bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clostridioides difficileWhole-genome Sequencing Differentiates Relapse With the Same Strain From Reinfection With a New Strain
Authors: Cho Janice , Cunningham Scott , Pu Meng , Lennon Ryan J , Dens Higano Jennifer , Jeraldo Patricio , Sampathkumar Priya , Shannon Samantha , Kashyap Purna C , Patel Robin 
Published: February 2020

AbstractBackgroundCurrent approaches in tracking Clostridioides difficile infection (CDI) and individualizing patient management are incompletely defined.MethodsWe recruited 468 subjects with CDI at Mayo Clinic Rochester between May and December 2016 and performed whole-genome sequencing (WGS) on C. difficile isolates from 397. WGS was also performed on isolates from a subset of the subjects at the time of a recurrence of infection. The sequence data were analyzed by determining core genome multilocus sequence type (cgMLST), with isolates grouped by allelic differences and the predicted ribotype.ResultsThere were no correlations between C. difficile isolates based either on cgMLST or ribotype groupings and CDI outcome. An epidemiologic assessment of hospitalized subjects harboring C. difficile isolates with ≤2 allelic differences, based on standard infection prevention and control assessment, revealed no evidence of person-to-person transmission. Interestingly, community-acquired CDI subjects in 40% of groups with ≤2 allelic differences resided within the same zip code. Among 18 subjects clinically classified as having recurrent CDI, WGS revealed 14 with initial and subsequent isolates differing by ≤2 allelic differences, suggesting a relapse of infection with the same initial strain, and 4 with isolates differing by &gt;50 allelic differences, suggesting reinfection. Among the 5 subjects classified as having a reinfection based on the timing of recurrence, 3 had isolates with ≤2 allelic differences between them, suggesting a relapse, and 2 had isolates differing by &gt;50 allelic differences, suggesting reinfection.ConclusionsOur findings point to potential transmission of C. difficile in the community. WGS better differentiates relapse from reinfection than do definitions based on the timing of recurrence.
Identifying Vaccine-associated Rash Illness Amidst a Large Measles Outbreak: Minnesota, 2017
Authors: Martin Karen G , Banerjee Emily , McMahon Melissa , Kenyon Cynthia , Strain Anna , Halstead Muscoplat Miriam , Gastañaduy Paul A , Rota Paul A , Mody Rajal K , Ehresmann Kristen 
Published: February 2020

Abstract
Characteristics of vaccine-associated rash illness (VARI) and confirmed measles cases were compared during a measles outbreak. Although some clinical differences were noted, measles exposure and identification of the vaccine strain were helpful for public health decision-making. Rapid, vaccine strain–specific diagnostic assays will more efficiently distinguish VARI from measles.
Comparing Authoritarian Publics: The Benefits and Risks of Three Types of Publics for Autocrats
Authors: Toepfl Florian 
Published: February 2020

Abstract
Researchers comparing political communication across non-democratic contexts presently lack a widely acknowledged theoretical framework to guide their efforts. In order to fill in this gap, this essay develops a theoretical account that proposes comparing not authoritarian media systems, but “authoritarian publics.” Drawing on theories of the multiple public sphere, two typologies are delineated: (a) a three-fold typology of partial publics, operating within authoritarian regimes and (b) a three-fold typology of “publics-at-large,” to be distinguished across authoritarian regimes. As it is argued, the publics-at-large of authoritarian regimes can be composed of three types of partial publics: (a) uncritical, (b) policy-critical, and (c) leadership-critical publics. With reference to political science literature about the emergence of formally democratic institutions in non-democratic regimes, critical publics are interpreted as institutions that help autocrats carry out important tasks. The benefits and risks associated with critical publics for autocrats are comparable to those of other pseudo-democratic institutions.
Ambient temperature correlates with geographic variation in body size of least horseshoe bats
Authors: Wang Man , Chen Kelly , Guo Dongge , Luo Bo , Wang Weiwei , Gao Huimin , Liu Ying , Feng Jiang 
Published: February 2020

AbstractGeographic variation in body size is common within many animal species. The causes of this pattern, however, remain largely unexplored in most vertebrate groups. Bats are widely distributed globally owing to their ability of powered flight. Most bat species encounter a variety of climatic conditions across their distribution range, making them an ideal taxon for the study of ecogeographic patterns in body size. Here, we used adult least horseshoe bats, Rhinolophus pusillus, to test whether geographic variation in body size was determined by heat conservation, heat dissipation, climatic seasonality, or primary productivity. We measured body mass and head-body length for 246 adult bats from 12 allopatric colonies in China. We quantified the ecological conditions inhabited by each colony, including mean maximum temperature of the warmest month, mean minimum temperature of the coldest month, temperature seasonality, precipitation seasonality, and annual net primary productivity (ANPP). Body mass and head-body length, 2 of the most reliable indicators of body size, exhibited marked differences between colonies. After controlling for spatial autocorrelation, the mean minimum temperature of the coldest month explained most of the variation in body size among colonies, regardless of sex. The mean maximum temperature, climatic seasonality, and ANPP had limited power in predicting body size of males or females in comparison with mean minimum temperature. These results support the heat conservation hypothesis and suggest adaptive responses of body size to cold climates in cave-dwelling bats.
Toxoplasma gondii causes lipofuscinosis, collagenopathy and spleen and white pulp atrophy during the acute phase of infection
Authors: Pereira Andréia Vieira , Gois Marcelo Biondaro , Silva Mariana Sacchi , Miranda Junior Nelson Raimundo de , Campos Carla Betânia Huf Ferraz , Schneider Larissa Carla Lauer , Barbosa Carmem Patrícia , Nogueira-Melo Gessilda de Alcântara , Sant'Ana Débora de Mello Gonçales 
Published: February 2020

ABSTRACT
In this study, we evaluated homeostatic and functional disorders of the spleen in mice inoculated with Toxoplasma gondii. The kinetics of megakaryocyte and leukocyte production, body and spleen mass and certain histopathological aspects were analyzed. There was increased (P &lt; 0.05) the accumulation of lipofuscin in the red pulp of the spleen, in the periods of 30 and 60 dpi of the infection, that is, in the chronification stage of the disease and decrease of the white pulp area. In addition, we observed (from 7dpi) a quantitative and qualitative increase (P &lt; 0.05) in the deposition of collagen fibers in the spleen of all infected mice. Since resolution of the inflammatory process resulted in pathophysiological changes, we can suggest that the T. gondii invaded and multiplied in the cells of the white and red pulps of the spleen. Although we did not find the parasite in the spleen, this hypothesis is supported by the presence of diffuse inflammatory infiltrate, which extended through the spleen parenchyma of all inoculated mice. Taken together, our results suggest that T. gondii causes severe homeostatic disorders that have altered spleen physiology, including diffuse parenchymal inflammation, lipofuscinosis in histiocytes, early aging, collagenopathy, systemic sclerosis and spleen and white pulp atrophy.
Laboratory study on the effects of fault waviness on granodiorite stick-slip instabilities
Authors: Zhuo Yan-Qun , Guo Yanshuang , Chen Shunyun , Ji Yuntao 
Published: February 2020

SUMMARYThe effects of fault waviness on the fault slip modes are unclear. Laboratory study on the effects of the centimetre-scale fault contact distribution, which is mainly controlled by the fault waviness, on granodiorite stick-slip instabilities may help to unveil some aspects of the problem. The fast and slow stick-slip motions were separately generated in two granodiorite samples of the same roughness but different fault contact distributions in the centimetre scale in the laboratory. The experimental results show the following: (1) the fault with the small contact area and heterogeneous contact distribution generates fast stick-slip instabilities, while the fault with the large contact area and homogeneous contact distribution produces slow stick-slip events; (2) the nucleation processes of the fast stick-slip events are characterized by abrupt changes once the nucleation zones expand to the critical nucleation length that is observed to be shorter than the fault length, while the slow stick-slip events appear as a gradual evolution of the nucleation zones leading to total fault sliding. These indicate that, unlike the micron-scale fault contact distribution controlled by roughness, which depends mainly on the grain size of the abrasives used for lapping the fault surface, the centimetre-scale fault contact distribution, which depends mainly on the waviness of the fault surface profile, also plays an important role in the fault slip modes. In addition, the effects of the fault waviness on the fault friction properties are preliminarily analysed based on the rate- and state-dependent friction law.
Overcoming Resistance Through Narratives: Findings from a Meta-Analytic Review
Authors: Ratcliff Chelsea L , Sun Ye 
Published: February 2020

AbstractTo understand the mechanisms underlying narrative persuasion, a growing body of theoretical and empirical work suggests that narratives reduce audience resistance, possibly via narrative engagement. To synthesize this research, we performed a two-part meta-analysis using three-level random-effects models. Part I focused on experimental studies that directly compared narratives and non-narratives on resistance. Based on 15 effect sizes from nine experimental studies, the overall effect size was d = −.213 (equivalent r = −.107; p &lt; .001), suggesting that narratives generated less resistance than non-narratives. Part II was a synthesis of studies of the relationship between narrative engagement and resistance, consisting of 63 effect sizes from 25 studies. Narrative engagement and resistance were negatively correlated (r = −.131; p &lt; .001), and this relationship was moderated by narrative message characteristics, including genre, length, medium, and character unit. Implications of our findings and directions for future research are discussed.
Air pollution in China: health information seeking and protective behaviors
Authors: Yang Qinghua , Wu Shiwen 
Published: February 2020

Abstract
Haze has become one of the most life-threatening problems in China. Chinese people become more dependent on receiving health information from social media, especially WeChat, which shapes their health perceptions and behaviors. Despite the prevalence of health information-seeking behavior (HISB) on WeChat, the predicting factors and consequences of Chinese people’s haze HISB using WeChat remain unclear. To fill this gap, a hypothesized model was proposed under the risk perception attitude framework and tested with a longitudinal web-based survey of Chinese people residing in Mainland China, to understand the antecedents and behavioral outcomes of HISB on WeChat. The results from the structural equation modeling showed that perceived risk significantly predicted haze HISB on WeChat, which predicted the intention of wearing PM2.5 mask but not reducing outdoor exercises. The efficacy beliefs of both protective behaviors were not significant predictor of haze HISB. Theoretical and practical implications were discussed.
The Prince William Sound Plankton Camera: a profiling in situ observatory of plankton and particulates
Authors: Campbell R W , Roberts P L , Jaffe J 
Published: February 2020

Abstract
A novel plankton imager was developed and deployed aboard a profiling mooring in Prince William Sound in 2016–2018. The imager consisted of a 12-MP camera and a 0.137× telecentric lens, along with darkfield illumination produced by an in-line ring/condenser lens system. Just under 2.5 × 106 images were collected during 3 years of deployments. A subset of almost 2 × 104 images was manually identified into 43 unique classes, and a hybrid convolutional neural network classifier was developed and trained to identify the images. Classification accuracy varied among the different classes, and applying thresholds to the output of the neural network (interpretable as probabilities or classifier confidence), improved classification accuracy in non-ambiguous groups to between 80% and 100%.
Describing the evolution of myeloid-derived leucocytes in treated B-lineage paediatric acute lymphoblastic leukaemia with a data-driven granulocyte-monocyte-blast model
Authors: Bolton Larisse , Acho Thomas M , Stones David K , Hui Cang 
Published: February 2020

AbstractAcute lymphoblastic leukaemia (ALL) is associated with a compromised myeloid system. Understanding the state of granulopoiesis in a patient during treatment, places the clinician in an advantageous position. Mathematical models are aids able to present the clinician with insight into the behaviour of myeloid-derived leucocytes. The main objective of this investigation was to determine whether a proposed model of ALL during induction therapy would be a usable descriptor of the system. The model assumes the co-occurrence of the independent leukaemic and normal marrow populations. It is comprised of four delay-differential equations, capturing the fundamental characteristics of the blood and bone marrow myeloid leucocytes and B-lineage lymphoblasts. The effect of treatment was presumed to amplify cell loss within both populations. Clinical data was used to inform the construction, calibration and examination of the model. The model is promising—presenting a good foundation for the development of a clinical supportive tool. The predicted parameters and forecasts aligned with clinical expectations. The starting assumptions were also found to be sound. A comparative investigation highlighted the differing responses of similarly diagnosed patients during treatment and further testing on patient data emphasized patient specificity. Model examination recommended the explicit consideration of the suppressive effects of treatment on the normal population production. Additionally, patient-related factors that could have resulted in such different responses between patients need to be considered. The parameter estimates require refinement to incorporate the action of treatment. Furthermore, the myeloid populations require separate consideration. Despite the model providing explanation, incorporating these recommendations would enhance both model usability and predictive capacity.
An innovative quality improvement approach for rapid improvement of infection prevention and control at health facilities in Sierra Leone
Authors: Rondinelli Ilka , Dougherty Gillian , Madevu-Matson Caitlin A , Toure Mame , Akinjeji Adewale , Ogongo Irene , Kolwaite Amy , Weiss Jamine , Gleason Brigette , Lyman Meghan Marie , Benya Hassan , Rabkin Miriam 
Published: February 2020

Abstract

Quality challenge
The Sierra Leone (SL) Ministry of Health and Sanitation’s National Infection Prevention and Control Unit (NIPCU) launched National Infection and Prevention Control (IPC) Policy and Guidelines in 2015, but a 2017 assessment found suboptimal compliance with standards on environmental cleanliness (EC), waste disposal (WD) and personal protective equipment (PPE) use.

Methods
ICAP at Columbia University (ICAP), NIPCU and the Centers for Disease Control and Prevention (CDC) designed and implemented a Rapid Improvement Model (RIM) quality improvement (QI) initiative with a compressed timeframe of 6 months to improve EC, WD and PPE at eight purposively selected health facilities (HFs). Targets were collaboratively developed, and a 37-item checklist was designed to monitor performance. HF teams received QI training and weekly coaching and convened monthly to review progress and exchange best practices. At the final learning session, a “harvest package” of the most effective ideas and tools was developed for use at additional HFs.

Results
The RIM resulted in marked improvement in WD and EC performance and modest improvement in PPE. Aggregate compliance for the 37 indicators increased from 67 to 96% over the course of 4 months, with all HFs showing improvement. Average PPE compliance improved from 85 to 89%, WD from 63 to 99% and EC from 51 to 99%.

Lessons learned
The RIM QIC approach is feasible and effective in SL’s austere health system and led to marked improvement in IPC performance. The best practices are being scaled up and the RIM QIC methodology is being applied to other domains.
Integration of the blaNDM-1 carbapenemase gene into a novel SXT/R391 integrative and conjugative element in Proteus vulgaris
Authors: Kong Ling-Han , Xiang Rong , Wang Yu-Long , Wu Shun-Kang , Lei Chang-Wei , Kang Zhuang-Zhuang , Chen Yan-Peng , Ye Xiao-Lan , Lai Yan , Wang Hong-Ning 
Published: February 2020

AbstractObjectivesTo characterize the genetic environment of the carbapenem resistance determinant in Proteus vulgaris of swine origin.MethodsThe carbapenem-resistant P. vulgaris strain BC22 was isolated from a faecal swab from a diseased pig with diarrhoea in Sichuan Province of China in 2018. The presence of carbapenemase genes was screened by PCR. WGS and bioinformatics analysis were performed to analyse the genetic environment of the carbapenem resistance determinant.ResultsP. vulgaris strain BC22 was found to harbour the carbapenemase gene blaNDM-1. WGS data revealed that blaNDM-1 was located in a truncated ISAba125 composite transposon. The carbapenem resistance gene blaNDM-1 and 20 other resistance genes, including the multiresistance gene cfr and the bifunctional aminoglycoside/quinolone resistance gene aac(6′)-lb-cr, were located in a novel SXT/R391 integrative and conjugative element (ICE). This new SXT/R391 ICE of 148.7 kb was chromosomally located, and could be transferred to Escherichia coli.ConclusionsHere, we report a carbapenemase gene, blaNDM-1, integrated into an SXT/R391 ICE. Our study highlights that this SXT/R391 ICE may facilitate the dissemination of clinically important resistance genes such as blaNDM-1, cfr and aac(6′)-lb-cr.
How does medical scribes’ work inform development of speech-based clinical documentation technologies? A systematic review
Authors: Tran Brian D , Chen Yunan , Liu Songzi , Zheng Kai 
Published: February 2020

Abstract

Objective
Use of medical scribes reduces clinician burnout by sharing the burden of clinical documentation. However, medical scribes are cost-prohibitive for most settings, prompting a growing interest in developing ambient, speech-based technologies capable of automatically generating clinical documentation based on patient–provider conversation. Through a systematic review, we aimed to develop a thorough understanding of the work performed by medical scribes in order to inform the design of such technologies.

Materials and Methods
Relevant articles retrieved by searching in multiple literature databases. We conducted the screening process following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in guidelines, and then analyzed the data using qualitative methods to identify recurring themes.

Results
The literature search returned 854 results, 65 of which met the inclusion criteria. We found that there is significant variation in scribe expectations and responsibilities across healthcare organizations; scribes also frequently adapt their work based on the provider’s style and preferences. Further, scribes’ job extends far beyond capturing conversation in the exam room; they also actively interact with patients and the care team and integrate data from other sources such as prior charts and lab test results.

Discussion
The results of this study provide several implications for designing technologies that can generate clinical documentation based on naturalistic conversations taking place in the exam room. First, a one-size-fits-all solution will be unlikely to work because of the significant variation in scribe work. Second, technology designers need to be aware of the limited role that their solution can fulfill. Third, to produce comprehensive clinical documentation, such technologies will likely have to incorporate information beyond the exam room conversation. Finally, issues of patient consent and privacy have yet to be adequately addressed, which could become paramount barriers to implementing such technologies in realistic clinical settings.

Conclusions
Medical scribes perform complex and delicate work. Further research is needed to better understand their roles in a clinical setting in order to inform the development of speech-based clinical documentation technologies.
Devising a new dialogue for nutrition science: how life course perspective, U-shaped thinking, whole organism thinking, and language precision contribute to our understanding of biological heterogeneity and forge a fresh advance toward precision medicine
Authors: Waters David J 
Published: February 2020

Abstract
The process of designing and implementing individualized health-promoting interventions, nutritional or otherwise, is fraught with great difficulty owing to the heterogeneity inherent in factors that influence healthy longevity. This article proposes that careful attention to three principles—life course perspective, U-shaped thinking, and whole organism thinking—creates an attitudinal framework that can be used to reframe biological heterogeneity into the clinically relevant question: Who will benefit? The search for tools to cope with the complexity of this heterogeneity has been dominated by technological advances, including state-of-the-art “-omics” approaches and machine-based handling of “big data.” Here, it is proposed that language precision and nuanced category usage could provide critical tools for coping with heterogeneity, thereby enabling interventionalists to design and implement strategies to promote healthy longevity with greater precision. The lack of a clear understanding of “Who will benefit?” stands as a major obstacle to the design and implementation of nutritional strategies to optimize healthy longevity. This article opens a new dialogue situating the principles of life course perspective, U-shaped thinking, and whole organism thinking, along with cultivating an attitude of language precision at the very core of accelerating creative discovery and refining practical advance in the field of nutrition science.