bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Use of Telemedicine Infectious Diseases Consultation With an Antimicrobial Stewardship-Led Staphylococcus aureus Bacteremia Care Bundle
Authors: Meredith Jacqueline , Onsrud Jennifer , Davidson Lisa , Medaris Leigh Ann , Kowalkowski Marc , Fischer Kristin , Priem Jennifer , Leonard Michael , McCurdy Lewis 
Published: May 2021

Abstract

Background
Telemedicine (TM) programs can be implemented to deliver specialty care through virtual platforms and overcome geographic/resource constraints. Few data exist to describe outcomes associated with TM-based infectious diseases (ID) management. The purpose of this study was to compare outcomes associated with TM and onsite standard-of-care (SOC) ID consultation after implementation of an antimicrobial stewardship (AMS)-led Staphylococcus aureus bacteremia (SAB) bundle.

Methods
A retrospective cohort study was conducted on the effects of a SAB bundle comparing ID consult delivery (SOC or TM) at 10 US hospitals within Atrium Health in adult patients admitted from September 2016 through December 2017. The type of ID consult provided was based on the admitting hospital; no hospital had both modalities. Bundle components included the following: (1) ID consult, (2) appropriate antibiotics, (3) repeat blood cultures until clearance, (4) echocardiogram obtainment, and (5) appropriate antibiotic duration. The AMS facilitated bundle initiation and compliance. The primary outcome was bundle adherence between groups. Differences in clinical outcomes were also assessed.

Results
We evaluated 738 patients with SAB (576 with SOC, 162 with TM ID). No differences were observed in overall bundle adherence (SOC 86% vs TM 89%, P = .33). In addition, no significant differences resulted between groups for hospital mortality, 30-day SAB-related readmission, persistent bacteremia, and culture clearance. Groups did not differ in 30-day mortality when controlling for demographics, bacteremia source, and physiological measures with multivariable logistic regression.

Conclusions
Our findings provide evidence to support effective use of TM ID consultation and AMS-led care bundles for SAB management in resource-limited settings.
Development of a new wideband heterodyne receiver system for the Osaka 1.85 m mm–submm telescope: Receiver development and the first light of simultaneous observations in 230 GHz and 345 GHz bands with an SIS-mixer with 4–21 GHz IF output
Authors: Masui Sho , Yamasaki Yasumasa , Ogawa Hideo , Kondo Hiroshi , Yokoyama Koki , Matsumoto Takeru , Minami Taisei , Okawa Masanari , Konishi Ryotaro , Kawashita Sana , Konishi Ayu , Nakao Yuka , Nishimoto Shimpei , Yoneyama Sho , Ueda Shota , Hasegawa Yutaka , Fujita Shinji , Nishimura Atsushi , Kojima Takafumi , Uemizu Kazunori , Kaneko Keiko , Sakai Ryo , Gonzalez Alvaro , Uzawa Yoshinori , Onishi Toshikazu 
Published: May 2021

AbstractWe have developed a wideband receiver system for simultaneous observations in CO lines of J = 2–1 and J = 3–2 transitions using the Osaka 1.85 m mm–submm telescope. As a frequency separation system, we developed multiplexers that connect three types of diplexers, each consisting of branch-line couplers and high-pass filters. The radio frequency (RF) signal is eventually distributed into four frequency bands, each of which is fed to a superconductor–insulator–superconductor (SIS) mixer. The RF signal from the horn is divided into two frequency bands by a wideband diplexer with a fractional bandwidth of $56\%$, and then each frequency band is further divided into two bands by each diplexer. The developed multiplexers were designed, fabricated, and characterized using a vector network analyzer. The measurement results showed good agreement with the simulation. The receiver noise temperature was measured by connecting the SIS-mixers, one of which has a wideband 4–21 GHz intermediate frequency (IF) output. The receiver noise temperatures were measured to be ∼70 K in the 220 GHz band, ∼100 K in the 230 GHz band, 110–175 K in the 330 GHz band, and 150–250 K in the 345 GHz band. This receiver system has been installed on the 1.85 m telescope at the Nobeyama Radio Observatory. We succeeded in simultaneous observations of six CO isotopologue lines with the transitions of J = 2–1 and J = 3–2 toward the Orion KL as well as on-the-fly mappings toward the Orion KL and W 51.
The Atiyah–Patodi–Singer index theorem from the axial anomaly
Authors: Kobayashi Shun K , Yonekura Kazuya 
Published: May 2021

Abstract
We give a very simple derivation of the Atiyah–Patodi–Singer (APS) index theorem and its small generalization by using the path integral of massless Dirac fermions. It is based on Fujikawa’s argument for the relation between the axial anomaly and the Atiyah–Singer index theorem, and only a minor modification of that argument is sufficient to show the APS index theorem. The key ingredient is the identification of the APS boundary condition and its generalization as physical state vectors in the Hilbert space of the massless fermion theory. The APS $\eta$-invariant appears as the axial charge of the physical states.
ACTIVITY CONCENTRATION ESTIMATION IN AUTOMATED KIDNEY SEGMENTATION BASED ON CONVOLUTION NEURAL NETWORK METHOD FOR 177LU–SPECT/CT KIDNEY DOSIMETRY
Authors: Khan Jehangir , Rydèn Tobias , Van Essen Martijn , Svensson Johanna , Bernhardt Peter 
Published: May 2021

Abstract
For 177Lu-DOTATATE treatments, dosimetry based on manual kidney segmentation from computed tomography (CT) is accurate but time consuming and might be affected by misregistration between CT and SPECT images. This study develops a convolution neural network (CNN) for automated kidney segmentation that accurately aligns CT segmented volume of interest (VOI) to the kidneys in SPECT images. The CNN was trained with SPECT/CT images performed over the abdominal area of 137 patients treated with 177Lu-DOTATATE. Activity concentrations in automated and manual segmentations were strongly correlated for both kidneys (r &gt; 0.96, p &lt; 0.01) in the testing cohort (n = 20). The Bland–Altman analyses demonstrated higher accuracy for the CNN segmentation compared to the manual segmented kidneys without VOI adjustment. The CNN demonstrated a potential for accurate kidney segmentation. The CNN was a fast and robust approach for assessment of activity concentrations in SPECT images, and performed equally well as the manual segmentation method.
Shrink, weighing accuracy, and weighing precision of mineral supplement in five commercial dairies in the Western United States
Authors: Arce-Cordero J A , Archibeque S L , Faciola A P 
Published: May 2021

Abstract
Shrink, accuracy, and precision of ingredient weighing are critical factors of efficiency in TMR-fed dairy systems. Those factors have been evaluated for major feeds; however, we are not aware of any reports for mineral supplement. Farms commonly mix mineral supplement with other low-inclusion ingredients into a premix which is used later as a single ingredient for TMR formulation. Our objectives were to evaluate shrink, weighing accuracy, and weighing precision of mineral supplement during premix formulation, and variation in concentration of minerals in mineral supplement and TMR, in five large dairies in the Western United States. We used the automated weight-tracking system at each farm to account for all the mineral supplement loaded into the mixing-wagon and collected samples of mineral supplement and TMR from time of mineral supplement delivery at the farm until 100% of it was consumed. Mean, standard deviation and coefficient of variation (CV) for each variable were calculated with SAS 9.4. Average shrink was estimated at 2.0% for mineral supplement during storage and loading, ranging from 0.37% to 3.25%. Mineral supplement weighing deviation from the targeted amount was 1.54% on average for the five dairies with a 95% CV. Mineral composition of mineral supplements averaged 11.3%, 0.27%, and 3.16% for Ca, P, and Mg, and 215, 881, and 1533 ppm for Cu, Mn, and Zn, respectively. Mineral compositions in TMR averaged 0.84%, 0.41%, and 0.37% for Ca, P, and Mg, respectively; and 15.1, 71, and 94.5 ppm for Cu, Mn, and Zn, respectively. The CV of all minerals except Ca, were larger for mineral supplement than TMR, and with the exception of P in mineral supplement, CV of trace minerals were larger than CV values for macro minerals. Our shrink estimates for mineral supplement represent an initial approximation to this issue. Results of our weighing deviation analysis suggest some room for improvement on the precision of weighing mineral supplement at the time when premix is prepared at the farm, which could improve consistency in chemical composition of the premix and consequently reduce the variation (CV values) of mineral concentrations in TMR.
Radial stem growth dynamics and phenology of a multi-stemmed species (Corylus avellanaL.) across orchards in the Northern and Southern hemispheres
Authors: Pasqualotto Gaia , Ascari Lorenzo , Bicego Giovanni , Carraro Vinicio , Huerta Eloy Suarez , De Gregorio Tommaso , Siniscalco Consolata , Anfodillo Tommaso 
Published: May 2021

AbstractClimate change and the global economy impose new challenges in the management of food-producing trees and require studying how to model plant physiological responses, namely growth dynamics and phenology. Hazelnut (Corylus avellana L.) is a multi-stemmed forest species domesticated for nut production and now widely spread across different continents. However, information on stem growth and its synchronization with leaf and reproductive phenology is extremely limited. This study aimed at (i) defining the sequencing of radial growth phases in hazelnut (onset, maximum growth and cessation) and the specific temperature triggering stem growth; and (ii) combining the stem growth phases with leaf and fruit phenology. Point dendrometers were installed on 20 hazelnut trees across eight orchards distributed in the Northern and Southern hemisphere during a period of three growing seasons between 2015 and 2018. The radial growth variations and climatic parameters were averaged and recorded every 15 min. Leaf and reproductive phenology were collected weekly at each site. Results showed that stem radial growth started from day of year 84 to 134 in relation to site and year but within a relatively narrow range of temperature (from 13 to 16.5 °C). However, we observed a temperature-related acclimation in the cultivar Tonda di Giffoni. Maximum growth always occurred well before the summer solstice (on average 35 days) and before the maximum annual air temperatures. Xylogenesis developed rapidly since the time interval between onset and maximum growth rate was about 3 weeks. Importantly, the species showed an evident delay of stem growth onset with respect to leaf emergence (on average 4–6 weeks) rarely observed in tree species. These findings represent the first global analysis of radial growth dynamics in hazelnut, which is an essential step for developing models on orchard functioning and management on different continents.
PthAW1, a Transcription Activator-Like Effector ofXanthomonas citrisubsp.citri, Promotes Host-Specific Immune Responses
Authors: Teper Doron , Xu Jin , Pandey Sheo Shankar , Wang Nian 
Published: May 2021

Citrus canker disease caused by Xanthomonas citri subsp. citri is one of the most destructive diseases in citrus. X. citri subsp. citri pathotypes display different host ranges. X. citri subsp. citri strain A (XccA) causes canker disease in most commercial citrus varieties, whereas strain AW (XccAW), which is genetically similar to XccA, infects only lime and alemow. Understanding the mechanism that determines the host range of pathogens is critical to investigating and utilizing host resistance. We hypothesized that XccAWwould undergo mutations in genes that restrict its host range when artificially inoculated into incompatible citrus varieties. To test this hypothesis, we used an experimental evolution approach to identify phenotypic traits and genetic loci associated with the adaptation of XccAWto incompatible sweet orange. Repeated inoculation and reisolation cycles improved the ability of three independent XccAWstrains to colonize sweet orange. Adapted XccAWstrains displayed increased expression of type III secretion system and effector genes. Genome sequencing analysis indicated that two of the adapted strains harbored mutations in pthAW1, a transcription activator-like effector (TALE) gene, that corresponded to the removal of one or two repeats from the central DNA-binding repeat region. Introduction of the original but not the adapted pthAW1 variants into XccAabolished its ability to cause canker symptoms in sweet orange, Meyer lemon, and clementine but not in other XccAW-resistant citrus varieties. The original pthAW1, when expressed in XccA, induced ion leakage and the expression of pathogenesis-related genes but had no effect on CsLOB1 expression in sweet orange. Our study has identified a novel host-specific avirulence TALE and demonstrated active adaptive rearrangements of the TALE repeat array during host adaptation.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Genomics- and Machine Learning-Accelerated Discovery of Biocontrol Bacteria
Authors: Biggs Matthew B. , Craig Kelly , Gachango Esther , Ingham David , Twizeyimana Mathias 
Published: May 2021

Microorganisms with antimicrobial activity have been used to successfully control various plant pathogens. The discovery of organisms with protective activity depends on empirical screenings to assess microbial activity against pathogens of interest. Machine learning can accelerate the discovery process by making screening and, thus, discovery more efficient. We developed a novel machine-learning workflow to identify genomic features associated with fungicidal activity of bacteria, and leveraged those genomic features to discover additional bacteria with the desired activity. We applied our workflow to discover solutions to two problematic fungal diseases: sorghum anthracnose and black sigatoka of banana. These diseases are problematic worldwide, with a particularly devastating impact on small-holder farmers in Sub-Saharan Africa. We screened a total of 1,227 bacterial isolates for antifungal activity against these pathogens using detached-leaf methods and identified 72 taxonomically diverse isolates with robust activity against one or both of these pathogens. We identified biosynthetic gene clusters associated with activity against each pathogen. Machine learning improved the discovery rate of our screen by threefold, and led to the discovery of a taxonomic group in which fungicidal activity has never been reported. This work highlights the wealth of biocontrol mechanisms available in the microbial world for management of fungal pathogens, generates opportunities for future characterization of novel fungicidal mechanisms, and provides a set of genomic features and models for discovering additional bacterial isolates with activity against these two pathogens. Finally, our workflow generalizes to any discovery effort where genomic information is available to guide candidate selection.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Functional Outcomes and Their Association With Physical Performance in Mechanically Ventilated Coronavirus Disease 2019 Survivors at 3 Months Following Hospital Discharge: A Cohort Study
Authors: van Gassel Rob J. J. , Bels Julia , Remij Loes , van Bussel Bas C. T. , Posthuma Rein , Gietema Hester A. , Verbunt Jeanine , van der Horst Iwan C. C. , Olde Damink Steven W. M. , van Santen Susanne , van de Poll Marcel C. G. 
Published: May 2021

OBJECTIVES:
We performed a comprehensive health assessment in mechanically ventilated coronavirus disease 2019 survivors to assess the impact of respiratory and skeletal muscle injury sustained during ICU stay on physical performance at 3 months following hospital discharge.

DESIGN:
Preregistered prospective observational cohort study.

SETTING:
University hospital ICU.

PATIENTS:
All mechanically ventilated coronavirus disease 2019 patients admitted to our ICU during the first European pandemic wave.

MEASUREMENTS AND MAIN RESULTS:
At 3 months after hospital discharge, 46 survivors underwent a comprehensive physical assessment (6-min walking distance, Medical Research Council sum score and handgrip strength), a full pulmonary function test, and a chest CT scan which was used to analyze skeletal muscle architecture. In addition, patient-reported outcomes measures were collected. Physical performance assessed by 6-minute walking distance was below 80% of predicted in 48% of patients. Patients with impaired physical performance had more muscle weakness (Medical Research Council sum score 53 [51–56] vs 59 [56–60]; p < 0.001), lower lung diffusing capacity (54% [44–66%] vs 68% of predicted [61–72% of predicted]; p = 0.002), and higher intermuscular adipose tissue area (p = 0.037). Reduced lung diffusing capacity and increased intermuscular adipose tissue were independently associated with physical performance.

CONCLUSIONS:
Physical disability is common at 3 months in severe coronavirus disease 2019 survivors. Lung diffusing capacity and intermuscular adipose tissue assessed on CT were independently associated with walking distance, suggesting a key role for pulmonary function and muscle quality in functional disability.
Thinking through the multimodal treatment of localized oesophageal cancer: the point of view of the surgeon
Authors: Pucher Philip H. , Wijnhoven Bas P.L. , Underwood Timothy J. , Reynolds John V. , Davies Andrew R. 
Published: May 2021

Purpose of review
This review examines current developments and controversies in the multimodal management of oesophageal cancer, with an emphasis on surgical dilemmas and outcomes from the surgeon's perspective.

Recent findings
Despite the advancement of oncological neoadjuvant treatments, there is still no consensus on what regimen is superior. The majority of patients may still fail to respond to neoadjuvant therapy and suffer potential harm without any survival advantage as a result. In patients who do not respond, adjuvant therapy is still often recommended after surgery despite any evidence for its benefit. We examine the implications of different regimens and treatment approaches for both squamous cell cancer and adenocarcinoma of the oesophagus.

Summary
The efficacy of neoadjuvant treatment is highly variable and likely relates to variability of tumour biology. Ongoing work to identify responders, or optimize treatment on an individual patient, should increase the efficacy of multimodal therapy and improve patient outcomes.
Bendamustine treatment of Chinese patients with relapsed indolent non-Hodgkin lymphoma: a multicenter, open-label, single-arm, phase 3 study
Authors: Shi Yuan-Kai , Hong Xiao-Nan , Yang Jian-Liang , Xu Wei , Huang Hui-Qiang , Xiao Xiu-Bin , Zhu Jun , Zhou Dao-Bin , Han Xiao-Hong , Wu Jian-Qiu , Zhang Ming-Zhi , Jin Jie , Ke Xiao-Yan , Li Wei , Wu De-Pei , Yang Shen-Miao , Du Xin , Jia Yong-Qian , Liu Ai-Chun , Liu Dai-Hong , Shen Zhi-Xiang , Zhang Lian-Sheng , James Leonard , Hellriegel Edward 
Published: May 2021

Abstract

Background:
Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.

Methods:
This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR.

Results:
A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%–81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.

Conclusion:
Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients.

Clinical trial registration:
ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621
Determining pediatric hypertension criteria: concordance between observed physician methods and guideline-recommended methods
Authors: Turer Christy B. , Doney Analise , Bowen Michael E. , Menzies Christopher , Gheen William T. , Bhat Deepa , Fish Jason , Barlow Sarah E. , Skinner Celette S. , Lehmann Christoph U. 
Published: May 2021

Objective:
To determine and evaluate the accuracy of methods physicians use to detect diagnostic criteria for pediatric hypertension [hypertensive blood pressures (BPs) on three or more occasions] in electronic health records (EHRs).

Methods:
Methods used by pediatric-trained physicians (n = 12) to detect diagnostic criteria for hypertension in a simulation using a child's EHR data were directly observed, timed, and evaluated for accuracy. All physicians were given the same information regarding diagnostic criteria to eliminate knowledge gaps. Then, computer modeling and EHR data from 41 654 3–18-year-olds were used to simulate and compare the accuracy of detecting hypertension criteria using an observed-shorthand method vs. the guideline-recommended/gold-standard method.

Results:
No physician used the guideline-recommended method of determining multiple time-of-care hypertension thresholds for child age/height at the time of each BP measure. One physician estimated the child's BP diagnosis without computing thresholds; 11 of 12 physicians determined the child's hypertension threshold from age/height data at the time of a current visit and applied/imputed this threshold to BP measured at all visits (current-visit threshold used to assess historical-visit BPs) to detect three separate BP elevations. Physicians took 2.3 min (95% confidence interval, 1.5–3.0) to declare a diagnosis. Sensitivity was 83.1% when applying the current-visit threshold to detect the guideline-recommended-BP-threshold diagnosis using EHR data. Specificity and positive-predictive/negative-predictive values ranged from 98.5 to 99.9%.

Conclusion:
Physicians applied a shorthand method to evaluate pediatric BPs. Computer-simulated comparison of the shorthand and guideline methods using clinical data suggest the shorthand method could yield an inaccurate impression of a child's BP history in 17% of pediatric ambulatory visits.