Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z score ≤-1 in at least 2 out of 5 cognitive domains. Participants' mean age was 45.8 years; 84% male; 87% white; 56% university educated; median CD4 count 550 cells/mm(3); 89% on antiretroviral therapy. 156 (35%) participants had NCI, among whom 26 (17%; 5.8% overall) reported a decline in activities of daily living. Prevalence of NCI was lower in those always able to afford basic needs (adjusted prevalence ratio [aPR] 0.71, 95% confidence interval [CI] 0.54-0.94) or with a university education (aPR 0.72, 95% CI 0.54-0.97) and higher in those with severe depressive symptoms (aPR 1.53, 95% CI 1.09-2.14) or a significant comorbid condition (aPR 1.40, 95% CI 1.03-1.90)

Voluntary disclosure of corporate strategy: determinants and outcomes. An empirical study into the risks and payoffs of communicating corporate strategy.

Business leaders increasingly face pressure from stakeholders to be transparent. There appears however little consensus on the risks and payoffs of disclosing vital information such as corporate strategy. To fill this gap, this study analyzes firm-specific determinants and organisational outcomes of voluntary disclosure of corporate strategy. Stakeholder theory and agency theory help to understand whether companies serve their interest to engage with stakeholders and overcome information asymmetries. I connect these theories and propose a comprehensive approach to measure voluntary disclosure of corporate strategy. Hypotheses from the theoretical framework are empirically tested through panel regression of data on identified determinants and outcomes and of disclosed strategy through annual reports, corporate social responsibility reports, corporate websites and corporate press releases by the 70 largest publicly listed companies in the Netherlands from 2003 through 2008. I found that industry, profitability, dual-listing status, national ranking status and listing age have significant effects on voluntary disclosure of corporate strategy. No significant effects are found for size, leverage and ownership concentration. On outcomes, I found that liquidity of stock and corporate reputation are significantly influenced by voluntary disclosure of corporate strategy. No significant effect is found for volatility of stock. My contributions to theory, methodology and empirics offers a stepping-stone for further research into understanding how companies can use transparency to manage stakeholder relations

Lifestyles of bacteria in wounds: Presence of biofilms?

Biofilms consist of bacteria and other organisms that live within a matrix of extracellular polysaccharide (EPS) and have been implicated in bacterial diseases, such as otitis media, dental plaque, and chronic infections in cystic fibrosis. The purpose of this study was to examine wounds for the Formation of bacterial biofilms. partial-thickness wounds were mode on three pigs with a dermatome. Wounds were challenged with Pseudomonas aeruginosa and covered with either a polyurethane dressing or plastic cover slip. At 72 hours, each wound was vigorously flushed three times with sterile saline to dislodge any non-adherent bacteria. The flushed wounds were then cultured with a surfactant solution using a scrub technique. Both the flushed and scrubbed samples were plated on Pseudomonas isolation agar for quantitation. Cover slips were removed from the wounds at 72 hours, and wound curettage was obtained. Congo red staining procedure, which detects EPS, was used to stain both cultures. A thick, dark red to yellow-orange amorphous EPS matrix was seen surrounding bacteria, indicating a biofilm. Wounds cultured with saline or surfactant demonstrated that there were two distinct populations of bacteria living in the wound area. The non-adherent population displayed a quantitative variation from wound to wound, whereas the adherent population had a narrower range suggesting a critical mass for those bacteria that were adherent to the wound. This preliminary work has demonstrated that bacterial biofilms do form in wounds. This in-vivo assay system will provide a means to examine therapeutic modalities for bacteria living in a protective biofilm

Bacterial profiling using skin grafting, standard culture and molecular bacteriological methods

OBJECTIVE: Wound healing can be delayed by the presence of colonising bacteria, and in polymicrobial wounds they may act synergistically to the further detriment of wound healing. In this pilot investigation, biopsy and swab samples were obtained as part of skin-graft operations performed on a chronic venous leg ulcer in order to study the spatial microbial diversity and to compare standard bacteriological and molecular biological techniques. METHOD: The wound was sampled before excision, and sampling was undertaken at multiple locations across the wound. Swab samples and biopsies were subjected to culture analysis and 16S rRNA polymerase chain reaction (PCR), and to denaturing gradient gel electrophoresis (DGGE). RESULTS: Within the wound samples, DGGE identified the major wound microflora components and established the extent of local differences in bacterial diversity. CONCLUSION: This ongoing investigation has verified DGGE as a powerful tool for elucidating the clinical microbiology of a chronic disease state. It also suggests that skin graft operations are a novel way of obtaining multiple samples for in vivo bacteriology and for establishing the spatial distribution of bacteria in the complex micro-environment of chronic wounds