A generalization of midzuno-sen sampling scheme for finite populations

This paper proposes a generalization of the classical Midzuno-Sen sampling procedure to allow more than one PPSWOR selection followed by SRSWOR draws. The Horvitz-Thompson (H-T) estimator, its variance and variance estimator are discussed. Two methods of controlling the sampling variability of the H-T estimator are outlined. These require simple transformations of the study or the auxiliary variates. They can also be viewed as attempts to make the sampling scheme IPPS. Simple numerical illustrations are given

Molecular detection and epidemiological analysis of staphylococcus aureus from Malaysian hospitals using random amplified Po lymorphic DNA-typing.

Staphylococcus aureus is among the most prominent pathogen in both community acquired and nosocomial infection. The epidemiology analysis of Staphylococcus aureus isolates will be required to ascertain the incidence, prevalence and diversity of strains. To investigate the epidemiological of S. aureus in Malaysia, a highly reliable typing method-Randomly amplified polymorphic DNA was applied to 50 S. aureus isolates obtained from 3 different hospitals in Malaysia namely Hospital Tunku Ampuan Afzan Kuantan, Hospital Besar Seremban and Hospital Miri Malaysia. The results obtained from this study showed that the isolates can be clustered into 8 different clones. All members of the respective clones are of the same origin. In addition, there were 2 clonal grouping of isolates for each hospital. However, the clonal groupings are not in accordance to the geographical distribution. To understand the epidemiology of these isolates in depth it is very important to have information about the patient’s history. The Nei and Li’s genetic distances obtained from this study ranged from 0.0803922-0.11111. Two genetic markers a band of size 500 bp when amplified with primer OPAE-14 and another marker band of size 750 bp amplified with primer OPAE-15 was identified and this band can be used as diagnostic marker for the rapid identification of S. aureus. Apart from the genetic markers, an epidemiological marker of 1200 bp was also identified for the Miri isolates. This marker can be used as the epidemiological marker for the identification of the isolates from Miri in the future outbreaks. From this study, RAPD has proved to be an useful aid to epidemiological investigations of S. aureus

Multiplex PCR assays for the detection of clinically relevant antibiotic resistance genes in Staphylococcus aureus isolated from Malaysian hospitals.

Multiple drug resistant Staphylococcus aureus is one the most common nosocomial pathogen worldwide. The timely identification of this hospital acquired pathogen and detection of the various antibiotic resistant genes harbored is one of the most important function of the microbiology laboratory. In this study, we report the development of a multiplex PCR system for the diagnosis of S. aureus and the detection of clinically relevant antibiotic resistance genes harbored by some isolates. This system was designed to identify S. aureus at species level and to detect methicillin, gentamycin, erythromycin, vancomycin and mupirocin resistant genes, respectively from a single colony in a single tube reaction. All isolates amplified a 108 bp fragment (conserved in S. aureus) confirming the identity of S. aureus, 23 isolates produced a band at the position of 533 bp, 28 isolates at 139 bp and 30 isolates at 174 bp evidencing the presence of mecA (methicillin or oxacillin resistance), ermA (erythromycin resistance), aac (6`)-aph (2``) (gentamycin resistance) genes. None of the isolates amplified van A (vancomycin resistance) and ileS-2 (mupirocin resistance) genes showing the absence of their resistance in the isolates studied. These genotypic results when compared with classical antibiotic susceptibility tests showed less correlation. Overall, we found a correlation between phenotypic and genotypic methods of 60% for methicillin, 36.7% for gentamycin, 43.3% for erythromycin, 100% for vancomycin and mupirocin. This suggests that classical antibiotic sensitivity test is not accurate, but need to be supplemented with other methods to be applied in a clinical laboratory. The system developed in this study offers a rapid, simple specific and accurate detection of multiple antibiotic resistant genes in clinical S. aureus isolates and thus could be systematically applied as a diagnostic test in clinical microbiology laboratories, facilitating the design and use of antibiotic therapy

Urinary, Circulating, and Tissue Biomonitoring Studies Indicate Widespread Exposure to Bisphenol A

Bisphenol A (BPA) is one of the highest-volume chemicals produced worldwide, and human exposure to BPA is thought to be ubiquitous. Thus, there are concerns that the amount of BPA to which humans are exposed may cause adverse health effects. We examined many possibilities for why biomonitoring and toxicokinetic studies could come to seemingly conflicting conclusions. More than 80 published human biomonitoring studies that measured BPA concentrations in human tissues, urine, blood, and other fluids, along with two toxicokinetic studies of human BPA metabolism were examined. Unconjugated BPA was routinely detected in blood (in the nanograms per milliliter range), and conjugated BPA was routinely detected in the vast majority of urine samples (also in the nanograms per milliliter range). In stark contrast, toxicokinetic studies proposed that humans are not internally exposed to BPA. Available data from biomonitoring studies clearly indicate that the general population is exposed to BPA and is at risk from internal exposure to unconjugated BPA. The two toxicokinetic studies that suggested human BPA exposure is negligible have significant deficiencies, are directly contradicted by hypothesis-driven studies, and are therefore not reliable for risk assessment purposes.Bisfenol A (BPA) é um dos produtos químicos mais produzido em todo o mundo, e a exposição humana a ele é considerada onipresente. Assim, há preocupações de que a quantidade de BPA para o qual os seres humanos estão expostos podem causar efeitos adversos à saúde. Nós examinamos muitas possibilidades sobre o porquê estudos de biomonitorização e toxicocinética podem chegar a conclusões aparentemente conflitantes. Mais de 80 estudos publicados de biomonitorização humana que mediram a concentração de BPA em tecidos humanos, urina, sangue e outros fluidos, juntamente com dois estudos de toxicocinética do metabolismo humano BPA foram examinados. BPA não conjugado foi detectado no sangue (nonanogramas por mililitro gama), e BPA conjugado foi detectado na grande maioria das amostras de urina. Em contraste, estudos de toxico-cinética propuseram que os seres humanos não são internamente expostos ao BPA. Dados disponíveis de estudos de biomonitorização indicam que a população em geral está exposta ao BPA e em risco de exposição interna ao BPA não conjugado. Os dois estudos de toxicocinética, que sugeriram a exposição humana ao BPA é insignificante, têm deficiências significativas e estão diretamente refutados por outros estudos e, portanto não são confiáveis para fins de avaliação de risco

Prenatal Exposure of the Ovine Fetus to Androgens Sexually Differentiates the Steroid Feedback Mechanisms That Control Gonadotropin Releasing Hormone Secretion and Disrupts Ovarian Cycles

Exposure of the female sheep fetus to exogenous testosterone in early pregnancy permanently masculinizes the reproductive neuroendocrine axis. Specifically, in utero androgens given to female lambs from day 30 to 90 of a 147 day pregnancy dramatically altered the response of the gonadotropin releasing hormone (GnRH) neuronal network in the hypothalamus to both estrogen (E) and progesterone (P) feedback. Elevated concentrations of estrogen stimulated a massive release of GnRH in gonadectomized female sheep; however, male and androgenized female lambs were unable to respond to high E concentrations by producing this preovulatory-like “surge” of GnRH. Further, the inhibitory actions of progesterone (P) were also sexually differentiated and adult males and androgenized females were much less responsive to P-negative feedback than normal ewes. The consequences of these abnormal steroid feedback mechanisms were reflected in the fact that only 72% of ovary-intact androgenized ewes exhibited normal estrous cycles in their first breeding season whereas none had a single estrous cycle during the second breeding season. In contrast, 100% of the control animals exhibited repeated reproductive cycles in both seasons. These data indicate that a relatively short exposure to male hormones during in utero life permanently alters the neural mechanisms that control reproduction and leads progressively to a state of infertility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44102/1/10508_2004_Article_365183.pd

Unsuspected Dengue and Acute Febrile Illness in Rural and Semi-Urban Southern Sri Lanka

Acute dengue may be under-recognized in other regions because of limited studies and tools for rapid diagnosis

Style-Aware Radiology Report Generation with RadGraph and Few-Shot Prompting

Automatically generated reports from medical images promise to improve the workflow of radiologists. Existing methods consider an image-to-report modeling task by directly generating a fully-fledged report from an image. However, this conflates the content of the report (e.g., findings and their attributes) with its style (e.g., format and choice of words), which can lead to clinically inaccurate reports. To address this, we propose a two-step approach for radiology report generation. First, we extract the content from an image; then, we verbalize the extracted content into a report that matches the style of a specific radiologist. For this, we leverage RadGraph -- a graph representation of reports -- together with large language models (LLMs). In our quantitative evaluations, we find that our approach leads to beneficial performance. Our human evaluation with clinical raters highlights that the AI-generated reports are indistinguishably tailored to the style of individual radiologist despite leveraging only a few examples as context.Comment: Accepted to Findings of EMNLP 202

Methicillin-susceptible Staphylococcus aureus from clinical and community sources are genetically diverse.

Despite the association of methicillin-susceptible S. aureus (MSSA) with several life-threatening diseases, relatively little is known about their clinical epidemiology in Malaysia. We characterized MSSA isolates (n=252) obtained from clinical and community (carriage) sources based on spa sequencing and multilocus sequence typing (MLST). The prevalence of several important virulence genes was determined to further define the molecular characteristics of MSSA clones circulating in Malaysia. Among the 142 clinical and 110 community-acquired MSSA isolates, 98 different spa types were identified, corresponding to 8 different spa clonal clusters (spa-CCs). In addition, MLST analysis revealed 22 sequence types (STs) with 5 singletons corresponding to 12 MLST-CCs. Interestingly, spa-CC084/085 (MLST-CC15) (p=0.038), spa-non-founder 2 (MLST-ST188) (p=0.002), and spa-CC127 (MLST-CC1) (p=0.049) were identified significantly more often among clinical isolates. spa-CC3204 (MLST-CC121) (p=0.02) and spa-CC015 (MLST-CC45) (p=0.0002) were more common among community isolates. Five dominant MLST-CCs (CC8, CC121, CC1, CC45, and CC5) having clear counterparts among the major MRSA clones were also identified in this study. While the MSSA strains are usually genetically heterogeneous, a relatively high frequency (19/7.5%) of ST188 (t189) strains was found, with 57.8% of these strains carrying the Panton-Valentine leukocidin (PVL). Analysis of additional virulence genes showed a frequency of 36.5% and 36.9% for seg and sei and 0.8% and 6.3% for etb and tst genes, respectively. Arginine catabolic mobile element (ACME) was detected in 4 community isolates only. These represent the first isolates harbouring this gene in an Asian region. In conclusion, MSSA from the Malaysian community and their clinical counterparts are genetically diverse, but certain clones occur more often among clinical isolates than among carriage isolates and vice versa