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Article ; Online: Within-host genetic diversity of extended-spectrum beta-lactamase-producing Enterobacterales in long-term colonized patients.

Aguilar-Bultet, Lisandra / García-Martín, Ana B / Vock, Isabelle / Maurer Pekerman, Laura / Stadler, Rahel / Schindler, Ruth / Battegay, Manuel / Stadler, Tanja / Gómez-Sanz, Elena / Tschudin-Sutter, Sarah

Nature communications

2023 Volume 14, Issue 1, Page(s) 8495

Abstract: Despite recognition of the immediate impact of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) on human health, essential aspects of their molecular epidemiology remain under-investigated. This includes ... ...

Abstract	Despite recognition of the immediate impact of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) on human health, essential aspects of their molecular epidemiology remain under-investigated. This includes knowledge on the potential of a particular strain to persist in a host, mutational events during colonization, and the genetic diversity in individual patients over time. To investigate long-term genetic diversity of colonizing and infecting ESBL-Klebsiella pneumoniae species complex and ESBL-Escherichia coli in individual patients over time, we performed a ten-year longitudinal retrospective study and extracted clinical and microbiological data from electronic health records. In this investigation, 76 ESBL-K. pneumoniae species complex and 284 ESBL-E. coli isolates were recovered from 19 and 61 patients. Strain persistence was detected in all patients colonized with ESBL-K. pneumoniae species complex, and 83.6% of patients colonized with ESBL-E. coli. We frequently observed isolates of the same strain recovered from different body sites associated with either colonization or infection. Antimicrobial resistance genes, plasmid replicons, and whole ESBL-plasmids were shared between isolates regardless of chromosomal relatedness. Our study suggests that patients colonized with ESBL-producers may act as durable reservoirs for ongoing transmission of ESBLs, and that they are at prolonged risk of recurrent infection with colonizing strains.
MeSH term(s)	Humans ; Escherichia coli/genetics ; Escherichia coli Infections/microbiology ; Retrospective Studies ; beta-Lactamases/genetics ; Klebsiella Infections/microbiology ; Klebsiella ; Klebsiella pneumoniae/genetics ; Genetic Variation ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Microbial Sensitivity Tests
Chemical Substances	beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-12-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-44285-w
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Article: Extended-spectrum β-lactamase-producing Enterobacterales in diverse foodstuffs: a prospective, longitudinal study in the city of Basel, Switzerland.

Gómez-Sanz, Elena / Bagutti, Claudia / García-Martín, Ana B / Roth, Jan A / Alt Hug, Monica / Maurer Pekerman, Laura / Schindler, Ruth / Furger, Reto / Eichenberger, Lucas / Steffen, Ingrid / Hübner, Philipp / Stadler, Tanja / Aguilar-Bultet, Lisandra / Tschudin-Sutter, Sarah

Frontiers in microbiology

2023 Volume 14, Page(s) 1295037

Abstract: Background: The involvement of non-human-to-human transmission of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) remains elusive. Foodstuffs may serve as reservoirs for ESBL-PE and contribute to their spread.: Aim: We aimed to ... ...

Abstract	Background: The involvement of non-human-to-human transmission of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) remains elusive. Foodstuffs may serve as reservoirs for ESBL-PE and contribute to their spread. Aim: We aimed to systematically investigate the presence and spatiotemporal distribution of ESBL-PE in diverse unprocessed foodstuffs of different origin purchased in a central European city. Methods: Chicken and green (herbs, salad, sprouts, vegetables) samples were collected monthly for two consecutive years, from June 2017 to June 2019, from large supermarket chains and small local food retailers, representing all ten postcode areas of the City of Basel (Switzerland), and the kitchen of the University Hospital Basel (Basel, Switzerland). After enrichment, presumptive ESBL-PE were isolated by selective culture methods and identified by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. ESBL production was confirmed by phenotypic testing. Results: Among 947 food samples, 14.8% were positive for ESBL-PE isolate/s belonging to eight different ESBL-producing bacterial species. Conclusion: Our findings indicate moderate dissemination of ESBL-PE in foodstuffs, especially between chicken products and sprouts. Chicken meat represents a source for several ESBL-producing Enterobacterales, especially
Language	English
Publishing date	2023-11-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2023.1295037
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Article: Spatiotemporal dissemination of ESBL-producing Enterobacterales in municipal sewer systems: a prospective, longitudinal study in the city of Basel, Switzerland.

Gómez-Sanz, Elena / Bagutti, Claudia / Roth, Jan A / Alt Hug, Monica / García-Martín, Ana B / Maurer Pekerman, Laura / Schindler, Ruth / Furger, Reto / Eichenberger, Lucas / Steffen, Ingrid / Egli, Adrian / Hübner, Philipp / Stadler, Tanja / Aguilar-Bultet, Lisandra / Tschudin-Sutter, Sarah

Frontiers in microbiology

2023 Volume 14, Page(s) 1174336

Abstract: Background: The contribution of community and hospital sources to the transmission of extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE) remains elusive.: Aim: To investigate the extent of community dissemination and the contribution ... ...

Abstract	Background: The contribution of community and hospital sources to the transmission of extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE) remains elusive. Aim: To investigate the extent of community dissemination and the contribution of hospitals to the spread of ESBL-PE by exploring their spatiotemporal distribution in municipal wastewater of the central European city of Basel. Methods: Wastewater samples were collected monthly for two consecutive years throughout Basel, Switzerland, including 21 sites across 10 postcode areas of the city collecting either community wastewater (urban sites, Results: Ninety-five percent (477/504) of samples were positive for ESBL-PE. Among these isolates, Conclusion: ESBL-PE are widely spread in municipal wastewater supporting that community sources are important reservoirs entertaining the spread of ESBL-PE. Hospital-influenced abundance of ESBL-PE appears to be species dependent.
Language	English
Publishing date	2023-05-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2023.1174336
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Article ; Online: Identification of a Cluster of Extended-spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Sequence Type 101 Isolated From Food and Humans.

Aguilar-Bultet, Lisandra / Bagutti, Claudia / Egli, Adrian / Alt, Monica / Maurer Pekerman, Laura / Schindler, Ruth / Furger, Reto / Eichenberger, Lucas / Roloff, Tim / Steffen, Ingrid / Huebner, Philipp / Stadler, Tanja / Tschudin-Sutter, Sarah

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 73, Issue 2, Page(s) 332–335

Abstract: We report a cluster of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae sequence type 101, derived from 1 poultry and 2 clinical samples collected within the setting of a prospective study designed to determine the diversity and ... ...

Abstract	We report a cluster of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae sequence type 101, derived from 1 poultry and 2 clinical samples collected within the setting of a prospective study designed to determine the diversity and migration of ESBL-producing Enterobacterales between humans, foodstuffs, and wastewater.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Escherichia coli ; Humans ; Klebsiella Infections/epidemiology ; Klebsiella pneumoniae/genetics ; Microbial Sensitivity Tests ; Prospective Studies ; beta-Lactamases/genetics
Chemical Substances	Anti-Bacterial Agents ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1164
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Article ; Online: Multicenter Prevalence Study Comparing Molecular and Toxin Assays for Clostridioides difficile Surveillance, Switzerland.

Widmer, Andreas F / Frei, Reno / Kuijper, Ed J / Wilcox, Mark H / Schindler, Ruth / Spaniol, Violeta / Goldenberger, Daniel / Egli, Adrian / Tschudin-Sutter, Sarah

Emerging infectious diseases

2020 Volume 26, Issue 10, Page(s) 2370–2377

Abstract: Public health authorities in the United States and Europe recommend surveillance for Clostridioides difficile infections among hospitalized patients, but differing diagnostic algorithms can hamper comparisons between institutions and countries. We ... ...

Abstract	Public health authorities in the United States and Europe recommend surveillance for Clostridioides difficile infections among hospitalized patients, but differing diagnostic algorithms can hamper comparisons between institutions and countries. We compared surveillance based on detection of C. difficile by PCR or enzyme immunoassay (EIA) in a nationwide C. difficile prevalence study in Switzerland. We included all routinely collected stool samples from hospitalized patients with diarrhea in 76 hospitals in Switzerland on 2 days, 1 in winter and 1 in summer, in 2015. EIA C. difficile detection rates were 6.4 cases/10,000 patient bed-days in winter and 5.7 cases/10,000 patient bed-days in summer. PCR detection rates were 11.4 cases/10,000 patient bed-days in winter and 7.1 cases/10,000 patient bed-days in summer. We found PCR used alone increased reported C. difficile prevalence rates by <80% compared with a 2-stage EIA-based algorithm.
MeSH term(s)	Bacterial Toxins/genetics ; Clostridioides ; Clostridioides difficile/genetics ; Clostridium Infections/diagnosis ; Clostridium Infections/epidemiology ; Cross-Sectional Studies ; Europe ; Feces ; Humans ; Prevalence ; Switzerland/epidemiology
Chemical Substances	Bacterial Toxins
Language	English
Publishing date	2020-10-05
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2610.190804
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Article ; Online: Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections.

Antimicrobial resistance and infection control

2021 Volume 10, Issue 1, Page(s) 44

Abstract: The proportion of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains elusive and the potential benefit of systematic screening during the SARS-CoV-2-pandemic is controversial. We investigated the proportion of ... ...

Abstract	The proportion of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains elusive and the potential benefit of systematic screening during the SARS-CoV-2-pandemic is controversial. We investigated the proportion of asymptomatic inpatients who were identified by systematic screening for SARS-CoV-2 upon hospital admission. Our analysis revealed that systematic screening of asymptomatic inpatients detects a low total number of SARS-CoV-2 infections (0.1%), questioning the cost-benefit ratio of this intervention. Even when the population-wide prevalence was low, the proportion of asymptomatic carriers remained stable, supporting the need for universal infection prevention and control strategies to avoid onward transmission by undetected SARS-CoV-2-carriers during the pandemic.
MeSH term(s)	Aged ; Asymptomatic Infections/epidemiology ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/transmission ; COVID-19 Testing/economics ; COVID-19 Testing/methods ; Cost-Benefit Analysis ; Female ; Humans ; Male ; Mass Screening/economics ; Mass Screening/methods ; Middle Aged ; SARS-CoV-2/isolation & purification ; Switzerland/epidemiology
Language	English
Publishing date	2021-02-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-021-00912-z
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Article ; Online: Transmission of ESBL-producing Enterobacteriaceae and their mobile genetic elements-identification of sources by whole genome sequencing: study protocol for an observational study in Switzerland.

Stadler, Tanja / Meinel, Dominik / Aguilar-Bultet, Lisandra / Huisman, Jana S / Schindler, Ruth / Egli, Adrian / Seth-Smith, Helena M B / Eichenberger, Lucas / Brodmann, Peter / Hübner, Philipp / Bagutti, Claudia / Tschudin-Sutter, Sarah

BMJ open

2018 Volume 8, Issue 2, Page(s) e021823

Abstract: Introduction: Extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae were first described in relation with hospital-acquired infections. In the 2000s, the epidemiology of ESBL-producing organisms changed as especially ESBL-producing : ... ...

Abstract	Introduction: Extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae were first described in relation with hospital-acquired infections. In the 2000s, the epidemiology of ESBL-producing organisms changed as especially ESBL-producing Methods and analysis: This protocol presents an observational study that will be performed at the University Hospital Basel and in the city of Basel, Switzerland. ESBL-producing Enterobacteriaceae will be collected from any specimens obtained by routine clinical practice or by active screening in both inpatient and outpatient settings, as well as from wastewater samples and foodstuffs, both collected monthly over a 12-month period for analyses by whole genome sequencing. Bacterial chromosomal, plasmid and ESBL-gene sequences will be compared within the cohort to determine genetic relatedness and migration between humans and their environment. Ethics and dissemination: This study has been approved by the local ethics committee (Ethikkommission Nordwest-und Zentralschweiz) as a quality control project (Project-ID 2017-00100). The results of this study will be published in peer-reviewed medical journals, communicated to participants, the general public and all relevant stakeholders.
MeSH term(s)	Community-Acquired Infections/microbiology ; Community-Acquired Infections/transmission ; Cross Infection ; Enterobacteriaceae/genetics ; Enterobacteriaceae/isolation & purification ; Enterobacteriaceae Infections/transmission ; Humans ; Interspersed Repetitive Sequences ; Prospective Studies ; Research Design ; Retrospective Studies ; Switzerland/epidemiology ; Tertiary Care Centers ; Whole Genome Sequencing ; beta-Lactamases/genetics ; beta-Lactamases/metabolism
Chemical Substances	beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2018-02-17
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2747269-3
ISSN	2044-6055 ; 2044-6055 ; 2053-3624
ISSN (online)	2044-6055
ISSN	2044-6055 ; 2053-3624
DOI	10.1136/bmjopen-2018-021823
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Article ; Online: Why and how do elderly patients with heart failure die? Insights from the TIME-CHF study.

Rickenbacher, Peter / Pfisterer, Matthias / Burkard, Thilo / Kiowski, Wolfgang / Follath, Ferenc / Burckhardt, Dieter / Schindler, Ruth / Brunner-La Rocca, Hans-Peter

European journal of heart failure

2012 Volume 14, Issue 11, Page(s) 1218–1229

Abstract: Aims: Specific causes and modes of death (COD and MOD) of patients with heart failure (HF) are not well described, particularly in those with preserved ejection fraction >45% (HFPEF) and at old age. Thus, using the database of the TIME-CHF study, ... ...

Abstract	Aims: Specific causes and modes of death (COD and MOD) of patients with heart failure (HF) are not well described, particularly in those with preserved ejection fraction >45% (HFPEF) and at old age. Thus, using the database of the TIME-CHF study, patients with HFPEF were compared with those with reduced ejection fraction ≤45% (HFREF), and patients ≥75 with those 60-74 years of age to identify MOD and COD, predictors of death, and event rates before death as compared with survivors. Methods and results: During the 18-month follow-up, 132/622 patients (21%) died, with similar rates in patients with HFPEF and HFREF and a trend to higher rates in patients aged ≥75 years (24% vs. 17%, P = 0.06). COD and MOD (ACME system) were not different in the age groups. COD was more often non-cardiovascular in HFPEF patients than in HFREF patients (33% vs. 16%, P < 0.05) and cardiac MOD were more frequent in HFREF patients (75% vs. 56%, P < 0.05), mainly due to more sudden deaths (25% vs. 7%, P < 0.05). Patients who died experienced a median of four adverse events (interquartile range 1-7) and one (0-1) hospitalization within 60 days prior to death compared with 0.7 (0.4-1.4) and 0.1 (0.0-0.2) during a randomly selected 60 days in survivors (all P < 0.0001). Conclusion: Despite similar 18-month mortality in patients with HFREF and those with HFPEF, important differences in COD and MOD were found which were not observed between the two age groups. A high rate of adverse events and hospitalizations preceded death. These observations may be relevant for the management of HF patients.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Aging/pathology ; Cause of Death ; Chi-Square Distribution ; Comorbidity ; Female ; Health Status Indicators ; Heart Failure/epidemiology ; Heart Failure/mortality ; Heart Failure/pathology ; Humans ; Male ; Netherlands/epidemiology ; Prognosis ; Risk Assessment ; Statistics as Topic ; Stroke Volume ; Ventricular Function, Left
Language	English
Publishing date	2012-11
Publishing country	England
Document type	Journal Article
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1093/eurjhf/hfs113
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Article: Detection of intake of nonsteroidal anti-inflammatory drugs in elderly patients with heart failure. How to ask the patient?

Muzzarelli, Stefano / Tobler, Daniel / Leibundgut, Gregor / Schindler, Ruth / Buser, Peter / Pfisterer, Matthias Emil / Brunner-La Rocca, Hans Peter

Swiss medical weekly

2009 Volume 139, Issue 33-34, Page(s) 481–485

Abstract: Principles: Heart failure hospitalisations may be related to non-steroidal anti-inflammatory drug (NSAID) use. Since NSAIDs are usually prescribed by general practitioners or taken without prescription, their use may be largely underestimated. Therefore, ...

Abstract	Principles: Heart failure hospitalisations may be related to non-steroidal anti-inflammatory drug (NSAID) use. Since NSAIDs are usually prescribed by general practitioners or taken without prescription, their use may be largely underestimated. Therefore, we assessed the impact of a focussed analgesic medication history as compared to a usual medication history on detection of NSAID intake in elderly heart failure patients and the potential effect of medical advice on discontinuation of this therapy in a non-controlled study design. Methods: A structured and stepwise history of analgesic intake (firstly open questioning about medication intake, secondly with a focus on analgesic intake, finally focussing on behaviour in case of pain) was done in 197 elderly heart failure patients taking part in the TIME-CHF study at baseline and up to 3 follow-up visits. All participants were informed about the potential hazardous effects of NSAIDs and alternative analgesic therapy was proposed in case of NSAID intake. Patients were aged 60 years or older with clinical signs of heart failure NYHA > or =II, elevated NT-BNP, and had been hospitalised due to heart failure within the last year. Details of this study have been described previously. Results: At baseline, 43 patients (22%) were taking NSAID. Almost half (n = 19) taking NSAID reported the use only after specific questioning. Therefore, a focussed analgesic medication history was superior as compared to a usual medication history to detect patients taking NSAIDs (22% vs 12%; p <0.001). After instruction and proposal of alternative analgesic therapy, NSAID intake dropped from 22% to 7% (p <0.001). No risk factor for continuous use was identified. Conclusions: NSAID use in heart failure patients is relatively common. Specific questioning may help to increase detection of NSAID intake and information on its hazardous effects to decrease NSAID use.
MeSH term(s)	Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Female ; Heart Failure ; Humans ; Interviews as Topic ; Male ; Physician-Patient Relations ; Self Administration ; Self Medication
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal
Language	English
Publishing date	2009-08-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	smw-12501
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Article ; Online: Cognitive impairment in heart failure: results from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) randomized trial.

Huijts, Marjolein / van Oostenbrugge, Robert J / Duits, Annelien / Burkard, Thilo / Muzzarelli, Stefano / Maeder, Micha T / Schindler, Ruth / Pfisterer, Matthias E / Brunner-La Rocca, Hans-Peter

European journal of heart failure

2013 Volume 15, Issue 6, Page(s) 699–707

Abstract: Aims: Up to 50% of patients with heart failure (HF) may suffer from severe cognitive impairment (SCI), but longitudinal studies are sparse, and effects of changes in HF severity on cognitive function are unknown. Therefore, we assessed the prevalence of ...

Abstract	Aims: Up to 50% of patients with heart failure (HF) may suffer from severe cognitive impairment (SCI), but longitudinal studies are sparse, and effects of changes in HF severity on cognitive function are unknown. Therefore, we assessed the prevalence of SCI in HF patients, its relationship with HF severity, its effects on morbidity and mortality, and the relationship between changes in HF severity and cognitive function. Methods and results: We included 611 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) and assessed cognitive function [Hodkinson Abbreviated Mental Test (AMT)] in relation to severity of HF (NYHA class, NT-proBNP) at baseline and 18 months (n = 382) and effects on hospitalization-free survival and mortality. SCI (i.e. AMT score ≤ 7) was present in 9.2% of patients at baseline, but only 20% of them had a diagnosis of dementia. Prevalence of SCI remained stable during follow-up. SCI was present at baseline more often in NYHA IV patients compared with NYHA II [odds ratio 2.94; 95% confidence interval (CI) 1.15-7.51, P = 0.025], but it was not related to NT-proBNP levels. SCI was related to higher mortality (hazard ratio 1.53, 95% CI 1.02-2.30, P = 0.04), but not hospitalization-free survival. Changes in HF severity were not significantly related to changes in cognitive function. Conclusion: SCI is a frequent, but often unrecognized finding in HF patients, but the influence of HF severity and its changes on cognitive function were less than hypothesized. Trial registration ISRCTN43596477.
MeSH term(s)	Aged ; Aged, 80 and over ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Cognition Disorders/diagnosis ; Cognition Disorders/etiology ; Cognition Disorders/therapy ; Exercise Therapy ; Heart Failure/complications ; Heart Failure/diagnosis ; Heart Failure/therapy ; Hospitalization ; Humans ; Intelligence Tests ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prevalence ; Prospective Studies ; Severity of Illness Index
Chemical Substances	Angiotensin-Converting Enzyme Inhibitors ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2013-06
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1093/eurjhf/hft020
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