bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Characterization of High-Touch Surfaces in Emergency Departments and Hemodialysis Facilities
Authors: Wang Tina , Barofsky Alana , Simon Matthew , Saiman Lisa , Furuya E. Yoko , Calfee David 
Published: November 2020

Background: The healthcare environment can serve as a reservoir for many microorganisms and, in the absence of appropriate cleaning and disinfection, can contribute to pathogen transmission. Identification of high-touch surfaces (HTS) in hospital patient rooms has allowed the recognition of surfaces that represent the greatest transmission risk and prioritization of cleaning and disinfection resources for infection prevention. HTS in other healthcare settings, including high-volume and high-risk settings such as emergency departments (EDs) and hemodialysis facilities (HDFs), have not been well studied or defined. Methods: Observations were conducted in 2 EDs and 3 HDFs using structured observation tools. All touch episodes, defined as hand-to-surface contact regardless of hand hygiene and/or glove use, were recorded. Touches by healthcare personnel, patients, and visitors were included. Surfaces were classified as being allocated to individual patients or shared among multiple patients. The number of touch episodes per hour was calculated for each surface to rank surfaces by frequency of touch. Results: In total, 28 hours of observation (14 hours each in EDs and HDFs) were conducted. 1,976 touch episodes were observed among 62 surfaces. On average, more touch episodes were observed per hour in HDFs than in EDs (89 vs 52, respectively). The most frequently touched surfaces in EDs included stretcher rails, privacy curtains, visitor chair arm rests and seats, and patient bedside tables, which together accounted for 68.8% of all touch episodes in EDs (Fig. 1). Frequently touched surfaces in HDFs included both shared and single-patient surfaces: 27.8% and 72.2% of HDF touch episodes, respectively. The most frequently touched surfaces in HDFs were supply cart drawers, dialysis machine control panels and keyboards, handwashing faucet handles, bedside work tables, and bed rail or dialysis chair armrests, which accounted for 68.4% of all touch-episodes recorded. Conclusions: To our knowledge, this is the first quantitative study to identify HTSs in EDs and HDFs. Our observations reveal that certain surfaces within these environments are subject to a substantially greater frequency of hand contact than others and that a relatively small number of surfaces account for most touch episodes. Notably, whereas HTSs in EDs were primarily single-patient surfaces, HTSs in HDFs included surfaces shared in the care of multiple patients, which may represent an even greater risk of patient-to-patient pathogen transmission than single-patient surfaces. The identification of HTSs in EDs and HDFs contributes to a better understanding of the risk of environment-related pathogen transmission in these settings and may allow prioritization and optimization of cleaning and disinfection resources within facilities.Funding: NoneDisclosures: None
Real-Time Identification of Patients Included in the CMS Bundled Payment Care Improvement (BPCI) Program
Authors: Korvink Michael , Martin John , Long Michael 
Published: November 2020

Background:
The Bundled Payment Care Improvement Program is a CMS initiative designed to encourage greater collaboration across settings of care, especially as it relates to an initial set of targeted clinical episodes, which include sepsis and pneumonia. As with many CMS incentive programs, performance evaluation is retrospective in nature, resulting in after-the-fact changes in operational processes to improve both efficiency and quality. Although retrospective performance evaluation is informative, care providers would ideally identify a patient’s potential clinical cohort during the index stay and implement care management procedures as necessary to prevent or reduce the severity of the condition. The primary challenges for real-time identification of a patient’s clinical cohort are CMS-targeted cohorts are based on either MS-DRG (grouping of ICD-10 codes) or HCPCS coding—coding that occurs after discharge by clinical abstractors. Additionally, many informative data elements in the EHR lack standardization and no simple and reliable heuristic rules can be employed to meaningfully identify those cohorts without human review. Objective: To share the results of an ensemble statistical model to predict patient risks of sepsis and pneumonia during their hospital (ie, index) stay. Methods: The predictive model uses a combination of Bernoulli Naïve Bayes natural language processing (NLP) classifiers, to reduce text dimensionality into a single probability value, and an eXtreme Gradient Boosting (XGBoost) algorithm as a meta-model to collectively evaluate both standardized clinical elements alongside the NLP-based text probabilities. Results: Bernoulli Naïve Bayes classifiers have proven to perform well on short text strings and allow for highly explanatory unstructured or semistructured text fields (eg, reason for visit, culture results), to be used in a both comparative and generalizable way within the larger XGBoost model. Conclusions: The choice of XGBoost as the meta-model has the benefits of mitigating concerns of nonlinearity among clinical features, reducing potential of overfitting, while allowing missing values to exist within the data. Both the Bayesian classifier and meta-model were trained using a patient-level integrated dataset extracted from both a patient-billing and EHR data warehouse maintained by Premier. The data set, joined by patient admission-date, medical record number, date of birth, and hospital entity code, allows the presence of both the coded clinical cohort (derived from the MS-DRG) and the explanatory features in the EHR to exist within a single patient encounter record. The resulting model produced F1 performance scores of .65 for the sepsis population and .61 for the pneumonia population.Funding: NoneDisclosures: None
Reduction in Methicillin-Resistant Staphylococcus aureus (MRSA) Surveillance in a Low-Prevalence Neonatal Intensive Care Unit Does Not Lead to Increase in Vancomycin Utilization
Authors: Shapiro Craig , Ravin Karen , Chan Shannon , Gable Maura , Gupta Ashish 
Published: November 2020

Background:
Methicillin-resistant Staphylococcus aureus (MRSA) infection in neonates is associated with significant morbidity, mortality, and hospital cost. Multiple studies have shown that these infections are often preceded by colonization, but no consensus has been established for MRSA surveillance. The impact of changing the surveillance strategy on vancomycin utilization has not been evaluated previously. Methods: Retrospective chart review of infants who underwent MRSA screening in a level IV NICU with all outborn neonates. A weekly surveillance PCR was obtained from the nares between July 2016 and June 2017 (phase 1) and only on admission and discharge between July 2017 and June 2018 (phase 2). Patients with a positive PCR were placed on contact precautions without decolonization. The χ2 test was performed to compare the 2 phases of screening, and the Student t test and the Fisher exact test were used to compare the characteristics of MRSA colonized infants. Vancomycin utilization was measured in days of therapy (DOT) per 1,000 NICU patient days. Results: In total, 689 infants underwent MRSA screening during the study period; 324 infants had weekly MRSA surveillance and 365 infants had screening at admission and discharge. There was no statistically significant difference in MRSA colonization rates (4.3% vs 3.0%) or MRSA colonization acquisition (negative to positive, 1.8% vs 1.0%) between the phases. Among MRSA-colonized patients, nearly 60% were colonized on admission. Nearly 40% of the infants became colonized with MRSA during their hospitalization, none of whom developed MRSA infections prior to discharge. Mean vancomycin utilization decreased from 38.55 to 30.16 DOT per 1,000 NICU patient days between the 2 study periods. Conclusions: In a level IV NICU with relatively low MRSA prevalence, the change in MRSA screening practice from weekly surveillance to surveillance upon admission and discharge demonstrated no difference in MRSA acquisition or infection. Overall vancomycin utilization also decreased during this period, suggesting a culture shift around antibiotic utilization. Further study is needed to evaluate the utility of MRSA screening, decolonization, and isolation practices in low-prevalence NICUs and to identify additional drivers of vancomycin utilization.Funding: NoneDisclosures: None
Reduction of Central-Line–Associated Bloodstream Infections in a Spinal Cord Injury Unit
Authors: Baer Stephanie L. , Larsh Amy Halcyon , Prunier Annalise , Thurmond Victoria , Goins Donna , Hickox Nancy , Gardenhire Mary , Walker Tiffany , Bernal Sarah , Nowacki Maryea , Griffin Lenora , Hunter-Watson Heather 
Published: November 2020

Background: Central-line–associated bloodstream infections (CLABSIs) are a complication of indwelling central venous catheters, which increase morbidity, mortality, and cost to patients. Objective: Due to increased rates in a spinal cord injury unit (SCIU), a performance improvement project was started to reduce CLABSI in the patient population. Methods: To reduce the incidence of CLABSI, a prevention bundle was adopted, and a peer-surveillance tool was developed to monitor compliance with the bundle. Staff were trained to monitor their peers and submit weekly surveillance. Audits were conducted by the clinical nurse leader with accuracy feedback. Bundle peer-surveillance was implemented in February of 2018 with data being fed back to leadership, peer monitors, and stakeholders. Gaps in compliance were addressed with peer-to-peer education, changes in documentation requirements, and meetings to improve communication and reduce line days. In addition, the use of an antiseptic-impregnated disc for vascular accesses was implemented for dressing changes. Further quality improvement cycles during the first 2 quarters of fiscal year 2019 included service-wide education reinforcement, identification in variance of practice, and reporting to staff and stakeholders. Results: CLABSI bundle compliance increased from 67% to 98% between February and October 2018. The weekly audit reporting accuracy improved from 33% to 100% during the same period. Bundle compliance was sustained through the fourth quarter of 2019 at 98%, and audit accuracy was 99%. The initial CLABSI rates the quarter prior to the intervention were 6.10 infections per 1,000 line days for 1 of the 3 SCIUs and 2.68 infections per 1,000 line days for the service overall. After the action plan was initiated, no CLABSIs occurred for the next 3 quarters in all SCIUs despite unchanged use of central lines (5,726 line days in 2018). The improvement was sustained, and the line days decreased slightly for 2019, with a fiscal year rate of 0.61 per 1,000 line days (ie, 3 CLABSIs in 4,927 central-line days). Conclusions: The incidence of CLABSI in the SCIU was reduced by an intensive surveillance intervention to perform accurate peer monitoring of bundle compliance with weekly feedback, communication, and education strategies, improvement of the documentation, and the use of antiseptic-impregnated discs for dressings. Despite the complexity of the patient population requiring long-term central lines, the CLABSI rate was greatly impacted by evidence-based interventions coupled with reinforcement of adherence to the bundle.Funding: NoneDisclosures: None
Macroporosity and Grain Density of Rubble Pile Asteroid (162173) Ryugu
Authors: Grott Matthias , Biele Jens , Michel Patrick , Sugita Seiji , Schröder Stefan , Sakatani Naoya , Neumann Wladimir , Kameda Shingo , Michikami Tatsuhiro , Honda Chikatoshi 
Published: November 2020

AbstractRubble pile asteroids such as (162173) Ryugu have large bulk porosities, which are believed to result from void spaces in between the constituent boulders (macroporosity) as well as void spaces within the boulders themselves (microporosity). In general, both macroporosity and microporosity are estimated based on comparisons between the asteroid bulk density and both the bulk and grain density of meteorite analogs, and relatively large macroporosities are usually obtained. Here we use semiempirical models for the macroporosity of multicomponent mixtures to determine Ryugu's macroporosity based on the observed size‐frequency distribution (SFD) of boulders on the surface. We find that Ryugu's macroporosity can be significantly smaller than usually assumed, as the observed SFD allows for an efficient packing of boulders, resulting in a macroporosity of 16% ± 3%. Therefore, we confirm that Ryugu's high bulk porosity is a direct consequence of a very large boulder microporosity. Furthermore, using estimates of boulder microporosity of around 50% as derived from in situ measurements, the average grain density in boulders is 2,848 ± 152 kg m–3, similar to values obtained for CM and the Tagish lake meteorites. Ryugu's bulk porosity corresponding to the above values is 58%. Thus, the macroporosity of rubble pile asteroids may have been systematically overestimated in the past.
Food or just a free ride? A meta-analysis reveals the global diversity of the Plastisphere
Authors: Wright Robyn J , Langille Morgan G I , Walker Tony R 
Published: November 2020

Abstract
It is now indisputable that plastics are ubiquitous and problematic in ecosystems globally. Many suggestions have been made about the role that biofilms colonizing plastics in the environment—termed the “Plastisphere”—may play in the transportation and ecological impact of these plastics. By collecting and re-analyzing all raw 16S rRNA gene sequencing and metadata from 2,229 samples within 35 studies, we have performed the first meta-analysis of the Plastisphere in marine, freshwater, other aquatic (e.g., brackish or aquaculture) and terrestrial environments. We show that random forest models can be trained to differentiate between groupings of environmental factors as well as aspects of study design, but—crucially—also between plastics when compared with control biofilms and between different plastic types and community successional stages. Our meta-analysis confirms that potentially biodegrading Plastisphere members, the hydrocarbonoclastic Oceanospirillales and Alteromonadales are consistently more abundant in plastic than control biofilm samples across multiple studies and environments. This indicates the predilection of these organisms for plastics and confirms the urgent need for their ability to biodegrade plastics to be comprehensively tested. We also identified key knowledge gaps that should be addressed by future studies.
Genomics and metatranscriptomics of biogeochemical cycling and degradation of lignin-derived aromatic compounds in thermal swamp sediment
Authors: Levy-Booth David J , Hashimi Ameena , Roccor Raphael , Liu Li-Yang , Renneckar Scott , Eltis Lindsay D , Mohn William W 
Published: November 2020

AbstractThermal swamps are unique ecosystems where geothermally warmed waters mix with decomposing woody biomass, hosting novel biogeochemical-cycling and lignin-degrading microbial consortia. Assembly of shotgun metagenome libraries resolved 351 distinct genomes from hot-spring (30–45 °C) and mesophilic (17 °C) sediments. Annotation of 39 refined draft genomes revealed metabolism consistent with oligotrophy, including pathways for degradation of aromatic compounds, such as syringate, vanillate, p-hydroxybenzoate, and phenol. Thermotolerant Burkholderiales, including Rubrivivax ssp., were implicated in diverse biogeochemical and aromatic transformations, highlighting their broad metabolic capacity. Lignin catabolism was further investigated using metatranscriptomics of sediment incubated with milled or Kraft lignin at 45 °C. Aromatic compounds were depleted from lignin-amended sediment over 148 h. The metatranscriptomic data revealed upregulation of des/lig genes predicted to specify the catabolism of syringate, vanillate, and phenolic oligomers in the sphingomonads Altererythrobacter ssp. and Novosphingobium ssp., as well as in the Burkholderiales genus, Rubrivivax. This study demonstrates how temperature structures biogeochemical cycling populations in a unique ecosystem, and combines community-level metagenomics with targeted metatranscriptomics to identify pathways with potential for bio-refinement of lignin-derived aromatic compounds. In addition, the diverse aromatic catabolic pathways of Altererythrobacter ssp. may serve as a source of thermotolerant enzymes for lignin valorization.
KPNB1-mediated nuclear translocation of PD-L1 promotes non-small cell lung cancer cell proliferation via the Gas6/MerTK signaling pathway
Authors: Du Wenwen , Zhu Jianjie , Zeng Yuanyuan , Liu Ting , Zhang Yang , Cai Tingting , Fu Yulong , Zhang Weijie , Zhang Ruochen , Liu Zeyi , Huang Jian-an 
Published: November 2020

AbstractIn addition to the role of programmed cell death ligand 1 (PD-L1) in facilitating tumour cells escape from immune surveillance, it is considered as a crucial effector in transducing intrinsic signals to promote tumour development. Our previous study has pointed out that PD-L1 promotes non-small cell lung cancer (NSCLC) cell proliferation, but the mechanism remains elusive. Here we first demonstrated that PD-L1 expression levels were positively correlated with p-MerTK levels in patient samples and NSCLC cell lines. In addition, PD-L1 knockdown led to the reduced phosphorylation level of MerTK in vitro. We next showed that PD-L1 regulated NSCLC cell proliferation via Gas6/MerTK signaling pathway in vitro and in vivo. To investigate the underlying mechanism, we unexpectedly found that PD-L1 translocated into the nucleus of cancer cells which was facilitated through the binding of Karyopherin β1 (KPNB1). Nuclear PD-L1 (nPD-L1), coupled with transcription factor Sp1, regulated the synthesis of Gas6 mRNA and promoted Gas6 secretion to activate MerTK signaling pathway. Taken together, our results shed light on the novel role of nPD-L1 in NSCLC cell proliferation and reveal a new molecular mechanism underlying nPD-L1-mediated Gas6/MerTK signaling activation. All above findings provide the possible combinational implications for PD-L1 targeted immunotherapy in the clinic.
A spatial emergent constraint on the sensitivity of soil carbon turnover to global warming
Authors: Varney Rebecca M. , Chadburn Sarah E. , Friedlingstein Pierre , Burke Eleanor J. , Koven Charles D. , Hugelius Gustaf , Cox Peter M. 
Published: November 2020

AbstractCarbon cycle feedbacks represent large uncertainties in climate change projections, and the response of soil carbon to climate change contributes the greatest uncertainty to this. Future changes in soil carbon depend on changes in litter and root inputs from plants and especially on reductions in the turnover time of soil carbon (τs) with warming. An approximation to the latter term for the top one metre of soil (ΔCs,τ) can be diagnosed from projections made with the CMIP6 and CMIP5 Earth System Models (ESMs), and is found to span a large range even at 2 °C of global warming (−196 ± 117 PgC). Here, we present a constraint on ΔCs,τ, which makes use of current heterotrophic respiration and the spatial variability of τs inferred from observations. This spatial emergent constraint allows us to halve the uncertainty in ΔCs,τ at 2 °C to −232 ± 52 PgC.
An HDAC6-dependent surveillance mechanism suppresses tau-mediated neurodegeneration and cognitive decline
Authors: Trzeciakiewicz Hanna , Ajit Deepa , Tseng Jui-Heng , Chen Youjun , Ajit Aditi , Tabassum Zarin , Lobrovich Rebecca , Peterson Claire , Riddick Natallia V. , Itano Michelle S. , Tripathy Ashutosh , Moy Sheryl S. , Lee Virginia M. Y. , Trojanowski John Q. , Irwin David J. , Cohen Todd J. 
Published: November 2020

AbstractTauopathies including Alzheimer’s disease (AD) are marked by the accumulation of aberrantly modified tau proteins. Acetylated tau, in particular, has recently been implicated in neurodegeneration and cognitive decline. HDAC6 reversibly regulates tau acetylation, but its role in tauopathy progression remains unclear. Here, we identified an HDAC6-chaperone complex that targets aberrantly modified tau. HDAC6 not only deacetylates tau but also suppresses tau hyperphosphorylation within the microtubule-binding region. In neurons and human AD brain, HDAC6 becomes co-aggregated within focal tau swellings and human AD neuritic plaques. Using mass spectrometry, we identify a novel HDAC6-regulated tau acetylation site as a disease specific marker for 3R/4R and 3R tauopathies, supporting uniquely modified tau species in different neurodegenerative disorders. Tau transgenic mice lacking HDAC6 show reduced survival characterized by accelerated tau pathology and cognitive decline. We propose that a HDAC6-dependent surveillance mechanism suppresses toxic tau accumulation, which may protect against the progression of AD and related tauopathies.
Hybrid low-voltage physical unclonable function based on inkjet-printed metal-oxide transistors
Authors: Scholz Alexander , Zimmermann Lukas , Gengenbach Ulrich , Koker Liane , Chen Zehua , Hahn Horst , Sikora Axel , Tahoori Mehdi B. , Aghassi-Hagmann Jasmin 
Published: November 2020

AbstractModern society is striving for digital connectivity that demands information security. As an emerging technology, printed electronics is a key enabler for novel device types with free form factors, customizability, and the potential for large-area fabrication while being seamlessly integrated into our everyday environment. At present, information security is mainly based on software algorithms that use pseudo random numbers. In this regard, hardware-intrinsic security primitives, such as physical unclonable functions, are very promising to provide inherent security features comparable to biometrical data. Device-specific, random intrinsic variations are exploited to generate unique secure identifiers. Here, we introduce a hybrid physical unclonable function, combining silicon and printed electronics technologies, based on metal oxide thin film devices. Our system exploits the inherent randomness of printed materials due to surface roughness, film morphology and the resulting electrical characteristics. The security primitive provides high intrinsic variation, is non-volatile, scalable and exhibits nearly ideal uniqueness.
Changes in physiological activities and root exudation profile of two grapevine rootstocks reveal common and specific strategies for Fe acquisition
Authors: Marastoni Laura , Lucini Luigi , Miras-Moreno Begoña , Trevisan Marco , Sega Davide , Zamboni Anita , Varanini Zeno 
Published: November 2020

AbstractIn several cultivation areas, grapevine can suffer from Fe chlorosis due to the calcareous and alkaline nature of soils. This plant species has been described to cope with Fe deficiency by activating Strategy I mechanisms, hence increasing root H+ extrusion and ferric-chelate reductase activity. The degree of tolerance exhibited by the rootstocks has been reported to depend on both reactions, but to date, little emphasis has been given to the role played by root exudate extrusion. We studied the behaviour of two hydroponically-grown, tolerant grapevine rootstocks (Ramsey and 140R) in response to Fe deficiency. Under these experimental conditions, the two varieties displayed differences in their ability to modulate morpho-physiological parameters, root acidification and ferric chelate reductase activity. The metabolic profiling of root exudates revealed common strategies for Fe acquisition, including ones targeted at reducing microbial competition for this micronutrient by limiting the exudation of amino acids and sugars and increasing instead that of Fe(III)-reducing compounds. Other modifications in exudate composition hint that the two rootstocks cope with Fe shortage via specific adjustments of their exudation patterns. Furthermore, the presence of 3-hydroxymugenic acid in these compounds suggests that the responses of grapevine to Fe availability are rather diverse and much more complex than those usually described for Strategy I plants.