bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Assessment of Deep Venous Thrombosis and Its Influencing Factors in Burn Patients
Authors: Peng Huan , Yue Liqing , Gao Hongmei , Zheng Ruolan , Liang Penghui , Wang Ang , He Ailan 
Published: July 2020

Abstract
The objective of this study is to explore the relevant risk factors of deep venous thrombosis (DVT) in burn patients. A retrospective analysis was conducted for the medical records of 845 hospitalized burn patients from September 2012 to August 2017. Caprini thrombosis risk assessment scale (CTRAS) was employed for evaluating the risks of DVT. Based upon whether or not DVT occurred, they were divided into non-DVT group (n = 830) and DVT group (n = 15). Among 360 (42.7%) patients with high-risk Caprini scores, only 30 patients received color Doppler examination of lower limb veins, and 15 patients were diagnosed as DVT with a diagnostic rate of 1.8%. Caprini scores of non-DVT and DVT groups were 4.30 ± 2.71 and 9.87 ± 1.46 points, respectively. There was statistically significant difference (P &lt; .05). As revealed by stepwise Logistic regression analysis, age, lower limb burn, wound infection, femoral vein catheterization, and long bedriddening time (&gt;40 days) were independent risk factors for DVT. Burn patients are particularly prone to develop DVT. Age, wound infection, femoral vein catheterization, and long bedriddening time (&gt;40 days) are risk factors. Aggressive preventive measures of DVT should be implemented.
Structure of accretion flows in the nova-like cataclysmic variable RW Tri
Authors: Subebekova G , Zharikov S , Tovmassian G , Neustroev V , Wolf M , Hernandez M-S , Kučáková H , Khokhlov S 
Published: July 2020

ABSTRACT
We obtained photometric observations of the nova-like (NL) cataclysmic variable RW Tri and gathered all available AAVSO and other data from the literature. We determined the system parameters and found their uncertainties using the code developed by us to model the light curves of binary systems. New time-resolved optical spectroscopic observations of RW Tri were also obtained to study the properties of emission features produced by the system. The usual interpretation of the single-peaked emission lines in NL systems is related to the bi-conical wind from the accretion disc’s inner part. However, we found that the Hα emission profile is comprised of two components with different widths. We argue that the narrow component originates from the irradiated surface of the secondary, while the broader component’s source is an extended, low-velocity region in the outskirts of the accretion disc, located opposite to the collision point of the accretion stream and the disc. It appears to be a common feature for long-period NL systems – a point we discuss.
Measuring the eccentricity of GW170817 and GW190425
Authors: Lenon Amber K , Nitz Alexander H , Brown Duncan A 
Published: July 2020

ABSTRACT
Two binary neutron star mergers, GW170817 and GW190425, have been detected by Advanced LIGO and Virgo. These signals were detected by matched-filter searches that assume that the star’s orbit has circularized by the time their gravitational-wave emission is observable. This suggests that their eccentricity is low, but full parameter estimation of their eccentricity has not yet been performed. We use gravitational-wave observations to measure the eccentricity of GW170817 and GW190425. We find that the eccentricity at a gravitational-wave frequency of 10 Hz is e ≤ 0.024 and e ≤ 0.048 for GW170817 and GW190425, respectively (90 per cent confidence). This is consistent with the binaries being formed in the field, as such systems are expected to have circularized to e ≤ 10−4 by the time they reach the LIGO–Virgo band. Our constraint is a factor of 2 smaller that an estimate based on GW170817 being detected by searches that neglect eccentricity. However, we caution that we find significant prior dependence in our limits, suggesting that there is limited information in the signals. We note that other techniques used to constrain binary neutron star eccentricity without full parameter estimation may miss degeneracies in the waveform, and that for future signals, it will be important to perform full parameter estimation with accurate waveform templates.
Disequilibrium of Plasma Protease/Anti-Protease Due to Severe Periodontal Disease Contributes to Human Subarachnoid Hemorrhage
Authors: Yoshioka Shotaro , Miyamoto Takeshi , Satomi Junichiro , Tada Yoshiteru , Yagi Kenji , Shimada Kenji , Naruishi Koji , Shikata Eiji , Yamaguchi Izumi , Yamaguchi Tadashi , Korai Masaaki , Okayama Yoshihiro , Harada Masafumi , Kitazato Keiko T , Kanematsu Yasuhisa , Nagahiro Shinji , Takagi Yasushi 
Published: July 2020

ABSTRACT

BACKGROUND
The pathophysiology of subarachnoid hemorrhages (SAHs) due to ruptured intracranial aneurysms (IAs) remains unclear. Although a relationship between SAHs and periodontal disease (PD) has been suggested, the mechanism requires clarification.

OBJECTIVE
To evaluate the relationship between PD and SAHs and to identify periodontal pathogens associated with SAHs.

METHODS
This prospective study included consecutive patients with ruptured (n = 11) and unruptured (n = 14) IAs and healthy controls (n = 8). The plasma and plaque subgingival bacterial deoxyribonucleic acid (DNA) levels in PD were evaluated by a dentist using the Community Periodontal Index of Treatment Needs (CPITN). Plasma levels of matrix metalloproteinase (MMP-9), tissue inhibitors of matrix metalloproteinase (TIMP2), and procollagen I were analyzed.

RESULTS
Patients with ruptured IAs, had significantly higher CPITN scores than the controls, suggesting that ruptured IAs were associated with severe PD. Although no rupture-specific bacteria were identified, the positive rate of plaque subgingival bacterial DNA was significantly higher in patients with severe PD than in those without severe PD. Multivariate logistic regression analysis indicated that bleeding on probing (BOP) was associated with ruptured IAs (odds ratio, 1.10; 95% confidence interval 1.04–1.20; P = .0001). BOP was positively associated with plasma MMP-9 levels and a disequilibrium in the MMP-9/TIMP2 ratio. BOP was negatively correlated with plasma procollagen I levels (P < .05, for each). This suggested that local inflammation with severe PD might have systemic effects and lead to ruptured IAs.

CONCLUSION
Disequilibrium of plasma protease/anti-protease associated with a high BOP rate in severe PD may be attributable to IA rupture.
Positive Impact of a Point-of-Care Molecular Influenza Test in the Emergency Department During the 2017–2018 Seasonal Influenza Epidemic
Authors: Martinot Martin , Greigert Valentin , Gravier Simon , Klein Stephane , Eyriey Magali , Pachart Anne , Kaiser Jean-Daniel , Zadeh Mahsa Mohseni , De Briel Dominique , Gottwalles Yannick , Thibaud Eric 
Published: July 2020

Abstract
During the 2017–2018 flu epidemic, the point-of-care Alere-i (n = 72) and reverse transcription polymerase chain reaction (n = 106) tests were compared. Patients in the point-of-care group were administered oseltamivir significantly more rapidly (9 hours vs 23 hours), they spent less time in the emergency department, and they had lower rates of antibiotic administration and hospitalization.
1413. Surveillance of Variant Creutzfeldt Jakob Disease, Based on the Non-confirmatory Diagnostic Criteria of the EU Case Definition, Greece, 2014–2018
Authors: Dougas Georgios , Mellou Kassiani , Mitrou Konstantinos , Kontopidou Flora , Georgakopoulou Theano , Tsiodras Sotirios 
Published: July 2020

Abstract

Background
Variant Creutzfeldt–Jakob disease (vCJD), is a form of CJD associated with consumption of tissues from cattle infected with bovine spongiform encephalopathy. Confirmation requires cerebral histopathologic examination, ascertaining spongiform change and extensive prion protein deposition with florid plaques. In Greece, the disease has been included in the Mandatory Notification System since 2004 however no reference laboratory has been available since 2009 due to low global occurrence. In 2014, the surveillance system was strengthened to also include possible and probable cases based on the non-confirmatory diagnostic criteria of the EU case definition. Hereby we present the results of the surveillance for 2014–2018.

Methods
A new reporting form for CJD was introduced at the national level, including fields aligned with EU case definition criteria for vCJD (preconditions, clinical, diagnostic, and epidemiological). The non-confirmatory diagnostic criteria for the classification of probable and possible vCJD cases were based on examinations routinely available at hospitals, namely EEG and cerebral MRI. Reported CJD cases were assessed according to the fulfillment of required combinations of EU criteria for possible, probable, and confirmed vCJD cases.

Results
From 2014 to 2018, 37 CJD cases were reported, with a median age of 67 years (IQR: 58–73) concerning mostly females (71.3%, 95% CI: 56.7–85.9%). Among the reported cases, 6 (16.2%) fulfilled only the preconditions, 8 (21.6%) fulfilled the preconditions and the clinical criteria, 21 (56.8%) had a compatible EEG, and 7 (18.9%) had a compatible MRI brain scan. Confirmatory examination was not performed to any of the CJD cases; however, no case was classified as possible or probable vCJD based on the EU case definition.

Conclusion
Notification of CJD patients from 2014 to 2018 in Greece, yielded no vCJD cases. The possible re-emergence of vCJD renders continuous surveillance of the disease imperative. Current EU case definition can support the surveillance of vCJD, by screening CJD patients for possible and probable vCJD cases with the utilization of conventional diagnostic examinations, available in most hospitals.

Disclosures
All authors: No reported disclosures.
1760. Outcomes of Acyclovir-Resistant Herpes Simplex Virus Infections in Hematologic Malignancies and Hematopoietic Cell Transplant
Authors: Ross Justine Abella , Dickter Jana , Tegtmeier Bernard , Dadwal Sanjeet 
Published: July 2020

Abstract

Background
Acyclovir-resistant (ACVr) herpes simplex virus (HSV) infection management is a challenge in patients with hematologic malignancies (HM) and hematopoietic cell transplant (HCT) recipients.

Methods
Retrospective review of patients aged ≥ 18 years with underlying HM and/or HCT and culture-positive ACVr HSV between 1/1/2009 and December 1/2017 at a tertiary cancer center. Clinical, laboratory, microbiological, and treatment data collected.

Results
33 patients identified; 25 (76%) acute leukemias, 3 (9%) chronic myeloid leukemia/chronic lymphocytic leukemia (CML/CLL), 3 (9%) lymphoma, 2 (6%) other HM, and 32 (97%) had HCT. Median age of patients was 59 years (25–73) and 64% of them are females. HCT type: 22 (67%) matched unrelated donor, 3 (9%) cord blood, and 7 (21%) matched related donor. All patients were on acyclovir prophylaxis prior to diagnosis. The median time to onset of ACVr HSV infection was 147 days after transplant. Infection site: 16 (49%) oral, 10 (30%), ano-genital, 5 (15%) oral and esophagus/lung, 2 (6%) esophagus/lung. Pertinent laboratory data on day of viral culture (median/range): white blood cell (WBC) 4.6 cells/µL (0.1–85.9), absolute neutrophil count (ANC) 2,316 cells/µL (0–17,000), absolute lymphocyte count (ALC) 574.5 cells/µL (0–84,182). Serum creatinine at start and end of treatment are 0.8 mg/dL (0.32–1.98) and 0.92 mg/dL (0.36–2.7), respectively. The median duration of treatment was 30 days (4–116). Treatment: 20 (61%) foscarnet, 2 (6%) cidofovir, 4 (12%) foscarnet and cidofovir, 1 (3%) valacyclovir, 5 (15%) high-dose acyclovir, 1 (3%) unknown. 8 (24%) received adjunctive topical therapy: 5 imiquimod, 3 cidofovir. 31 included in outcome analysis (data missing in 2). Infection resolved in 15/31 (48%) while 5/31 (16%) had persistent infection. Median ANC and ALC in those with resolved vs. persistent infection (respectively): 3,082 cells/µL and 642 cells/µL vs. 1,895 cells/µL and 380 cells/µL with a trend toward lower ANC and ALC in patients with persistent infection. Overall mortality was 35% (9/31) while ACVr HSV attributable mortality was 6.4% (2/31).

Conclusion
ACVr HSV is predominantly encountered in allogeneic HCT, particularly the unrelated donor recipients, and lower ANC/ALC may predispose to persistent infection.

Disclosures
All authors: No reported disclosures.
2258. Correlation of Electroencephalogram Findings and Dose Relative to Renal Function among Patients with Possible Cefepime-Induced Encephalopathy
Authors: Pettit Natasha N , Pisano Jennifer , Alshaikh Jumana T , Rangarajan Aditi , Issa Naoum 
Published: July 2020

Abstract

Background
Cefepime-induced encephalopathy (CIE) is thought to be a rare toxicity, with an overall incidence of &lt;1%. However, the low incidence may be a result of under-recognition and difficulty in identifying the exact etiology of encephalopathy in hospitalized patients. Among patients with suspected CIE, electroencephalograms (EEGs) sometimes show abnormal activity like triphasic waveforms (TPWs). We asked whether the incidence of EEG findings consistent with CIE varies with cefepime (CFP) dose relative to eGFR (dose/eGFR). We also compared the incidence of these EEG findings in patients receiving CFP to the incidence in patients receiving piperacillin–tazobactam (PT).

Methods
In a retrospective analysis, data between 8/1/2016 and 5/24/2018 were extracted from the University of Chicago Clinical Data Warehouse. Patients 20–79 years old who received PT or CFP were included; those requiring renal replacement therapy or who had eGFR &lt;10 mL/minute/BSA at baseline were excluded. The average daily dose of PT or CFP was calculated to determine dose/eGFR. Linear or logistic regressions were performed in STATA.

Results
EEGs were obtained in 66 (4.3%) of 1525 patients receiving CFP and in 28 (3.3%) of 842 receiving PT. TPWs were present in 19 (28%) of EEGs from the CFP group, and in none of the EEGs from the PT group. Figure 1 shows the correlation between CFP dose/eGFR ratio and occurrence/severity of TPWs. Ordered logistic regression analysis identified a coefficient of 20.9 (95% CI; 3.7–38.2). Figure 2 shows only a weak association between CFP dose/eGFR and background frequency (BFS; R2 = 0.05). In the PT group, BFS was not correlated with PT dose/eGFR (R2 = 0.01).

Conclusion
TPWs were more likely to be found in patients receiving CFP than PT, suggesting that in the absence of other metabolic abnormalities, TPWs might be specific for CFP. Higher CFP dose-to-eGFR ratios predispose to and potentially worsen the severity of TPWs. Unlike TPWs, BFS was only weakly associated with CFP dose/eGFR and even less associated with PT dose/eGFR ratio.

Disclosures
All authors: No reported disclosures.
648. Baloxavir Resistance: qPCR Detection of Antiviral Resistance Markers in Influenza A Virus
Authors: Tyler Aaron J , Grantham James , Diaz Manisha , Miralles Mauricio , Bartlett Katelyn , Foland Derek , Berg Amy , Howard Karen , Nelsen Donald J , Westergaard Jordyn , Wissel Mark , Kleiboeker Steve , Altrich Michelle 
Published: July 2020

Abstract

Background
Influenza (flu) infections affect a large subset of the population every year and have significant impacts on the health of patients, especially those with weak or compromised immune systems such as the elderly, children, cancer patients, and transplant recipients. Baloxavir marboxil was approved in October 2018 as a novel antiviral therapeutic for treating flu. During clinical trials, mutations were identified at the I28 codon of the polymerase acidic (PA) protein that greatly increased the resistance of a flu strain to this novel drug. In this study, a qPCR was developed and validated to identify these resistance mutations, allowing for guided therapy based on the resistance profile of the strain.

Methods
Flu A sequences (6,175) of the PA gene from the NCBI Influenza Virus Database collected over the last 5 years were compiled and aligned. Primers and probes were designed to target the I38 codon of the PA gene, and specific probes for each codon yielding a resistant amino acid mutation (I38T, -M, and -F) were designed. Locked nucleic acid (LNA) bases were used to increase the specificity of the probes. A combination of clinical flu specimens, laboratory strains, and synthetic constructs of each potential resistance mutation were used to validate the precision, sensitivity, and accuracy of the assay in nasopharyngeal swabs.

Results
Precision of the cycle threshold (Ct) values for each detector was determined to have a standard deviation of less than 3 for inter-assay and less than 2 for intra-assay replicates. Sensitivity was determined to be 800 copies/mL in nasopharyngeal swabs. Accuracy was found to be 92.3%. A single laboratory strain from the H1N1 2009 epidemic showed cross-reactivity with both wild-type and resistant probes, but no circulating clinical H1N1 samples tested showed this response.

Conclusion
The precision, sensitivity, and accuracy of a qPCR for resistance mutations to baloxavir marboxil support this assay’s utility as an aid in the treatment of flu in at-risk patient groups. This assay allows for rapid detection (&lt;24 hours) of resistance markers to aid clinicians in improving flu case outcomes.

Disclosures
All authors: No reported disclosures.
665. In vitro Activity of Omadacycline Against Recent (2018) Bacterial Pathogens from the United States and Europe Obtained from Skin and Skin Structure, Respiratory, and Urinary Tract Infections
Authors: Huband Michael D , Pfaller Michael A , Streit Jennifer M , Sader Helio S , Flamm Robert K 
Published: July 2020

Abstract

Background
Omadacycline (OMC) was FDA approved to treat acute bacterial skin and skin structure infection (ABSSSI) and community-acquired bacterial pneumonia (CABP) for indicated organisms in 2018. Phase 2 OMC clinical trials for uncomplicated urinary tract infection (uUTI; NCT03425396) and acute pyelonephritis (NCT03757234) are ongoing. OMC is active against bacterial isolates expressing common tetracycline, penicillin, fluoroquinolone, and macrolide resistance mechanisms.

Methods
Isolates (14,000) were collected in 2018 from 31 medical centers located in the United States and 38 medical centers in Europe, including 3,458 staphylococci, 1,551 streptococci, 746 enterococci, 574 Haemophilus spp., and 5,690 Enterobacterales isolates. One isolate per patient infection episode was tested. Identifications were confirmed by MALDI-TOF MS and susceptibility testing was performed using CLSI broth microdilution methods.

Results
OMC (MIC50/90, 0.12/0.25 mg/L) was highly active against S. aureus isolates from skin and skin structure infection (SSSI; 99.3% susceptible [S]) including MRSA (97.7%S) and MSSA (99.9%S) (table). Similarly, OMC demonstrated potent activity against S. aureus isolates from respiratory tract infection (RTI; MIC50/90, 0.12/0.25 mg/L) including MSSA (98.2%S). All S. lugdunensis isolates from SSSI were S (100.0%) to OMC. All Streptococcus anginosus group (100.0%) and 97.6% of S. pyogenes isolates from SSSI were S to OMC as were 98.0% of S. pneumoniae from RTI. No streptococci were resistant (R) to OMC. OMC (MIC50/90 0.12/0.25 mg/L) had potent activity against E. faecalis isolates from SSSI (99.0%S). OMC S against E. cloacae and K. pneumoniae isolates from SSSI was 92.1% S and 89.4% S, respectively. Similarly, 86.2% of K. pneumoniae isolates from RTI were S to OMC. Susceptibility of H. influenzae isolates from RTI to OMC was 99.8%S (no isolates were R). ≥90.0% of E. coli (MIC50/90, 1/2 mg/L) and K. pneumoniae (MIC50/90, 2/4 mg/L) UTI isolates were inhibited by ≤4 mg/L of OMC.

Conclusion
OMC was highly active against bacterial pathogens associated with ABSSSI, CABP, and UTI including staphylococci (97.7%-100.0%S), streptococci (97.6%-100.0%S), E. faecalis (99.0%S). E. cloacae (92.1%S), K. pneumoniae (86.2%-89.4%S), and E. coli.

Disclosures
All authors: No reported disclosures.
666. Efficacy and Safety of Cefiderocol According to Renal Impairment in Patients With Complicated Urinary Tract Infection (cUTI) in a Phase 2 Study
Authors: Portsmouth Simon , Echols Roger , Machida Mitsuaki , Camilo Arjona Ferreira Juan , Ariyasu Mari , Den Nagata Tsutae 
Published: July 2020

Abstract

Background
Cefiderocol, a novel siderophore cephalosporin with broad activity against Gram-negative bacteria, requires dose adjustment in patients with renal impairment or augmented renal clearance, similarly to other β-lactams. The efficacy and safety of cefiderocol were assessed according to degree of renal impairment as part of a pivotal study vs. imipenem–cilastatin (IPM/CS) in patients with cUTI (NCT02321800).

Methods
A total of 448 randomized adults with cUTI received cefiderocol (2 g) or IPM/CS (1 g / 1 g), IV, q8h, for 7–14 days (safety population), with 371 patients in the microbiological intent-to-treat (Micro-ITT) population. Dose adjustments were made based on body weight (to enable IPM/CS blinding) and creatinine clearance (CrCL). The composite (clinical and microbiological) outcome at a test of cure (TOC; 7 days after treatment cessation) was analyzed by CrCL subgroup. Adverse events (AEs) according to renal subgroup were monitored throughout the study.

Results
A treatment difference in the composite outcome at TOC in favor of cefiderocol vs. IPM/CS was observed across renal subgroups (table), with greater differences in moderate and severe groups, consistent with that observed in the overall population (n = 371; 18.0%, 95% confidence interval: 7.5; 28.5). The incidence of AEs in the cefiderocol group was comparable across all renal subgroups. Conversely, AE incidence increased with the degree of impairment in the IPM/CS group (table).

Conclusion
In contrast to IPM/CS, the efficacy of cefiderocol was maintained across all renal function subgroups with no increase in the rate of AEs. These findings underscore the efficacy and safety of cefiderocol in patients with renal impairment and support the adequacy of the dose adjustment.

Disclosures
All authors: No reported disclosures.
Trade finance matters: evidence from the COVID-19 crisis
Authors: Demir Banu , Javorcik Beata 
Published: July 2020

Abstract
This study documents a substantial decline in the exports of major trading nations taking place in March 2020. Accounting for product-specific seasonality and annual trends, the data suggest a drop by 38 per cent in France, about a quarter in Turkey and Germany, and 12 per cent in the US, relative to their historical averages. Detailed export data from Turkey, disaggregated by financing terms, show another striking pattern. Flows using bank intermediation which eliminates or reduces the risk of non-payment or non-arrival of prepaid goods, such as letters of credit or documentary collection, appear to have been much more resilient to the current downturn relative to flows using other financing terms. These findings suggest that access to trade finance is vital during times of heightened uncertainty.