Miracle-dz/UniFAR-FTUs huggingface dataset:
Multidrug Resistant Gram Positive Pathogens with Special Reference to MRSA and Biofilm Production in ICU Patients: Recurrent Challenge for Clinicians

Gram positive pathogens mainly Staphylococcus aureus, Enterococcus and Coagulase Negative Staphylococcus are hospital acquired (HA) pathogens. HA strains are usually multidrug resistant (MDR). Monitoring of these strains is essential in order to control their spread in the hospital environment and transmission to the community. The objectives were to assess the prevalence of Gram positive pathogens in ICU patients and their drug resistance profile. Prevalence of methicillin Resistant Staphylococcus aureus (MRSA) was assessed. Health care workers (HCW) were screened for MRSA. Samples were collected aseptically from 150 ICU patients from February 2012 to November 2013. Culture, identification and antimicrobial susceptibility was performed according to CLSI guidelines. Pernasal swabs of HCW were collected for MRSA screening. Biofilm production among isolates was tested by the tube method. Among 143 bacterial isolates, 22 (13.8%) were gram positive while majority 121 (75.6%) were Gram negative. Staphylococcus aureus (9.4%) was the most common Gram positive pathogen isolated followed by Coagulase negative Staphylococcus (CoNS) (18.1%) and Enterococcus faecalis (2.4%). Among Gram positive bacterial isolates, S. aureus showed maximum resistance to clindamycin (73.3%), ofloxacin (75%) and gentamycin (66.7%). Sixty percent resistance was observed for oxacillin, levofloxacin and erythromycin each. Staphylococcus aureus isolates identified as MRSA were 66.7% and 60% by Oxacillin disc and Cefoxitin disc diffusion test respectively. Prevalence of MRSA was highest among surgical site infections(27.2%) followed by blood stream infections (20.7%)All the gram positive isolates (100%) were MDR. 13.4% of the HCW were MRSA carriers.None of the isolates were found resistant to vancomycin. Among the 22 bacterial isolates, 12 (54.5 %) were biofilm producers and all of them were MRSA. Resistance of Gram positive pathogens to commonly used antibiotics is alarmingly high. HCW are an important source of transmission of infection between hospitalized patients and they should acclimatize to proper hand washing and other simple infection control practices to inhibit such transmission. K e y w o r d s Multidrug resistant,
A 3′ untranslated region variant in FMR1 eliminates neuronal activity-dependent translation of FMRP by disrupting binding of the RNA-binding protein HuR

Significance The fragile X mental retardation protein (FMRP) is most highly expressed in neurons, and is critical for proper synaptic functioning. Fragile X syndrome, a common cause of intellectual disability, is the result of absent or dysfunctional FMRP, highlighting its importance to the processes underlying learning and memory. A rapid upregulation of FMRP synthesis at the synapse in response to specific neuronal signals is a key step in maintaining a dynamic synapse, although the mechanisms governing this up-regulation are not well-understood. We show that a variant in the 3′UTR of fragile X mental retardation 1 (FMR1) causes the loss of this characteristic increase in synaptic FMRP synthesis, which may lead to developmental delay in patients. These data identify several mechanisms and molecules modulating activity-dependent translation of FMRP. Fragile X syndrome is a common cause of intellectual disability and autism spectrum disorder. The gene underlying the disorder, fragile X mental retardation 1 (FMR1), is silenced in most cases by a CGG-repeat expansion mutation in the 5′ untranslated region (UTR). Recently, we identified a variant located in the 3′UTR of FMR1 enriched among developmentally delayed males with normal repeat lengths. A patient-derived cell line revealed reduced levels of endogenous fragile X mental retardation protein (FMRP), and a reporter containing a patient 3′UTR caused a decrease in expression. A control reporter expressed in cultured mouse cortical neurons showed an expected increase following synaptic stimulation that was absent when expressing the patient reporter, suggesting an impaired response to neuronal activity. Mobility-shift assays using a control RNA detected an RNA–protein interaction that is lost with the patient RNA, and HuR was subsequently identified as an associated protein. Cross-linking immunoprecipitation experiments identified the locus as an in vivo target of HuR, supporting our in vitro findings. These data suggest that the disrupted interaction of HuR impairs activity-dependent translation of FMRP, which may hinder synaptic plasticity in a clinically significant fashion.
Surrogate end‐points for treatment trials of hepatitis B virus

A third of a century ago, Greenberg and colleagues [1] gave human leukocyte interferon to patients with chronic hepatitis B infection and showed that markers of HBV replication were suppressed. Specifically, they used serial serum samples to measure DNA polymerase activity from HBV virions, measure the titre of HBsAg and quantify HBV core antigen. They reported that interferon had amarked effect on these parameters whichwas only transient because they returned to baseline levels once interferon was stopped. The investigators then proceeded to give prolonged therapy with interferon and showed that all of these markers could be suppressed long term. Ten years ago, there was sufficient evidence to be able to codify in practice guidelines what was meant by response to treatment: HBV DNA becoming undetectable (in non-amplified assays), loss of HBeAg in those who possessed it at baseline, decrease in liver enzymes into the normal range and a decrease by at least two points in the histological activity index [2]. However, there were difficulties with using each of these parameters as an absolute marker of success. Thus, the virological assays used different standards so that results could not be compared easily between different centres, although they had good precision when used to test sequential samples from the same individual. Serial assessment of serum levels of liver enzymes may identify short term flares due to inflammatory recognition of virus infected hepatocytes on the way to long term normalisation. Finally, the histological assessments are subjective, subject to sampling errors, have a low dynamic range and, because of their invasive nature, may produce complications particularly haemorrhage and so can only be performed infrequently. However, continuing experience showed that some of these problems could be overcome. Thus, the linear ranges of quantification by assays of varying sensitivities could be normalised and a composite value used to compare between studies [3]. The baseline level of HBV DNA could then be shown to
Inspiration Rather Than Limitation - Consumers Perspective on Perceived Value and Attitude towards One-to-one Marketing Oriented Loyalty Programs

We aim to investigate the consumers’ perspective on what kind of values within loyalty programs with a one-to-one marketing approach, meaning personalized offers, which can be identified in a grocery retail setting. Our aim is to seek if there is any correlation between the potential value and consumers’ loyalty to a store. We find a lack of qualitative studies within the area of loyalty programs and personalized offers that have evolved due to new technology in retail grocery stores. Since loyalty programs are a way to strengthen the customer relationship we find that there is a need to include the consumers’ opinions even more then what has been done in previous studies. We have used an explorative, qualitative approach and conducted ten semi-structured interviews with our respondents, who were picked through snowball sampling. The theories used in this thesis deals with brands, customer relationship marketing, loyalty, loyalty programs and one-to-one marketing. In this study we have investigated three elements that build up our case company’s loyalty program which has an approach towards one-to-one marketing; bonus checks, the customer magazine Buffe and the personalized offers “Mina Varor”. Based on these components we have distinguished five different values, both tangible and intangible, associated by the respondents’ that is related to a loyalty program connected to this kind of personalized targeting; economical rewards, efficiency, feeling of appreciation, inspiration and dialog. Based on these values, we can see that the particular one-to-one marketing approach that personalized offers represent cannot create an added value for the consumers in itself as a targeting tool. The way that the tangible and intangible values work and balance each other is a key to enhance value and seems to create both a hard economic bond and a emotional bond to the retailer.
Contracting Out for Employment Services in the Netherlands: A Decade of Experience

Today many Western welfare states are under reform. An important part of these reforms is the introduction of forms of privatization. In many countries this has led to the increased use of contracts as a governance tool for the delivery of employment reintegration services. In this paper we describe the overall development of how Dutch local governments (municipalities) buy these kinds of services and analyze how they deal with the challenges associated with contracting out and more specifically the challenge of maintaining control over service delivery. For this we make use of data collected through a case study at nine municipalities and the analysis of about 20 tender documents used to buy these kinds of services.Based on our findings we conclude that the idea of large scale privatization of the delivery of employment reintegration services in the Netherlands must be revised. Indeed, these days’ municipalities appear to buy far less parts of the service task then was the case in the early years, when contracting out was introduced. Moreover, we find that municipalities buy services with a strong emphasis on maintaining control by limiting the discretionary leeway given to the agents when delivering the services. In addition, it becomes clear that for contracting out to be successful requires not only investment in drafting and designing suitable contracts but also requires significant investments in internal capacity for implementing, monitoring and managing the contracts used to deliver services. Something, that even in successful municipalities is not always given.Overall, we can conclude that over the years municipalities have learned that it requires a significant amount of internal capacities to maintain control over how services are delivered. This has meant that in part municipalities have chosen to provide a substantial part of the services internally as this provides for better control over service delivery. While at the same time the municipalities have developed a modular buying strategy that has allowed them to deconstruct the service task into more bite-size chunks. That in turn allow for easier digestion from a contracting perspective. Opting to buy those elements that are well suited to be contracted-out and keeping the elements that are difficult to contract for, closer to home
The Effects of Environmental Policy on the Performance of Environmental Rivs

Much of the potential impact of environmental policy is though to come from the incentives it gives firms to develop and introduce new environmental products and processes. Almost all the literature on this issue has focused on the impact of environmental policy on the amount environmental RD information sharing -- and endogenises each of these inter-related decisions in both the cooperative and non-cooperative equilibria. The case we examine is that in which governments cannot commit to environmental policy, so all these decisions have to taken anticipating the environmental policy that will finally be imposed. We show that RJVs are welfare enhancing when the levels of environmental damage caused by pollution are low. In this case RJVs fully share information and internalize the associated externality. However when the level of damage is high, it turns out that firms anticipate tougher environmental policy when they share information then when they do not, and so do not share information. This distorts the RJV's R&D decisions in ways that make the non-cooperative equilibrium welfare enhancing.
Concentrations of stromal cell-derived factor-1 in serum, plasma, and synovial fluid of horses with osteochondral injury.

OBJECTIVE To determine whether stromal cell-derived factor-1 (SDF-1) concentrations in serum, plasma, and synovial fluid differed among untrained, race-trained, and osteochondral-injured Thoroughbred racehorses. ANIMALS 22 racehorses without osteochondral injury and 37 racehorses with osteochondral injury. PROCEDURES Horses without osteochondral injury were examined before and after 5 to 6 months of race training. Horses with osteochondral injury were undergoing arthroscopic surgery for removal of osteochondral fragments from carpal or metacarpophalangeal or metatarsophalangeal joints (fetlock joints). Serum, plasma, and fetlock or carpal synovial fluid samples were obtained and analyzed for SDF-1 concentration by use of an ELISA. RESULTS In horses with fetlock or carpal joint injury, mean synovial fluid SDF-1 concentrations were significantly higher, serum SDF-1 concentrations were significantly lower, and synovial fluid-to-serum SDF-1 ratios were significantly higher than in untrained and trained horses. Synovial fluid SDF-1 concentrations were not significantly different between trained and untrained horses. Plasma SDF-1 concentrations were not different among the 3 groups. Results obtained with serum, compared with synovial fluid and plasma, had better sensitivity for differentiating between osteochondral-injured horses and uninjured horses. In horses with fetlock joint osteochondral injury, serum SDF-1 concentrations were correlated with radiographic and arthroscopic inflammation scores, but not arthroscopic cartilage scores. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that serum SDF-1 concentrations were more sensitive than plasma and synovial fluid concentrations for detection of osteochondral injury in the fetlock or carpal joint of racehorses. Analysis of serum and synovial SDF-1 concentrations in horses with experimentally induced joint injury may help define the onset and progression of post-traumatic osteoarthritis and aid in the evaluation of anti-inflammatory treatments.
The Diversified Online Shopper: Website Feature Preferences and Individual Characteristics

The current study examined the nature of diversified online shoppers with respect to existing differences in their level of website feature preferences, Internet experience (usage and shopping behaviors) and individual demographic characteristics. Using an online survey, 540 individuals residing within United States responded to questions concerning their demographics, extent of Internet usage, online visiting and purchasing behaviors and preference for website features. Individuals were categorized into different user groupslow, medium and high, depending on the extent of their self-reported diversified online shopping across the nine specific product categories. Since shopping referred to both browsing of online information and online purchasing, this categorization was done separately for both browsing and purchasing behaviors. The study found that an individual’s diversified online browsing behavior was different from one’s diversified online purchasing behavior. With regard to their diversified online browsing, significant group differences were found between the three browser groups in their preference for website features and Internet experience. The typical diversified online browser was more likely to be affluent and male. With regard to the individuals’ online purchasing behavior, the low, medium and high diversified purchasers were found to differ significantly from one another in their website feature preferences as well as Internet experience. And the typical diversified online purchaser was more likely to be highly educated, affluent and male. Implications of these results as well as limitations of the current study were discussed.
Knowledge management driving customer behavior

Addressing the needs and wants of the customers increases the intention of the customers to remain loyal to the company that satisfies their wants and needs. Knowledge Management (KM) and Customer Relationship Management (CRM) have both been shown to impact customer behavior. The purpose of this thesis was to explore and understand the impact of KM supported by a CRM on customer behaviors, specifically customer loyalty and customer perceived value. The results indicate that in order for KM and CRM to be effective in affecting positive changes in organizations, certain conditions need to be met. These include having employees perceive the importance of the implementation of KM and CRM approaches / processes through incorporating both KM and CRM in the business culture. All employees of all levels of the company need to have the same objective, scope and roles and responsibilities are clear defined and communicated. Both KM and CRM end-to-end processes need to be supported by one stable, easy to use, and easily accessible system with a high sophisticated search engine. The significance of this study is three-fold: for the academic community, for the companies that aim to attain competitive advantage over others, and for the customers of these companies.
Comparison of Kidney Function Between Donation After Cardiac Death and Donation After Brain Death Kidney Transplantation

Backgroud Kidney graft survival is comparable between donation after cardiac death (DCD) and donation after brain death (DBD) kidney transplantation. However, data concerning kidney function after DCD kidney transplantation are lacking. Methods We retrospectively compared kidney function between 64 DCD and 248 DBD kidney transplant recipients. Graft function was assessed using iothalamate glomerular filtration rate at 1, 4, and 12 months, then annually. The primary endpoint was the composite of death-censored graft loss or two consecutive iothalamate glomerular filtration rates less than 50 mL/min/1.73 m2 occurring within 5 years from transplantation. Secondary endpoints included death and graft loss or death. Results Of the 312 patients, 102 (33%) experienced the primary endpoint, 78 (25%) experienced graft loss or death, and 44 (14%) died. In multivariable Cox regression analysis, there was no difference between DCD and DBD recipients regarding the primary endpoint (relative risk [RR], 1.16; P=0.59), death (RR, 0.97; P=0.94), or graft loss or death (RR, 1.09; P=0.79). In the subgroup of 64 DCD recipients, each 10-year increase in donor age was associated with increased risk of the primary endpoint (RR, 1.51; P=0.027) with the highest risk observed for donors older than 45 years (RR, 4.81; P=0.001). Delayed graft function affected 45% of the DCD recipients but had no impact on kidney function, graft survival, or patient survival. Conclusions Posttransplantation kidney function is comparable between DCD and DBD kidney transplantations. In the subgroup of DCD recipients, kidneys from donors older than 45 years may be associated with a higher risk of poor kidney function; however, this finding requires validation in a larger patient group.
Effective Business Communications

Part 1 Background for effective business communications: effective communications in business the 7 C's of effective communication. Part 2 Business communication in context: business communication and the ethical context business communication and the technology context. Part 3 Message design: the process of preparing effective business messages the appearance and design of business messages good news and neutral messages. Part 4 Written communication: major plans for letters and memos bad news messages persuasive written messages. Part 5 Written communication reports: short reports long (formal) reports proposals. Part 6 Strategies for oral communication: strategies for successful speaking and successful listening strategies for successful informative and persuasive speaking strategies for successful interpersonal communication strategies for successful business and group meetings. Part 7 The job application process: the job application process - the written job presentation the job application process - interviews and follow-up.
De-Confusing the THOG Problem: The Pythagorean Solution

Sources of facilitation for Needham and Amado's (1995) Pythagoras version of Wason's THOG problem were systematically examined in three experiments with 174 participants. Although both the narrative structure and figural notation used in the Pythagoras problem independently led to significant facilitation (40–50% correct), pairing hypothesis generation with either factor or pairing the two factors together was found to be necessary to obtain substantial facilitation (> 50% correct). Needham and Amado's original finding for the complete Pythagoras problem was also replicated. These results are discussed in terms of the “confusion theory” explanation for performance on the standard THOG problem. The possible role of labelling as a de-confusing factor in other versions of the THOG problem and the implications of the present findings for human reasoning are also considered.
Genome wide profiling in oral squamous cell carcinoma identifies a four genetic marker signature of prognostic significance

Background Cancers of the oral cavity are primarily oral squamous cell carcinomas (OSCCs). Many of the OSCCs present at late stages with an exceptionally poor prognosis. A probable limitation in management of patients with OSCC lies in the insufficient knowledge pertaining to the linkage between copy number alterations in OSCC and oral tumourigenesis thereby resulting in an inability to deliver targeted therapy. Objectives The current study aimed to identify copy number alterations (CNAs) in OSCC using array comparative genomic hybridization (array CGH) and to correlate the CNAs with clinico-pathologic parameters and clinical outcomes. Materials and methods Using array CGH, genome-wide profiling was performed on 75 OSCCs. Selected genes that were harboured in the frequently amplified and deleted regions were validated using quantitative polymerase chain reaction (qPCR). Thereafter, pathway and network functional analysis were carried out using Ingenuity Pathway Analysis (IPA) software. Results Multiple chromosomal regions including 3q, 5p, 7p, 8q, 9p, 10p, 11q were frequently amplified, while 3p and 8p chromosomal regions were frequently deleted. These findings were in confirmation with our previous study using ultra-dense array CGH. In addition, amplification of 8q, 11q, 7p and 9p and deletion of 8p chromosomal regions showed a significant correlation with clinico-pathologic parameters such as the size of the tumour, metastatic lymph nodes and pathological staging. Co-amplification of 7p, 8q, 9p and 11q regions that harbored amplified genes namely CCND1, EGFR, TPM2 and LRP12 respectively, when combined, continues to be an independent prognostic factor in OSCC. Conclusion Amplification of 3q, 5p, 7p, 8q, 9p, 10p, 11q and deletion of 3p and 8p chromosomal regions were recurrent among OSCC patients. Co-alteration of 7p, 8q, 9p and 11q was found to be associated with clinico-pathologic parameters and poor survival. These regions contain genes that play critical roles in tumourigenesis pathways.