bluuebunny/crossref_metadata_2025_split huggingface dataset:
EURAMET project No. 1225: intercomparsion of very low air speed standard facilities (0.05 m/s to 1 m/s)
Authors: Pachinger Dietmar , Huu Marc De , Mueller Harald , Care Isabelle , Frederiksen John , Piccato Aline , Bertasiene Agne 
Published: October 2017

For the first time a EURAMET comparison of standard facilities in the field of low air speed is presented. The air velocities range from 0.05 m/s up to 1 m/s. Two different thermal anemometers are used as Transfer Standards (TS), namely a ball-type and a planar-type anemometer. Due to their construction it is possible to analyze different components of the flow vector. Orientation-dependent measurements which are investigated in addition might also deliver information concerning the components of the flow vector. A Comparison Reference Value (CRV) is calculated with the help of the chi-squared test according to the procedure A presented by Cox [1] [2] and the degree of equivalence of the laboratory data to the CRV is determined. Both TS show reasonable results and a high degree of equivalence. Furthermore the degree of equivalence of the laboratory data to each other is investigated in detail.

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To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.
The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Sweet SIGNs: IgG glycosylation leads the way in IVIG-mediated resolution of inflammation
Authors: Brückner Christin , Lehmann Christian , Dudziak Diana , Nimmerjahn Falk 
Published: October 2017

Abstract
A hallmark of many chronic inflammatory and autoimmune diseases is that there is an impaired resolution of inflammation and return to the steady state. The infusion of high doses of pooled serum IgG preparations from thousands of donors [intravenous immunoglobulin (IVIG) therapy] has been shown to induce resolution of inflammation in a variety of chronic inflammatory and autoimmune diseases, suggesting that IgG molecules can instruct the immune system to stop inflammatory processes and initiate the return to the steady state. The aim of this review is to discuss how insights into the mechanism of IVIG activity may help to understand the molecular and cellular pathways underlying resolution of inflammation. We will put a special emphasis on pathways dependent on the IgG FC domain and IgG sialylation, as several recent studies have provided new insights into how this glycosylation-dependent pathway modulates innate and adaptive immune responses through different sets of C-type or I-type lectins.
Halo abundance and assembly history with extreme-axion wave dark matter at z ≥ 4
Authors: Schive Hsi-Yu , Chiueh Tzihong 
Published: September 2017

Abstract
Wave dark matter (ψDM) composed of extremely light bosons (mψ ∼ 10 − 22 eV), with quantum pressure suppressing structures below a kpc-scale de Broglie wavelength, has become a viable dark matter candidate. Compared to the conventional free-particle ψDM (FPψDM), the extreme-axion ψDM model (EAψDM) proposed by Zhang & Chiueh features a larger cut-off wavenumber and a broad spectral bump in the matter transfer function. Here, we conduct cosmological simulations to compare the halo abundances and assembly histories at z = 4–11 between three different scenarios: FPψDM, EAψDM and cold dark matter (CDM). We show that EAψDM produces significantly more abundant low-mass haloes than FPψDM with the same mψ, and therefore could alleviate the tension in mψ required by the Lyα forest data and by the kpc-scale dwarf galaxy cores. We also find that, compared to the CDM counterparts, massive EAψDM haloes are, on average, 3–4 times more massive at z = 10–11 due to their earlier formation, undergo a slower mass accretion at 7 ≲ z ≲ 11, and then show a rapidly rising major merger rate exceeding CDM by ∼ 50 per cent at 4 ≲ z ≲ 7. This fact suggests that EAψDM haloes may exhibit more prominent starbursts at z ≲ 7.
Classification of extremely metal-poor stars: absent region in A(C)–[Fe/H] plane and the role of dust cooling
Authors: Chiaki Gen , Tominaga Nozomu , Nozawa Takaya 
Published: October 2017

Abstract
Extremely metal-poor (EMP) stars are the living fossils with records of chemical enrichment history at the early epoch of galaxy formation. By the recent large observation campaigns, statistical samples of EMP stars have been obtained. This motivates us to reconsider their classification and formation conditions. From the observed lower limits of carbon and iron abundances of Acr(C) ∼ 6 and [Fe/H]cr ∼ −5 for C-enhanced EMP (CE-EMP) and C-normal EMP (CN-EMP) stars, we confirm that gas cooling by dust thermal emission is indispensable for the fragmentation of their parent clouds to form such low mass, i.e. long-lived stars, and that the dominant grain species are carbon and silicate, respectively. We constrain the grain radius $r_i^{\rm cool}$ of a species i and condensation efficiency fij of a key element j as $r_{\rm C}^{\rm cool} / f_{\rm C,C} = 10 \ {\rm \mu m}$ and $r_{\rm Sil}^{\rm cool} / f_{\rm Sil,Mg} = 0.1 \ {\rm \mu m}$ to reproduce Acr(C) and [Fe/H]cr, which give a universal condition 10[C/H] − 2.30 + 10[Fe/H] &gt; 10−5.07 for the formation of every EMP star. Instead of the conventional boundary [C/Fe] = 0.7 between CE-EMP and CN-EMP stars, this condition suggests a physically meaningful boundary [C/Fe]b = 2.30 above and below which carbon and silicate grains are dominant coolants, respectively.
Implementing Antimicrobial Stewardship in Two Community Nepali Hospitals
Authors: Veve Michael P , Kaljee Linda M , Prentiss Tyler , Joshi Rajesh Dhoj , Rai Shankar Man , Shrestha Basudha , Bajracharya Deepak Chandra , Zervos Marcus J 
Published: October 2017

Abstract

Background
Antimicrobial stewardship programs (ASP) are crucial to improving patient outcomes and decreasing resistance, but the effectiveness and the presence of ASP in low-income countries, like Nepal, are unknown. Nepal has no formal ASP efforts or antimicrobial regulations, which has lead to an increased prevalence of resistance in the community. We developed and implemented an educational ASP training program to identify areas for ASP in two community hospitals in Kathmandu. With a multidisciplinary team of clinicians and Nepal stakeholders, we developed an ASP toolkit aimed to improve patient outcomes through antimicrobial optimization.

Methods
A 1-day conference on ASP and resistance was held at a community hospital in Kathmandu, with subsequent field observations, microbiologic hospital surveillance, and 2,016 antibiogram review. Eleven physician champions (PC) from the two hospitals were selected for formal ASP instruction. ASP protocols were developed with stakeholders and included (i) empiric and definitive antibiotic selection recommendations, (ii) renal dose-adjustment guidelines, (iii) evidence-based duration of therapy recommendations, and (iv) an intravenous-to-oral antimicrobial conversion policy. Two days of fieldwork and stakeholder feedback occurred. A post-test PC evaluation was performed with the intent to gather feedback for implementation of a post-prescription review and feedback (PPRF) system incorporating AMS protocols related to antimicrobial optimization.

Results
The most prevalent infectious organism isolated was Escherichia coli (51%). Most E. coli isolates were commonly resistant to first-line or broad-spectrum antibiotics: 49% ceftriaxone, 46% ciprofloxacin, 22% piperacillin/tazobactam, and 32% meropenem. The overall PC response to ASP toolkit was positive: 73% of PC felt the guidelines would be useful in making decisions about antimicrobials. Cost and availability of antimicrobials were identified as barriers to successful implementation.

Conclusion
Development of a simple ASP toolkit can be an effective means to bring awareness appropriate antimicrobial use, and may be extrapolated to other low-income countries. Stakeholder buy-in is necessary for a successful international interventional program.

Disclosures
L. M. Kaljee, Merck: Grant Investigator, Grant recipient; T. Prentiss, Merck, Inc.: Investigator, Research grant; R. D. Joshi, Merck: Grant Investigator, Grant recipient; B. Shrestha, Merck: Grant Investigator, Research grant; D. C. Bajracharya, Merck: Grant Investigator, Grant recipient; M. J. Zervos, Merck: Grant Investigator, Grant recipient; Genentech: Grant Investigator, Grant recipient; Cempra: Grant Investigator, Grant recipient; Medicines Company: Consultant, Consulting fee
The Ontario Program To Improve AntiMIcrobial USE (OPTIMISE): A Descriptive Analysis of Dispensed Antibiotics
Authors: Schwartz Kevin , Achonu Camille , Brown Kevin , Garber Gary , Johnstone Jennie , Langford Bradley , Leung Valerie , Daneman Nick 
Published: October 2017

Abstract

Background
Antimicrobial resistant infections are an emerging global public health crisis. Antibiotic use is the largest modifiable risk factor for antimicrobial resistance. Greater than 90% of antibiotic use in Canada occurs outside of the hospital setting; however, there is a lack of data describing the patterns of community antibiotic use. Our objective was to describe outpatient antibiotic prescriptions for all of Ontario, Canada and to examine variability in antibiotic prescribing across physicians.

Methods
We conducted a cross-sectional study of antibiotics dispensed from community pharmacies in Ontario, Canada, between March 1, 2016 and February 28, 2017. Ontario has a population of 13.9 million people and over 30,000 physicians. We analyzed data from the Xponent™ database by QuintilesIMS. Xponent™ is based on data from 79% of retail pharmacies in Ontario. QuintilesIMS uses a geospatial extrapolation algorithm to project antibiotic utilization on 100% of the population. This analysis describes physician antibiotic prescribing patterns stratified by patient age and sex.

Results
There were 6,995,416 antibiotics dispensed or 501/1,000 population. The highest prescribing rate was for patients aged 65 and older at 702 antibiotic scripts/1,000 population, children 0–17 years received 477 antibiotic scripts/1,000 population and adults 18–64 years 446 antibiotics/1,000 population. Females aged 65 years and older received the highest number of antibiotics. Narrow spectrum penicillins, macrolides, first-generation cephalosporins, and second-generation fluoroquinolones (ciprofloxacin and norfloxacin) were the most common classes of antibiotics overall; however, the urinary antibiotics including ciprofloxacin, norfloxacin, and nitrofurantoin were the most common in older females (Figure 1). There was significant prescriber variability with 25% of all antibiotics being prescribed by 2.2% of physicians. Family physicians comprised 91% of these high prescribers.

Conclusion
This population-based study quantified community antibiotic utilization and demonstrated marked prescriber variability. Future antibiotic stewardship interventions should target the minority of family physicians that prescribe the majority of antibiotics.

Disclosures
All authors: No reported disclosures.
“Big data” and Gram-negative Resistance: A Multiple Logistic Regression Model Using EMR Data to Predict Carbapenem Resistance in Patients with Klebsiella pneumoniae Bloodstream Infection
Authors: Sullivan Timothy , Aberg Judith 
Published: October 2017

Abstract

Background
The timely identification of carbapenem resistance is essential in the management of patients with Klebsiella pneumoniae bloodstream infection (BSI). An algorithm using electronic medical record (EMR) data to quickly predict resistance could potentially help guide therapy until more definitive resistance testing results are available.

Methods
All cases of K. pneumoniae BSI at Mount Sinai Hospital from September 2012 through September 2016 were identified. Cases of persistent BSI or recurrent BSI within 2 weeks were included only once. Patients with recurrent BSI after more than 2 weeks of negative blood cultures were considered distinct cases and included more than once. Carbapenem resistance was defined as an imipenem minimum inhibitory concentration of ≥2 μg/ml. Extensive EMR data for each patient were compiled into a relational database using SQLite. Possible risk factors for carbapenem resistance were queried from the database and analyzed via univariate methods. Significant factors were then entered into a multiple logistic regression model in a forward stepwise approach using SPSS.

Results
A total of 613 cases of K. pneumoniae BSI were identified in 540 unique patients. The overall incidence of imipenem resistance was 10% (61 cases). Significant markers of resistance included in the final model were (1) prior colonization with imipenem-resistant Klebsiella pneumoniae; (2) hospital unit (defined as high-risk unit, low-risk unit, and emergency department); (3) total inpatient days in the previous 5 years; (4) total days of oral or parenteral antibiotics in the past 2 years; and (5) age &gt;60 years old (Figure 1). The model generated a receiver operating characteristic curve with an area under the curve of 0.75 (Figure 2). At a cut point of 0.083, the model correctly predicted 72% of imipenem-resistant cases while incorrectly labeling 32% of susceptible cases as resistant (Sn = 72%, Sp = 63%, Figure 3).

Conclusion
A multiple logistic regression model using EMR data can generate immediate, clinically useful predictions of carbapenem resistance in patients with K. pneumoniae BSI. Larger data sets are needed to improve and validate these findings.

Disclosures
All authors: No reported disclosures.
Treatment as Prevention for Hepatitis C (TraP HepC). A Real-world Experience from the First 12 Months of a Nationwide Elimination Program in Iceland
Authors: Gottfredsson Magnus , Tyrfingsson Thorarinn , Runarsdottir Valgerdur , Bergmann Ottar M , Bjornsson Einar S , Johannsson Birgir , Sigurdardottir Bryndis , Fridriksdottir Ragnheidur H , Löve Arthur , Löve Thorvardur J , Sigmundsdottir Gudrun , Heimisdottir Maria , Olafsson Sigurdur 
Published: October 2017

Abstract

Background
Hepatitis C virus (HCV) infection is associated with significant morbidity and mortality. Iceland, an island with a population of 330,000 has a HCV seroprevalence of 0.3% and an estimated total of 800–1000 patients. There is good access to health care among people who inject drugs (PWID) and Iceland thus serves as an ideal setting for a proof of concept intervention, aiming for elimination of the disease as a public health threat. If elimination is to be achieved PWID, who are key drivers of transmission, need to be a focus of treatment scale up.

Methods
All patients in the country infected with HCV were offered direct-acting antiviral agents (DAAs) starting in 01/2016. The regimens are chosen according to national guidelines; SOF/LDV +/−RBV through October 2016 and SOF/VEL +/− RBV thereafter. People with recent injection drug use (IDU), prisoners and patients with advanced liver disease are prioritized. PWID receive additional support to facilitate compliance. Various strategies are employed to enhance case detection and harm reduction. The goal is to initiate treatment for every patient in Iceland within 36 months (end-2018), aiming for elimination of domestic transmission of HCV.

Results
Twelve months after launching the nationwide program 527 patients had been evaluated, 53–66% of the estimated total patient population. The mean age is 42 years (range, 17–70 years, 2 males to every female). The reported main route of infection was IDU (90%). At the time of evaluation, 33% reported recent (within 6 months) IDU, 6% were homeless, and 5% in prison. Stimulants were the preferred IV drug among 84% of PWID but opiates by only 14%; overall 15% were receiving opiate substitution therapy (OST). During the first 12 months of the study period treatment with DAAs was initiated in 480 patients and 322 were scheduled to complete protocol. Drop-out rate is 6.5%. Sustained virological response at 12 weeks (SVR12) for the entire group, including patients who dropped out or are lost to follow-up is 90%. It is significantly lower among the homeless (60%) and active IDU (83% vs. 93%, P = 0.007).

Conclusion
A relatively large proportion of HCV infected patients in the community, including people actively injecting drugs, can be initiated on treatment in a short period of time. Current drug use does not preclude treatment success.

Disclosures
M. Gottfredsson, Gilead: Grant Investigator and Scientific Advisor, Consulting fee and Research support; Astellas: Consultant, Speaker honorarium
Impact of Infectious Diseases Consultation on Mortality in Patients with Candidemia
Authors: Mejia Carlos , Kronen Ryan , Lin Charlotte , Hsueh Kevin , Powderly William , Spec Andrej 
Published: October 2017

Abstract

Background
An infectious diseases (ID) consultation is often, but not always, obtained to help guide treatment of patients with candidemia. We examined if ID consultation affected patient outcome in patients with culture positive candidemia.

Methods
We assembled a retrospective cohort of 1,873 cases of candidemia in patients hospitalized in our academic tertiary care hospital from 2002 to 2015. We collected data on comorbidities, predisposing factors; antifungal therapy, survival and ID consult. Patients who died within 24 hours of diagnosis were excluded, under the presumption that they did not have an opportunity to receive an ID consult. Survival analysis was performed via univariate and multivariate Cox Regression with censoring at 90 days, as subsequent mortality was less likely to be related to candidemia.

Results
913 (49%) of the candidemic patients received an ID consult; 960 (51%) did not. Underlying comorbidities were evenly distributed between patients with and without an ID consult, except that patients with an ID consult more frequently had a central line (39% vs. 26%, p &lt; 0.001), were on mechanical ventilation (4% vs. 2%, P = 0.003) or were receiving extracorporeal membrane oxygenation (2.2% vs. 0.5%, p = 0.002). The ID consult group had lower 90-day mortality compared with patients without an ID consult (34% vs. 49%, P &lt; 0.001), with an adjusted hazard ratio of mortality for those patients receiving an ID consult of 0.55 (95% CI: 0.48, 0.64, P &lt; 0.001) (Fig 1). Patient management differed significantly: the ID consult group was more likely to receive an echinocandin (29% vs. 21%, P &lt; 0.001) or amphotericin B (AmB) (3.4% vs. 1.4%, P = 0.006).

Conclusion
Candidemic patients who received an ID consult were significantly less likely to die, and were more likely to receive therapy with amphotericin or an echinocandin. These data suggest that an ID consult should be an integral part of clinical care of patients with candidemia.

Disclosures
W. Powderly, Merck: Grant Investigator and Scientific Advisor, Consulting fee and Research grant; Gilead: Scientific Advisor, Consulting fee; Astellas: Grant Investigator, Research grant; A. Spec, Astellas Pharma US, Inc.: Grant Investigator, Research grant
Arboviral Infections Following the 2016 Olympic and Paralympic Games in a Cohort of US Athletes and Support Staff
Authors: Byington Carrie L , Ampofo Krow , Lewis Tammi , Mathie Taylor , Nanayakkara Dholani , Pavia Andrew , Hanson Kim , Couturier Marc Roger , Moreau Bill 
Published: October 2017

Abstract

Background
The 2016 Olympic and Paralympic games were held in Brazil after the peak of an explosive Zika virus (ZIKV) outbreak. The risk to US athletes and support staff of travel-associated ZIKV and other arboviral infections was unknown but concern was high.

Methods
Individuals traveling with the US Olympic Committee (USOC), including Olympic and Paralympic athletes and support staff were enrolled. Participants provided a pre- and post-travel (2–12 weeks) blood samples, and were also counseled about mosquito avoidance. Participants completed pre- and post-travel surveys detailing demographics, health history, vaccination, mosquito protection, and symptoms during and up to 2 weeks after travel to Brazil. Blood samples were tested at ARUP Laboratories, Utah, for ZIKV IgM and for Chikungunya (CHKV), Dengue (DENV), and West Nile (WNV) viruses IgM and IgG. Recent infection was defined as the presence of IgM in a post-travel blood sample and or IgG seroconversion.

Results
A total of 950 individual subjects provided pre-travel samples and surveys. Of these, 457 (48%) also provided post-travel samples. No ZIKV infections were detected by IgM. However, 48 (11%) participants had antibody evidence of other arboviral infections; 4 (0.9% tested) with CHKV, 6 (1.3%) with DENV, and 39 (9%) with WNV. Of these, new travel-associated infection was confirmed in 32 (7%); 3 of 4 CHKV, 2 of 6 DENV, and 27 of 39 WNV. Twelve (38%) of the subjects with travel associated arbovirus infection submitted post-travel surveys; 3 (25%) respondents had symptoms of arboviral infection during or within 2 weeks after travel; 2 (16%) CHKV, and 1 (8%) WNV. Those with travel-associated arboviral infections had similar demographics, and exposure whilst in Brazil, but were less likely to use mosquito repellent than athletes without arboviral infection (7/12 (58%) vs. 130/154 (84%), OR 0.26, P = 0.04).

Conclusion
ZIKV was not detected in the USOC athletes or staff traveling to Brazil. Other arboviral infections were detected in 7% of travelers, with WNV being most common. The use of mosquito repellent was associated with decreased risk of infection. This study demonstrates multiple arboviruses in addition to ZIKV were circulating simultaneously in Brazil and has implications for pre- and post-travel counseling.

Disclosures
C. L. Byington, BioFire: Collaborator and Grant Investigator, Licensing agreement or royalty and Research grant