bluuebunny/crossref_metadata_2025_split huggingface dataset:
Falsification and consciousness
Authors: Kleiner Johannes , Hoel Erik 
Published: April 2021

Abstract
The search for a scientific theory of consciousness should result in theories that are falsifiable. However, here we show that falsification is especially problematic for theories of consciousness. We formally describe the standard experimental setup for testing these theories. Based on a theory’s application to some physical system, such as the brain, testing requires comparing a theory’s predicted experience (given some internal observables of the system like brain imaging data) with an inferred experience (using report or behavior). If there is a mismatch between inference and prediction, a theory is falsified. We show that if inference and prediction are independent, it follows that any minimally informative theory of consciousness is automatically falsified. This is deeply problematic since the field’s reliance on report or behavior to infer conscious experiences implies such independence, so this fragility affects many contemporary theories of consciousness. Furthermore, we show that if inference and prediction are strictly dependent, it follows that a theory is unfalsifiable. This affects theories which claim consciousness to be determined by report or behavior. Finally, we explore possible ways out of this dilemma.
ZnO-based micromotors fueled by CO2: the first example of self-reorientation-induced biomimetic chemotaxis
Authors: Mou Fangzhi , Xie Qi , Liu Jianfeng , Che Shengping , Bahmane Lamya , You Ming , Guan Jianguo 
Published: April 2021

Abstract
Synthetic chemotactic micro/nanomotors are envisioned to actively ‘seek out’ targets by following specific chemicals, but they are mainly powered by bioincompatible fuels and only show pseudochemotaxis (or advanced chemokinesis) due to their weak self-reorientation capabilities. Here we demonstrate that synthetic ZnO-based Janus micromotors can be powered by the alternative biocompatible fuel of CO2, and further provide the first example of self-reorientation-induced biomimetic chemotaxis using them. The ZnO-based micromotors are highly sensitive to dissolved CO2 in water, which enables the corrosion of ZnO to continuously occur by providing H+ through hydration. Thus, they can autonomously move even in water exposed to air based on self-diffusiophoresis. Furthermore, they can sense the local CO2 gradient and perform positive chemotaxis by self-reorientations under the phoretic torque. Our discovery opens a gate to developing intelligent micro/nanomotors powered by, and sensitive to, biocompatible atmospheric or endogenous gaseous chemicals for biomedical and environmental applications.
Technological unemployment revisited: automation in a search and matching framework
Authors: Cords Dario , Prettner Klaus 
Published: April 2021

Abstract
Will automation raise unemployment and what is the role of education in this context? To answer these questions, we propose a search and matching model of the labour market with two skill types and with industrial robots. In line with evidence to date, robots are better substitutes for low-skilled workers than for high-skilled workers. We show that robot adoption leads to rising unemployment and falling wages of low-skilled workers and falling unemployment and rising wages of high-skilled workers. In a calibration to Austrian and German data, we find that robot adoption destroys fewer low-skilled jobs than the number of high-skilled jobs it creates. For Australia and the USA, the reverse holds true. Allowing for endogenous skill acquisition of workers implies positive employment effects of automation in all four countries. Thus, the firm creation mechanism in the search and matching model and skill acquisition are alleviating the adverse effects of automation.
Hepatitis C Virus Testing Among Men With Human Immunodeficiency Virus Who Have Sex With Men: Temporal Trends and Racial/Ethnic Disparities
Authors: Li Jun , Armon Carl , Palella Frank J , Tedaldi Ellen , Novak Richard M , Fuhrer Jack , Simoncini Gina , Carlson Kimberly , Buchacz Kate ,   for the HIV Outpatient Study (HOPS) Investigators, Li Jun , Buchacz Kate , Durham Marcus D , Akridge Cheryl , Purinton Stacey , Rayeed Nabil , Agbobil-Nuwoaty Selom , Chagaris Kalliope , Carlson Kimberly , Armon Carl , Battalora Linda , Mahnken Jonathan , Palella Frank J , Jahangir Saira , Flaherty Conor Daniel , Bustamante Patricia , Hammer John , Greenberg Kenneth S , Widick Barbara , Franklin Rosa , Ward Douglas J , Thomas Troy , Stewart Cheryl , Fuhrer Jack , Ording-Bauer Linda , Kelly Rita , Esteves Jane , Tedaldi Ellen M , Christian Ramona A , Ruley Faye , Beadle Dania , Davenport Princess , Novak Richard M , Wendrow Andrea , Mayer Stockton , Scott Mia , Thomas Billie , Van Slyke Loraine , Mayer Cynthia , Beitler Terry , Maroney Karen , Franklin Denise 
Published: April 2021

Abstract

Background
National guidelines recommend that sexually active people with human immunodeficiency virus (PWH) who are men who have sex with men (MSM) be tested for hepatitis C virus (HCV) infection at least annually. Hepatitis C virus testing rates vary by race/ethnicity in the general population, but limited data are available for PWH.

Methods
We analyzed medical records data from MSM in the HIV Outpatient Study at 9 human immunodeficiency virus (HIV) clinics from January 1, 2011 through December 31, 2019. We excluded observation time after documented past or current HCV infection. We evaluated HCV antibody testing in each calendar year among HCV-seronegative MSM, and we assessed testing correlates by generalized estimating equation analyses.

Results
Of 1829 eligible MSM who were PWH, 1174 (64.2%) were non-Hispanic/Latino white (NHW), 402 (22.0%) non-Hispanic black (NHB), 187 (10.2%) Hispanic/Latino, and 66 (3.6%) of other race/ethnicity. Most were ≥40 years old (68.9%), privately insured (64.5%), with CD4 cell count/mm3 (CD4) ≥350 (77.0%), and with HIV viral load &lt;200 copies/mL (76.9%). During 2011–2019, 1205 (65.9%) had ≥1 HCV antibody test and average annual HCV percentage tested was 30.3% (from 33.8% for NHB to 28.5% for NHW; P &lt; .001). Multivariable factors positively associated (P &lt; .05) with HCV testing included more recent HIV diagnosis, public insurance, lower CD4, prior chlamydia, gonorrhea, syphilis, or hepatitis B virus diagnoses, and elevated liver enzyme levels, but not race/ethnicity.

Conclusions
Although we found no disparities by race/ethnicity in HCV testing, low overall HCV testing rates indicate suboptimal uptake of recommended HCV testing among MSM in HIV care.
Candida Empyema Thoracis at Two Academic Medical Centers: New Insights Into Treatment and Outcomes
Authors: Senger Suheyla S , Thompson George R , Samanta Palash , Ahrens Jillian , Clancy Cornelius J , Nguyen M Hong 
Published: April 2021

Abstract

Background
Candida empyema thoracis (pleural empyema) is an uncommon manifestation of invasive candidiasis, for which optimal treatment is unknown.

Methods
This is a retrospective study of patients with Candida empyema at 2 academic medical centers from September 2006 through December 2015.

Results
We identified 81 patients with Candida empyema (median age, 62 years; 68% men). Sixty-five percent of patients underwent surgery or an invasive intervention of the thorax or abdomen within the preceding 90 days. Candida empyema originated from intrathoracic (51%) or intra-abdominal sources (20%), spontaneous esophageal rupture (12%), pleural space manipulation (9%), and pneumonia (6%). Eighty-four percent and 41% of patients were intensive care unit residents and in septic shock, respectively, within 3 days of diagnosis. Causative species were Candida albicans (65%), Candida glabrata (26%), Candida parapsilosis (11%), Candida tropicalis (4%), Candida krusei (2%), and Candida dubliniensis (1%). Bacteria were recovered from empyemas in 51% of patients. Concurrent candidemia was diagnosed in only 2% of patients. Management included pleural drainage and antifungal treatment in 98% and 85% of patients, respectively. Mortality at 100 days was 27%, and it was highest for cases stemming from esophageal rupture (67%). Spontaneous esophageal rupture and echinocandin rather than fluconazole treatment were independent risk factors for death at 100 days (P = .003 and .04, respectively); receipt of antifungal therapy was an independent predictor of survival (P = .046).

Conclusions
Candida empyema mortality rates were lower than reported previously. Optimal management included pleural drainage and fluconazole treatment. Superiority of fluconazole over echinocandins against Candida empyema needs to be confirmed in future studies.
Bictegravir-Based Antiretroviral Therapy-Associated Accelerated Hyperglycemia and Diabetes Mellitus
Authors: Nolan Nathanial S , Adamson Samantha , Reeds Dominic , O’Halloran Jane A 
Published: April 2021

Abstract
Integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is first line for treatment of people with human immunodeficiency virus (PWH). Emerging data suggest the possibility of adverse metabolic effects of these medications. We describe 3 cases in which PWH developed hyperglycemia and ketoacidosis within months of being switched to bictegravir-based ART.
Incidence and Predictors of Hepatitis B Surface Antigen Clearance in HIV Patients: A Retrospective Multisite Study
Authors: Jain Mamta K , Vigil Karen J , Parisot Paul , Go Gabriella , Vu Trung , Li Xilong , Hansen Laura , Taylor Barbara S 
Published: April 2021

Abstract

Background
New therapies to achieve hepatitis B surface antigen (HBsAg) clearance are under development. However, gaps in knowledge exist in understanding the incidence and predictors of HBsAg clearance in a racially diverse HIV population.

Methods
We examined the incidence and risk of HBsAg clearance in a retrospective cohort of people with HIV/hepatitis B virus (HBV). Included patients had sufficient data to establish chronic infection based on Centers for Disease Control and Prevention guidelines. We examined the incident rate for HBsAg loss and hazard rate ratios to evaluate predictors for HBsAg clearance in a multivariable model.

Results
Among 571 HIV/HBV patients, 87% were male, 61% were Black, 45% had AIDS, 48% were HBeAg positive, and the median follow-up was 88 months. Incident HBsAg clearance was 1.5 per 100 person-years. In the multivariate model, those with AIDS at baseline (adjusted hazard ratio [aHR], 2.43; 95% CI, 1.37–4.32), Hispanics (aHR, 3.57; 95% CI, 1.33–9.58), and those with injection drug use as an HIV risk factor (aHR, 3.35; 95% CI, 1.26–8.89) were more likely to lose HBsAg, whereas those who were HBeAg positive (aHR, 0.34; 95% CI, 0.19–0.63) were less likely to lose HBsAg. The median change in CD4 cell count during the observation period was 231 cells/mm3 in those with HBsAg loss vs 112 cells/mm3 in those with HBsAg persistence (P = .004).

Conclusions
HBsAg loss occurs in about 10% of those with chronic HBV infection. Being Hispanic, having AIDS at baseline, having an injection drug use history, and having HBeAg-negative status at baseline predicted the likelihood of HBsAg loss. Immune restoration may be a mechanism through which HBsAg loss occurs in HIV patients.
Clinical Effectiveness of Lyme Vaccine: A Matched Case–Control Study
Authors: Oliveira Carlos R , Massad Christopher , Shapiro Eugene D , Vazquez Marietta 
Published: April 2021

Abstract
We conducted a matched case–control study to assess the effectiveness of Lyme vaccine (LYMErix) as it was used in clinical practice. We found ≥3 doses to be 71% effective against Lyme disease. This is the first study to show that the Lyme vaccine is effective in a real-world setting.
Invasive Mycobacterium abscessus Outbreak at a Pediatric Dental Clinic
Authors: Singh Jasjit , O’Donnell Kathleen , Nieves Delma J , Adler-Shohet Felice C , Arrieta Antonio C , Ashouri Negar , Ahuja Gurpreet , Cheung Michele , Holmes W Nathan , Huoh Kevin , Tran Lisa , Tran M Tuan , Pham Nguyen , Zahn Matthew 
Published: April 2021

Abstract

Background
Mycobacterium species, specifically M. abscessus and M. chelonae (MABs), are known to contaminate water systems and are uncommon causes of health care–associated infection, but morbidity can be significant and treatment complex.

Methods
Odontogenic MAB infections occurred in patients following pulpotomy procedures at dental clinic A from 1 January to 6 September 2016. We identified confirmed and probable cases using culture data, imaging, pathology results, and surgical findings. Epidemiologic and clinical data including demographics, symptoms, laboratory findings, treatment regimens, and outcomes were extracted.

Results
Of 1082 at-risk patients, 71 case patients (22 confirmed; 49 probable) were identified. Median age was 6 years. Median symptom onset was 85 days postpulpotomy. Pain and/or swelling on admission occurred in 79%. On imaging, 49 of 70 had abnormalities of the mandible or maxilla, 13 of 70 had lymphadenopathy, and 19 of 68 had pulmonary nodules. Seventy were hospitalized (average of 8.5 days). Intravenous antibiotics were administered to 32 cases for a median length of 137 days. Clofazimine was administered to 29 patients as part of their multidrug regimen. Antibiotic treatment was associated with many adverse effects. Treated children showed evidence of jaw healing with resolved/improving pulmonary nodules at 1-year follow-up.

Conclusions
This is the largest outbreak of invasive MAB infections associated with a pediatric dental practice. While infections were indolent, patients suffered medical and surgical consequences of treatment, including permanent tooth loss. Identification of this outbreak led to a change in water standards for pediatric dental procedures in California. Enhanced national dental water quality standards are needed to prevent future outbreaks.
The Characteristics of Capnocytophaga Infection: 10 Years of Experience
Authors: Chesdachai Supavit , Tai Don Bambino Geno , Yetmar Zachary A , Misra Anisha , Ough Natalie , Abu Saleh Omar 
Published: April 2021

Abstract

Background
Capnocytopha ga is a gram-negative, facultative anaerobe. Human infection is rare but can lead to devastating outcomes. Capnocytophaga canimorsus can cause sepsis following an animal bite, whereas human-oral–associated Capnocytophaga infections were reported in immunocompromised patients. Current data on these infections are not robust. Our goal is to provide a contemporary description of a unique characteristic of Capnocytophaga infections.

Methods
We performed a retrospective review of all patients with Capnocytophaga infection from January 2010 to August 2020 at 3 main hospitals of Mayo Clinic in Rochester, Minnesota; Scottsdale, Arizona; and Jacksonville, Florida. We collected baseline demographic data, clinical characteristics, microbiological data, and outcomes of C. canimorsus and human-oral–associated Capnocytophaga infection.

Results
Among 82 patients with Capnocytophaga infection, 46 patients (56.0%) had bacteremia. The most common species identified in this group was C. sputigena (57.9%), followed by C. canimorsus (34.8%). Patients with human-oral–associated Capnocytophaga bacteremia were often immunocompromised, presented with neutropenic fever, and had worse 6-month all-cause mortality compared to C. canimorsus bacteremia (36.4% vs 6.2%, P = .03). They also had a higher β-lactamase production rate (36.4% vs 0.0%, P = .02). Among patients without bacteremia, the main clinical syndrome was polymicrobial head and neck infections (47.2%).

Conclusions
Human-oral–associated Capnocytophaga bacteremia occurs primarily in immunocompromised patients, particularly those with hematologic malignancy. In contrast, C. canimorsus bacteremia is more likely to present with community-onset infection related to zoonotic exposure. Human-oral–associated Capnocytophaga infection without bacteremia is frequently isolated in polymicrobial infection; this phenomenon’s significance is yet to be fully understood.
Control and Elimination of Schistosomiasis as a Public Health Problem: Thresholds Fail to Differentiate Schistosomiasis Morbidity Prevalence in Children
Authors: Wiegand Ryan E , Secor W Evan , Fleming Fiona M , French Michael D , King Charles H , Montgomery Susan P , Evans Darin , Utzinger Jürg , Vounatsou Penelope , de Vlas Sake J 
Published: April 2021

Abstract

Background
Current World Health Organization guidelines utilize prevalence of heavy-intensity infections (PHIs), that is, ≥50 eggs per 10 mL of urine for Schistosoma haematobium and ≥400 eggs per gram of stool for S. mansoni, to determine whether a targeted area has controlled schistosomiasis morbidity or eliminated schistosomiasis as a public health problem. The relationship between these PHI categories and morbidity is not well understood.

Methods
School-age participants enrolled in schistosomiasis monitoring and evaluation cohorts from 2003 to 2008 in Burkina Faso, Mali, Niger, Tanzania, Uganda, and Zambia were surveyed for infection and morbidity at baseline and after 1 and 2 rounds of preventive chemotherapy. Logistic regression was used to compare morbidity prevalence among participants based on their school’s PHI category.

Results
Microhematuria levels were associated with the S. haematobium PHI categories at all 3 time points. For any other S. haematobium or S. mansoni morbidity that was measured, PHI categories did not differentiate morbidity prevalence levels consistently.

Conclusions
These analyses suggest that current PHI categorizations do not differentiate the prevalence of standard morbidity markers. A reevaluation of the criteria for schistosomiasis control is warranted.
Evaluation of Clinical Outcomes After Introduction of a Dedicated Infectious Diseases–Critical Care Medicine Service in Critical Care Units
Authors: Trachuk Polina , Hemmige Vagish , Eisenberg Ruth , Cowman Kelsie , Chen Victor , Weston Gregory , Gendlina Inessa , Ferguson Nadia , Dicpinigaitis Peter , Berger Jay , Pirofski Liise-anne , Sarwar Uzma N 
Published: April 2021

AbstractBackgroundInfection is a leading cause of admission to intensive care units (ICUs), with critically ill patients often receiving empiric broad-spectrum antibiotics. Nevertheless, a dedicated infectious diseases (ID) consultation and stewardship team is not routinely established. An ID–critical care medicine (ID-CCM) pilot program was designed at a 400-bed tertiary care hospital in which an ID attending was assigned to participate in daily rounds with the ICU team, as well as provide ID consultation on select patients. We sought to evaluate the impact of this dedicated ID program on antibiotic utilization and clinical outcomes in patients admitted to the ICU.MethodsIn this single-site retrospective study, we analyzed antibiotic utilization and clinical outcomes in patients admitted to an ICU during the postintervention period from January 1 to December 31, 2017, and compared it to antibiotic utilization in the same ICUs during the preintervention period from January 1 to December 31, 2015.ResultsOur data showed a statistically significant reduction in usage of most frequently prescribed antibiotics including vancomycin, piperacillin-tazobactam, and cefepime during the intervention period. When compared to the preintervention period there was no difference in-hospital mortality, hospital length of stay, and readmission.ConclusionsWith this multidisciplinary intervention, we saw a decrease in the use of the most frequently prescribed broad-spectrum antibiotics without a negative impact on clinical outcomes. Our study shows that the implementation of an ID-CCM service is a feasible way to promote antibiotic stewardship in the ICU and can be used as a strategy to reduce unnecessary patient exposure to broad-spectrum agents.
Partnering With Barbershops and Salons to Engage Vulnerable Communities During the COVID-19 Pandemic
Authors: Hill Krystal , Haynes Norrisa , Momplaisir Florence 
Published: April 2021

Abstract
This manuscript conveys the story of the health and economic challenges faced by a coalition of barbershops and salons in West Philadelphia. It is grounded in city and national data that illustrate the widening racial and class disparities during coronavirus disease 2019. Ultimately, it is a story of resilience that outlines a budding partnership between barbershop and salon owners, their community, and medical providers.
Mycobacterium chimaera Genomics With Regard to Epidemiological and Clinical Investigations Conducted for an Open Chest Postsurgical Mycobacterium chimaera Infection Outbreak
Authors: Lecorche Emmanuel , Daniau Côme , La Kevin , Mougari Faiza , Benmansour Hanaa , Kumanski Sylvain , Robert Jérôme , Fournier Sandra , Lebreton Guillaume , Carbonne Anne , Cambau Emmanuelle ,   CNR-MyRMA, Alauzet Corentine , Cavalié Laurent , Chefson-Girault Christine , Belmonte Olivier , Bounhiol Colin Catherine , Bourgoin Anne , Bousseau Anne , Brasme Lucien , Cépoulain Céline , Cizeau Florence , De Champs Christophe , Decousser Jean-Winoc , Ducellier David , Fines Guyon Marguerite , Fournier Sandra , Gambarotto Karine , Grare Marion , Guet-Revillet Hélène , Jansen Chloe , Janvier Frederic , Kassis-Chikhani Najiby , Lalande Valerie , Lanotte Philippe , Lefebvre Annick , Lesteven Claire , Levy Marc , Maitre Thomas , Malavaud Sandra , Morel Stéphanie , Podglajen Isabelle , Poisnel Elodie , Poulain Cécile , Rafidiarisoa Marie-Fleur , Ringeval Jean , Rivier Alexandre , Robert Jerome , Roques-Ceschin Christine , Skalli Soumaya , Traore Ousmane , Vauterin Celine , Verdet Charlotte 
Published: April 2021

Abstract

Background
Postsurgical infections due to Mycobacterium chimaera appeared as a novel nosocomial threat in 2015, with a worldwide outbreak due to contaminated heater-cooler units used in open chest surgery. We report the results of investigations conducted in France including whole-genome sequencing comparison of patient and heater-cooler unit isolates.

Methods
We sought M. chimaera infection cases from 2010 onwards through national epidemiological investigations in health care facilities performing cardiopulmonary bypass, together with a survey on good practices and systematic heater-cooler unit microbial analyses. Clinical and heater-cooler unit isolates were subjected to whole-genome sequencing analyzed with regard to the reference outbreak strain Zuerich-1.

Results
Only 2 clinical cases were shown to be related to the outbreak, although 23% (41/175) of heater-cooler units were declared positive for M. avium complex. Specific measures to prevent infection were applied in 89% (50/56) of health care facilities, although only 14% (8/56) of them followed the manufacturer maintenance recommendations. Whole-genome sequencing comparison showed that the clinical isolates and 72% (26/36) of heater-cooler unit isolates belonged to the epidemic cluster. Within clinical isolates, 5–9 nonsynonymous single nucleotide polymorphisms were observed, among which an in vivo mutation in a putative efflux pump gene was observed in a clinical isolate obtained for 1 patient on antimicrobial treatment.

Conclusions
Cases of postsurgical M. chimaera infections have been declared to be rare in France, although heater-cooler units were contaminated, as in other countries. Genomic analyses confirmed the connection to the outbreak and identified specific single nucleotide polymorphisms, including 1 suggesting fitness evolution in vivo.