviral therapy (ART) are at risk of developing nephropathy and therefore require monitoring of renal function. Some medications used in the management of HIV, opportunistic infections (OIs) and other comorbidities are nephrotoxic and may further compromise renal function, underlining the importance of regular monitoring of renal function. This study was designed to determine the incidence of nephropathy in HIV infected patients on antiretroviral therapy (ART) at Newlands Clinic and to determine the associated risk factors. Methodology: A retrospective cohort study was conducted involving 1986 HIV-1 infected participants who were commenced on ART between January 2007 and December 2013 at Newlands Clinic. The majority of participants were female (1340 (67.5%)). All participants were aged 18 or older at ART commencement. Participants with pre-existing nephropathy at baseline were excluded. Nephropathy was defined as two consecutive calculated creatinine clearances (CrCl) less than 60 ml/min by the Cockcroft-Gault equation, or two consecutive urine dipsticks positive for protein (≥30 g/L albumin). Data collected during routine patient visits were exported from the clinic’s database and analysed for incidence of nephropathy and risk factors. Results: During the follow-up period, 93 of the 1986 participants (4.7%) developed nephropathy. The estimated incidence rate (IR) of nephropathy was 1.45/100 person years (CI: 1.17 - 1.78). In the multivariate analysis, statistically significant risk factors were baseline age > 45 (HR 2.30, CI: 1.50 - 3.55), diabetes mellitus (HR 4.12, CI: 1.75 - 9.69), pulmonary tuberculosis (HR 2.00, CI: 1.28 - 3.12), and HIV wasting syndrome (HR 2.72, CI: 1.30 - 5.68). Conclusion: The incidence of nephropathy was low in this cohort. The traditional risk factors for renal disease; older age and diabetes mellitus were significant, as well as HIV wasting syndrome and pulmonary tuberculosis. HIV care should be complimented with proper diabetic care and patients that develop pulmonary tuberculosis, HIV wasting syndrome or are initiated on ART above 45 years require regular monitoring for early detection of nephropathy.
Identification of a Neurologic Scale That Optimizes EMS Detection of Older Adult Traumatic Brain Injury Patients Who Require Transport to a Trauma Center

Abstract Objective. We sought to identify a scale or components of a scale that optimize detection of older adult traumatic brain injury (TBI) patients who require transport to a trauma center, regardless of mechanism. Methods. We assembled a consensus panel consisting of nine experts in geriatric emergency medicine, prehospital medicine, trauma surgery, geriatric medicine, and TBI, as well as prehospital providers, to evaluate the existing scales used to identify TBI. We reviewed the relevant literature and solicited group feedback to create a list of candidate scales and criteria for evaluation. Using the nominal group technique, scales were evaluated by the expert panel through an iterative process until consensus was achieved. Results. We identified 15 scales for evaluation. The panel's criteria for rating the scales included ease of administration, prehospital familiarity with scale components, feasibility of use with older adults, time to administer, and strength of evidence for their performance in the prehospital setting. After review and discussion of aggregated ratings, the panel identified the Simplified Motor Scale, GCS-Motor Component, and AVPU (alert, voice, pain, unresponsive) as the strongest scales, but determined that none meet all EMS provider and patient needs due to poor usability and lack of supportive evidence. The panel proposed that a dichotomized decision scheme that includes domains of the top-rated scales –level of alertness (alert vs. not alert) and motor function (obeys commands vs. does not obey) –may be more effective in identifying older adult TBI patients who require transport to a trauma center in the prehospital setting. Conclusions. Existing scales to identify TBI are inadequate to detect older adult TBI patients who require transport to a trauma center. A new algorithm, derived from elements of previously established scales, has the potential to guide prehospital providers in improving the triage of older adult TBI patients, but needs further evaluation prior to use.
The cutaneous pathology of extrafacial lesions in Cowden's disease

Twenty extrafacial lesions from 6 patients with Cowden's disease were studied. Most were hyperkeratotic papillomas that resembled verruca vulgaris, acrokeratosis verruciformis, or hyperkeratotic acanthomas. Small hyperkeratotic papillomas frequently showed abnormalities of the follicular infundibulum. Occasionally, follicular abnormalities were seen without concomitant epidermal hyperplasia. It is concluded that some of the extrafacial lesions may originate from the follicular infundibulum. No evidence of a virus infection was found using an antiserum to papilloma virus.
Nonresident Fathersâ Involvement after a Nonmarital Birth: Exploring Differences by Race/Ethnicity

Despite the higher prevalence of nonmarital childbearing among racial/ethnic minorities, there is limited evidence about differences in unmarried father involvement across race/ethnic groups. Using data from the Fragile Families and Child Wellbeing Study (N=2,534), we evaluate racial/ethnic variation in father involvement after a nonmarital birth for nonresident fathers. Since nonresident father involvement typically requires coordinating with the mother, we evaluated involvement measures related to the father-child relationship (time and engagement) as well as measures related to the mother-father relationship vis-A -vis their common child (sharing responsibilities and coparenting). Black fathers were significantly more likely to spend time and engage in activities with their children as compared to Hispanic fathersâ€”but not White fathers. With regard to the mother-father parenting interaction, Black fathers exhibited significantly higher levels of shared responsibility and positive coparenting with mothers than either White or Hispanic fathers. The low level of involvement among Hispanic fathers is notable, and future research should address possible reasons for this outcome.
Energy analysis of e-commerce and conventional retail distribution of books in Japan

Energy use associated with distribution via e-commerce and conventional retail is compared for book sales in Japan. The simulation of energy consumption includes the following factors: fossil fuel used by trucks in distribution from distributor to bookstore or e-commerce firm, transport fuel used by the consumer or courier service production of packaging, and energy for appliances and climate control at the point of sale (home or bookstore). Results indicate a crossover in environmental performance according to population density. Conventional retail uses less energy than e-commerce in dense urban areas, mainly due to avoided packaging, but can consume more in suburban and rural areas due to the inefficiency of personal automobile transport.
Prescription Trend of Topical Corticosteroids in Outpatient of Dermatology in a Tertiary Care Hospital in Tumakuru, Karnataka

Background: Skin diseases amounts for a large fraction of patients attending the outpatient of dermatology and topical corticosteroids (TCS) are being commonly prescribed, the data related to drug usage patterns of TCS in skin conditions are particularly lacking. Hence it is vital to study the drug prescribing patterns of TCS in skin diseases. Objective: To study the demographic details and drug prescription pattern of TCS in patients with skin diseases. Materials and Methods: A cross-sectional study conducted in the Dermatology Department, Sri Siddhartha Medical College, over a period of 2 months. The patients with skin diseases who were prescribed TCS were included. The data was collected by direct observation in a specially designed proforma containing relevant detail such as demography, skin conditions and drug used. The data were analyzed as counts and percentages. Result: Majority of the patients were under the age of less than 20 years (38%) followed by those between the age of 21 years to 40 years (36%). Female patients (61%) were more and majority were from rural areas (69%). Clobetasol propionate (46%), mometasone furoate (15%) and betamethasone dipropionate (12%) were the commonly prescribed TCS. Fixed dose combinations (FDC) of TCS were commonly with fusidic acid, gentamicin and salicylic acid. Average drug per prescription was 2.09. None of the prescriptions used generic names. Conclusion: Prescription pattern provides critical feedback to prescribing physician by focusing on rationalizing drug therapy. FDC of TCS with gentamicin, salicylic acid and fusidic acids are rational and approved by CDSCO.
Changes in concentrations of microcystins in rainbow trout, freshwater mussels, and cyanobacteria in Lakes Rotoiti and Rotoehu

Microcystin concentrations in cyanobacteria and their accumulation in rainbow trout (Oncorhynchus mykiss) and freshwater mussels (Hyridella menziesi) in Lakes Rotoiti and Rotoehu (New Zealand) were investigated. Hatchery rainbow trout were added to an enclosure in Lake Rotoiti where concentrations of microcystins in the phytoplankton and cyanobacterial cell concentrations could be closely monitored. Rainbow trout that were free to roam in the entire area of each lake were also included in the study. Freshwater mussels were suspended subsurface in cages in the enclosure. Phytoplankton samples, rainbow trout liver and muscle tissue, and the tissues of mussels were analyzed for microcystins using the ADDA‐ELISA method, and selected samples were analyzed using LC‐MS. A maximum concentration of microcystins in the phytoplankton samples of 760 μg L−1 was recorded in Te Weta Bay, Lake Rotoiti, in March 2004. ELISA results confirmed microcystin immunoreactivity in rainbow trout liver and muscle tissues and in freshwater mussels. The microcystin congeners LR, YR, RR, AR, FR, LA, and WR were detected by LC‐MS in caged freshwater mussels in Lake Rotoiti but were not detected in either muscle or liver tissue of rainbow trout. The daily tolerable intake limit of microcystins for human consumption recommended by the World Health Organisation is 0.04 μg kg−1 day−1. Modeling was carried out for the human intake of microcystin compounds from rainbow trout muscle tissue, and the potential health risks were estimated, assuming the ADDA‐ELISA was determining compounds of toxicity equivalent to microcystin‐LR. © 2006 Wiley Periodicals, Inc. Environ Toxicol 21: 205–222, 2006.
On the Nature and Predictability of Corporate Bond Returns

Corporate bond returns consist of two distinct components: an interest rate component, which is default-free and anti-cyclical, and a credit spread component, which is default-risky and pro-cyclical. These components are mutually negatively correlated and their relative importance varies with credit quality. We show that it is of critical importance to take this into account when studying the predictability of corporate bond returns. In this paper we focus on the credit spread component of corporate bond returns, enabling us to find new predictors that were previously unknown to the literature. Moreover, by re-examining previously documented predictors, we are able to dismiss several of them as irrelevant for credit spread returns and to explain inconsistent findings between investment grade and high yield corporate bonds. In total, we find four factors with significant in-sample and out-of-sample predictability of both investment grade and high yield excess returns over Treasury. Two variables come from the existing literature: past equity return and past corporate bond return. Evidence for the other two variables is new: change in implied equity volatility and the Halloween indicator.
Routing instability in ad hoc networks

An ad hoc network is a collection of self-configured nodes that are dynamically and arbitrarily located in such a manner that the interconnections between nodes are capable of changing on a continual basis. In order to facilitate communication within the network, a routing protocol plays an important role in discovering and defining the routes between nodes. To date, a considerable amount of research effort has focused on the design of ad hoc network routing protocols. However, relatively little of this work examines the stability of routes in such networks. There are several reasons to believe that the routes in ad hoc networks will be unstable. One reason is that the majority of routing messages are broadcast packets which tend to be unreliable and have lower service quality at lower layer. The routing traffic usually shares resources such as bandwidth and buffer space with data traffic. The data traffic constitutes a larger portion of traffic mix. Furthermore, data traffic comprises mostly of unicast transmission because it offers more reliable delivery and higher service quality for user applications. Thus, the routing packets will suffer from a higher degree of loss when a network contains both routing and data traffic. The loss of routing packets can cause peering sessions to fail and consequently leads to routing instabilities. Due to the layered network architecture, the routing protocol designs often overlook any severe packet loss that is induced not only by the surrounding wireless traffic but also by their own traffic. Therefore, the communication link
Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement

BackgroundBurnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. ObjectivesThe purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. MethodsWorking nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. ResultsFindings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. DiscussionThere are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.
A-to-I RNA Editing and Human Disease

The post-transcriptional modification of mammalian transcripts by A-to-I RNA editing has beenrecognized as an important mechanism for the generation of molecular diversity and alsoregulates protein function through recoding of genomic information. As the molecular players ofediting are characterized and an increasing number of genes become identified that are subject toA-to-I modification, the potential impact of editing on the etiology or progression of humandiseases is realized. Here we review the recent knowledge on where disturbances in A-to-I RNAediting have been correlated with human disease phenotypes.
CT in patients with scirrhous carcinoma of the GI tract: imaging findings and value for tumor detection and staging.

OBJECTIVE The purposes of this study were to analyze the CT features of scirrhous carcinoma of the gastrointestinal (GI) tract and to assess the usefulness of CT in detecting and staging these lesions. MATERIAL AND METHODS This is a retrospective evaluation of 31 proven cases of scirrhous carcinoma (linitis plastica) of the GI tract imaged in our institution from 1986 to 1994. Twenty-two patients had primary gastric carcinoma, and nine had carcinoma of the colon (rectosigmoid in eight and right colon in one). CT examinations were reviewed and correlated with pathologic and/or surgical findings in all patients and with barium examinations in 19 cases. A modified Dukes classification was used to stage these lesions without knowledge of the pathologic and surgical results. RESULTS Four gastric lesions were missed during the initial CT examination. Seventeen patients had extensive circumferential lesions, and five had focal plaquelike lesions. The wall thickness ranged from 1 to 3 cm (mean, 1.8 cm). Homogeneous enhancement was seen in 17 patients, slightly heterogeneous enhancement was seen in one, a target configuration was present in two patients, and intramural calcification was present in one patient. All colonic lesions were circumferential, homogeneously enhancing with a wall thickness ranging from 1 to 3 cm (mean, 2 cm). CT scans showed limitations in evaluating local parameters. Compared with surgical and pathologic staging, CT correctly staged 26 patients, understaged four patients, and overstaged one patient. Among the 19 patients with pathologically proven stage D lesions (61%), CT correctly staged 17 patients (89%) and had a 100% positive predictive value. One case of hepatic metastases, 13 cases of malignant ascites, and 11 cases of omental and peritoneal metastases were found. CONCLUSION CT is an important complimentary imaging technique to detect scirrhous carcinoma. The sensitivity of detection depends on the size of the lesion and the quality of the examination. CT has limitations in staging early lesions but shows a high sensitivity (89%) in detecting Dukes stage D lesions. Accurate CT staging in these individuals (61% in this series) allows a more adequate treatment strategy and avoids unnecessary exploratory laparotomies.