Miracle-dz/UniFAR-FTUs huggingface dataset:
Utility of Multilocus Sequence Typing as an Epidemiological Tool for Investigation of Outbreaks of Gastroenteritis Caused by Campylobacter jejuni

ABSTRACT Multilocus sequence typing (MLST) has been proven useful for the study of the global population structure of Campylobacter jejuni; however, its usefulness for the investigation of outbreaks of disease caused by C. jejuni has not been proven. In this study, MLST plus sequencing of the flaA short variable region (SVR) were applied to 47 isolates from 12 outbreaks of C. jejuni infection whose relatedness has been determined previously, and the results were compared to those of serotyping and pulsed-field gel electrophoresis (PFGE). Isolates implicated in an outbreak were indistinguishable by all four subtyping methods, with sporadic isolates being distinguished from outbreak isolates. Two sporadic isolates from one outbreak were resistant to SmaI digestion and therefore nontypeable by PFGE but were differentiated from the outbreak strain by the other methods. PFGE and flaA SVR typing were the most discriminatory methods, with discriminatory indices (DI) of 0.930 and 0.923, respectively. However, an epidemic strain from one outbreak was distinguished from the other outbreak isolates by flaA SVR typing; its flaA allele was different at five nucleotides, suggesting that this change was possibly mediated by recombination. MLST was less discriminatory than PFGE and flaA SVR typing (DI = 0.859), and many of the epidemic strains possessed common sequence types (STs) including ST-8, -21, -22, and -42. However, further discrimination within STs was achieved by flaA SVR typing or PFGE. The results from this study demonstrate that a combined approach of MLST plus flaA SVR typing provides a level of discrimination equivalent to PFGE for outbreak investigations.
Epidermotropic B-Cell Lymphoma: A Unique Subset of CXCR3-Positive Marginal Zone Lymphoma

Background:Epidermotropic B-cell lymphoma is a very rare entity that has primarily been reported in the literature as anecdotal case reports. The majority of the reported cases exhibit a diffuse skin rash affecting middle-aged to older adults with a male predominance. The exact mechanism of marginal zone B-cell localization to the epidermis is unclear. Material and Methods:To describe a very rare subset of cutaneous B-cell lymphoma and explore potential pathogenetic mechanisms for the epidermotropic tendency, the hospital database and literature review was conducted to isolate cases of epidermotropic B-cell lymphoma. Routine hematoxylin and eosin stain followed by selective phenotypic studies. Results:Two of the cases were encountered in the hospital database, whereas 5 cases have been previously reported; material was requested on previously reported cases and was received on 3 of them. In one of the 2 cases encountered in our database, the patient presented with a progressive skin rash over 7 months resembling pityriasis rosea. Subsequent to a diagnosis of B-cell lymphoma, further staging revealed bone marrow involvement. The other patient, an elderly female, presented with isolated nodules. The biopsies of both cases showed areas of superficial band-like lymphocytic infiltration with large monocytoid appearance and an epidermotropic pattern of lymphocyte migration into the epidermis. Neoplastic cells were extensively positive for CD20, CD79a, and BCL-2 and negative for CD10 and BCL-6. Of interest, a similar pityriasis rosea–like presentation was encountered in the cases reported in the literature. All patients were elderly males with established bone marrow, peripheral blood, and spleen involvement several months to years after the initial cutaneous presentation in 3 of them. None of the patients to date have died of lymphoma. CXCR3 epidermotropic B cells were detected in both our cases and in 3 of the 3 previously published cases. Conclusions:Epidermotropic B-cell lymphoma represents a subset of marginal zone lymphoma characterized by a papulosquamous rash most frequently resembling pityriasis rosea, occurring almost exclusively in older males. We speculate that aberrant expression of CXCR3 in marginal zone lymphoma of the skin is associated with migration of lymphoma cells to the epidermis and could lead to an epidermotropic pattern given the known role of CXCR3 expression in neoplastic T cells in the localization of mycosis fungoides to the epidermis. There is a tendency toward bone marrow, spleen, and peripheral blood involvement.
Pricing long-dated equity derivatives under stochastic interest rates

A key requirement of any equity hybrid derivatives pricing model is the ability to rapidly and accurately calibrate to vanilla option prices. However, existing methodologies are often reliant on costly numerical procedures or approximations that may not be suitable when dealing with long-term expiries. Therefore, in this thesis, we introduce new techniques for calibrating equity models under correlated stochastic interest rates, which do not suffer from these limitations. We also present a number of empirical examples to highlight the potential impact of interest rate stochasticity on long-dated derivatives. In chapter 3, we begin by introducing a class of equity hybrid models that is capable of producing an implied volatility smile. This is achieved by equating the stock price divided by the bank account to a chosen function of a driving Gaussian process. The resulting processes for the stock price, short-rate and bank account can be exactly simulated over arbitrary time steps because they follow a straightforward transformation of the joint normal distribution. Furthermore, vanilla option prices are available as a one dimensional integral, meaning that these models can be efficiently calibrated. However, under our approach, the function linking the stock price to the driving Gaussian process is not allowed to vary arbitrarily with time, and must instead be chosen to satisfy a particular no arbitrage condition. This restriction means that there is only a single time-dependent parameter, the volatility of the driving Gaussian process, and it may struggle to match vanilla option prices across multiple expires. We address this issue in chapter 4 by showing how to construct mixture models, under non-deterministic interest rates, which use the models developed in chapter 3 as the underlying components. These mixture models allow for an arbitrary number of time-dependent parameters, and may therefore be accurately calibrated to the entire implied volatility surface. Building on this, in chapter 5, we extend our mixture-based approach to include stochastic volatility, in addition to local volatility and stochastic interest rates. This requires deriving the joint characteristic function of a suitable class of component models, and then utilizing the multidimensional fractional FFT. Compared to those previously discussed, the resulting model allows for more realistic volatility dynamics, which is helpful when pricing certain exotic derivatives, such as forward start options and ratchet options. On the other hand, when dealing with volatility derivatives, it is sometimes possible to write their price directly in terms of the prices of vanilla options across all strikes and expiries, without
PREVALENCE OF SEDATIVE DRUG USE IN GERIATRIC IN-PATIENTS: A MULTI-CENTRE STUDY

Abstract Objective: This cross-sectional study registered the prevalence of sedative drug use and withdrawal strategies in geriatric in-patients from 30 centres in nine European countries. Methods: We conducted a survey among young geriatricians using a standardised questionnaire on sedative drug use for more than three weeks. The study population consisted of 1972 in-patients aged 75 years or older. Acute care (620), intermediate care/rehabilitation (359), long-term care (261), terminal care (47) and nursing home (685) settings were represented. The pre-specified outcomes included the prevalence of sedative drug use; the identification of main prescribers and main reasons for prescribing and, the assessment of withdrawal policy, including psychological counselling and involvement of general practitioners. Results: Prevalence of sedative use was highest in long-term care (72%), followed by nursing homes (70%) and terminal care (59%). Geriatricians started prescribing sedatives after admission on 52% of all occasions. The main reasons for prescribing were continuation of medication taken at home (37%), sleep problems emerging after admission (26%) and post-admission worsening of existing sleep problems (20%). Most prescribers (70%) applied an active withdrawal policy. Short-term withdrawal programmes were mostly applied (57%). Most patients (60%) were psychologically counselled during withdrawal from sedatives. General practitioners were often (60%) involved in withdrawal policy. Conclusion: The prevalence of prescription of sedative drugs in geriatric in-patients is high. Appropriate setting specific guidelines are needed to control use of sedatives in geriatric in-patients and to ensure withdrawal from these drugs whenever possible.
Possible etiologic heterogeneity of vulvar intraepithelial neoplasia. A correlation of pathologic characteristics with human papillomavirus detection by in situ hybridization and polymerase chain reaction

A correlated histopathologic and molecular virologic study of 30 cases of vulvar intraepithelial neoplasia Grade 3 (VIN 3) and six associated invasive vulvar carcinomas was performed. Paraffin sections were examined for human papillomavirus (HPV) types 6, 11, 16, and 18 by in situ hybridization for viral transcripts and by polymerase chain reaction (PCR) for amplification of HPV and of the β‐globin gene. Vulvar intraepithelial neoplasia Grade 3 was histologically subclassified into warty (bowenoid) (20 cases) and basaloid (undifferentiated) (ten cases) types. Warty VIN characteristically was composed of squamous cells displaying abnormal proliferation and maturation and an undulating or spiked surface creating a “condylomatous” appearance whereas basaloid VIN had a smooth surface and was composed of undifferentiated basaloid cells resembling carcinoma in situ of the cervix. Human papillomavirus‐16 was the only type detected in 16 of 30 VIN 3 and in five of six invasive carcinomas. The HPV‐positive women were younger than HPV‐negative women (mean age at diagnosis, 49 versus 60 years), their lesions more frequently demonstrated koilocytotic atypia (94% versus 43%), and they were more likely to have warty compared with basaloid VIN lesions (65% versus 30%). These findings suggest that there are at least two different types of VIN which have differing clinical, pathologic, and viral profiles.
Unconventional Monetary Policy in a Currency Union with Segmentation in the Market for Government Debt

The literature on large-scale purchases of government debt emphasises the importance of bond market segmentation along the maturity dimension for their transmission. This study investigates how another form of segmentation that we observe, the segmentation of government bond markets across countries, can be exploited by the central bank of a currency union in which fiscal coordination is not attainable. Under general conditions, government bond purchases which lower bond yields have first-order effects through a fiscal channel, even in the absence of the heterogeneity in investment opportunities found in Chen et al. (2012). The total effect on aggregate demand can be broken down into an "income-from-debt-issuance effect" and a "primary-surplus effect". If there is cross-country segmentation in bond markets and home bias in government spending, the central bank is able to use government bond purchases to control the terms of trade and achieve asymmetric degrees of stimulus across the members of the currency union without a transfer of resources. I characterise the welfare-optimising mix of conventional and unconventional monetary policy in this scenario and give an upper bound on the welfare benefits from using the unconventional tool.
Impact of PMS on organizational performance and moderating effects of context

Purpose The purpose of this paper is to explore the impact of performance measurement systems (PMS) on organizational performance in public sector. In addition, it investigates the moderating effects of the organizational context. Design/methodology/approach Using a multivariate analysis, the authors investigate the extent of PMS used among Portuguese Government agencies and their effects on organizational performance. Data were gathered from the only survey (based on their Comparative Public Organization Data Base for Research and Analysis survey) applied to the Portuguese Government agencies. Findings The authors find that the extent to which agencies use PMS is positively associated with the organizational performance (in a multidimensional perspective). Moreover, the organizational performance is contingent upon the fit between PMS and the agency’s context in light of the contingency theory (especially the orientation to citizens and the level of competition). Originality/value Although prior research has studied the use of PMS in public sector organizations, one question that has not been effectively answered is whether performance information is effectively used to improve public sector performance. In this way, this paper contributes to the understanding of the impact of PMS on the organizational performance, providing empirical evidence in a country that is in a period of “transition” in the introduction of NPM reforms.
Caspar, a suppressor of antibacterial immunity in Drosophila

Drosophila has a primitive yet highly effective innate immune system. Although the infection-dependent activation mechanisms of the Drosophila immune system are well understood, its inhibitory regulation remains elusive. To find novel suppressors of the immune system, we performed a genetic screening for Drosophila mutants with hyperactivated immune responses and isolated a loss-of-function mutant of caspar whose product is homologous to Fas-associating factor 1 in mammals. Interestingly, caspar mutant flies showed increased antibacterial immune responses including increased resistance to bacterial infection and a constitutive expression of diptericin, a representative antibacterial peptide gene. Conversely, ectopic expression of caspar strongly suppressed the infection-dependent gene expression of diptericin, which allowed bacterial outgrowth. Consistent with these physiological phenotypes, Caspar negatively regulated the immune deficiency (Imd)-mediated immune responses by blocking nuclear translocation of Relish, an NF-κB transcription factor. In addition, we further demonstrated that Dredd-dependent cleavage of Relish, a prerequisite event for the nuclear entry of Relish, is the target of the Caspar-mediated suppression of the Imd pathway. Remarkably, Caspar was highly specific for the Imd pathway and did not affect the Toll pathway, which is crucial for antifungal immunity. Collectively, our elucidation of an inhibitory mechanism of the Imd pathway by Caspar will provide a valuable insight into understanding complex regulatory mechanisms of the innate immune systems in both Drosophila and mammals.
Biological and clinical response to desmopressin (DDAVP) in a retrospective cohort study of children with low von Willebrand factor levels and bleeding history

Summary The diagnosis and management of von Willebrand disease (VWD) in paediatrics is challenging. Our aim was to review patient’s characteristics related to biological and clinical response to DDAVP in children with low von Willebrand factor (VWF) levels and bleeding history from a single institution. We included a retrospective cohort of 221 children (median age 11 years; 137 females): 27 type 1 (VWF levels within 15–30 IU dL-1) and 194 possible type 1 (VWF levels within 31–49 IU dL-1). The DDAVP infusion-test was performed in 214/221 children, 93.4% of whom showed good response. Patients with type 1 were at higher risk of DDAVP-test failure: 9/26 (34.6%) vs. 18/188 (9.6%) with possible type 1 (RR 3.44, 1.75–6.79; p= 0.002, Fisher’s exact test). In 68 children, the clinical response to DDAVP was evaluated 87 times: i) to stop bleeding: menorrhagia (13), mucocutaneous (12), haemarthrosis (1); and ii) to prevent surgical bleeding: adenotonsillectomy (17), major (15) and minor surgery (10); and dental procedures (19). No major adverse events or bleeding were observed. The treatment was effective with one single dose of DDAVP in almost all patients, without antifibrinolytic or local therapy, except in a girl with severe haemorrhage during menarche who required replacement therapy. In conclusion, patients with VWD type 1 were at higher risk of no response to DDAVP infusion-test. In this series, one dose of DDAVP proved effective and safe for children with VWD. Since this is a safe, effective and affordable therapy, we consider that a wider use should be promoted, especially in developing countries.
Tunneled Hemodialysis Catheter Survival: Comparison of Radiologic and Surgical Implantation

Cuffed, tunneled hemodialysis catheters (caths) are often implanted in the operating rooms (OR) by surgeons or by interventional radiologists in radiology suites (RS). Comparative outcome studies between OR and RS placed caths are few and tend to favor the specialty of the authors. In this longitudinal study, we monitored cath survival in patients while awaiting maturation of their fistulae, and compared outcomes between OR and RS placement. A total of 95 caths were placed in 50 patients between July 1996 and July 1999. Radiologically placed caths had a shorter primary patency duration than OR placed caths (80 ± 40 days vs. 100 ± 31 days, p = 0.04) and a lower primary patency rate at 120 days than OR placed caths (42% vs. 67%, p = 0.04). Cumulative infection rate per 1,000 catheter days was higher in RS than OR cases (3.8 Vs 2.2, p = 0.09), whereas mean sepsis free duration was shorter in RS than OR (60 ± 45 days vs. 88 ± 40 days, p = 0.02). The risk of infection was 1.7 times greater in RS than OR cases (chi-square = 6.4, p = 0.01). The RS placed caths also had a higher rate of primary nonfunction (31% vs. 8.3%, p = 0.04) and bleeding complications (42% vs. 17%, p = 0.04), but significantly shorter procedure scheduling time than OR cases (1.1 ± 0.3 days vs. 2.5 ± 0.6 days, p < 0.0001). In conclusion, radiologically placed caths seem to have higher rates of infection, bleeding, and functional failure but shorter scheduling time than surgically placed caths. Discussions are under way to improve the survival of RS placed caths at our affiliated hospitals.
Increase in total blood antioxidant status and selenium levels in black patients with active vitiligo

Background Oxidative stress could be an important phenomenon leading to melanocyte death in vitiligo. The accumulation of hydrogen peroxide (H2O2) and low catalase levels have recently been demonstrated in the epidermis of vitiligo patients. Few abnormalities of antioxidants have been found in the blood of patients with vitiligo, except for an elevation of selenium. No studies on oxidative stress have been performed so far on patients with skin phototype VI (Fitzpatrick classification).
Bitcoin for energy commodities before and after the December 2013 crash: diversifier, hedge or safe haven?

ABSTRACT We study the relationship between Bitcoin and commodities by assessing the ability of Bitcoin to act as a diversifier, hedge, or safe haven against daily movements in commodities in general, and energy commodities in particular. We focus on energy commodities because energy, in the form of electricity, is an essential input in the Bitcoin production. For the entire period, results show that Bitcoin is a strong hedge and a safe-haven against movements in both commodity indices. We further examine whether that ability is also present for non-energy commodities and our analysis show insignificant results when energy commodities are excluded from the general commodity index. We also account for the December 2013 Bitcoin price crash and our results reveal that Bitcoin hedge and safe-haven properties against commodities and energy commodities are only present in the pre-crash period, whereas in the post-crash period Bitcoin is no more than a diversifier. In addition to uncovering the time-varying role of Bitcoin, we highlight the dissimilarity in the dynamic correlations between the extreme downward and extreme upward movements.
Use of out-of-hospital variables to predict severity of injury in pediatric patients involved in motor vehicle crashes.

STUDY OBJECTIVE We sought to create a clinical decision rule, on the basis of variables available to out-of-hospital personnel, that could be used to accurately predict severe injury in pediatric patients involved in motor vehicle crashes as occupants. METHODS We analyzed the National Automotive Sampling System database, a national probability sample, using pediatric patients up to 15 years old (occupants only) involved in motor vehicle crashes from January 1993 to December 1999. The National Automotive Sampling System database includes patients from regions throughout the country, weighted to represent a nationwide sample. Twelve out-of-hospital variables were used in classification and regression tree analysis to create a decision rule separating children with severe injuries (Injury Severity Score [ISS] > or =16) from those with minor injuries (ISS < 16). Misclassification costs and complexity parameters were selected to yield a decision tree with appropriate sensitivity and specificity for the identification of severely injured patients, while also being simple and practical for out-of-hospital use. Probability weights were used throughout the analysis to account for the sampling design and sampling weights. RESULTS Using a sample size of 8,392 children, we constructed a decision rule using 3 out-of-hospital variables (Glasgow Coma Scale score, passenger space intrusion > or =6 in [> or =15 cm], and restraint use) to predict those patients with an ISS of 16 or more. Internal cross-validation was used to determine the sensitivity and specificity, yielding values of 92% and 73%, respectively, for the prediction of patients with an ISS of 16 or more. CONCLUSION Out-of-hospital variables available to field personnel could be used to effectively triage pediatric motor vehicle crash patients using the decision rule developed here. Prospective trials would be needed to test this decision rule in actual use.
Econometric Analysis of Cross Section and Panel Data

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