bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Incidence of Clostridioides difficile Colonization Among a Cohort of Transplant Patients
Authors: Curry Scott , Gill Danielle , Vanderhorst Aisha , Kiley Kate , Salgado Carolina Cassandra 
Published: November 2020

Background: Allogeneic bone marrow transplant (BMT) as well as liver, heart, and lung transplant patients have high reported incidence rates of Clostridioides difficile infection (CDI). The prevalence and incidence of asymptomatic colonization with Clostridioides difficile (ACCD) in this group is not known. Methods: ACCD was defined as the presence of C. difficile on screening cultures without positive clinical testing for CDI ±1 week from the date of sampling. Patients undergoing BMT as well as liver, heart, and lung transplants at MUSC between October 2017 and October 2019 were cultured for C. difficile at admission for transplant then once weekly during inpatient admissions and at each outpatient follow-up for 90 days after transplantation. Testing for CDI occurred at the discretion of treating physicians and was done by PCR. Transient ACCD was defined as a positive culture from samples collected <7 days apart, and persistent ACCD was defined as having 2 or more positive cultures collected a minimum of 7 days apart. Results: The baseline prevalences of ACCD were 1 of 5 (20%), 0 of 2 (0%), 1 of 40 (3%), and 2 of 16(13%) for lung, heart, liver and BMT patients, respectively. Of 63 patients, 3 had a pretransplant history of CDI, 2 of whom had baseline ACCD. Incident ACCD occurred in 23 of 63 patients (37%) (Table 1). Overall, ACCD was observed in 30 of 63 patients (48%). Of the 30 patients with ACCD, 14 displayed persistent asymptomatic colonization, whereas 16 displayed transient asymptomatic colonization. Also, 5 patients in the cohort were diagnosed with CDI after transplantation, of whom 3 had ACCD prior to or following CDI. Conclusions: The baseline prevalence of C. difficile colonization in transplant patients (6.3%) was not substantially greater than those observed in recent studies of hospitalized inpatients, but the incidence of new colonization events (37%) was high in this patient population with numerous pretransplant risk factors for CDI.Funding: NoneDisclosures: None
Proficiency Testing Performances Analysis of Microbiology Laboratories Participating in Cambodia Antimicrobial Resistance (AMR) Surveillance System
Authors: Nov Vandarith , Chau Darapheak , Pa Kimsorn , Hem Keodane , Krang Sidonn 
Published: November 2020

Background: The WHO recommends the establishment of sustainable and evidence-based surveillance systems are recommended for the prevention of microbial resistance. For these surveillance systems, all medical microbiology laboratories are required to participate an external quality assessment (EQA) program that covers antimicrobial susceptibility testing (AST). Clinical microbiology EQA panels with 3 isolates have been provided 3 times per year to antimicrobial resistance (AMR) sentinel laboratories in Cambodia since 2012. We evaluated the performance of laboratory testing implemented between 2016 and 2019, based on 4 years EQA results to highlight the main sources of unsatisfactory analytical processes and to suggest areas for improvement. Methods: We analyzed the results of microbiology EQA in 7 AMR surveillance sentinel laboratories from 2016 to 2019, which were coordinated by the National Institute of Public Health (NIPH) under the program of Pacific Paramedical Training Centre (PPTC) from New Zealand. All participating laboratories were required to identify bacteria to the species level, to verify AST results, and to answer a case study question on parasitology. Feedback results and appropriate corrective actions were reviewed to identify the root cause of nonconformity and to suggest areas for improvement. Results: Proficiency test results of participating laboratories from 9 cycles with 27 isolates were analyzed. The overall average of EQA result was 94.0%. The laboratories failed to identify the isolated pathogens in 7.0% of the tests and failed to interpret the inhibition zone of AST (ie, resistant, intermediate or susceptible) in 6.0% of tested strains. The main causes of erroneous of PT results were either preanalytical (ie, handling of the samples, timing of analysis, equipment and reagent management), analytical (ie, quality control, unsuitable methods, confusion of samples, or errors of confirmation), or postanalytical mistakes (eg, interpretation guideline, cross-checking of results, or the information management system). Followed by the root causes, internal quality control and inventory management were the highest-priority suggestions for improvement. Conclusions: All participating laboratories showed good performance on EQA for evidence-based AMR surveillance. The national antimicrobial resistance data quality is sufficiently good and the data should be shared on national and international platforms. However, the regular monitoring of national AMR surveillance system should be conducted for continued quality improvement.Funding: NoneDisclosures: None
Quantifying the Risk of Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission From Patient to Healthcare Personnel in the Critical Care Setting
Authors: Adediran Timileyin , Harris Anthony , Johnson J. Kristie , Roghmann Mary-Claire , Hitchcok Stephanie , Liang Yuanyuan , Thom Kerri 
Published: November 2020

Background: Healthcare personnel (HCP) acquire MRSA on their gown and gloves during routine care activities for patients who are colonized or infected with MRSA at a rate of ∼15%. Certain care activities (eg, physical exam, care of endotracheal tube, wound care and bathing/hygiene) have been associated with a higher frequency of transmission from the patient to HCP gown and gloves than other activities (ie, administration of oral medicines, glucose monitoring, and manipulation of IV tubing/medication delivery). However, quantification of MRSA contamination and risk to subsequent patients is poorly defined. Objective: We sought to determine the mean MRSA colony-forming units (CFU) found on the gloves and gowns of HCP who acquire MRSA after various care activities involving patients with MRSA. Methods: We conducted a prospective cohort study at the University of Maryland Medical Center from December 2018 to October 2019. We identified patients colonized or infected with MRSA based on culture data from the prior 7 days. HCP performing prespecified care activities on eligible patients were observed. To isolate the risk of each care activity, HCP donned new gloves and gown prior to a specific care activity. Once that care activity was performed, HCP gloves and gown were swabbed prior to the any further care activities. HCP gloves were cultured with an E-swab by swabbing each digit up and down 3 times followed by 2 circles on the palm of their hands. HCP gowns were sampled by swabbing a 15 × 30-cm area along the beltline of the gown and along each inner forearm twice. E-swab liquid was then serially diluted and plated in triplicate on CHROMagar MRSA II (BD, Sparks, MD) to obtain CFU. We calculated the median CFUs and the interquartile range (IQR) for each specific care activity stratified by gown and gloves. Results: In total, 604 HCP–patient care interactions were observed. Table 1 displays the mean MRSA CFUs stratified by gown and gloves for each patient care activity of interest. Conclusions: The quantity of MRSA found on gowns and gloves varies depending on patient care activities. Recognition of differential transmission rates between various activities may allow different approaches to infection prevention, such as the use of personal protective equipment in high- versus low-risk activities and/or the use of more aggressive interventions for high-risk activities.Funding: NoneDisclosures: None
Reducing Sternal Site Surgical Site Infections by Postdischarge Follow-Up Using WhatsApp
Authors: Warrier Anup , Merin Arlin 
Published: November 2020

Background:
We conduct ∼180–200 CABG surgeries a year, and >70% of these patients are diabetic. Our SSI rate for sternal site was 4.4%, above the global benchmarks, and on review of the risk factors, poor glycemic control was identified as a major risk factor. Despite focusing on and achieving excellent glycemic control in the perioperative period, the SSI rates did not decrease significantly. We identified that the predischarge insulin regimens were inadequate for the patient once they returned to meals at home. Hence, we extended the interventions to the postdischarge phase and observed the impact of this change on SSIs. Methods: We developed a multidisciplinary and cross-functional team of cardiac surgeons, endocrinologists, physician assistants, infection control nurses and quality professionals. The CABG admissions information was obtained when financial clearance was sought for the procedure; the quality improvement professionals tracked these patients to ensure involvement of the endocrinology team. The physician assistant conducted the education to the patient and family regarding sugar management and use of a glucometer at home. The quality improvement team took a weekly report from the physician assistant and from the patient regarding the frequency of interactions and achievement of glycemic control. At the time of discharge, each of the diabetic patients who underwent CABG were educated by the physician assistant in the use of a glucometer, were provided with a sugar monitoring and insulin dosing chart as well as a WhatsApp number. The patient’s were instructed to monitor the sugars at specified intervals, to input the data into the personalized chart, and to send it to the PA through WhatsApp. The physician assistant then provided instructions on the insulin dosages using a standing order (dynamic insulin prescription regimen) developed by the endocrinologist. Results: The sternal site infection rate among the CABG patients dropped from 4.44% (4 cases of 90 surgeries) to 1.78% (2 cases of 112 patients), a 60% improvement. Readmissions among the CABG patients dropped from 3 cases in the study period to zero during the project phase. Conclusion: We have achieved significant reduction in sternal site SSI by (1) implementing a novel strategy of focusing on the postdischarge period and home management of blood sugar; (2) using freely available technology, WhatsApp; and (3) effectively using physician assistants by training and developing standing order sets for insulin.Funding: NoneDisclosures: None
Reflex Urine Culture Practices in a Regional Community Hospital Network
Authors: Ling Dorothy , Seidelman Jessica , Ashley Elizabeth Dodds , Lewis Sarah , Moehring Rebekah , Anderson Deverick John , Advani Sonali 
Published: November 2020

Background:
Reflex urine cultures (RUCs) have the potential to reduce unnecessary urine cultures and antibiotic use. However, urinalysis parameters that best predict true infection are unknown. In this study, we surveyed different RUC practices in laboratories across a regional network of community hospitals. Methods: We conducted a voluntary electronic survey of infection preventionists to describe laboratory practices relating to RUCs across 51 community hospitals in the Duke Infection Control Outreach Network (DICON) between May 15, 2019, and July 3, 2019. Results: We received 51 responses (response rate, 100%). Most hospital laboratories were located in North Carolina (n = 25, 49%) and Georgia (n = 18, 35%); 28 laboratories (55%) incorporated RUCs. Surveyed laboratories accepted urine samples from any source and various collection methods (eg, indwelling catheter specimens, clean catch specimens). Moreover, 24 laboratories (86%) offered RUCs for all patients, whereas 4 laboratories (14%) restricted RUCs to specific populations (ie, outpatient, emergency room or children). We observed wide variability in the urinalysis criteria used for RUCs (Table 1); 26 unique approaches were used among 28 laboratories. Also, 24 laboratories (86%) used multiple criteria and 4 (14%) used 1 criterion. Of those that used multiple criteria, all 24 proceeded to RUC if at least 1 UA criterion was met. Furthermore, 22 laboratories (79%) incorporated the presence of nitrites as a urinalysis criterion; 21 laboratories (75%) incorporated white blood cell count (WBC) as a criterion. The most frequent WBC cutoffs were “≥5” (n = 11, 39%) and “≥10” (n = 7, 25%). In addition, 21 laboratories (75%) incorporated leukocyte esterase as a urinalysis criterion, with criteria including “positive” (n = 15, 54%), “trace” (n = 4, 14%), “moderate” (n = 1, 4%), and “large” (n = 1, 4%). Also, 17 (61%) laboratories incorporated magnitude of bacteriuria as a urinalysis criterion. The cutoff ranged from “few” (n = 8, 29%), “moderate” (n = 7, 25%), to “many” (n = 2, 7%). Another 3 (11%) laboratories incorporated other criteria: presence of blood (n = 2, 7%) and presence of fungal elements (n = 1, 4%). Only 3 (11%) laboratories utilized epithelial cells as an exclusion criterion where urinalysis would not proceed to culture if epithelial cells in urinalysis samples exceeded the designated limit, ranging from “>5” to “>15”. Conclusions: More than half of the hospitals in our community hospital network utilize RUCs, but criteria varied widely. Future epidemiological research should aim to identify ideal urinalysis parameters as well as specific patient populations that safely benefit from RUC strategies.Funding: NoneDisclosures: None
Advances in deciphering the genetic basis of insect cuticular hydrocarbon biosynthesis and variation
Authors: Holze Henrietta , Schrader Lukas , Buellesbach Jan 
Published: November 2020

AbstractCuticular hydrocarbons (CHCs) have two fundamental functions in insects. They protect terrestrial insects against desiccation and serve as signaling molecules in a wide variety of chemical communication systems. It has been hypothesized that these pivotal dual traits for adaptation to both desiccation and signaling have contributed to the considerable evolutionary success of insects. CHCs have been extensively studied concerning their variation, behavioral impact, physiological properties, and chemical compositions. However, our understanding of the genetic underpinnings of CHC biosynthesis has remained limited and mostly biased towards one particular model organism (Drosophila). This rather narrow focus has hampered the establishment of a comprehensive view of CHC genetics across wider phylogenetic boundaries. This review attempts to integrate new insights and recent knowledge gained in the genetics of CHC biosynthesis, which is just beginning to incorporate work on more insect taxa beyondDrosophila. It is intended to provide a stepping stone towards a wider and more general understanding of the genetic mechanisms that gave rise to the astonishing diversity of CHC compounds across different insect taxa. Further research in this field is encouraged to aim at better discriminating conserved versus taxon-specific genetic elements underlying CHC variation. This will be instrumental in greatly expanding our knowledge of the origins and variation of genes governing the biosynthesis of these crucial phenotypic traits that have greatly impacted insect behavior, physiology, and evolution.
Implementation of leakage elimination operators and subspace protection
Authors: Markaida B. G. , Wu L.-A. 
Published: November 2020

AbstractDecoherence-induced leakage errors can potentially damage physical or logical qubits embedded in a subspace of the entire Hilbert space by coupling them to other system levels. Here we report the first experimental implementation of Leakage Elimination Operators (LEOs) that aims to reduce this undermining. LEOs are a type of dynamical decoupling control that have been previously introduced to counteract leakage from a chosen subspace into the rest of a Hilbert space, and have been widely explored theoretically. Different from other error correction strategies, LEOs are compatible with any gate sequence in a code space, and thus, compatible with universal quantum computation. Using IBM’s cloud quantum computer (QC), we design three potentially applicable examples of subspaces in two- and three-qubit Hilbert spaces and derive the explicit forms of the corresponding LEOs for these subspaces. For the first time, we experimentally demonstrate that these LEOs significantly suppress leakage. The results also show that the LEO time-scale condition can be satisfied with noise in the IBM’s cloud QC and pave a way for quantum setups to get rid of leakage trouble.
Single-cell RNA profiling links ncRNAs to spatiotemporal gene expression during C. elegans embryogenesis
Authors: Sun Yan , Yu Qichao , Li Lei , Mei Zhanlong , Zhou Biaofeng , Liu Shang , Pan Taotao , Wu Liang , Lei Ying , Liu Longqi , Drmanac Radoje , Ma Kun , Liu Shiping 
Published: November 2020

AbstractRecent studies show that non-coding RNAs (ncRNAs) can regulate the expression of protein-coding genes and play important roles in mammalian development. Previous studies have revealed that during C. elegans (Caenorhabditis elegans) embryo development, numerous genes in each cell are spatiotemporally regulated, causing the cell to differentiate into distinct cell types and tissues. We ask whether ncRNAs participate in the spatiotemporal regulation of genes in different types of cells and tissues during the embryogenesis of C. elegans. Here, by using marker-free full-length high-depth single-cell RNA sequencing (scRNA-seq) technique, we sequence the whole transcriptomes from 1031 embryonic cells of C. elegans and detect 20,431 protein-coding genes, including 22 cell-type-specific protein-coding markers, and 9843 ncRNAs including 11 cell-type-specific ncRNA markers. We induce a ncRNAs-based clustering strategy as a complementary strategy to the protein-coding gene-based clustering strategy for single-cell classification. We identify 94 ncRNAs that have never been reported to regulate gene expressions, are co-expressed with 1208 protein-coding genes in cell type specific and/or embryo time specific manners. Our findings suggest that these ncRNAs could potentially influence the spatiotemporal expression of the corresponding genes during the embryogenesis of C. elegans.
Brain morphometry in 22q11.2 deletion syndrome: an exploration of differences in cortical thickness, surface area, and their contribution to cortical volume
Authors: Gudbrandsen M. , Daly E. , Murphy C. M. , Blackmore C. E. , Rogdaki M. , Mann C. , Bletsch A. , Kushan L. , Bearden C. E. , Murphy D. G. M. , Craig M. C. , Ecker Christine 
Published: November 2020

Abstract22q11.2 Deletion Syndrome (22q11.2DS) is the most common microdeletion in humans, with a heterogenous clinical presentation including medical, behavioural and psychiatric conditions. Previous neuroimaging studies examining the neuroanatomical underpinnings of 22q11.2DS show alterations in cortical volume (CV), cortical thickness (CT) and surface area (SA). The aim of this study was to identify (1) the spatially distributed networks of differences in CT and SA in 22q11.2DS compared to controls, (2) their unique and spatial overlap, as well as (3) their relative contribution to observed differences in CV. Structural MRI scans were obtained from 62 individuals with 22q11.2DS and 57 age-and-gender-matched controls (aged 6–31). Using FreeSurfer, we examined differences in vertex-wise estimates of CV, CT and SA at each vertex, and compared the frequencies of vertices with a unique or overlapping difference for each morphometric feature. Our findings indicate that CT and SA make both common and unique contributions to volumetric differences in 22q11.2DS, and in some areas, their strong opposite effects mask differences in CV. By identifying the neuroanatomic variability in 22q11.2DS, and the separate contributions of CT and SA, we can start exploring the shared and distinct mechanisms that mediate neuropsychiatric symptoms across disorders, e.g. 22q11.2DS-related ASD and/or psychosis/schizophrenia.
3D hierarchical porous hybrid nanostructure of carbon nanotubes and N-doped activated carbon
Authors: Kamedulski Piotr , Zielinski Wojciech , Nowak Pawel , Lukaszewicz Jerzy P. , Ilnicka Anna 
Published: November 2020

AbstractIn this work, carbon nanotubes (CNTs)/nitrogen-doped activated carbon (AC) hybrids were designed and fabricated using a facile and one-step synthesis. The synthesis of CNTs is based on the recently discovered phenomenon of thermally-induced polyfurfuryl alcohol (PFA) conversion. Hybrid materials are fabricated through the in-situ free growth of closed carbon nanotubes on low-cost activated carbon substrates which were obtained from green algae or amino acids. Herein, three types of carbon nanotubes were observed to freely grow on an activated carbon background from Chlorella vulgaris or l-lysine, types such as multiwalled carbon and bamboo-like nanotubes, whose structure depends on the background used and conditions of the synthesis. Structure type is identified by analyzing transmission electron microscopy images. HRTEM images reveal the tubes’ outer diameter to be in the range of 20–120 nm. Because the carbon surface for the growth of carbon tubes contains nitrogen, the final hybrid materials also possess pyridinic-N and quaternary-N groups, as indicated by X-ray photoelectron spectra.
A novel 3D technique to assess symmetry of hemi pelvises
Authors: Bakhshayesh Peyman , Zaghloul Ahmed , Sephton Benjamin Michael , Enocson Anders 
Published: November 2020

AbstractAnatomical reconstruction of pelvic fractures has been shown to affect functional outcome. Using the contra lateral side of the extremities to create a template for an ipsilateral reconstruction is common practice in orthopedic surgery. We aimed to assess whether hemi pelvises are symmetrical in terms of translation and rotation using 3D reconstruction, point to point mirroring and merging of the 3D created volumes, a method with previous proven high precision and accuracy. CT images of ten randomly selected patients were used. The DICOM images were converted to STL files. Three dimensional images of left hemi pelvis were reversed and merged with the right side. The posterior aspect of the pelvises was considered static and the anterior aspect as moving. Differences in translation and rotation were measured. There were no statistically significant differences between right and left hemi pelvis. The 95% confidence interval (CI) for all mean angular differences between right hemi pelvis and mirrored left hemi pelvis were − 2° to 1.5°. The 95% CI for all mean translational differences between these two objects were − 2.3 to 2.9 mm. Differences between the right hemi pelvis and the mirrored images of the left hemi pelvis for any patient greater than 3 mm or 2 degrees could be excluded with a 95% confidence. The left and right hemi pelvis of healthy adults are symmetrical enough. The pre-operative planning based on a healthy contra lateral side seems reasonable.