Molecular Characterization of Staphylococcus aureus Strains Isolated from Mobile Phones.

The widespread use of mobile phones (MP) among healthcare personnel might be considered as an important source of contamination. One of the most pathogenic bacteria to humans is Staphylococcus aureus, which can be transmitted through the constant use of MP. Nevertheless, which specific type of strains are transmitted and which are their sources have not been sufficiently studied. The aim of this study is to determine the source of contamination of MP and characterize the corresponding genotypic and phenotypic properties of the strains found. Nose, pharynx, and MP samples were taken from a group of health science students. We were able to determinate the clonality of the isolated strains by pulsed-field gel electrophoresis (PFGE) and spa gene typing (spa-type). Adhesin and toxin genes were detected, and the capacity of biofilm formation was determined. Several of the MP exhibited strains of S. aureus present in the nose and/or pharynx of their owners. methicillin-susceptible Staphylococcus aureus (MSSA), hospital-acquired methicillin-resistant S. aureus (HA-MRSA), and community-acquired methicillin-resistant S. aureus (CA-MRSA) strains were found, which indicated a variety of genotypes. This study concludes that MP can be contaminated with the strains of S. aureus present in the nose and/or pharynx of the owners; these strains can be of different types and there is no dominant genotype.

Biomarker profile predicts clinical efficacy of extracorporeal photopheresis in steroid-resistant acute and chronic graft-vs-host disease after allogenic hematopoietic stem cell transplant.

We conducted a multicenter interventional study to assess the efficacy of Therakos ECP to treat steroid-resistant graft-vs-host disease (SRes-GVHD) after allogeneic HSCT and to identify biomarkers of GVHD response. A total of 62 patients were treated for acute SRes-GVHD (n = 37) or chronic SRes-GVHD (n = 25). Median time to best response was 35 days (range, 28-85) and 90 days (range, 27-240) in acute and chronic SRes-GVHD, respectively. Overall, 27 patients (72.9%) with SRes-aGVHD responded to treatment (40.5% CR and 32.4% PR). The response rate was significantly higher in grade I-II than in grade III-IV aGVHD (100% vs 50.0%, respectively, P-value = .001). In chronic SRes-GVHD, 22 patients (88%) achieved a clinical response (24.0% CR and 64% PR). Response was higher in moderate than in severe SRes-cGVHD (100% vs 75%, P = .096). In both acute and chronic SRes-GVHD patients, the percentage of peripheral blood CD3+ CD4+ was higher and CD3+ CD8+ lower in responding than nonresponding patients. Acute SRes-GVHD responding patients presented a higher number of Treg cells (CD4+ CD25+ CD127low/- ) at day 0 (P = .028) than nonresponding patients, differences that were maintained over the observation period. Phenotypic analysis of T-cell maturation showed a trend toward reduction in TCD8 naive cells, along with an increased percentage of TCD8 Mem Efect T cells after starting ECP in responding patients. None of the studied serum cytokines displayed statistically significant changes in either acute or chronic SRes-GVHD. ECP is an effective treatment for patients with SRes-GVHD. Biomarkers could help guide decision-making on ECP treatment initiation and duration.

Estimating the occurrence of traffic accidents near school locations: A case study from Valencia (Spain) including several approaches.

Traffic safety around school locations is a topic of particular interest given the large number of vulnerable users, such as pedestrians or cyclists, that commute to them at certain times of the day. A dataset of traffic accidents recorded in Valencia (Spain) during 2014 and 2015 is analyzed in order to estimate the effects that school locations produce on traffic risk within their surroundings. The four typologies of school in this city according to the academic levels they offer (All-level, Preschool, Primary, Secondary) are distinguished and taken into consideration for the analysis. Two time windows comprising the starting time in the morning and the evening time once day school has ended are analyzed independently. Several statistical methods are used, including observed vs expected ratios, macroscopic conditional autoregressive modelling, logistic regression in the context of a case-control study design and risk modelling in relation to several school locations. The distances to each type of school and a set of environmental, traffic-related, demographic and socioeconomic covariates are employed for the analysis. The macroscopic modelling of accident counts and the modelling of risk as a function of the distance to each type of school serves to confirm that proximity to a school has an effect on the incidence of traffic accidents in particular time windows. Specifically, school types coexisting in Valencia show differential behaviour in this regard. In addition, several covariates have displayed a positive (bus stop density, complex intersections, main road length) and negative (land use entropy) association with accident counts in the time windows investigated. Finally, the definition of a case-control study design enabled us to observe some differences undetected by the macroscopic approaches that would require further research.

Identification of differential risk hotspots for collision and vehicle type in a directed linear network.

Traffic accidents can take place in very different ways and involve a substantially distinct number and types of vehicles. Thus, it is of interest to know which parts of a road structure present an overrepresentation of a specific type of traffic accident, specially for some typologies of collisions and vehicles that tend to trigger more severe consequences for the users being involved. In this study, a spatial approach is followed to estimate the risk that different types of collisions and vehicles present in the central area of Valencia (Spain), considering the accidents observed in this city during the period 2014-2017. A directed spatial linear network representing the non-pedestrian road structure of the area of interest was employed to guarantee an accurate analysis of the point pattern. A kernel density estimation technique was used to approximate the probability of risk along the network for each collision and vehicle type. A procedure based on these estimates and the sample size locally available within the network was designed and tested to determine a set of differential risk hotspots for each typology of accident considered. A Monte Carlo based simulation process was then defined to assess the statistical significance of each of the differential risk hotspots found, allowing the elaboration of rankings of importance and the possible rejection of the least significant ones.

Investigation of the consequences of the modifiable areal unit problem in macroscopic traffic safety analysis: A case study accounting for scale and zoning.

Traffic safety analysis at the macroscopic level usually relies on previously defined areal traffic analysis zones (TAZs) that are used as the units of investigation. Hence, statistical inference is made on the basis of such units, implying that the consideration of a certain TAZ configuration may influence the results and conclusions achieved. Regarding this, the modifiable areal unit problem (MAUP) is a well-known issue in the field of spatial statistics, which refers to the effects that arise in statistical properties and estimations when there is a change in areal units of analysis. In this paper, the consequences of MAUP have been investigated through a dataset of traffic crashes that occurred in Valencia within the years 2014 and 2015 and two common statistical models: a conditional autoregressive model and a geographically weighted regression. In the absence of an established TAZ scheme for the city, four classes of basic spatial units (BSUs) were considered: census tracts, hexagonal units and two types with construction based on the structure of main roads and intersections of the city. Each of these BSU types was specified at different levels of spatial aggregation. The main research objective was to investigate the final effects that changes in BSU type and scale have on model parameter estimations, but also the specific alterations that MAUP causes to data in terms of the distributional characteristics of the response, multicollinearity among the covariates and covariates' spatial autocorrelation. The results showed the presence and severity of MAUP for the dataset and area that were analysed. Although effects from scale variations were more moderate, changing the BSU type affected the results severely. The joint use of hexagonal units and a conditional autoregressive model achieved the best performance among all the possibilities explored, but the choice of a proper BSU unit should rely on more factors. Despite MAUP effects, educational centres showed a consistent (and negative) association with traffic crashes, a fact possibly related to their distribution across the whole city. Other covariates revealed a positive correlation with crash counts, but these findings were more uncertain given the discrepancies found at different scales and zonings.

Spatial analysis of traffic accidents near and between road intersections in a directed linear network.

Although most of the literature on traffic safety analysis has been developed over areal zones, there is a growing interest in using the specific road structure of the region under investigation, which is known as a linear network in the field of spatial statistics. The use of linear networks entails several technical complications, ranging from the accurate location of traffic accidents to the definition of covariates at a spatial micro-level. Therefore, the primary goal of this study was to display a detailed analysis of a dataset of traffic accidents recorded in Valencia (Spain), which were located into a linear network representing more than 30 km of urban road structure corresponding to one district of the city. A set of traffic-related covariates was constructed at the road segment level for performing the analysis. Several issues and methodological approaches that are inherent to linear networks have been shown and discussed. In particular, the network was defined in a way that allowed the explicit investigation of traffic accidents around road intersections and the consideration of traffic flow directionality. Zero-inflated negative binomial count models accounting for spatial heterogeneity were used. Traffic safety at road intersections was specifically taken into account in the analysis by considering the higher variability and number of zeros that can be observed at these road entities and the differential contribution of the covariates depending on the proximity of a road intersection. To complement the results obtained from the count models fitted, coldspots and hotspots along the network were also detected, with explanatory objectives. The models confirmed that spatial heterogeneity, overdispersion and the close presence of road intersections explain the accident counts observed in the road network analyzed. Hotspot detection revealed that several covariates whose contribution was unclear in the modelling approaches may also be affecting accident counts at the road segment level.

Vapour-liquid interfacial properties of square-well chains from density functional theory and Monte Carlo simulation.

The statistical associating fluid theory for attractive potentials of variable range (SAFT-VR) density functional theory (DFT) developed by [Gloor et al., J. Chem. Phys., 2004, 121, 12740-12759] is used to predict the interfacial behaviour of molecules modelled as fully-flexible square-well chains formed from tangentially-bonded monomers of diameter σ and potential range λ = 1.5σ. Four different model systems, comprising 4, 8, 12, and 16 monomers per molecule, are considered. In addition to that, we also compute a number of interfacial properties of molecular chains from direct simulation of the vapour-liquid interface. The simulations are performed in the canonical ensemble, and the vapour-liquid interfacial tension is evaluated using the wandering interface (WIM) method, a technique based on the thermodynamic definition of surface tension. Apart from surface tension, we also obtain density profiles, coexistence densities, vapour pressures, and critical temperature and density, paying particular attention to the effect of the chain length on these properties. According to our results, the main effect of increasing the chain length (at fixed temperature) is to sharpen the vapour-liquid interface and to increase the width of the biphasic coexistence region. As a result, the interfacial thickness decreases and the surface tension increases as the molecular chains get longer. The interfacial thickness and surface tension appear to exhibit an asymptotic limiting behaviour for long chains. A similar behaviour is also observed for the coexistence densities and critical properties. Agreement between theory and simulation results indicates that SAFT-VR DFT is only able to predict qualitatively the interfacial properties of the model. Our results are also compared with simulation data taken from the literature, including the vapour-liquid coexistence densities, vapour pressures, and surface tension.

Space-time airborne disease mapping applied to detect specific behaviour of varicella in Valencia, Spain.

Airborne diseases are one of humanity's most feared sicknesses and have regularly caused concern among specialists. Varicella is an airborne disease which usually affects children before the age of 10. Because of its nature, varicella gives rise to interesting spatial, temporal and spatio-temporal patterns. This paper studies spatio-temporal exploratory analysis tools to detect specific behaviour of varicella in the city of Valencia, Spain, from 2008 to 2013. These methods have shown a significant association between the spatial and the temporal component, confirmed by the space-time models applied to the data. High relative risk of varicella is observed in economically disadvantaged regions, areas less involved in vaccination programmes.

Spatio-temporal cluster detection of chickenpox in Valencia, Spain in the period 2008-2012.

Chickenpox is a highly contagious airborne disease caused by Varicella zoster, which affects nearly all non-immune children worldwide with an annual incidence estimated at 80-90 million cases. To analyze the spatiotemporal pattern of the chickenpox incidence in the city of Valencia, Spain two complementary statistical approaches were used. First, we evaluated the existence of clusters and spatio-temporal interaction; secondly, we used this information to find the locations of the spatio-temporal clusters via the space-time permutation model. The first method used detects any aggregation in our data but does not provide the spatial and temporal information. The second method gives the locations, areas and time-frame for the spatio-temporal clusters. An overall decreasing time trend, a pronounced 12-monthly periodicity and two complementary periods were observed. Several areas with high incidence, surrounding the center of the city were identified. The existence of aggregation in time and space was observed, and a number of spatio-temporal clusters were located.

Functional polymorphisms in SOCS1 and PTPN22 genes correlate with the response to imatinib treatment in newly diagnosed chronic-phase chronic myeloid leukemia.

The function of the natural modulators of BCR-ABL-induced signaling pathways could influence the results to imatinib treatment. We assessed the association between single nucleotide polymorphisms (SNPs) on genes of the phosphatase family and the suppressors of cytokine signaling and the response to imatinib in 105 patients newly diagnosed with chronic-phase CML. SNPs in SOCS1 (rs243327) and PTPN22 (rs2476601) genes correlated with the risk of primary resistance to imatinib. A high-risk Sokal score, the T allele in PTPN22 SNP, and each copy of the C allele in SOCS1 SNP were adverse prognostic factors for failure-free survival (FFS). Based on such parameters, three risk groups were identified, with the 5-year FFS for each group being 95%, 75%, and 50%, respectively (P<0.001). A simple predictive model including Sokal score and genotype of SOCS1 and PTPN22 SNPs may be useful in the selection of the initial treatment in CML.

Clinical evaluation of the European LeukaemiaNet criteria for clinicohaematological response and resistance/intolerance to hydroxycarbamide in essential thrombocythaemia.

Standardized criteria of response to treatment and a unified definition of resistance/intolerance to hydroxycarbamide (HC) in essential thrombocythaemia (ET) have been proposed by the European LeukaemiaNet (ELN). We have retrospectively evaluated such criteria in 166 ET patients treated with HC for a median of 4·5 years. Overall, 134 patients achieved a complete clinicohaematological response (CR) and 25 a partial response. Thirty-three patients met at least one of the ELN criteria defining resistance (n = 15) or intolerance (n = 21) to HC. Fifteen cases developed anaemia with thrombocytosis, which was associated with a high incidence of myelofibrosis and death from any cause. Other definitions of resistance were less useful. Factors determining the thrombotic risk were a history of prior thrombosis and a baseline leucocyte count >10 × 109/ l. Of note, patients achieving a CR, even if sustained during the entire follow-up, did not benefit from a lower incidence of thrombosis or an improved survival. In conclusion, most ET patients respond to HC, but the achievement of response, as defined by the ELN, does not correlate with the patients' outcome. The best discriminating ELN criterion of resistance to HC was the detection of anaemia, which also identified a subgroup of patients with poor prognosis.

Impact of a mammography screening programme on the breast cancer population of the Region of Valencia (Spain).

OBJECTIVE: Randomised clinical trials with a control arm of non-screened patients are nowadays ethically impossible. The aim of this study was to establish the impact of mammography screening on a non-selected population. PATIENTS AND METHODS: Between January 1993 and December 2002, 3662 patients were included, 2313 in the screened group and 1349 in the unscreened group. RESULTS: 55.3% of the screened patients were diagnosed in stage I vs. 26.1% in the non-screened group. The proportion of stage III-IV was 4.6% and 19.8% for the screened and unscreened groups respectively (p<0.001). 48.8% in the screening group were submitted to mastectomy vs. 66.4% of the unscreened patients (p<0.001). Overall survival was superior for the prevalent cases in the screening group, with a relative risk of 0.49, and was not significant for the incident cases. CONCLUSIONS: Diagnosis of breast cancer in the mammography screening programme of the Region of Valencia significantly increases conservative surgery rates and suggests an improvement in survival in prevalent cases. The increased rate of early stages in these patients could be the main reason of this benefit.