bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Drug-Resistant Mycobacterium tuberculosis in the Veterans Health Administration (VHA)
Authors: Oda Gina , Lucero-Obusan Cynthia , Schirmer Patricia , Holodniy Mark 
Published: November 2020

Background: In 2018, the CDC reported that isoniazid (INH)-resistant and multidrug-resistant Mycobacterium tuberculosis (MDR-TB, ie, resistant to at least INH and rifampin) represented 9.3% and 1.5% of TB cases, respectively, in the United States. Objective: We analyzed the prevalence of drug-resistant TB within the Veterans Health Administration (VHA) to determine factors associated with hospitalization. Method: Patients were identified using Council of State and Territorial Epidemiologists case definition for laboratory-confirmed TB by querying VHA data sources from January 1, 2010, to June 30, 2019. Susceptibility results were included for isolates from all body sites. Using a 2-proportion z test, we compared the following demographic factors for susceptible versus drug-resistant TB: age, gender, race/ethnicity, location of residence and birth. We also assessed the following clinical and hospitalization factors: pulmonary versus extrapulmonary disease, latent TB infection (LTBI) screening and treatment, length of stay (LOS), intensive care unit (ICU) stay, and death. Results: In total, 878 patients had lab-confirmed TB, and 812 (92%) had electronic drug-susceptibility results available. Of 812 patients, 49 (6%) showed anti-TB drug resistance (Fig. 1), which was less than that reported nationally by the CDC (Fig. 2). No patients had extensively drug-resistant TB. Only 18 of 49 patients (37%) with resistant TB had LTBI screening ≥3 months prior to diagnosis. Among 6 patients with LTBI, 3 (50%) received treatment. Patient state of residence was the only demographic factor associated with resistant TB. Arizona, Iowa, Massachusetts, Montana, Nevada, South Dakota, and Utah were significantly associated with drug-resistant TB cases (P < .05); however, overall numbers of VHA TB cases in these states were low. Patients with resistant TB were more likely to have extrapulmonary TB (13 of 49, 26.5%) than patients with susceptible TB (111 of 763, 14.5%; P < .05) (Table 1). Mortality at 30 and 90 days for resistant versus susceptible TB cases did not differ significantly: 6.1% versus 5.1% at 30 days (P = .75) and 10.2% versus 10.6% at 90 days (P = 0.92), respectively. The proportion of drug-resistant TB cases hospitalized did not differ from susceptible cases (59% vs 63%), respectively (P = .62) nor did the proportion with ICU stay (14.3% vs 12.3%), respectively (P = .40). Median LOS for drug-resistant TB cases and susceptible cases were similar: 5 days (range, 0–303 versus 4 days (range, 0–111), respectively. Conclusions: Rates of drug-resistant TB are lower in the VHA than in the general US population. However, improvement is needed in LTBI screening and treatment rates. Little has been published on drug resistance in extrapulmonary TB; however, our findings should alert clinicians to the possibility of resistance in these challenging infections.Funding: NoneDisclosures: None
Quality of Hospital Infection Control Programs in Low- and Middle-income Countries: A National Survey
Authors: Alvim André , Gazzinell Gazzinell , Couto Braulio 
Published: November 2020

Background: One of the strategies to reduce healthcare-associated infections (HAIs) and promote the quality of disease prevention and control actions is the creation of a hospital infection control program. This program is a set of deliberately and systematically developed actions aimed toward reducing the incidence and severity of infections to the maximum extent possible. In Brazil, studies on the subject still need to be improved; they focus on structural and process assessments, especially the survey of continuing education indicators as a quality requirement for the prevention of HAIs. The organizational context does not contribute to the success of the program, and difficulties remain in implementing recommendations and in implementing patient safety policies. Objective: To analyze hospital infection control programs in relation to quality components. Methods: This cross-sectional epidemiological study was conducted in health services located in the 5 official regions of Brazil: Midwest, Northeast, North, Southeast, and South. To select the study sites, nonprobabilistic sampling using the snowball technique was used. The potential study population consisted of 114 hospital infection control services. Health professionals responded to the structured instrument sent electronically via e-mail, and other health services near their locality, until reaching a national proportion. We used the “Hospital Infection Control Program Evaluation Questionnaire”; it consists of 36 multiple-choice questions. This tool was validated by 96 expert judges using the Cronbach’s alpha test (0.82) and the content validity index (0.88). A data analysis was performed using the multivariate principal component analysis technique (PCA). Results: Overall, 13 PCA components (Fig. 1) were used to build a score for measuring the performance of the hospital infection control program (ie, IQPC score). The Southern region had the best performance of the hospital infection control program (mi = 1.50; P = .02) (Fig. 2), private administration (mi = 0.45; P = .05), of hospitals that contained 300 beds or (mi = 1.38; P < .01), hospitals that used the NHSN criterion for HAI surveillance (mi = 2.12; P < .01), and those who searched prospective activity as a surveillance method (mi = 0.51; P < .01). Conclusions: The quality of nosocomial infection control programs still needs to be improved among health services, highlighting the need to invest in small, publicly managed hospitals that use retrospective active surveillance methods.Funding: NoneDisclosures: None
Real-Time Bedside Root Cause Analysis (RCA) as a Catalyst for Clostridioides difficile Reduction
Authors: Newman Hannah , Kirschenbaum Linda , Macyk Irene , Baker Daniel , Haas Janet C 
Published: November 2020

Background:C. difficile infection has been a significant cause of morbidity and mortality over the past decade. Our hospital had rates of hospital-onset, laboratory-identified, C. difficile infection (HO-CDI) that were significantly higher than our state and national benchmarks. HO-CDI is defined as a test positive for C. difficile occurring on or after day 4 of hospitalization, regardless of the presence of symptoms. New leadership at the hospital sought a creative way to engage staff in finding solutions to our high rates of HO-CDI. Objective: The purpose of this intervention was to engage frontline staff in reporting and solving patient care situations that may increase infection risk to decrease HO-CDI rates. Methods: Starting in July 2015, real-time bedside RCAs were performed weekly for any HO-CDI on the unit to which the infection was attributed and on any unit from which the patient had been recently transferred. Top clinical leadership of the hospital, and all services and departments, physicians, nurses, and others involved with the patient’s care were expected to attend and identify factors that may have contributed to the infection. The findings were documented, and changes to care were made based on the findings. The rate of incident hospital onset HO-CDI per 10,000 patient days was used to measure outcome because standardized infection ratios for the period before 2016 were not available. Results: Staff members suggested 6 specific actions that were undertaken to decrease HO-CDI risk (Table 1). The HO-CDI rate during the preintervention period (2012–2014) was 6.85 per 10,000 patient days (275 cases). In the postintervention period (2016–2018) the HO-CDI rate was 3.13 per 10,000 patient days (101 cases). There was a 54% reduction in the HO-CDI rate in the postintervention period (P < .001). Conclusions: The multidisciplinary bedside RCA process resulted in staff providing recommendations for actions to reduce HO-CDI risk. Implementation of staff suggestions resulted in a sustained, significant decrease in HO-CDI.Funding: NoneDisclosures: None
The Dark Side of Executive Compensation Duration: Evidence from Mergers and Acquisitions
Authors: Li Zhi , Peng Qiyuan 
Published: November 2020

AbstractWe find that contrary to popular belief, CEOs with long compensation duration do not make better long-term investment decisions. Using a comprehensive pay duration measure, we find that acquisitions conducted by CEOs with long compensation duration receive more negative announcement returns, and experience significantly worse post-acquisition abnormal operating and stock performance, compared with deals conducted by CEOs with short compensation duration. The negative correlation between compensation duration and mergers and acquisitions (M&A) performance is driven by long-term time-vesting plans, not by performance-vesting plans. The results suggest that extending CEO pay horizons without implementing performance requirements is insufficient to improve managerial long-term investment decisions.
3D microfluidic gradient generator for combination antimicrobial susceptibility testing
Authors: Sweet Eric , Yang Brenda , Chen Joshua , Vickerman Reed , Lin Yujui , Long Alison , Jacobs Eric , Wu Tinglin , Mercier Camille , Jew Ryan , Attal Yash , Liu Siyang , Chang Andrew , Lin Liwei 
Published: November 2020

AbstractMicrofluidic concentration gradient generators (µ-CGGs) have been utilized to identify optimal drug compositions through antimicrobial susceptibility testing (AST) for the treatment of antimicrobial-resistant (AMR) infections. Conventional µ-CGGs fabricated via photolithography-based micromachining processes, however, are fundamentally limited to two-dimensional fluidic routing, such that only two distinct antimicrobial drugs can be tested at once. This work addresses this limitation by employing Multijet-3D-printed microchannel networks capable of fluidic routing in three dimensions to generate symmetric multidrug concentration gradients. The three-fluid gradient generation characteristics of the fabricated 3D µ-CGG prototype were quantified through both theoretical simulations and experimental validations. Furthermore, the antimicrobial effects of three highly clinically relevant antibiotic drugs, tetracycline, ciprofloxacin, and amikacin, were evaluated via experimental single-antibiotic minimum inhibitory concentration (MIC) and pairwise and three-way antibiotic combination drug screening (CDS) studies against model antibiotic-resistant Escherichia coli bacteria. As such, this 3D µ-CGG platform has great potential to enable expedited combination AST screening for various biomedical and diagnostic applications.
Fabrication of on-chip probes for double-tip scanning tunneling microscopy
Authors: Leeuwenhoek Maarten , Groenewoud Freek , van Oosten Kees , Benschop Tjerk , Allan Milan P. , Gröblacher Simon 
Published: November 2020

AbstractA reduction of the interprobe distance in multiprobe and double-tip scanning tunneling microscopy to the nanometer scale has been a longstanding and technically difficult challenge. Recent multiprobe systems have allowed for significant progress by achieving distances of ~30 nm using two individually driven, traditional metal wire tips. For situations where simple alignment and fixed separation can be advantageous, we present the fabrication of on-chip double-tip devices that incorporate two mechanically fixed gold tips with a tip separation of only 35 nm. We utilize the excellent mechanical, insulating and dielectric properties of high-quality SiN as a base material to realize easy-to-implement, lithographically defined and mechanically stable tips. With their large contact pads and adjustable footprint, these novel tips can be easily integrated with most existing commercial combined STM/AFM systems.
COVID-19-associated gastrointestinal and liver injury: clinical features and potential mechanisms
Authors: Zhong Peijie , Xu Jing , Yang Dong , Shen Yue , Wang Lu , Feng Yun , Du Chunling , Song Yuanlin , Wu Chaomin , Hu Xianglin , Sun Yangbai 
Published: November 2020

AbstractCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infection is spreading globally and poses a huge threat to human health. Besides common respiratory symptoms, some patients with COVID-19 experience gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and loss of appetite. SARS-CoV-2 might infect the gastrointestinal tract through its viral receptor angiotensin-converting enzyme 2 (ACE2) and there is increasing evidence of a possible fecal–oral transmission route. In addition, there exist multiple abnormalities in liver enzymes. COVID-19-related liver injury may be due to drug-induced liver injury, systemic inflammatory reaction, and hypoxia–ischemia reperfusion injury. The direct toxic attack of SARS-CoV-2 on the liver is still questionable. This review highlights the manifestations and potential mechanisms of gastrointestinal and hepatic injuries in COVID-19 to raise awareness of digestive system injury in COVID-19.
Microbial ecology of the newly discovered serpentinite-hosted Old City hydrothermal field (southwest Indian ridge)
Authors: Lecoeuvre Aurélien , Ménez Bénédicte , Cannat Mathilde , Chavagnac Valérie , Gérard Emmanuelle 
Published: November 2020

Abstract
Lost City (mid-Atlantic ridge) is a unique oceanic hydrothermal field where carbonate-brucite chimneys are colonized by a single phylotype of archaeal Methanosarcinales, as well as sulfur- and methane-metabolizing bacteria. So far, only one submarine analog of Lost City has been characterized, the Prony Bay hydrothermal field (New Caledonia), which nonetheless shows more microbiological similarities with ecosystems associated with continental ophiolites. This study presents the microbial ecology of the ‘Lost City’-type Old City hydrothermal field, recently discovered along the southwest Indian ridge. Five carbonate-brucite chimneys were sampled and subjected to mineralogical and geochemical analyses, microimaging, as well as 16S rRNA-encoding gene and metagenomic sequencing. Dominant taxa and metabolisms vary between chimneys, in conjunction with the predicted redox state, while potential formate- and CO-metabolizing microorganisms as well as sulfur-metabolizing bacteria are always abundant. We hypothesize that the variable environmental conditions resulting from the slow and diffuse hydrothermal fluid discharge that currently characterizes Old City could lead to different microbial populations between chimneys that utilize CO and formate differently as carbon or electron sources. Old City discovery and this first description of its microbial ecology opens up attractive perspectives for understanding environmental factors shaping communities and metabolisms in oceanic serpentinite-hosted ecosystems.
Blood-brain barrier associated tight junction disruption is a hallmark feature of major psychiatric disorders
Authors: Greene Chris , Hanley Nicole , Campbell Matthew 
Published: November 2020

AbstractMajor psychiatric disorders affect 25% of the population. While genetic and environmental risk factors have been identified, the underlying pathophysiology of conditions, such as schizophrenia, bipolar disorder and major depression remains largely unknown. Here, we show that endothelial associated tight junction components are differentially regulated at the blood-brain barrier (BBB) in distinct neuroanatomic regions of human donor brain tissues. Previous studies have shown associations between BBB disruption and the development of psychiatric behaviours in rodents. Using immunohistochemistry and qRT-PCR, we show that the expression of claudin-5 is reduced in the hippocampus of individuals diagnosed with major depression or schizophrenia. We also show that levels of tight junction mRNA transcripts, including claudin-5, claudin-12 and ZO-1 correlate with disease duration and age of onset of a range of psychiatric disorders. Together, these data show that BBB associated tight junction disruption and dysregulation is a common pathology observed across the major psychiatric disorders. Targeting and regulating tight junction protein integrity at the BBB could, therefore, represent a novel therapeutic strategy for these conditions.
Blood pressure monitoring following individual carpules of anesthetic utilizing computer-controlled anesthetic delivery
Authors: Soileau Kristi M. , DeGenova Adam E. , Yu Qingzhao 
Published: November 2020

AbstractTo date, no study has evaluated blood pressure following administration of each carpule given for dental procedures using a computerized dental anesthesia system. Blood pressures taken prior to performing invasive periodontal procedures were compared with those readings measured following delivery of each of up to three consecutive carpules of Marcaine or Xylocaine in varying order. Pressure differences were also adjusted for age, sex, race, and whether a prescribed anxiolytic was taken beforehand. Neither systolic nor diastolic blood pressures changed significantly as compared to initial blood pressure readings. However, compared with Whites, Hispanics, and Middle Easterners, Blacks had significantly higher systolic pressure at the third carpule delivery, the cause being unknown. Blood pressure in patients being anesthetized for root planing and various periodontal surgical procedures will not increase significantly when administering up to three carpules, whether Marcaine or Xylocaine, in varying order, using controlled flow dental anesthesia, and this method may be preferable to syringes in managing dental procedural stress.
Interpretation of morphogen gradients by a synthetic bistable circuit
Authors: Grant Paul K. , Szep Gregory , Patange Om , Halatek Jacob , Coppard Valerie , Csikász-Nagy Attila , Haseloff Jim , Locke James C. W. , Dalchau Neil , Phillips Andrew 
Published: November 2020

AbstractDuring development, cells gain positional information through the interpretation of dynamic morphogen gradients. A proposed mechanism for interpreting opposing morphogen gradients is mutual inhibition of downstream transcription factors, but isolating the role of this specific motif within a natural network remains a challenge. Here, we engineer a synthetic morphogen-induced mutual inhibition circuit in E. coli populations and show that mutual inhibition alone is sufficient to produce stable domains of gene expression in response to dynamic morphogen gradients, provided the spatial average of the morphogens falls within the region of bistability at the single cell level. When we add sender devices, the resulting patterning circuit produces theoretically predicted self-organised gene expression domains in response to a single gradient. We develop computational models of our synthetic circuits parameterised to timecourse fluorescence data, providing both a theoretical and experimental framework for engineering morphogen-induced spatial patterning in cell populations.
Heritability of the HIV-1 reservoir size and decay under long-term suppressive ART
Authors: Wan Chenjie , Bachmann Nadine , Mitov Venelin , Blanquart François , Céspedes Susana Posada , Turk Teja , Neumann Kathrin , Beerenwinkel Niko , Bogojeska Jasmina , Fellay Jacques , Roth Volker , Böni Jürg , Perreau Matthieu , Klimkait Thomas , Yerly Sabine , Battegay Manuel , Walti Laura , Calmy Alexandra , Vernazza Pietro , Bernasconi Enos , Cavassini Matthias , Metzner Karin J. , Günthard Huldrych F. , Kouyos Roger D. ,   the Swiss HIV Cohort Study, Anagnostopoulos Alexia , Battegay Manuel , Bernasconi Enos , Böni Jürg , Braun Dominique L. , Bucher Heiner C. , Calmy Alexandra , Cavassini Matthias , Ciuffi Angela , Dollenmaier Günter , Egger Matthias , Elzi Luigia , Fehr Jan , Fellay Jacques , Furrer Hansjakob , Fux Christoph A. , Günthard Huldrych F. , Haerry David , Hasse Barbara , Hirsch Hans H. , Hoffmann Matthias , Hösli Irene , Huber Michael , Kahlert Christian , Kaiser Laurent , Keiser Olivia , Klimkait Thomas , Kouyos Roger D. , Kovari Helen , Ledergerber Bruno , Martinetti Gladys , de Tejada Begona Martinez , Marzolini Catia , Metzner Karin J. , Müller Nicolas , Nicca Dunja , Paioni Paolo , Pantaleo Guiseppe , Perreau Matthieu , Rauch Andri , Rudin Christoph , Scherrer Alexandra U. , Schmid Patrick , Speck Roberto , Stöckle Marcel , Tarr Philip , Trkola Alexandra , Vernazza Pietro , Wandeler Gilles , Weber Rainer , Yerly Sabine 
Published: November 2020

AbstractThe HIV-1 reservoir is the major hurdle to curing HIV-1. However, the impact of the viral genome on the HIV-1 reservoir, i.e. its heritability, remains unknown. We investigate the heritability of the HIV-1 reservoir size and its long-term decay by analyzing the distribution of those traits on viral phylogenies from both partial-pol and viral near full-length genome sequences. We use a unique nationwide cohort of 610 well-characterized HIV-1 subtype-B infected individuals on suppressive ART for a median of 5.4 years. We find that a moderate but significant fraction of the HIV-1 reservoir size 1.5 years after the initiation of ART is explained by genetic factors. At the same time, we find more tentative evidence for the heritability of the long-term HIV-1 reservoir decay. Our findings indicate that viral genetic factors contribute to the HIV-1 reservoir size and hence the infecting HIV-1 strain may affect individual patients’ hurdle towards a cure.
Structural and electronic switching of a single crystal 2D metal-organic framework prepared by chemical vapor deposition
Authors: Claire F. James , Solomos Marina A. , Kim Jungkil , Wang Gaoqiang , Siegler Maxime A. , Crommie Michael F. , Kempa Thomas J. 
Published: November 2020

AbstractThe incorporation of metal-organic frameworks into advanced devices remains a desirable goal, but progress is hindered by difficulties in preparing large crystalline metal-organic framework films with suitable electronic performance. We demonstrate the direct growth of large-area, high quality, and phase pure single metal-organic framework crystals through chemical vapor deposition of a dimolybdenum paddlewheel precursor, Mo2(INA)4. These exceptionally uniform, high quality crystals cover areas up to 8600 µm2 and can be grown down to thicknesses of 30 nm. Moreover, scanning tunneling microscopy indicates that the Mo2(INA)4 clusters assemble into a two-dimensional, single-layer framework. Devices are readily fabricated from single vapor-phase grown crystals and exhibit reversible 8-fold changes in conductivity upon illumination at modest powers. Moreover, we identify vapor-induced single crystal transitions that are reversible and responsible for 30-fold changes in conductivity of the metal-organic framework as monitored by in situ device measurements. Gas-phase methods, including chemical vapor deposition, show broader promise for the preparation of high-quality molecular frameworks, and may enable their integration into devices, including detectors and actuators.