bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in a Dutch general hospital, 2014–2017: successful control using a restrictive screening strategy
Authors: Weterings Veronica , van Oosten Anita , Nieuwkoop Ellen , Nelson Jolande , Voss Andreas , Wintermans Bas , van Lieshout Joris , Kluytmans Jan , Veenemans Jacobien 
Published: February 2021

Abstract
Background
The emergence of vancomycin resistant enterococci poses a major problem in healthcare settings. Here we describe a hospital-wide outbreak of vancomycin-resistant Enterococcus faecium in a general hospital in The Netherlands in the period December 2014–February 2017. Due to late detection of the outbreak, a large cohort of approximately 25,000 (discharged) patients was classified as ‘VRE suspected’. Hereupon a mitigated screening and isolation policy, as compared with the national guideline, was implemented to control the outbreak.

Methods
After the outbreak was identified, a screening policy consisting of a single rectal swab culture (with enrichment broth) to discontinue isolation and removing ‘VRE suspected’ label in the electronic patient files for readmitted VRE suspected patients, was implemented. In addition to the on admission screening, periodic hospital-wide point prevalence screening, measures to improve compliance with standard infection control precautions and enhanced environmental cleaning were implemented to control the outbreak.

Results
Between September 2014 and February 2017, 140 patients were identified to be colonised by vanA mediated vancomycin-resistant Enterococcus faecium (VREfm). Two of these patients developed bacteraemia. AFLP typing showed that the outbreak was caused by a single clone. Extensive environmental contamination was found in multiple wards. Within nine months after the detection of the outbreak no new VRE cases were detected.

Conclusion
We implemented a control strategy based on targeted screening and isolation in combination with implementation of general precautions and environmental cleaning. The strategy was less stringent than the Dutch national guideline for VRE control. This strategy successfully controlled the outbreak, while it was associated with a reduction in the number of isolation days and the number of cultures taken.
Post-peak Behaviour of Composite Column Using a Ductile Lightweight Aggregate Concrete
Authors: Hamidian Mohammad Reza , Shafigh Payam 
Published: February 2021

AbstractOil palm shell (OPS) concrete filled steel tube (CFT) columns are acknowledged to be a new type of sustainable composite column. In this type of column, the conventional coarse aggregate was partially replaced with OPS lightweight aggregate to provide a green composite column. This type of CFT column showed higher energy absorption and flexibility compared to CFT columns with normal weight concrete. This research studied the effect of the strength of OPS concrete on the axial compressive behaviour of CFT columns for two grades of OPS concretes. The behaviour was comparable to that of CFT columns with two grades of normal concrete. The results showed that the CFT columns with OPS concrete achieved a new post-peak behaviour. The experimental results of the axial compressive load were compared with the estimation of two international standards. EC4-1994 and ACI318-14 showed a reliable and conservative estimation of the axial load capacity of CFT columns, respectively.
Lactobacillus reuteri-derived extracellular vesicles maintain intestinal immune homeostasis against lipopolysaccharide-induced inflammatory responses in broilers
Authors: Hu Rujiu , Lin Hua , Wang Mimi , Zhao Yuezhen , Liu Haojing , Min Yuna , Yang Xiaojun , Gao Yupeng , Yang Mingming 
Published: February 2021

Abstract
Background
Lactobacillus reuteri strains are widely used as probiotics to prevent and treat inflammatory bowel disease by modulating the host’s immune system. However, the underlying mechanisms by which they communicate with the host have not been clearly understood. Bacterial extracellular vesicles (EVs) have been considered as important mediators of host-pathogen interactions, but their potential role in commensals-host crosstalk has not been widely studied. Here, we investigated the regulatory actions of EVs produced by L. reuteri BBC3, a gut-associated commensal bacterium of Black-Bone chicken, in the development of lipopolysaccharide (LPS)-induced intestinal inflammation in a chicken model using both in vivo and in vitro experiments.

Results
L. reuteri BBC3 produced nano-scale membrane vesicles with the size range of 60–250 nm. Biochemical and proteomic analyses showed that L. reuteri BBC3-derived EVs (LrEVs) carried DNA, RNA and several bioactive proteins previously described as mediators of other probiotics’ beneficial effects such as glucosyltransferase, serine protease and elongation factor Tu. In vivo broiler experiments showed that administration of LrEVs exerted similar effects as L. reuteri BBC3 in attenuating LPS-induced inflammation by improving growth performance, reducing mortality and decreasing intestinal injury. LrEVs suppressed the LPS-induced expression of pro-inflammatory genes (TNF-α, IL-1β, IL-6, IL-17 and IL-8), and improved the expression of anti-inflammatory genes (IL-10 and TGF-β) in the jejunum. LrEVs could be internalized by chicken macrophages. In vitro pretreatment with LrEVs reduced the gene expression of TNF-α, IL-1β and IL-6 by suppressing the NF-κB activity, and enhanced the gene expression of IL-10 and TGF-β in LPS-activated chicken macrophages. Additionally, LrEVs could inhibit Th1- and Th17-mediated inflammatory responses and enhance the immunoregulatory cells-mediated immunosuppression in splenic lymphocytes of LPS-challenged chickens through the activation of macrophages. Finally, we revealed that the reduced content of both vesicular proteins and nucleic acids attenuated the suppression of LrEVs on LPS-induced inflammatory responses in ex vivo experiments, suggesting that they are essential for the LrEVs-mediated immunoregulation.

Conclusions
We revealed that LrEVs participated in maintaining intestinal immune homeostasis against LPS-induced inflammatory responses in a chicken model. Our findings provide mechanistic insight into how commensal and probiotic Lactobacillus species modulate the host’s immune system in pathogens-induced inflammation.
Belinostat in combination with standard cyclophosphamide, doxorubicin, vincristine and prednisone as first-line treatment for patients with newly diagnosed peripheral T-cell lymphoma
Authors: Johnston Patrick B. , Cashen Amanda F. , Nikolinakos Petros G. , Beaven Anne W. , Barta Stefan Klaus , Bhat Gajanan , Hasal Steven J. , De Vos Sven , Oki Yasuhiro , Deng Changchun , Foss Francine M. 
Published: February 2021

Abstract
Background
Belinostat is a histone deacetylase inhibitor approved for relapsed refractory peripheral T-cell lymphoma (PTCL). The primary objective of this study was to determine the maximum tolerated dose (MTD) of belinostat combined with CHOP (Bel-CHOP). Secondary objectives included safety/tolerability, overall response rate (ORR), and belinostat pharmacokinetics (PK).

Methods
Patients were ≥ 18 years with histologically confirmed, previously untreated PTCL. Patients received belinostat (1000 mg/m2 once daily) + standard CHOP for 6 cycles with varying schedules using a 3 + 3 design in Part A. Part B enrolled patients at MTD dose.

Results
Twenty-three patients were treated. One patient experienced DLT (Grade 3 non-hematologic toxicity) on Day 1–3 schedule, resulting in escalation to Day 1–5 schedule (n = 3). No DLTs were observed and Day 1–5 schedule with 1000 mg/m2 was declared as MTD. Twelve additional patients were enrolled in Part B using MTD. Median relative dose intensity was 98%. All patients experienced adverse events (AEs), including nausea (78%), fatigue (61%), and vomiting (57%). Serious AEs occurred in 43%, with febrile neutropenia (17%) and pyrexia (13%). Overall ORR was 86% with 71% reported CR at MTD. Belinostat PK parameters were similar to single-agent.

Conclusions
Bel-CHOP was well tolerated and MTD in CHOP combination was the same dose and schedule as single agent dosing.
Trial Registration: ClinicalTrials.gov Identifier: NCT01839097.
Characterization of the human skin resistome and identification of two microbiota cutotypes
Authors: Li Zhiming , Xia Jingjing , Jiang Liuyiqi , Tan Yimei , An Yitai , Zhu Xingyu , Ruan Jie , Chen Zhihua , Zhen Hefu , Ma Yanyun , Jie Zhuye , Xiao Liang , Yang Huanming , Wang Jian , Kristiansen Karsten , Xu Xun , Jin Li , Nie Chao , Krutmann Jean , Liu Xiao , Wang Jiucun 
Published: February 2021

Abstract
Background
The human skin microbiota is considered to be essential for skin homeostasis and barrier function. Comprehensive analyses of its function would substantially benefit from a catalog of reference genes derived from metagenomic sequencing. The existing catalog for the human skin microbiome is based on samples from limited individuals from a single cohort on reference genomes, which limits the coverage of global skin microbiome diversity.

Results
In the present study, we have used shotgun metagenomics to newly sequence 822 skin samples from Han Chinese, which were subsequently combined with 538 previously sequenced North American samples to construct an integrated Human Skin Microbial Gene Catalog (iHSMGC). The iHSMGC comprised 10,930,638 genes with the detection of 4,879,024 new genes. Characterization of the human skin resistome based on iHSMGC confirmed that skin commensals, such as Staphylococcus spp, are an important reservoir of antibiotic resistance genes (ARGs). Further analyses of skin microbial ARGs detected microbe-specific and skin site-specific ARG signatures. Of note, the abundance of ARGs was significantly higher in Chinese than Americans, while multidrug-resistant bacteria (“superbugs”) existed on the skin of both Americans and Chinese. A detailed analysis of microbial signatures identified Moraxella osloensis as a species specific for Chinese skin. Importantly, Moraxella osloensis proved to be a signature species for one of two robust patterns of microbial networks present on Chinese skin, with Cutibacterium acnes indicating the second one. Each of such “cutotypes” was associated with distinct patterns of data-driven marker genes, functional modules, and host skin properties. The two cutotypes markedly differed in functional modules related to their metabolic characteristics, indicating that host-dependent trophic chains might underlie their development.

Conclusions
The development of the iHSMGC will facilitate further studies on the human skin microbiome. In the present study, it was used to further characterize the human skin resistome. It also allowed to discover the existence of two cutotypes on the human skin. The latter finding will contribute to a better understanding of the interpersonal complexity of the skin microbiome.
Expression of immune checkpoints on circulating tumor cells in men with metastatic prostate cancer
Authors: Zhang Tian , Agarwal Anika , Almquist R. Garland , Runyambo Daniella , Park Sally , Bronson Elizabeth , Boominathan Rengasamy , Rao Chandra , Anand Monika , Oyekunle Taofik , Healy Patrick , McNamara Megan A. , Ware Kathryn , Somarelli Jason A. , George Daniel J. , Armstrong Andrew J. 
Published: February 2021

AbstractBackgroundA subset of men with metastatic prostate cancer (mPC) responds to immune checkpoint inhibitors, and there is an unmet need to predict those most likely to benefit. We characterized circulating tumor cells (CTCs) for expression of immune checkpoint ligands in men with mPC as a non-invasive biomarker of immune evasion and immunotherapy benefit.MethodsThree cohorts of patients were enrolled: 1) men with mCRPC starting abiraterone acetate/prednisone or enzalutamide (pre-ARSI), 2) men with mCRPC who were progressing on enzalutamide or abiraterone acetate/prednisone (post-ARSI), and 3) men with newly diagnosed metastatic hormone sensitive prostate cancer (mHSPC) starting androgen deprivation therapy. CTCs were captured using the CellSearch® system and stained for PD-L1, PD-L2, B7-H3, and CTLA-4 at baseline, on treatment, and disease progression. Summary statistics on mean CTCs per cohort, as well as rates of ligand positivity were used to analyze CTCs by cohort and by timepoint.ResultsMen in all cohorts and timepoints had prevalent CTC B7-H3 expression (> 80%). We found evidence for CTC PD-L1 expression across disease states, in which > 1 positive CTC or > 50% of CTCs were positive for PD-L1 in 40 and 30% of men with mHSPC, respectively, 60 and 20% of men with mCRPC pre-ARSI, and 70 and 30% of men with mCRPC post-ARSI. CTC PD-L2 expression was present in 20–40% of men in each disease state, while CTC CTLA-4 expression was rare, present in 20% of men with mCRPC pre-ARSI and 10% of men with mCRPC post-ARSI or with mHSPC. CTC immune checkpoint expression was heterogeneous within/between men and across disease states.ConclusionsWe have identified that CTCs from men with mPC heterogeneously express immune checkpoints B7-H3, PD-L1, PD-L2, and CTLA-4, and the detection of these immune checkpoints may enable monitoring on immunotherapy.
5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma
Authors: Thamboo Andrew , Patel Vishal S. , Hwang Peter H. 
Published: February 2021

Objective Recurrent nasopharyngeal carcinoma (rNPC) can be salvaged with re-irradiation, open nasopharyngectomy, and more recently endoscopic nasopharyngectomy. However, long-term outcomes of endoscopic approaches are lacking. Thus, we report 5-year outcomes following endoscopic nasopharyngectomy for rNPC. Methods Patients who underwent endoscopic nasopharyngectomy for rNPC between January 2000 and January 2012 were retrospectively reviewed. Patients were included if they had their first endoscopic nasopharyngectomy at least 5 years prior to this study. Presenting (cTNM) status and recurrent (rTNM) status for each recurrence was determined. Outcomes included margin status, disease recurrence, death, and complication rates. Results Thirteen patients were included. Four patients had a prior open nasopharyngectomy. Mean time follow-up was 74.3 months (range = 56.4–96 months). Negative margins were achieved in 77% of initial cases. Positive margins were associated with higher rT stages. Re-recurrence was seen in 6 patients, which was also associated with a higher cStage and rStage. All patients with positive margins had re-recurrence. Four patients required repeat endoscopic nasopharyngectomy and two received chemoradiation. All four with a second endoscopic procedure had further disease recurrence. Five-year local disease-free and overall survival rates were 53.9 and 84.6%, respectively. The minor complication rate was 52.6%, major operative complication rate was 0.0%, and late complication rate was 23.1%. Conclusion Endoscopic nasopharyngectomy demonstrates promising 5-year overall survival rate for rT1 and rT2 cases of rNPC with favorable complication rates. Lower rStages were associated with a higher disease-free rate, and lower cStages were associated with improved overall prognosis. Close surveillance and prompt management of recurrences can be associated with favorable long-term tumor control. Level of evidence 4 Graphical Abstract
Interdisciplinary conversations in STEM education: can faculty understand each other better than their students do?
Authors: Rabin Jeffrey M. , Burgasser Adam , Bussey Thomas J. , Eggers John , Lo Stanley M. , Seethaler Sherry , Stevens Laura , Weizman Haim 
Published: February 2021

AbstractRate of change concepts from calculus are presented and applied rather differently in college mathematics, physics, biology, and chemistry classes. This is not simply a matter of pedagogical style but reflects real cultural differences between these disciplines. We describe the efforts of our interdisciplinary collaboration to understand and reconcile these differences as we designed and discussed instructional videos for students. We summarize our conversations about terminology, notation, functions, rates, units, and sign conventions across the disciplines. We present some strategies that enabled us to communicate effectively, resolve confusions, and reach shared understandings. Our work has implications for others involved in collaborative interdisciplinary projects and for STEM educators.In theory, there’s no difference between theory and practice. But in practice, there is.– Benjamin Brewster. Also attributed to Yogi Berra.
Geomagnetic Virtual Observatories: monitoring geomagnetic secular variation with the Swarm satellites
Authors: Hammer Magnus D. , Cox Grace A. , Brown William J. , Beggan Ciarán D. , Finlay Christopher C. 
Published: February 2021

AbstractWe present geomagnetic main field and secular variation time series, at 300 equal-area distributed locations and at 490 km altitude, derived from magnetic field measurements collected by the three Swarm satellites. These Geomagnetic Virtual Observatory (GVO) series provide a convenient means to globally monitor and analyze long-term variations of the geomagnetic field from low-Earth orbit. The series are obtained by robust fits of local Cartesian potential field models to along-track and East–West sums and differences of Swarm satellite data collected within a radius of 700 km of the GVO locations during either 1-monthly or 4-monthly time windows. We describe two GVO data products: (1) ‘Observed Field’ GVO time series, where all observed sources contribute to the estimated values, without any data selection or correction, and (2) ‘Core Field’ GVO time series, where additional data selection is carried out, then de-noising schemes and epoch-by-epoch spherical harmonic analysis are applied to reduce contamination by magnetospheric and ionospheric signals. Secular variation series are provided as annual differences of the Core Field GVOs. We present examples of the resulting Swarm GVO series, assessing their quality through comparisons with ground observatories and geomagnetic field models. In benchmark comparisons with six high-quality mid-to-low latitude ground observatories we find the secular variation of the Core Field GVO field intensities, calculated using annual differences, agrees to an rms of 1.8 nT/yr and 1.2 nT/yr for the 1-monthly and 4-monthly versions, respectively. Regular sampling in space and time, and the availability of data error estimates, makes the GVO series well suited for users wishing to perform data assimilation studies of core dynamics, or to study long-period magnetospheric and ionospheric signals and their induced counterparts. The Swarm GVO time series will be regularly updated, approximately every four months, allowing ready access to the latest secular variation data from the Swarm satellites.
Feasibility of ABLE 1.0—a program aiming at enhancing the ability to perform activities of daily living in persons with chronic conditions
Authors: Nielsen Kristina Tomra , Guidetti Susanne , von Bülow Cecilie , Klokker Louise , Wæhrens Eva Ejlersen 
Published: February 2021

Abstract
Background
The “A Better everyday LifE” (ABLE) intervention was developed to accommodate the need of a program addressing ability to perform activities of daily living (ADL) in persons with chronic conditions living at home. During intervention development, it is necessary to evaluate relevant aspects of the feasibility of a program. Thus, the aim was to evaluate the feasibility of content and delivery of ABLE version 1.0.

Methods
A one group pre- and post-test design was applied. Thirty persons with chronic conditions, two occupational therapists (OTs), and five occupational therapy students (OTSs) participated. ABLE 1.0 is an 8-week program consisting of ADL evaluation (session 1); goal setting and reasons for ADL problems (session 2); intervention (sessions 3–7); and re-evaluation (final session), conducted in the clients’ home-setting and local area. Sessions 1–4 and the final session was mandatory.
To evaluate the feasibility of content and delivery, the OTs, after each session, reported on applied intervention component(s), time-use, needed equipment, adjustments, meaningfulness, confidence, progress toward goal attainment, and side effects using registration forms. The clients reported on progress toward goal attainment, meaningfulness, and satisfaction. Clinically relevant improvements in ADL ability were identified using the ADL-Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). Goal attainment was evaluated using the Goal Attainment Scaling (GAS).

Results
Twenty clients (67%) completed ABLE 1.0 and received four sessions (median = 4, range 4–7) each lasting between 30 and 94 min. Most frequently applied component was “Changing habits related to task performance”. Generally, OTs reported having the needed equipment. Deviations from the manual were made by omission of GAS and AMPS and less than mandatory number of sessions per client. The OTs reported confidence in delivering the program and the clients perceived the program as meaningful and satisfying, and experienced progress toward goal attainment. Goal attainment was found in 52% of the goals. Sixteen (80%) clients obtained clinically relevant improvements in self-reported or observed ADL ability.

Conclusions
The content and delivery of ABLE 1.0 was feasible. However, the study revealed a need to adjust the recruitment procedure and make minor changes in the intervention manual. A pilot randomized controlled trial (RCT) study is recommended.

Trial registration
The study was registered at ClinicalTrials.gov with registration no. NCT03335709 on November 8, 2017.
Benefits of Stryphnodendron adstringens when associated with hydrogel on wound healing in diabetic rats
Authors: de Souza de Aguiar Patricia , Correa Áurea Pandolfo , Antunes Flavia Tasmin Techera , de Barros Ferraz Alexandre Falcão , Vencato Suele Biehals , Amado Gabriela Jouglard Vasques , Wiiland Elenir , Corrêa Dione Silva , Grivicich Ivana , de Souza Alessandra Hubner 
Published: February 2021

AbstractThe plantStryphnodendron adstringensis a species of legume in the genusStryphnodendronthat is found in Brazil. It is also known as “barbatimão-verdadeiro” and it is popularly used in folk medicine due to its healing properties. Purpose: The aim of this study was to evaluate the healing activity of hydrogel, together with anS. adstringenshydroalcoholic extract, in diabetic and non-diabetic rats. Methods: The phytochemical analysis of theS. adstringenshydroalcoholic extract was evaluated through HPLC and its antioxidant activity was measured by the DPPH assay. The cytotoxicity, the scratch assay, and the fibroblast cell proliferation were also evaluated. Forty (40) Wistar rats were submitted to an excision for a full-thickness wound of 1.5 cm × 1.5 cm in their dorsum. The animals were treated twice a day over 16 days, with a rich layer of the corresponding treatment: Hydrogel; Hydrogel associated with 5%S. adstringenshydroalcoholic extract (H + SAHE);S. adstringenshydroalcoholic extract (SAHE); Collagenase with Chloramphenicol; or Carbopol. Morphological and histological analyses of the injury were performed. Results: The phytochemical analysis of SAHE indicated the presence of phenolic compounds, tannins, and flavonoids. The hydroalcoholic extract showed strong antioxidant activities (IC50 = 25.56 ± 1.04 μg/mL). H + SAHE induced the fibroblast proliferation (148 ± 6.9%) and it was not cytotoxic. The association with H + SAHE showed a more pronounced healing activity than did the other treatments in the non-diabetic animals and in the diabetic animals, hence, promoting angiogenesis and reepithelialization. Conclusion: Under these scenarios, this study has demonstrated effectiveness in the recovering wounds of diabetic rats.Graphical abstract