bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a Novel Antimicrobial Surface Coating on Health Care–Associated Infections and Environmental Bioburden at 2 Urban Hospitals
Authors: Ellingson Katherine D , Pogreba-Brown Kristen , Gerba Charles P , Elliott Sean P 
Published: October 2019

Abstract

Background
Approximately 1 in 25 people admitted to a hospital in the United States will suffer a health care–associated infection (HAI). Environmental contamination of hospital surfaces contributes to HAI transmission. We investigated the impact of an antimicrobial surface coating on HAIs and environmental bioburdens at 2 urban hospitals.

Methods
A transparent antimicrobial surface coating was applied to patient rooms and common areas in 3 units at each hospital. Longitudinal regression models were used to compare changes in hospital-onset multidrug-resistant organism bloodstream infection (MDRO-BSI) and Clostridium difficile infection (CDI) rates in the 12 months before and after application of the surface coating. Incidence rate ratios (IRRs) were compared for units receiving the surface coating application and for contemporaneous control units. Environmental samples were collected pre- and post-application to identify bacterial colony forming units (CFUs) and the percent of sites positive for select, clinically relevant pathogens.

Results
Across both hospitals, there was a 36% decline in pooled HAIs (combined MDRO-BSIs and CDIs) in units receiving the surface coating application (IRR, 0.64; 95% confidence interval [CI], .44–.91), and no decline in the control units (IRR, 1.20; 95% CI, .92–1.55). Following the surface application, the total bacterial CFUs at Hospitals A and B declined by 79% and 75%, respectively; the percentages of environmental samples positive for clinically relevant pathogens also declined significantly for both hospitals.

Conclusions
Statistically significant reductions in HAIs and environmental bioburdens occurred in the units receiving the antimicrobial surface coating, suggesting the potential for improved patient outcomes and persistent reductions in environmental contamination. Future studies should assess optimal implementation methods and long-term impacts.
Spectra, Hitting Times and Resistance Distances ofq- Subdivision Graphs
Authors: Zeng Yibo , Zhang Zhongzhi 
Published: October 2019

AbstractSubdivision, triangulation, Kronecker product, corona product and many other graph operations or products play an important role in complex networks. In this paper, we study the properties of $q$-subdivision graphs, which have been applied to model complex networks. For a simple connected graph $G$, its $q$-subdivision graph $S_q(G)$ is obtained from $G$ through replacing every edge $uv$ in $G$ by $q$ disjoint paths of length 2, with each path having $u$ and $v$ as its ends. We derive explicit formulas for many quantities of $S_q(G)$ in terms of those corresponding to $G$, including the eigenvalues and eigenvectors of normalized adjacency matrix, two-node hitting time, Kemeny constant, two-node resistance distance, Kirchhoff index, additive degree-Kirchhoff index and multiplicative degree-Kirchhoff index. We also study the properties of the iterated $q$-subdivision graphs, based on which we obtain the closed-form expressions for a family of hierarchical lattices, which has been used to describe scale-free fractal networks.
Multiantenna Receiver Signal Detection in AmBC Based on Cluster Analysis
Authors: Zhao Jumin , Zhang Liang , Li Deng'ao 
Published: October 2019

Abstract
Ambient backscatter communication (AmBC) has great application prospects in the green Internet of Things due to its shared nature of energy and spectrum. In this paper, we have done research on the signal detection problem in the AmBC system and proposed to use the k-means clustering analysis algorithm to detect the received backscattered signal. At the same time, in order to obtain a more obvious clustering center, this paper introduces a multi-antenna receiver channel detection mechanism. The proposed method can compare and analyze the energy received by the receiver antennas in an extremely short time slots. The channel state information between the reader and the backscatter tag is obtained, and the optimal communication channel is selected, thereby effectively improving the clustering effect. Finally, a large number of experimental simulations are provided to compare and analyze the corresponding BER performance to confirm our theoretical research.
Concomitant tumourous lesions in the left atrium and aortic valve suspected to be myxoma
Authors: Mandryk Yuriy , Czesla Markus , Flora Christian , Massoudy Parwis 
Published: October 2019

Abstract
The occurrence of multiple primary cardiac tumours in a single patient is extremely rare. Despite growing expertise in non-invasive diagnostic modalities, especially in transoesophageal echocardiography, only a few cases report the coincidence of papillary fibroelastoma of the aortic valve and myxoma of the left atrium. Moreover, echocardiographic as well as a macroscopic distinction between cardiac myxoma and cardiac fibroelastoma may be difficult. Only post-excisional histopathology provides diagnostic safety. Cryoablation of the remnant tissue prevents recurrence in both the aortic valve and the left atrium.
Change in Antibiotic Use in Secondary and Tertiary Hospitals Nationwide After a National Antimicrobial Stewardship Campaign Was Launched in China, 2011–2016: An Observational Study
Authors: Xiao Yonghong , Shen Ping , Zheng Beiwen , Zhou Kai , Luo Qixia , Li Lanjuan 
Published: October 2019

Abstract

Background
An antimicrobial stewardship campaign was launched in 2011 by the Ministry of Health. This study aimed to assess the achievements and trends in the clinical use of antibiotics in secondary and tertiary hospitals following this campaign in China.

Methods
This observational study analyzed nationwide hospital antibiotic procurement and consumption data and antibiotic-resistance surveillance data based on claims filed in 2010–2016.

Results
After a 6-year national campaign, the proportion of outpatients and surgical patients who received antibiotic treatment decreased from 19.5% to 8.5% and from 97.9% to 38.3%, respectively. The intensity of antibiotic use among inpatients decreased from 85.3±29.8 defined daily dosage (DDD) per 100 patient days to 48.5±8.0 DDD per 100 patient days. Moreover, the antibiotic procurement expenditure among hospitals declined from 22.3% of total drug procurement costs in 2010 to 12.1% in 2016, although total drug procurement costs doubled during that time. The incidence of methicillin-resistant Staphylococcus aureus isolates also dropped (from 54.4% in 2010 to 34.4% in 2016), as did the proportion of carbapenem-resistant Pseudomonas aeruginosa isolates (from 30.8% to 22.3%).

Conclusions
The 6-year campaign successfully reduced antibiotic consumption and irrational drug use in Chinese hospitals which was associated with declines in the prevalence of common antibiotic-resistant bacteria.
A Retrospective Analysis of Risk Factors and Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Bacteremia in Nontransplant Patients
Authors: Xiao Tingting , Zhu Yunying , Zhang Shuntian , Wang Yuan , Shen Ping , Zhou Yanzi , Yu Xiao , Xiao Yonghong 
Published: October 2019

Abstract

Background
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a major problem among nosocomial infections, and it is a serious threat to patients. The clinical characteristics and outcome of CRKP bloodstream infection (BSI) in nontransplant patients remains unelucidated. The aim of this study was as follows: identify the risk factors of CRKP infection; generate new ideas for prevention; and generate new ideas for the most effective therapeutic management in nontransplant patients.

Methods
The study retrospectively analyzed the clinical and microbiological data of nontransplant patients with K pneumoniae (KP) bacteremia from January 2013 to December 2015 to identify risk factors, clinical features, and outcomes using multivariate logistic regression analysis.

Results
Of the 371 patients with KP-BSI in nontransplant patients included in this study, 28.0% (N = 104) had CRKP. The 28-day mortality was higher in patients infected with CRKP (55.8%) than in those with carbapenem-susceptible KP (13.9%) (P &lt; .001). Multivariate analysis showed previous gastric catheterization, previous use of carbapenems, hypoproteinemia, and high Acute Physiologic Assessment and Chronic Health Evaluation II scores as independent risk factors for CRKP-BSIs. Carbapenem-resistant KP infection, severe illness, and tigecycline therapy were independent risk factors for death from KP-BSIs. Taken together, inappropriate antibiotic treatment both in empirical and definitive therapy and imipenem minimum inhibitory concentrations (MICs) of &gt;8 mg/L were associated with poor clinical outcome.

Conclusions
Nontransplant patients with CRKP-BSI had higher mortality. Carbapenems exposure was an independent risk factor for CRKP infection. Imipenem MICs of &gt;8 mg/L, tigecycline therapy, and inappropriate treatments increased the 28-day mortality of KP-BSI patients.
A comparison of individual and ecological indicators of social deprivation and their association with hospital efficiency in the context of infectious diseases in two French general paediatric departments
Authors: Roussel Aphaia , Faye Albert , Lefevre-Utile Alain , De Pontual Loic , Chevreul Karine , Michel Morgane 
Published: October 2019

Abstract

Background
To identify deprivation indicators usable in everyday practice and included in medico-administrative databases, particularly with infectious diseases, which represent the greatest proportion of hospitalizations. Our objective was to compare ecological indicators to individual questionnaires and apply both types to the study of the impact of deprivation on hospital efficiency.

Methods
We conducted an epidemiological observational prospective multicentre study in two French public hospitals between 20 October 2016 and 20 March 2017. Children hospitalized for one of the four most common infectious diseases were included and their parents were asked to answer the Evaluation of Precarity and Inequalities in Health Examination Centers (EPICES) questionnaire. The ecological indicator French DEPrivation index (FDep) was derived from patients’ address, both at the zip code and at a smaller geographical area (IRIS [ilôts de regroupement pour l'information statistique]) level. Correlation and concordance between the three indicators were assessed. The endpoint used to assess the impact on hospital efficiency was the ratio between patients’ length of stay (LOS) and the national LOS of their disease-related group.

Results
Data were available for 540 patients with a mean age of 9 mo. A total of 56.1% of patients were considered deprived with EPICES, 50.4% with zip code FDep and 45.7% with IRIS FDep. Concordance between EPICES and either type of FDep was &lt;0.1. There was no increase in LOS compared with national LOS with any of the indicators.

Conclusions
Individual and ecological indicators do not measure the same aspects of deprivation. The decision to use one or the other must be carefully weighed when studying the impact of deprivation on the healthcare system.
The logic of imaginary scenarios
Authors: Casas-Roma Joan , Huertas Antonia , Rodríguez M Elena 
Published: October 2019

Abstract
Imagining is something we use everyday in our lives and in a wide variety of ways. In spite of the amount of works devoted to its study from both psychology and philosophy, there are only a few formal systems capable of modelling it; besides, almost all of those systems are static, in the sense that their models are initially predefined, and they fail to capture the dynamic process behind the creation of new imaginary scenarios. In this work, we review some influential theories of imagination and use their insights to distil an algorithm describing such process. Then, we use this algorithm to define a dynamic logical system built upon on a single-agent epistemic logic that provides the necessary tools to capture how the agent voluntarily creates new imaginary worlds; in other words, our system allows the model to be expanded dynamically at any time as a result of the agent performing an act of imagination. Furthermore, we provide an axiomatization and prove that the system is sound and complete.
Measuring the H i mass function below the detection threshold
Authors: Pan Hengxing , Jarvis Matt J , Allison James R , Heywood Ian , Santos Mario G , Maddox Natasha , Frank Bradley S , Kang Xi 
Published: October 2019

Abstract
We present a Bayesian stacking technique to directly measure the H i mass function (HIMF) and its evolution with redshift using galaxies formally below the nominal detection threshold. We generate galaxy samples over several sky areas given an assumed HIMF described by a Schechter function and simulate the H i emission lines with different levels of background noise to test the technique. We use Multinest to constrain the parameters of the HIMF in a broad redshift bin, demonstrating that the HIMF can be accurately reconstructed, using the simulated spectral cube far below the H i mass limit determined by the 5σ flux-density limit, i.e. down to MHI = 107.5 M⊙ over the redshift range 0 < z < 0.55 for this particular simulation, with a noise level similar to that expected for the MIGHTEE survey. We also find that the constraints on the parameters of the Schechter function, φ⋆, M⋆ and α can be reliably fit, becoming tighter as the background noise decreases as expected, although the constraints on the redshift evolution are not significantly affected. All the parameters become better constrained as the survey area increases. In summary, we provide an optimal method for estimating the H i mass at cosmological distances that allows us to constrain the H i mass function below the detection threshold in forthcoming H i surveys. This study is a first step towards the measurement of the HIMF at high (z > 0.1) redshifts.
Disc growth and quenching
Authors: Peng Ying-jie , Renzini Alvio 
Published: October 2019

ABSTRACT
Based on well-established scaling relation for star-forming galaxies as a function of redshift, we argue that the implied growth by a large factor of their angular momentum requires that the angular momentum of the inflowing gas fuelling star formation and disc growth must also secularly increase. We then propose that star formation in discs can cease (quench) once the accreted material (mainly atomic hydrogen) comes in with excessive angular momentum for sustaining an adequate radial flow of cold, molecular gas. Existing observational evidence supporting this scenario is mentioned, together with some future observational studies that may validate (or invalidate) it.
Breaking the centrifugal barrier to giant planet contraction by magnetic disc braking
Authors: Ginzburg Sivan , Chiang Eugene 
Published: October 2019

ABSTRACT
During the runaway phase of their formation, gas giants fill their gravitational spheres of influence out to Bondi or Hill radii. When runaway ends, planets shrink several orders of magnitude in radius until they are comparable in size to present-day Jupiter; in 1D models, the contraction occurs on the Kelvin–Helmholtz time-scale tKH, which is initially a few thousand years. However, if angular momentum is conserved, contraction cannot complete, as planets are inevitably spun up to their breakup periods Pbreak. We consider how a circumplanetary disc (CPD) can de-spin a primordially magnetized gas giant and remove the centrifugal barrier, provided the disc is hot enough to couple to the magnetic field, a condition that is easier to satisfy at later times. By inferring the planet’s magnetic field from its convective cooling luminosity, we show that magnetic spin-down times are shorter than contraction times throughout post-runaway contraction: tmag/tKH ∼ (Pbreak/tKH)1/21 ≲ 1. Planets can spin-down until they corotate with the CPD’s magnetospheric truncation radius, at a period Pmax/Pbreak ∼ (tKH/Pbreak)1/7. By the time the disc disperses, Pmax/Pbreak ∼ 20–30; further contraction at fixed angular momentum can spin planets back up to ∼10Pbreak, potentially explaining observed rotation periods of giant planets and brown dwarfs.
Water rights reform and water marketing: Australia vs the US West
Authors: Hanemann Michael , Young Michael 
Published: October 2019

AbstractWe consider the connection between water marketing and the modification of property rights to water in Australia, highlighting the Australian’s distinctiveness through a contrast with water rights in the western US (especially California). Australia started out the same as California, but in the 1880s it abandoned California’s system and adopted a new approach, ending the common law property right to water and creating a statutory right that could be modified by administrative fiat. This shifted the arena for dispute resolution from courts to parliaments. It eliminated the seniority inherent in appropriative water rights and it sidelined issues of third-party impacts. Another difference was the tight control of irrigation institutions by state governments and the national government’s willingness to intervene in state and local water management. Australian water reform was wrapped in politics. When there were successes, this is because the politics were managed adroitly; when political challenges proved insurmountable, reform stalled.
Patients With Persistent Low Back Pain and Nerve Root Involvement
Authors: Petersen Tom , Juhl Carsten B. , Fournier Gilles L. 
Published: October 2019

Study Design.
Prospective cohort study.

Objective.
The aims of this study were to evaluate the outcome of surgical and nonsurgical treatment for patients with lumbar herniated disc (LHD) or lumbar spinal stenosis (LSS) after 2 years and to identify predictors for nonsuccess.

Summary of Background Data.
Studies regarding the clinician's ability to identify patients with a poor prognosis are not in concurrence and further studies are warranted.

Methods.
This study included 390 patients with LHD or LSS referred for surgical evaluation after unsuccessful conservative treatment. Nonsuccess was defined as a Roland-Morris Disability score above 4 (0–23) or a Numeric Rating Scale back and leg pain score above 20 (0–60). Uni- and multivariate logistic regression analyses were used to investigate potential predictive factors including sociodemographic characteristics, history findings, levels of pain and disability, and magnetic resonance imaging findings.

Results.
Rates of nonsuccess at 2 years were approximately 30% in surgically treated patients with LHD, approximately about 60% in patients with LSS for disability, and 30% and 40%, respectively for pain. For the main outcome variable, disability, in the final multiple logistic regression model, nonsuccess after surgery was associated with male sex (odds ratio [OR] 2.04, 95% confidence interval [CI]: 1.02–4.11, P = 0.04), low level of education (OR 2.60, 95% CI: 1.28–5.29, P = 0.01), high pain intensity (OR 3.06, 95% CI: 1.51–6.21, P < 0.01), and widespread pain (OR 3.59, 95% CI: 1.36–9.46, P = 0.01).

Conclusion.
The results indicate that the prognosis for patients referred for surgery with persistent LHD or LSS and unsuccessful conservative treatment is substantially better when surgery is performed as opposed to not performed. The predictive value of the variables male sex, low level of education, high pain intensity, and widespread pain location found in our study are partly in accordance with results of previous studies. Thus, our results warrant further investigation until firm conclusions can be made.

Level of Evidence: 3
Diagnostic Delays Lead to Greater Disability in Degenerative Cervical Myelopathy and Represent a Health Inequality
Authors: Pope Daniel H. , Mowforth Oliver D. , Davies Benjamin M. , Kotter Mark R.N. 
Published: October 2019

Study Design.
Online survey.

Objective.
This study seeks to quantify delays faced, determine demographics of patients most likely to face delay, and determine whether delays affect surgical management and outcomes.

Summary of Background Data.
Patients report significant delays in diagnosis of degenerative cervical myelopathy (DCM).

Methods.
Seven hundred seventy-eighty patients with self-reported DCM recruited via online survey hosted on myelopathy.org. A cumulative odds ordinal logistic regression was run to determine the effects of demographic (sex, country of residence, ethnicity, household income, and educational status) on the delay in diagnosis of DCM. Chi-square tests of homogeneity were run to determine the effects of delayed diagnosis on functional outcomes (patient-derived modified Japanese Orthopaedic Association disability score, support dependence, and employment status) and surgical management (anterior/posterior approach, single-/multilevel surgery). A Kruskal-Wallis H test was used to determine whether delayed diagnosis affected the number of operations undergone.

Results.
The average delay in diagnosis faced was “1–2 years." Greater delays in diagnosis were faced by Black or African American patients (P = 0.010). Delayed diagnosis was predictive of greater disability as assessed by patient-derived modified Japanese Orthopaedic Association score (P = 0.001), support dependence (P = 0.040), and employment status (P < 0.0005). Delayed diagnosis did not affect the likelihood of surgery, the number of operations undergone or perioperative characteristics.

Conclusion.
Patients continue to face significant delays in diagnosis of DCM. Ethnicity significantly influences length of delay experienced. Longer delays do not appear to affect surgical management but are associated with greater disability.

Level of Evidence: 3
Four-Flanged Intrascleral Intraocular Lens Fixation Technique: No Flaps, No Knots, No Glue
Authors: Canabrava Sergio , Canêdo Domingos Lima Ana Carolina , Ribeiro Guilherme 
Published: October 2019

Purpose:
To develop a novel, sutureless, single-piece, nonfoldable intraocular lens (IOL) intrascleral fixation technique based on the existing Malbran IOL scleral fixation and Yamane double-needle techniques.

Methods:
The novel method uses a 5.0 polypropylene suture and a bipolar cautery to create 2 flanges in the eyelets of the IOL and 2 flanges outside to insert inside the scleral tunnel and thus fixate the IOL.

Results:
This technique had been applied in 4 patients with aphakia after phacoemulsification complications. The mean preoperative and postoperative corrected distance visual acuities were 0.45 ± 0.17 and 0.67 ± 0.27 (Snellen decimal units), respectively.

Conclusions:
The 4-flanged technique improves and simplifies the existing single-piece, nonfoldable IOL intrascleral fixation techniques.