Miracle-dz/UniFAR-FTUs huggingface dataset:
Recorded Criteria as a “Gold Standard” for Sensitivity and Specificity Estimates of Surveillance of Nosocomial Infection: A Novel Method to Measure Job Performance

Abstract Objectives: To compare the accuracy of infection control practitioners' (ICPs') classifications of operative site infection in Florida Consortium for Infection Control (FCIC) hospitals, in two time periods, 1990 to 1991 and 1991 to 1992, and to estimate the effect of duration of surveillance experience on that accuracy. Methods: Medical record reviewers examined records of all patients classified by an ICP as infected, to distinguish false-positives from true infections based on evidence of standard infection criteria and the ICP's contemporaneous clinical observations. Reviewers also examined a random sample of 100 records from patients classified as noninfected for evidence of undetected infections (false-negatives). These observations permitted estimates of the sensitivity and specificity of each ICP's classification of infection status. Setting: Fourteen FCIC communit:y hospitals at which performance of 16 ICPs was monitored. Results: There was a strong linear trend relating increasing sensitivity to numbers of years of ICP surveillance experience (P<.001). For ICPs with <4 years of experience, satisfactory sensitivity (≥80%) was reached in only one of 10 ICP-years of observation. For ICPs with ≥4 years' experience, satisfactory sensitivity was achieved for 14 of 18 person-years (P=.001). Estimated specificity was 97% to 100% for all ICP-years observed. Conclusions: ICPs with <4 years of surveillance experience in FCIC community hospitals rarely achieved a satisfactory sensitivity estimate, whereas ICPs with ≥4 years' experience generally did. Monitoring ICP surveillance accuracy through retrospective medical record audits offers an objective approach to evaluating ICP performance and to interpreting infection rates at different hospitals.
A Second Galacturonic Acid Transferase Is Required for Core Lipopolysaccharide Biosynthesis and Complete Capsule Association with the Cell Surface in Klebsiella pneumoniae

ABSTRACT The core lipopolysaccharide (LPS) of Klebsiella pneumoniae contains two galacturonic acid (GalA) residues, but only one GalA transferase (WabG) has been identified. Data from chemical and structural analysis of LPS isolated from a wabO mutant show the absence of the inner core β-GalA residue linked to l-glycero-d-manno-heptose III (l,d-Hep III). An in vitro assay demonstrates that the purified WabO is able to catalyze the transfer of GalA from UDP-GalA to the acceptor LPS isolated from the wabO mutant, but not to LPS isolated from waaQ mutant (deficient in l,d-Hep III). The absence of this inner core β-GalA residue results in a decrease in virulence in a capsule-dependent experimental mouse pneumonia model. In addition, this mutation leads to a strong reduction in cell-bound capsule. Interestingly, a K66 Klebsiella strain (natural isolate) without a functional wabO gene shows reduced levels of cell-bound capsule in comparison to those of other K66 strains. Thus, the WabO enzyme plays an important role in core LPS biosynthesis and determines the level of cell-bound capsule in Klebsiella pneumoniae.
New Approaches towards ex vivo and in vivo Gene Therapy

A number of hurdles have to be overcome for efficient and specific gene therapy approaches. Here, we report on two different strategies that should lead to an improvement of current protocols. A strategy is presented to tag unique chromosomal integration sites by means of retroviral infection, which can be reused for exchange with the gene of interest by action of site-specific recombinases. Targeting exchange is achieved in one step with 100% efficiency by a stringent positive selection, which makes further screening superfluous. With this strategy a predictable gene expression is obtained for foreign genes integrated into a predefined chromatin structure. A second approach aims at the stabilization of mouse retroviruses towards human serum which is a prerequisite for in vivo gene therapy protocols. To stabilize murine leukemia virus-based retroviruses against human serum, complement regulatory proteins were fused to the retroviral ENV proteins. This resulted in infectious and human complement-protected particles.
[Sedation in spinal anesthesia. Comparison of remifentanil and propofol].

OBJECTIVES To assess the efficacy and safety of remifentanil for analgesia and sedation during subarachnoidea anesthesia, and to compare remifentanil with propofol. METHOD Ninety ASA I-III patients undergoing orthopedic or traumatologic surgery under subarachnoid anesthesia were enrolled for prospective study and randomly assigned to two treatment groups. The propofol group (n = 45) received a single dose of 0.5 mg/kg followed by infusion at 3 mg/kg/h. The remifentanil group (n = 45) received a single dose of 0.5 microgram/kg followed by infusion at 0.1 microgram/kg/min. We evaluated quality of sedation, pain intensity during nerve blockade, hemodynamic and respiratory parameters and time until recovery. RESULTS The remifentanil group experienced less moderate-to-intense pain (13%) than did the propofol group (63%) (p < 0.01). Sedation was adequate in both groups and was easy to control by adjusting the rate of infusion. Times until recovery of consciousness and respiratory frequency after withdrawal of infusion until recovery of baseline levels were 7.87 +/- 3.54 min and 5.22 +/- 2.49 min, respectively, in the remifentanil group and 8.72 +/- 4.59 min and 5.36 +/- 2.49 min, respectively, in the propofol group, respectively. Patients in the remifentanil group experienced a significantly greater decrease in SpO2 than did those in the propofol group (20% and 4%, respectively; p < 0.05). Mean blood pressure was higher for patients treated with remifentanil. The incidence of vomiting was also higher in the remifentanil group than in the propofol group (9% vs 0%). CONCLUSION Remifentanil is more effective in reducing pain related to nerve blockade and level of sedation is lower; however remifentanil is associated with a higher incidence of respiratory depression and vomiting.
Thymus medulla under construction: Time and space oddities

The development of effective T‐cell‐based immunotherapies to treat infection, cancer, and autoimmunity should incorporate the ground rules that control differentiation of T cells in the thymus. Within the thymus, thymic epithelial cells (TECs) provide microenvironments supportive of the generation and selection of T cells that are responsive to pathogen‐derived antigens, and yet tolerant to self‐determinants. Defects in TEC differentiation cause syndromes that range from immunodeficiency to autoimmunity, which makes the study of TECs of fundamental and clinical importance to comprehend how immunity and tolerance are balanced. Critical to tolerance induction are medullary thymic epithelial cells (mTECs), which purge autoreactive T cells, or redirect them to a regulatory T‐cell lineage. In this issue of the European Journal of Immunology, studies by Baik et al. and Mayer et al. [Eur. J. Immunol. 2016. 46: XXXX‐XXXX and 46: XXXX‐XXXX]) document novel spatial–temporal singularities in the lineage specification and maintenance of mTECs. While Baik et al. define a developmental checkpoint during mTEC specification in the embryo, Mayer et al. reveal that the generation and maintenance of the adult mTEC compartment is temporally controlled in vivo. The two reports described new developmentally related, but temporally distinct principles that underlie the homeostasis of the thymic medulla across life.
Role of the dorsolateral prefrontal cortex in context‐dependent motor performance

Context‐dependent motor performance is a phenomenon in which people perform better in the environmental context where they originally practised a task. Some animal and computer simulation studies have suggested that context‐dependent performance may be associated with neural activation of the dorsolateral prefrontal cortex (DLPFC). This study aimed to determine the role of the DLPFC in context‐dependent motor performance by perturbing the neural processing of the DLPFC with repetitive transcranial magnetic stimulation (rTMS) in healthy adults. Thirty healthy adults were recruited into the Control, rTMS DLPFC and rTMS Vertex groups. The participants practised three finger sequences associated with a specific incidental context (a coloured circle and a location on the computer screen). One day following practice, the rTMS groups received 1 Hz rTMS prior to the testing conditions in which the sequence‐context associations remained the same as practice (SAME) or changed (SWITCH). All three groups improved significantly over practice on day 1. The second day testing results showed that the DLPFC group had a significantly lower decrease in motor performance under the SWITCH condition than the Control and Vertex groups. This finding suggests a specific role of the DLPFC in context‐dependent motor performance.
C-reactive protein is elevated in the offspring of parents with essential hypertension

Background: Hypertension is a risk factor for cardiovascular disease (CVD). Studies in adults have shown that high sensitivity C-reactive protein (CRP) levels are associated with increased risk of CVD and essential hypertension (EHT). Genetic background is widely accepted as a risk factor for CVD. The aim of the present study was to analyse the association of high sensitivity CRP levels with other cardiovascular risk factors in children and young adults with at least one parent with EHT. Methods: Fifty one healthy children and young adults (28 boys) with at least one parent with hypertension and 69 (41 boys) whose parents did not have hypertension were recruited prospectively from primary care centres. High sensitivity CRP, fasting lipid profile, blood pressure (BP) and anthropometric variables were obtained for all participants. Results: CRP values were higher in the study group than in controls (logCRP mean difference: −0.69; 95% confidence interval: −1.05 to −0.33), even when differences were adjusted for age, gender, body mass index (BMI) and triglyceride levels (p = 0.01). No differences were observed in BP values between groups. In the study group, 35.3% of the participants had a CRP level ⩾1 mg/l compared to 14.5% in the control group (p = 0.009). CRP showed a significant correlation with body weight (rho = 0.28, p = 0.04), BMI (rho = 0.32; p = 0.02) and ponderosity index (rho = 0.28; p<0.05). Conclusions: CRP is significantly higher in the offspring of parents with EHT. A significant positive relationship exists between BMI and serum CRP levels in this high risk group of children and young adults.
Pleurectomy/Decortication, Hyperthermic Pleural Lavage with Povidone-Iodine Followed by Adjuvant Chemotherapy in Patients with Malignant Pleural Mesothelioma

Introduction: Malignant pleural mesothelioma is a fatal neoplasm related to asbestos exposure. We investigated the effects of pleurectomy/decortication (P/D), hyperthermic pleural lavage with povidone-iodine and adjuvant chemotherapy in patients with malignant pleural mesothelioma. Patients and Methods: Observational prospective study of patients referred for multimodality therapy and operated on at our institution between October 2004 and May 2010. Thirty-six selected patients underwent P/D and hyperthermic pleural lavage, prophylactic radiotherapy, and adjuvant chemotherapy. All patients were reviewed at 4 weeks and then 6 monthly in the outpatient clinic, with positron-emission tomography-computed tomography. Second-line treatments were administered when appropriate. Results: Thirty-day mortality was nil. Nine patients experienced postoperative complications: persistent air leak (n = 5, 13.9%), chylothorax requiring surgical intervention (n = 4, 11%), and adult respiratory distress syndrome (n = 1, 3.9%). Fourteen of 36 patients were alive at last follow-up (median follow-up: 33 months, range: 12–63 months). Ten patients were alive with no evidence of disease recurrence, four patients were alive with disease recurrence, and 22 patients had died of disease progression. Overall median survival (Kaplan-Meier) was 24 months (95% confidence interval: 18.5–29.4 months). One-year survival was 91.7%, and 2-year survival was 61%. Patients undergoing complete macroscopical resection (R0–R1) had a significantly better survival than those undergoing an incomplete macroscopical resection (R2) (median overall survival: 32 months versus 18.9 months, p = 0.012). Conclusion: In our experience, P/D combined with hyperthermic pleural lavage with povidone-iodine and adjuvant chemotherapy is a well-tolerated multimodality treatment associated with low morbidity and mortality. This multimodality treatment compares favorably with classical trimodality regimens involving chemotherapy, extrapleural pneumonectomy, and adjuvant radiotherapy, in our experience. Study limitations include small sample size, nonrandomization, and patient selection bias.
Expression of the E‐cadherin–catenin complex in lung neuroendocrine tumours

Neuroendocrine tumours (NETs) of the lung represent a wide spectrum of phenotypically distinct entities, with differences in tumour progression and aggressiveness. The redistribution and/or the loss of various cell adhesion molecules, such as the E‐cadherin–catenin complex, play a predominant role in carcinogenesis and in tumour invasion. Moreover, mutations in exon 3 of the β‐catenin gene, the adenomatous polyposis coli (APC) gene or the E‐cadherin genes were previously found to result in intracytoplasmic and/or nuclear β‐catenin protein accumulation, activating nuclear transcription of target genes involved in tumour progression. In the present study, the distribution of the components of this E‐cadherin–catenin complex has been investigated by immunohistochemistry and an attempt has been made to correlate the abnormal expression pattern with the eventual detection of mutations in the corresponding genes. This study included 27 primary NETs of the lung, with nine typical carcinoids (TCs), three atypical carcinoids (ACs), and 15 large cell neuroendocrine carcinomas (LCNECs). The E‐cadherin–catenin complex remained expressed in most of these lung tumours, but with a cytoplasmic and/or nuclear redistribution of β‐catenin, E‐cadherin, and α‐catenin; abnormal positive immunoreactivity was observed in 24 (88.9%), in 21 (80.8%), and in 20 (76.9%) NETs, respectively. In the great majority of cases, there was a good correlation between the expression of these three proteins, but no significant association with histological classification or TNM stage. Thus, E‐cadherin–complex redistribution cannot be considered a prognostic marker in NET of the lung. Of particular interest was the frequent focal β‐catenin nuclear immunostaining (55.5% in total), which was also unrelated to histological type or TNM stage. However, this study failed to detect any mutation in exon 3 of the β‐catenin gene, in the APC gene or in the E‐cadherin gene. These data suggest another mechanism of regulation of β‐catenin in these tumours. Copyright © 2001 John Wiley & Sons, Ltd.
Yield Curve Fitting with Artificial Intelligence: A Comparison of Standard Fitting Methods with Artificial Intelligence Algorithms

The yield curve is a fundamental input parameter of valuation theories in capital markets. Information about yields can be observed in a discrete form, either directly through traded yield instruments (eg., interest rate swaps) or indirectly through the prices of bonds (eg., government bonds). Capital markets usually create benchmark yield curves for specific and very liquid market instruments, or for issuers where many different quotes of individual yield information for specific maturities are observable. The standard methods to construct a continuous yield curve from discrete observable yield data quotes are the fit of a mathematical model function, interpolation or regression algorithms. This paper expands these standard methods to include artificial intelligence algorithms, which have the advantage of avoiding any assumptions with regard to the mathematical model functions of the yield curve, and which can conceptually adapt easily to any market changes. Nowadays, the most widely used risk-free yield curve in capital markets is the overnight index swap (OIS) curve, which is derived from observable OISs and is used in this paper as the benchmark curve to derive and compare different yield curve fits.
A comparative study of NC and PP-SRAM cells with 6T SRAM cell using 45nm CMOS technology

Data stability, performance and leakage currents are the few important issues of Static Random Access Memory (SRAM) due to scaling down the technology. We revisited these issues by making a comparative study of N-Controlled SRAM cell (NC-SRAM) and PMOS pass transistor SRAM cell (PP-SRAM) with conventional 6T SRAM cell. We observe decrease in Static Noise Margin (SNM) of NC-SRAM and PP-SRAM cells with 6T SRAM cell in hold mode by 60.09% and 0.22% at temperature (T) = 25°C, 63.25% and 3.34% at T = 50°C, 63.82% and 3.37% at T = 100°C respectively. For our transistors sizing we obtain a degradation in write operation of NC-SRAM cell by 7.31% compare to 6T SRAM cell, While it is unchanged in case of PP-SRAM cell. Significant reduction in total leakage power is obtained for NC and PP-SRAM cells compared to 6T SRAM cell by 77.06% and 47.42% at T = 25°C, 76.89% and 48.98% at T = 50°C, 76.87% and 50.94% at T = 100°C respectively, which is due to the gate and sub-threshold leakage currents. We also design a 16 bit memory array of 6T, NC and PP SRAM cells. There is a reduction in total leakage power for 16 bit array of NC and PP-SRAM cells by 69.86 %, 50.75 % respectively compared to the 16 bit array of 6T SRAM cell. All the simulations are performed by Cadence Virtuoso (version IC 6.1.6.500.1) tool using gpdk 45nm CMOS process technology.
Follicular Dynamics and Apoptosis Following Unilateral Oophorectomy

Ovarian physiology has been based on the assumption that the mammalian ovary has a constant germ cell pool. According to this accepted doctrine primordial follicles, which are limited in number, are depleted through ovulation or atresia. Therefore, the primary goal of this study was to examine the follicle dynamics and morphologic apoptotic changes following unilateral oophorectomy. In order to evaluate the short-, mid-, and long term effects of unilateral oophorectomy, three groups of rats were included in the study. One ovary was removed from each rat on day 0 and used as a control. In group A (n=7), the remaining ovaries were removed via relaparatomy on the 7th day, group B (n=8), the remaining ovaries were removed via relaparatomy on the 14th day, and group C (n=8), the remaining ovaries were removed via relaparatomy on the 42nd day. The changes in the number of primordial, primary, and growing follicles and the difference in apoptotic index were assessed. Even after 10–12 oestrus cycles (in group C) following unilateral oophorectomy, follicle reserve did not show a decrease in the remaining ovary. However, within the growing follicle the ovulatory rate increased. Atretic follicles were elevated contrary to the belief that reproductive functions are compensated as a result of the reduction in atresia. The observations suggest that the number of primordial follicles remains relatively constant.
Pathogenesis of mouse scrapie: evidence for neural spread of infection to the CNS.

The replication of infectious agent has been studied in brain, thoracic cord, and lumbar cord of Compton white mice (Sinc87) infected with the 139A strain of scrapie. Nine experiments were carried out using four different peripheral routes of injection. A highly consistent pattern of results was obtained in which replication in the CNS started in the thoracic cord after about 35% of the total incubation period had elapsed (range 25 to 42%). This was followed by the simultaneous onset of replication in brain and lumbar cord which occurred 2 to 4 weeks later. It is difficult to explain these results on the basis of haematogenous spread of infection from peripheral sites of replication (e.g. in spleen) to the CNS. However, the data are consistent with spread of infection along peripheral nerves and, in particular, along nerves of the sympathetic nervous system. It is suggested, therefore, that this may be the major route by which scrapie agent invades the CNS.
Diagnosis of recurrent brain tumor: value of 201Tl SPECT vs 18F-fluorodeoxyglucose PET.

OBJECTIVE This prospective study was designed to compare the sensitivity and specificity of a relatively simple examination, 201Tl chloride single-photon emission CT (SPECT), with a more complex examination, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), in patients thought to have recurrent brain tumor. Because both agents have been shown to be markers of viable tumor, we hypothesized that their sensitivity and specificity should be the same. SUBJECTS AND METHODS Nineteen patients with evidence of recurrent tumor on CT or MR images were studied with both 201Tl SPECT and FDG PET imaging. Two patients were examined twice, so a total of 21 studies were evaluated. The 201Tl SPECT and FDG PET examinations were performed on the same day in 17 patients, and the remaining four examinations were done within 1 week of one another. Three reviewers independently interpreted each Tl SPECT and PET scan. Inappropriate regional increases in 201Tl or FDG activity were considered indicative of tumor recurrence. Sensitivity and specificity values were based on biopsy results and clinical follow-up. The final diagnosis was tumor recurrence in 16 cases and radiation necrosis in 5 cases. The relationship of scan results to survival was analyzed. RESULTS The sensitivity and specificity of the 201Tl examination for detecting tumor recurrence were 11 (69%) of 16 and two (40%) of five, respectively; values for the FDG PET examination were 13 (81%) of 16 and 2 (40%) of 5, respectively. In patients with recurrent tumors less than 1.6 cm in size, results were false-negative in four 201Tl SPECT examinations and three FDG PET studies. All tumor lesions 1.6 cm or larger (n = 8) were detected. Agreement among the three nuclear medicine specialists was complete for each of the 201Tl SPECT scans. There was disagreement on the interpretation of five (24%) of the 21 FDG PET scans, which was resolved by consensus. Scintigraphic findings did not correlate with patients' survival times. CONCLUSION We were unable to detect a statistically significant difference in sensitivity or specificity between the 201Tl SPECT and FDG PET scans. Both techniques were sensitive for tumor recurrence with lesions less than 1.6 cm or larger. However, given the greater availability, simplicity, and ease of interpretation and the lower cost of the 201Tl SPECT studies, this technique should be considered for detection of tumor recurrence with lesions that are demonstrated to be 1.6 cm or larger on CT or MR examinations.