bluuebunny/crossref_metadata_2025 huggingface dataset:
Mineralisation of distinct biogas digestate qualities directly after application to soil
Authors: Barduca Laura , Wentzel Stefanie , Schmidt Reiner , Malagoli Mario , Joergensen Rainer Georg
Published: November 2020

Biogas is an important energy source produced by the anaerobic fermentation of raw faecal slurries and plant residues. Separation of the total digestate increases the fertilizer quality of the liquid fraction and the carbon sequestration potential of the solid fraction. A 12-day incubation study was carried out to investigate the relationships between the chemical composition of different digestate qualities and the immediate response of soil microbial activity and biomass indices. The highest cumulative (Σ) CO2-C efflux was observed after adding the solid fraction and lowest after adding the liquid fraction to soil, which was even lower than that of the control. The ΣCO2-C efflux showed the strongest negative correlation with the raw ash and strong positive correlations with the raw fibre concentration and the C/N ratio of the different digestate qualities. The highest and similar ΣN2O-N efflux was observed after adding the total digestate or the liquid fraction, which were equivalent to approximately 1% of added N. This relatively low percentage indicates a possible origin from nitrifier denitrification. Total digestate and its liquid fraction exhibited considerable net-N mineralisation rates, which could mainly be predicted by the C/N ratios of the different digestate qualities. Microbial biomass C did not respond to the application of any digestate quality, whereas the fungal ergosterol content increased after applying the solid and the composted solid fractions. This raw fibre–induced fungal growth led to strong net-N immobilisation in soil after applying these two digestate qualities.
The overall diet quality in childhood is prospectively associated with the timing of puberty
Authors: Duan Ruonan , Qiao Tian , Chen Yue , Chen Mengxue , Xue Hongmei , Zhou Xue , Yang Mingzhe , Liu Yan , Zhao Li , Libuda Lars , Cheng Guo
Published: November 2020

Purpose

The influences of nutrition in childhood on puberty onset could have sustained consequences for health and wellbeing later in life. The aim of this study was to investigate the prospective association of diet quality prior to puberty with the timing of puberty onset.

Methods

We considered data from 3983 SCCNG (Southwest China Childhood Nutrition and Growth) study participants with dietary data, anthropometric measurement, and information on potential confounders at their baseline assessment (mean age: 7.1 years for girls and 7.3 years for boys; mean length of follow-up was 4.2 years). Cox proportional hazard regression estimating hazard ratios (HRs) and 95% confidence intervals (CIs) were used to examine the relationship between diet quality and puberty onset. Dietary intake at baseline was assessed using a validated food frequency questionnaire. Diet quality was determined using the Chinese Children Dietary Index (CCDI) which measures adherence to current dietary recommendations (theoretical range: 0–160 points). Age at Tanner stage 2 for breast/genital development (B2/G2), menarche or voice break (M/VB) were used as pubertal markers.

Results

The CCDI score ranged from 56.2 to 136.3 for girls and 46.1–131.5 for boys. Pubertal markers consistently indicate that girls and boys with higher diet quality were more likely to enter their puberty later than their counterparts with lower CCDI scores (higher vs. lower CCDI tertiles: adjusted HR for age at B2: 0.85 (95% CI, 0.81–0.94), p for trend = 0.02; G2: 0.86 (95% CI,0.80–0.96), p for trend = 0.02; M: 0.86 (95% CI,0.80–0.95), p for trend = 0.02; VB: 0.86 (95% CI,0.79–0.98), p for trend = 0.03), after adjustment for paternal education level, baseline energy intake, and pre-pubertal body fat.

Conclusions

Our data suggested a later puberty onset and later timing of progressed puberty stages in children with a high diet quality, which were independent of pre-pubertal body fat.
Laparoscopic versus open right posterior sectionectomy: an international, multicenter, propensity score-matched evaluation
Authors: van der Heijde Nicky , Ratti Francesca , Aldrighetti Luca , Benedetti Cacciaguerra Andrea , Can Mehmet F. , D’Hondt Mathieu , Di Benedetto Fabrizio , Ivanecz Arpad , Magistri Paolo , Menon Krishna , Papoulas Michail , Vivarelli Marco , Besselink Marc G. , Abu Hilal Mohammed
Published: November 2020

Background

Although laparoscopic liver resection has become the standard for minor resections, evidence is lacking for more complex resections such as the right posterior sectionectomy (RPS). We aimed to compare surgical outcomes between laparoscopic (LRPS) and open right posterior sectionectomy (ORPS).

Methods

An international multicenter retrospective study comparing patients undergoing LRPS or ORPS (January 2007—December 2018) was performed. Patients were matched based on propensity scores in a 1:1 ratio. Primary endpoint was major complication rate defined as Accordion ≥ 3 grade. Secondary endpoints included blood loss, length of hospital stay (LOS) and resection status. A sensitivity analysis was done excluding the first 10 LRPS patients of each center to correct for the learning curve. Additionally, possible risk factors were explored for operative time, blood loss and LOS.

Results

Overall, 399 patients were included from 9 centers from 6 European countries of which 150 LRPS could be matched to 150 ORPS. LRPS was associated with a shorter operative time [235 (195–285) vs. 247 min (195–315) p = 0.004], less blood loss [260 (188–400) vs. 400 mL (280–550) p = 0.009] and a shorter LOS [5 (4–7) vs. 8 days (6–10), p = 0.002]. Major complication rate [n = 8 (5.3%) vs. n = 9 (6.0%) p = 1.00] and R0 resection rate [144 (96.0%) vs. 141 (94.0%), p = 0.607] did not differ between LRPS and ORPS, respectively. The sensitivity analysis showed similar findings in the previous mentioned outcomes. In multivariable regression analysis blood loss was significantly associated with the open approach, higher ASA classification and malignancy as diagnosis. For LOS this was the open approach and a malignancy.

Conclusion

This international multicenter propensity score-matched study showed an advantage in favor of LRPS in selected patients as compared to ORPS in terms of operative time, blood loss and LOS without differences in major complications and R0 resection rate.
Adrenomedullin for steroid-resistant ulcerative colitis: a randomized, double-blind, placebo-controlled phase-2a clinical trial
Authors: Kita Toshihiro , Ashizuka Sinya , Ohmiya Naoki , Yamamoto Takayuki , Kanai Takanori , Motoya Satoshi , Hirai Fumihito , Nakase Hiroshi , Moriyama Tomohiko , Nakamura Masanao , Suzuki Yasuo , Kanmura Shuji , Kobayashi Taku , Ohi Hidehisa , Nozaki Ryoichi , Mitsuyama Keiichi , Yamamoto Shojiro , Inatsu Haruhiko , Watanabe Koji , Hibi Toshifumi , Kitamura Kazuo
Published: November 2020

Background

Adrenomedullin (AM) is a bioactive peptide having many pleiotropic effects, including mucosal healing and immunomodulation. AM has shown beneficial effects in rodent models and in preliminary study for patients with ulcerative colitis (UC). We performed a clinical trial to investigate the efficacy and safety of AM in patients with UC.

Methods

This was a multi-center, double-blind, placebo-controlled phase-2a trial evaluating 28 patients in Japan with steroid-resistant UC. Patients were randomly assigned to four groups and given an infusion of 5, 10, 15 ng/kg/min of AM or placebo for 8 h per day for 14 days. The primary endpoint was the change in Mayo scores at 2 weeks. Main secondary endpoints included the change in Mayo scores and the rate of clinical remission at 8 weeks, defined as a Mayo score 0.

Results

No differences in the primary or secondary endpoints were observed among the four groups at 2 weeks. Despite the insufficient tracking rate, the Mayo score at 8 weeks was only significantly decreased in the high-dose AM group (15 ng/kg/min) compared with the placebo group (− 9.3 ± 1.2 vs. − 3.0 ± 2.8, P = 0.035), with its rate of clinical remission at 8 weeks being significantly higher (3/3, 100% vs. 0/2, 0%, P = 0.025). We noted mild but no serious adverse events caused by the vasodilatory effect of AM.

Conclusions

In this double-blind randomized trial, we observed the complete remission at 8 weeks in patients with steroid-resistant UC receiving a high dose of AM.

Clinical trial registry

JAPIC clinical trials information; Japic CTI-205255 (200410115290). https://www.clinicaltrials.jp/cti-user/trial/Search.jsp.
Increasing physical literacy in youth: A two-week Sport for Development program for children aged 6-10
Authors: Warner Marika , Robinson Jackie , Heal Bryan , Lloyd Jennifer , Mandigo James , Lennox Bess , Davenport Huyer Larkin
Published: November 2020

Regular physical activity significantly improves health outcomes, yet rates of childhood physical activity remain alarmingly low. Physical literacy has been identified as the foundation for quality physical education, suggesting that sport, education, and public health interventions should seek to increase physical literacy to promote physical activity. A two-week day camp program for children aged 6–10 facing barriers to positive development, was developed and delivered by a Sport for Development facility in Toronto, Canada. Utilizing fundamental movement skills (FMS) as a teaching tool and a pre- and post-assessment, the camp aimed to increase physical literacy and promote engagement in physical activity. Results indicate a significant increase in FMS (t (44) = 4.37, p < .001) as well as improved self-perceptions of physical literacy (t (40) = 14.96, p < .001). The largest FMS increases were found in running and balance and the most significant impacts were among low baseline performers.
Weekly hypofractionated radiation therapy in elderly non-resectable cutaneous squamous cell carcinoma of the head and neck region
Authors: De Felice Francesca , Musio Daniela , Tombolini Vincenzo
Published: November 2020

Introduction

Treatment of inoperable cutaneous squamous cell carcinoma (cSCC) of the head and neck region is still debated.

Case report

We report an original case of cure of cSCC of the head and neck region with weekly hypofractionated radiation therapy with megavoltage electrons prescribed for locally advanced inoperable disease.

Results

Weekly hypofractionated radiotherapy assured complete regression and was well-tolerated.

Conclusion

The real efficacy of this treatment in the therapeutic arsenal remains to be defined. A clinical trial is ongoing to test the use of 8 weekly fractions of 8 Gy hypofractionated RT regimens in non-resectable cSCC cases.
Decentralized modular production to increase supply chain efficiency in chemical markets
Authors: Becker Tristan , Bruns Bastian , Lier Stefan , Werners Brigitte
Published: November 2020

In the chemical industry, shortened product life cycles and greater differentiation of customer demand increase challenges to efficiently meet specific customer requirements. Thus, production systems with high flexibility are required. One innovative production concept that meets this requirement is decentralized, small-scale modular production which offers significantly more flexibility in the tactical configuration of the production network. Corresponding production plants are assembled from standardized apparatus modules in transportation containers, hereby enabling a fast relocation of modular plants and adjustments of the production process. Therefore, modular plants can be operated close to customers or suppliers, which supports local sourcing strategies and a reduction in delivery costs. In this paper, we analyze the advantages of these modular production systems for a case from the specialty chemicals industry. Respective advantages arise especially from a technically flexible design of parallel process lines, autonomous production and local sourcing. In order to evaluate economic efficiency and network configuration of modular production networks, an efficient mathematical formulation for the optimization is proposed. This formulation includes a new way to model relocations of modules. We apply this model to a case based on real data from the chemical industry. As a result of this application we come to three technical and managerial conclusions. Firstly, technical designs with parallel process lines improve flexibility and efficiency compared to mono processes. Secondly, autonomous production increases economic efficiency in contrast to staffed production and finally, local sourcing offers significant cost reduction potential compared to central sourcing.
Portrayal of the Germani in Latin Textbooks in Germany, 1945–1989
Authors: McNamara James David
Published: November 2020

This article is a contribution to the history of classical education, focused on the reception of Roman texts about Germania in German schools between 1945 and 1989. The period under discussion here represents a time during which there was an aversion to handling material tainted by its appropriation under Nazi ideology, and traces the development of new approaches to its treatment.
Forty years of study on interactions between walnut tree and arbuscular mycorrhizal fungi. A review
Authors: Mortier Emma , Lamotte Olivier , Martin-Laurent Fabrice , Recorbet Ghislaine
Published: November 2020

Walnut trees are among the most important hardwood species in the northern hemisphere, ecologically and economically. They are mainly cultivated for timber and nut production but are also attractive ornamental trees in parks. Establishing walnut orchards is difficult because seedlings have a coarse root architecture and few of them survive to transplanting. Planting success is mainly determined by the root system morphology and the nutrient status of the seedlings, so that rhizosphere conditions are critical for plant performance. Walnut trees can associate with soil-borne arbuscular mycorrhizal fungi, which are obligate biotrophs. In this association, plant-produced carbon compounds are traded against fungus-acquired soil mineral nutrients. The beneficial effect of arbuscular mycorrhizal symbiosis on hardwood seedling quality and field performance has long been known, but an integrated view is lacking about the effects of arbuscular mycorrhizas on walnut cropping. Therefore, we surveyed the literature published over the last 40 years to provide up-to-date knowledge on the relationships between arbuscular mycorrhizas and walnut trees. Our review outlines the major following points: (1) the arbuscular-mycorrhiza-mediated nutrient uptake capacity of walnut trees is associated with first- to third-order roots, and fibrous tip-ended roots are dependent on arbuscular mycorrhizal fungi, whereas pioneer roots are not; (2) early inoculation with arbuscular mycorrhizal fungi improves the survival and seedling performance attributes of transplanted walnut trees: biotization enhances walnut transplant success by increasing the number of lateral roots and plant P uptake, but these benefits are fungus- and host-dependent; (3) in the context of walnut agroforestry, deeply rooted walnut trees play a role as reservoirs of arbuscular mycorrhizal fungal propagules for the surrounding vegetation, but tree shade and soluble phosphate availability decrease walnut mycorrhizal dependency; and (4) the arbuscular mycorrhizal mycelium mediates the transport of juglone and thus plays a role in walnut tree allelopathy.
Wirksamkeit der schulischen Vor- und Nachbereitung eines Schülerlaborbesuches
Authors: Reimann Maria , Herzog Stefanie , Parchmann Ilka , Schwarzer Stefan
Published: November 2020

MINT-Schülerlabore sind non-formelle Lernorte, welche den Schulunterricht ergänzen sollen. Aufgrund ihrer anschaulichen, interaktiven und motivierenden Darbietungsmethoden können sich positive Effekte auf psychologische und kognitive Konstrukte zeigen, welche durch eine Verknüpfung mit dem schulischen Lernort nachhaltig gesichert werden sollen. Hierbei können berufsorientierende, interessebasierte und motivationale Aspekte sowie das Fähigkeitsselbstkonzept, die Selbstwirksamkeit und der Wissenserwerb positiv und langfristig beeinflusst werden. Im Rahmen dieser Studie wurde mit standortübergreifenden Daten von 752 gymnasialen und nicht-gymnasialen Lernenden anhand einer Prä-Post-Follow-up-Erhebung die Entwicklung der beschriebenen Konstrukte durch einen einfachen Schülerlaborbesuch sowie eine zusätzliche rein fachliche bzw. berufsorientierte schulische Vor- und Nachbereitung untersucht. Hierbei konnte durch die Intervention lediglich bei den kognitiven jedoch nicht bei den psychologischen Konstrukten eine positive Änderung erreicht werden. Zudem wurde im Rahmen eines Vergleichs der Konstrukt-Ausprägungen in den beiden Schulformen festgestellt, dass gymnasiale Lernende stärker selbstbestimmte motivationale Regulationen nutzen als nicht-gymnasiale Schülerinnen und Schüler. Diese Ergebnisse müssen aus diversen Blickwinkeln diskutiert werden.
Strategic decision-making under ambiguity: a new problem space and a proposed optimization approach
Authors: Arend Richard J.
Published: November 2020

The existence of ambiguity presents a challenge to decision-makers as it eliminates the ability to apply standard optimization approaches, such as those based on calculating the objective expected values of alternative actions. In reality, ambiguity arises in most strategically important decisions in some form because of the genuine limits on the decision-maker’s rationality and on the information available about the alternatives and the future. To address that reality, we define such problems as strategic decision-making under ambiguity where choices over resource investments must be made in competitive environments where possible outcomes and their payoffs are known ex ante, but the probabilities of such outcomes are unknowable ex ante. We outline a multi-step, logical approach for addressing such problems in theory with the goal of providing an improved basis for practical decisions that should increase organizational performance.
Cloud theory-based simulated annealing for a single-machine past sequence setup scheduling with scenario-dependent processing times
Authors: Wu Chin-Chia , Lin Win-Chin , Zhang Xin-Gong , Bai Dan-Yu , Tsai Yung-Wei , Ren Tao , Cheng Shuenn-Ren
Published: November 2020

Recently, the setup times or costs have become an important research topic. The main reason is huge economic savings can be achieved when setup times are explicitly included in scheduling decisions in various real-world industrial environments. On the other hand, many real systems commonly face various uncertainties, such as working environment changes, machine breakages, a worker becomes unstable, etc. In such an environment, job-processing times should not be fixed numbers. Motivated by these situations, this article introduces a single-machine scheduling problem with sequence-dependent setup times and scenario-dependent processing times where the objective function is the total completion time. The robust version of this problem without setup times has been shown to be NP hard. To tackle this problem, a lower bound and a dominance rule are derived in a branch-and-bound method for finding an optimal solution. As for determining approximate solutions, five neighborhood schemes are proposed and embedded in the cloud theory-based simulated annealing. Finally, the performances of all proposed algorithms are determined and compared.
An Overview on SARS-CoV-2 (COVID-19) and Other Human Coronaviruses and Their Detection Capability via Amplification Assay, Chemical Sensing, Biosensing, Immunosensing, and Clinical Assays
Authors: Orooji Yasin , Sohrabi Hessamaddin , Hemmat Nima , Oroojalian Fatemeh , Baradaran Behzad , Mokhtarzadeh Ahad , Mohaghegh Mohamad , Karimi-Maleh Hassan
Published: November 2020

A novel coronavirus of zoonotic origin (SARS-CoV-2) has recently been recognized in patients with acute respiratory disease. COVID-19 causative agent is structurally and genetically similar to SARS and bat SARS-like coronaviruses. The drastic increase in the number of coronavirus and its genome sequence have given us an unprecedented opportunity to perform bioinformatics and genomics analysis on this class of viruses. Clinical tests like PCR and ELISA for rapid detection of this virus are urgently needed for early identification of infected patients. However, these techniques are expensive and not readily available for point-of-care (POC) applications. Currently, lack of any rapid, available, and reliable POC detection method gives rise to the progression of COVID-19 as a horrible global problem. To solve the negative features of clinical investigation, we provide a brief introduction of the general features of coronaviruses and describe various amplification assays, sensing, biosensing, immunosensing, and aptasensing for the determination of various groups of coronaviruses applied as a template for the detection of SARS-CoV-2. All sensing and biosensing techniques developed for the determination of various classes of coronaviruses are useful to recognize the newly immerged coronavirus, i.e., SARS-CoV-2. Also, the introduction of sensing and biosensing methods sheds light on the way of designing a proper screening system to detect the virus at the early stage of infection to tranquilize the speed and vastity of spreading. Among other approaches investigated among molecular approaches and PCR or recognition of viral diseases, LAMP-based methods and LFAs are of great importance for their numerous benefits, which can be helpful to design a universal platform for detection of future emerging pathogenic viruses.
Network analysis of attitudes towards immigrants in Asia
Authors: Kawasaki Rachael Kei , Ikeda Yuichi
Published: November 2020

This study models cross-national attitudes towards immigrants in East and Southeast Asia as a signed and weighted bipartite network of countries and evaluative reactions to a variety of political issues, or determinants. This network is then projected into two one-mode networks, one of countries and one of determinants, and community detection methods are applied. The paper aims to fill two deficiencies in the current research on attitudes towards immigrants: 1) the lack of cross-national studies in Asia, a region where migration is growing, and 2) the tendency of researchers to treat determinants as uncorrelated, despite the interdependent nature of evaluative reactions. The results show that the nine countries in the sample are a cohesive clique, showing greater similarities than differences in the determinants of their attitudes. A blockmodeling approach was employed to identify eight determinants in attitudes towards immigrants, namely views on independence and social dependencies, group identities, absolute or relative moral orientation, attitudes towards democracy, science and technology, prejudice and stigma, and two determinants related to religion. However, the findings of this survey yielded some surprising results when compared with the literature review. First, education was not found to be a significant determinants of attitudes towards immigrants, despite its strong and consistent predictive power in European models. Second, prejudice appears to be mediated in part by religion, especially in religious identification and belief in God. Group identity and prejudice also appear to be related, though only weakly. Finally, anxiety appears in clusters related to social norms, suggesting that fears regarding immigrants relates closely to expectations of others’ behavior.
Fail to Prepare and you Prepare to Fail: the Human Rights Consequences of the UK Government’s Inaction during the COVID-19 Pandemic
Authors: Frowde Rhiannon , Dove Edward S. , Laurie Graeme T.
Published: November 2020

As the sustained and devastating extent of the coronavirus disease 2019 (COVID-19) pandemic becomes apparent, a key focus of public scrutiny in the UK has centred on the novel legal and regulatory measures introduced in response to the virus. When those measures were first implemented in March 2020 by the UK Government, it was thought that human rights obligations would limit excesses of governmental action and that the public had more to fear from unwarranted intrusion into civil liberties. However, within the first year of the pandemic’s devastation in the UK, a different picture has emerged: rather than through action, it is governmentalinactionthat has given rise to greater human rights concerns. The UK Government has been roundly criticized for its inadequate response, including missteps in decision-making, delayed implementation and poor enforcement of lockdown measures, abandonment of testing, shortages of critical resources and inadequate test and trace methods. In this article, we analyse the UK Government’s missteps and compare them with published international guidance; we also contrast the UK’s decisions with those taken by several other countries (including the devolved administrations within the UK) to understand how its actions and inactions have contributed to unfavourable outcomes. Using an analytical perspective that demonstrates how human rights are both a protection from the power of the state and a requirement that governmental powers are used to protect the lives, health and wellbeing of citizens, we argue that the UK Government’s failure to exercise their powers competently allowed the virus to spread without ensuring the country had the means to manage a high case load. This abject failure has led to one of the highest rates of deaths per capita worldwide. We offer several lessons that can be learnt from this unfortunate, but preventable, situation.
Music generation with variational recurrent autoencoder supported by history
Authors: Yamshchikov Ivan P. , Tikhonov Alexey
Published: November 2020

A new artificial neural network architecture that helps generating longer melodic patterns is introduced alongside with methods for post-generation filtering. The proposed approach, called variational autoencoder supported by history, is based on a recurrent highway gated network combined with a variational autoencoder. The combination of this architecture with filtering heuristics allows the generation of pseudo-live, acoustically pleasing, melodically diverse music.
Ubiquitinome Profiling Reveals the Landscape of Ubiquitination Regulation in Rice Young Panicles
Authors: Zhu Liya , Cheng Han , Peng Guoqing , Wang Shuansuo , Zhang Zhiguo , Ni Erdong , Fu Xiangdong , Zhuang Chuxiong , Liu Zexian , Zhou Hai
Published: November 2020

Ubiquitination, an essential post-transcriptional modification (PTM), plays a vital role in nearly every biological process, including development and growth. Despite its functions in plant reproductive development, its targets in rice panicles remain unclear. In this study, we used proteome-wide profiling of lysine ubiquitination in rice (O. sativa ssp. indica) young panicles. We created the largest ubiquitinome dataset in rice to date, identifying 1638 lysine ubiquitination sites on 916 unique proteins. We detected three conserved ubiquitination motifs, noting that acidic glutamic acid (E) and aspartic acid (D) were most frequently present around ubiquitinated lysine. Enrichment analysis of Gene Ontology (GO) annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of these ubiquitinated proteins revealed that ubiquitination plays an important role in fundamental cellular processes in rice young panicles. Interestingly, enrichment analysis of protein domains indicated that ubiquitination was enriched on a variety of receptor-like kinases and cytoplasmic tyrosine and serine-threonine kinases. Furthermore, we analyzed the crosstalk between ubiquitination, acetylation, and succinylation, and constructed a potential protein interaction network within our rice ubiquitinome. Moreover, we identified ubiquitinated proteins related to pollen and grain development, indicating that ubiquitination may play a critical role in the physiological functions in young panicles. Taken together, we reported the most comprehensive lysine ubiquitinome in rice so far, and used it to reveal the functional role of lysine ubiquitination in rice young panicles.
Memsift explores further markets for its technologies by focusing on North America
Authors: Atkinson Simon
Published: November 2020

Singapore-based Memsift Innovations Pte Ltd is continuing to explore further markets for its proprietary thermal separation process and membranes. Following an agreement formed earlier this year with a company in China, to jointly develop brine treatment and zero liquid discharge technology, it is now set to work with a USA-based centre that is dedicated to separation technology applied research and development, as this brief focus article explains.
Citations in Interdisciplinary Research Articles
Authors: Muguiro Natalia
Published: November 2020

This Element explores interdisciplinarity in academic writing. It describes the ways in which disciplines interact when forming interdisciplinary fields and how language reflects (and is reflected by) these interactions. Specifically, bibliographical citations are investigated in corpora of research articles from three interdisciplines: Educational Neuroscience, Economic History, and Science and Technology Studies, as well as the single-domain disciplines from which they are derived. Comparisons are carried out between the interdisciplinary fields and between those fields and their related single-domain disciplines. The study combines analysis of quantitative data and qualitative interpretation by means of close reading. It concludes that bibliographical citations constitute a viable tool to explore interdisciplinary writing in the fields explored. The Element demonstrates that it is possible to describe epistemologically distinct types of interdisciplinarity by means of linguistic evidence.
Decolonization is a process, not a goal: Encounters in the library of the Kunsthalle Basel
Authors: Erdede Nistiman , Vogel Regina , Foden-Lenahan Erica
Published: November 2020

Chance encounters, some several years apart, form the basis of this article between 2 librarians and an artist, all 3 considering the process of decolonizing libraries within the wider context of colonial legacies in the societies in which they were born and in which they now live. The librarians Regina Vogel and Erica Foden-Lenahan have been friends and colleagues for many years, and their personal conversations over the years have often involved discussions of equality and injustice. The overlap in their professional interests led to this article proposal. A serendipitous meeting between Vogel and decolonial artist and curator Nistiman Erdede at an event2 organized by Abendschule Import in co-operation with the famous Cabaret Voltaire in Zurich and later when he visited the Kunsthalle Basel where Vogel is the librarian, changed the original direction of the article, but presented an opportunity for a 3-way discussion of decolonization in the context of a Swiss and a German art library and a refugee artist's experience. The Covid-19 border and workplace lockdowns necessitated that some of these encounters happened virtually.
Unholy Alliances and their Threat: The Convergence of Terrorism, Organized Crime and Corruption
Authors: Viano Emilio C.
Published: November 2020

Since the tragedy of September 11, 2001 (9/11) there have been a growing awareness and recognition of the expanding threat presented by the transmutation and convergence of international organized crime and terrorist groups. There is a semantic debate on whether these organizations are “converging” or “transforming.” Regardless, this worrisome development is complicated and progressively difficult to combat and calls for law enforcement, intelligence and military interventions. While the United States and other countries have been dealing with the post-9/11 world of persistent problems like Iraq, Afghanistan, al Qaeda, “Islamic State in Iraq and Syria” (ISIS), Syria, and more, the links between organized crime and terrorism could prolong these challenges and generate further disruptions and menace to global security and development. There are strong operational needs and requirements that bring organized crime and terrorists together for collaboration and even seamless transitions within the same general operation. However, there are substantial hurdles that make a total teamwork between the two groups not so easily achievable. For example, organized crime normally avoids the publicity and the indiscriminate killings often used by terrorists. However, it is clear that the merging of international organized crime and terrorist groups is growing and presents unique challenges and opportunities. This paper examines this ongoing transmutation, convergence and cooperation between transnational organized crime and terrorism, and offers examples and recommendations on how to prevent it and defeat it.
Role of the Environment in Transmission of Multiresistant Enterobacter cloacae in a Hematology-Oncology Department
Authors: Zwet Wil Van der , Nijsen Yvonne , Alphen Lieke Van , Wintersdorff Christian Von , Beckers Erik , Savelkoul Paul
Published: November 2020

Background: The patient environment is increasingly considered a major source of transmission of nosocomial bacteria to patients. In May 2019, a cluster of 3 patients with multiresistant Enterobacter cloacae was discovered in the hematology-oncology department of the Maastricht University Medical Center (built in 1991). The strains had an identical antibiogram: ESBL-positive, ciprofloxacin R, cotrimoxazole R, meropenem S, and colistin S. One neutropenic patient had a positive blood culture for this strain, resistant to the empiric treatment with piperacillin-tazobactam, but the patient recovered after switching the antibiotic regimen to meropenem. All strains were determined to be identical by amplified-fragment length polymorphism and whole-genome multi-locus sequencing typing (genotype A). New cases occurred, despite the introduction of contact isolation of positive and contact patients. Therefore, weekly point-prevalence screening was introduced, in which more newly colonized patients were identified in the subsequent weeks. Attention to hand hygiene was enforced, and the hypothesis of contamination from “wet” environmental locations was tested by performing cultures of sinks and shower drains. In June and July, 47 of 241 environmental cultures (19.5%) were positive for E. cloacae with an identical antibiogram, among which some were typed as genotype A. To diminish the environmental contamination, all siphons of sinks were replaced, and disinfection of sinks and shower drains was intensified using chlorine and soda on a daily basis. Replacement of shower drains was not possible. After this intervention, the incidence of newly colonized patients declined gradually. A change in the regimen of selective gut decontamination in hematology patients was considered as an alternative intervention, but with the decrease in new patient cases, this was not implemented. A final round of environmental cultures at the end of August revealed 8 positive cultures, of which 5 were positive for genotype A. In retrospect, this finding could be explained by the fact that the cleaning team did not follow the intensified instructions for disinfection. From week 29, genotype A E. cloacae was no longer cultured in weekly patient screenings. Based on this observation, it is important that in (re)building plans for hospitals, a master plan for the prevention of nosocomial transmission from environment to patients is incorporated.

Funding: None

Disclosures: None
Rubella Outbreak in Heballi Agasi Ward, Dharwad District, Karnataka, India, 2014–2015
Authors: Mohankumar Sree Kalpana , Hiremath Vishweshwarayya , Koppad Rajashree
Published: November 2020

Background: Countries that have good rubella surveillance, report ∼10,000–20,000 rubella cases annually. In India, not many cases of rubella are reported. The Hebballi Agasi ward of Dharwad district in Karnataka state, India, reported rubella cases on the last week of January 2015. Objective: We investigated the outbreak by time, place, person, and clinical symptoms. Methods: We performed a cross-sectional study. We defined a case as any resident of Heballi Agasi who had fever and rash, with or without lymphadenopathy, arthralgia, conjunctivitis, coryza, and cough, after December 15, 2014. We collected sociodemographic details and clinical symptoms of patients. We collected 5 serum samples and sent them to the National Measles Laboratory, Bangalore. We tested for measles and rubella antibodies. We drew an epidemic curve and a spot map. We computed mean age of cases, and we calculated attack rates by mean age and gender. We calculated proportions to describe clinical symptoms, and we interviewed stakeholders regarding rubella vaccination. We continued surveillance until March 2015. Results: The population of Heballi Agasi was 1,458. We identified 15 rubella cases (9 girls and 6 boys). The outbreak lasted between December 10, 2014, and February 21, 2015, with a peak on January 16, 2015. The overall attack rate was 1% (15 of 1,458). The mean age of the cases was 6 years (range, 1–23). The attack rate was high (7.7%) among those aged 1–6 years (11 of 143). The attack rate among those aged >6 years was 0.3% (4 of 1,315). In addition to fever and rash, 93% of cases (14 of 15) had coryza, 47% had cough (7 of 15), and 40% had conjunctivitis (6 of 15). Lymphadenopathy was present in only 1 case (1 of 15), and arthralgia was absent among all 15 cases. There was no death among the cases. All 5 sera were positive for rubella and negative for measles. Rubella vaccination was not given for any of the cases because no rubella vaccination is provided in the routine immunization program. Conclusions: There was a rubella outbreak in Heballi Agasi ward. Children aged 1–6 years were most affected. We recommend rubella vaccination in the routine immunization.

Funding: None

Disclosures: None
Self-Contamination While Doffing Personal Protective Equipment
Authors: Silva Jaqueline Pereira da , Pennathur Priyadarshini , Salehi Hugh , Chasco Emily , Baloh Jure , Dukes Kimberly , Ward Melissa , Reisinger Heather , Abbott Loreen Herwaldt
Published: November 2020

Background: Personal protective equipment (PPE) effectiveness can be undermined by inappropriate doffing methods. Objective: We used human factors engineering methods to evaluate self-contamination during PPE doffing. Methods: In this study, 30 participants at a Midwestern academic hospital (A) donned and doffed 3 mask styles (n = 10), 2 gown styles (n = 10), and 2 glove styles (n = 10; the Doffy glove has a tab to facilitate doffing). Also, 30 additional participants at hospital A (residents or fellows, nurses, special isolation trained staff [SITS]) and 10 SITS at academic hospital B doffed a surgical mask, a breakaway neck gown, and exam gloves (PPE ensemble) twice: once while distracted with conversation and once when not distracted. We randomized the order in which participants used different PPE styles or they did the doffing scenario. We collected demographic data. We applied Glo Germ Mist (1.5 dilution in water) with a mucosal atomizer to participants’ PPE before they doffed. We video-recorded participants as they doffed, and we photographed their scrubs and exposed skin before and after each donning and doffing episode. We reviewed videos for doffing errors and photographs for fluorescent spots. We counted fluorescent spots and noted their locations. Results: Overall, 45 (64.3%) participants were women, 31 (44.3%) were nurses, 24 (34.3%) were physicians. Among the participants, 25 (35.7%) had >15 years of experience and 61 (87.1%) had some training in doffing. Participants frequently contaminated their skin or clothing while doffing (Table 1). For all scenarios, hands followed by the torso were contaminated most frequently. Analysis of the videos found that touching the gown front with bare hands was the most common doffing error. Fewer participants self-contaminated when using the Doffy glove without training than when using the standard exam glove. Although most participants in the glove trial indicated that they did not need to watch the Doffy glove training video again, most had difficulty doffing the Doffy glove with the beak method. Many participants stopped doffing to answer questions when they doffed the PPE ensemble during the interruption scenario. Conclusions: Self-contamination was very common with all PPE styles and during all scenarios. Distraction did not increase the risk of contamination. However, participants often stopped doffing to answer questions, which they rarely do in practice. Watching a video was inadequate training for the beak glove-doffing method. The Doffy glove, which decreased contamination compared with the standard glove in the untrained scenario, may have advantages over standard exam gloves and should be evaluated further.

Funding: None

Disclosures: None
Successful Diagnostic Stewardship for Clostridioides difficile Testing in Pediatrics
Authors: Halabi Katia , Saiman Lisa , Zachariah Philip , Acker Karen , Cannon Jean-Marie , Messina Maria , Mangino Diane , Balzer Krystal , Green Daniel , Salvatore Christine
Published: November 2020

Background: As many as 40% of infants aged ≤12 months and 10%–28% of children aged 13–24 months are colonized by Clostridioides difficile. The IDSA and the SHEA recommend that testing should never be routinely recommended for infants ≤12 months of age and should not be routinely performed for children 1–2 years of age unless other causes are excluded. We report implementation of C. difficile diagnostic stewardship at 2 children’s hospitals. Methods: We implemented age-based restrictions for C. difficile testing at hospital A (∼200-bed, free-standing, children’s hospital) and hospital B (∼100-bed children’s hospital within a larger hospital). Both sites are part of the same multicampus institution, and both used nucleic acid amplification testing to detect C. difficile throughout the study. In May 2018, we implemented an electronic order set for C. difficile that provided alerts to avoid testing young infants and patients with recent use of laxatives, stool softeners, or enemas, but providers could order C. difficile testing at their discretion. In October 2018, we implemented a more restrictive diagnostic stewardship algorithm for C. difficile. No testing was allowed for infants aged ≤12 months. Approval pediatric infectious diseases staff was required to test children aged 13–24 months. Pathology resident approval was required to test children aged ≥24 months who had received laxatives, stool softeners, or enemas within ≤24 hours. Clinical microbiology laboratory supervisors reinforced rejection of nondiarrheal stool specimens for testing. Providers at both campuses were informed about the new testing guidelines by e-mail. We compared the number of tests sent and positive cases of healthcare facility-onset C. difficile (HO-CDI) by age strata before and after the implementation of the restrictive testing algorithm. Results: After the intervention, the number of tests in infants significantly declined; 2 infants aged ≤12 months and 4 infants aged 13–24 months were tested for C. difficile (Table). After the intervention, the number of tests per month declined at hospital A, as did the number of HO-CDI cases at both hospitals. Rejections of nondiarrheal stools significantly increased after the intervention (P < .001). Conclusions:C. difficile diagnostic stewardship for children was successfully implemented using a rule-based alert system in the electronic health record. This intervention was associated with a reduced number of tests sent and cases of HO-CDI. This strategy was cost-saving and prevented misdiagnosis, unnecessary antibiotic therapy, and overestimation of HO-CDI rates.

Funding: None

Disclosures: None
Targeted Outpatient Fluoroquinolone Intervention utilizing an Integrated Electronic Health Record in the Bureau of Prisons
Authors: Long Deborah , Edmunds Alisha , Campbell Tyler , Long Michael
Published: November 2020

Background: Fluoroquinolones are the perfect target for antimicrobial stewardship programs (ASPs) due to their broad-spectrum nature, poor safety profile, and frequent misuse. In April 2019, the Bureau of Prisons (BOP) created a national antimicrobial stewardship clinical pharmacist consultant program. One of the program’s main initiatives was to screen active fluoroquinolone prescriptions for appropriateness and work with providers to tailor therapy as needed. Since July 2019, pharmacist consultants have utilized a singular system-wide electronic health record (EHR) to conduct fluoroquinolone prospective audit and feedback targeting all BOP sites across the country. The objective was to assess the national impact of prospective audit and feedback on outpatient fluoroquinolone prescriptions utilizing pharmacist consultants and an integrated EHR. Method: Reviews were conducted in a federal correctional setting including 122 BOP sites with an average daily population of 167,308 inmates. The ASP consisted of 7 pharmacists, each assigned a region across the country. Consultant pharmacists were in charge of conducting daily fluoroquinolone reviews within 72 hours of the prescription being written, utilizing a singular system-wide EHR to gain remote access to newly prescribed prescriptions along with all other pertinent information (ie, clinical notes, patient profiles, laboratory, and radiology). Interventions were sent via e-mail. Total fluoroquinolone prescriptions per 1,000 inmates during the preintervention period (July 1, 2018, to September 30, 2018) were compared to the postintervention period (July 1, 2019, to September 30, 2019), after the development of the clinical consultant program. Data were also collected during the 3-month postintervention period to include total fluoroquinolone prescriptions reviewed, total recommendations sent, percentage of recommendations accepted, and intervention types. Results: In total, 833 fluoroquinolone prescriptions of 1, 264 total prescriptions written (66%)were reviewed over the 3-month postintervention period. In total,192 interventions were recommended (23%). Of the interventions recommended, 65 (34%) were accepted. The most common intervention was to stop therapy (41%), followed by changing antibiotic (37%), and shorten therapy duration (8%). Total outpatient fluoroquinolone prescriptions decreased by 1.5 prescriptions per 1,000 patients after the intervention. Conclusions: Pharmacist-driven prospective audit and feedback on a national scale utilizing a singular system-wide EHR resulted in an overall decrease in outpatient fluoroquinolone prescriptions over short period of time.

Funding: None

Disclosures: None