bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the impact of the COVID-19 pandemic on hospital-associated Clostridioides difficile infection
Authors: Ray Michael , Furuno Jon , Strnad Luke , Lofgren Eric , McGregor Jessina 
Published: September 2023

Background: The epidemiology of Clostridioides difficile infection (CDI) is complex, and the COVID-19 pandemic has had extreme impacts on known risk factors such as comorbidity burden and antibiotic prescribing. However, whether these changes have affected the incidence of hospital-associated CDI (HA-CDI) remains unknown. We compared incidence and trends of HA-CDI before and after the pandemic onset, and we assessed the impact of changes in key CDI-related risk factors. Methods: We conducted an interrupted time-series study (March 2018–March 2021) of adult inpatients hospitalized 4 or more days with no known CDI on admission at a 576-bed academic medical center. Our primary outcome was monthly HA-CDI per 10,000 patient days. We performed segmented linear regression to compare the preinterruption trend in HA-CDI rate to the postinterruption slope and level change. We established a series of 30-day intervals before and after the interruption timepoint of March 23, 2020, which corresponds with the Oregon stay-at-home executive order. The data included 24 preinterruption time points and 12 postinterruption time points. We also assessed changes in slope and trend for known HA-CDI risk factors. Results: We included 34,592 inpatient encounters in our prepandemic period and 10,932 encounters in our postinterruption period. The mean prepandemic HA-CDI rate was 4.07 cases per 10,000 patient days. After the pandemic onset, the rate was 3.6 per 10,000 patient days. However, the observed differences in rate (both in terms of slope and level) were not statistically significant (P = .90 for level; P = .60 for slope change). We observed a significant decrease in admissions per 30 days (1,441 vs 911; level-change P < .0001) and a slight increase in the mean number of Elixhauser comorbidities (1.96 vs 2.07; level-change P = .05). We also observed significant increases in both frequency and intensity of antibiotic use, with an increase average days of therapy per encounter (5.8 vs 7.2; level-change P = .01; slope-change P < .0001) and in antibiotic spectrum index (ASI) points per antibiotic day (4.4 vs 4.9; P < .0001). We observed a consistent downward trend for case days of CDI colonization pressure per hospital day (preinterruption slope P < .0001), which remained consistent after the pandemic onset (P = 0.5 for postinterruption slope change) (Fig. 1). Conclusions: Despite significant increases in high-intensity antibiotic use and comorbidity burden, we did not observe significant differences in HA-CDI after the pandemic onset. This may be due to the significant decrease in colonization pressure in the postpandemic period. Further research is required to fully understand the impact of the pandemic-related changes onDisclosures: None
CDC consultations related to ophthalmologic practices and settings, 2016–2021
Authors: Spicer Kevin , Perz Joseph , Perkins Kiran 
Published: September 2023

Background: Healthcare activities that include instrumentation or manipulation of mucosal tissue or normally sterile sites, such as the eye and its associated structures, place patients at risk of infectious and other complications. We reviewed queries to the CDC Prevention and Response Branch that were focused on ophthalmologic procedures and settings to examine opportunities to improve infection prevention and control (IPC) practices in these settings. Methods: We reviewed internal CDC consultation records received from January 1, 2016, through December 31, 2021, to identify those involving ophthalmologic procedures or settings. Consultations were reviewed to determine setting type, number of patients affected, organisms identified, nature of infection control breaches, and whether medical products were implicated. Descriptive statistics were calculated. Results: We identified 24 consultations among 19 states and US territories. Of these, 21 (87.5%) involved outpatient settings, of which 9 (43%) were ambulatory surgery centers. Consultations included the following non–mutually exclusive categories. There were 18 adverse postsurgical events (75%), such as mycobacterial infection after laser surgery and toxic anterior segment syndrome following cataract surgery (n = 5). There were 11 infections following ophthalmologic clinical care (46%), such as epidemic keratoconjunctivitis due to adenovirus 8. There were 8 suspected medication-related events (33%) including contamination of ophthalmic medication when manufactured or compounded offsite. There were 8 medical-device reprocessing concerns (33%) including inappropriate high-level disinfection. There were 8 instances of improper environmental cleaning and disinfection (33%), for example, during an adenovirus outbreak. There were 3 cases of potential mishandling of medications onsite (12.5%), such as multiuse eye drops. Also, 3 events (12.5%) were associated with potentially contaminated donor tissue, such as corneas for transplantation. When a consultation included identification of a pathogen (n = 11), organisms included bacteria (n = 7, 64%), viruses (n = 2, 18%), and fungi (n = 3, 27%). In total, 202 patients had confirmed ophthalmologic infections or adverse events. Conclusions: Based on our review of recent outbreaks, healthcare personnel in ophthalmologic settings may have deficits in training related to instrument reprocessing and environmental cleaning specific to ophthalmic equipment and settings that can result in harm to patients. These settings could benefit from targeted training to improve IPC practices specific to ophthalmologic examinations and procedures. This review was limited to analysis of investigations that were voluntarily reported to the CDC. A formal surveillance system for adverse outcomes in this setting could clarify the nature and frequency of IPC issues of greatest concern.Disclosures: None
A TOPOLOGICAL APPROACH TO UNDEFINABILITY IN ALGEBRAIC EXTENSIONS OF
Authors: EISENTRÄGER KIRSTEN , MILLER RUSSELL , SPRINGER CALEB , WESTRICK LINDA 
Published: September 2023

AbstractFor any subset
$Z \subseteq {\mathbb {Q}}$
, consider the set
$S_Z$
of subfields
$L\subseteq {\overline {\mathbb {Q}}}$
which contain a co-infinite subset
$C \subseteq L$
that is universally definable in L such that
$C \cap {\mathbb {Q}}=Z$
. Placing a natural topology on the set
${\operatorname {Sub}({\overline {\mathbb {Q}}})}$
of subfields of
${\overline {\mathbb {Q}}}$
, we show that if Z is not thin in
${\mathbb {Q}}$
, then
$S_Z$
is meager in
${\operatorname {Sub}({\overline {\mathbb {Q}}})}$
. Here, thin and meager both mean “small”, in terms of arithmetic geometry and topology, respectively. For example, this implies that only a meager set of fields L have the property that the ring of algebraic integers
$\mathcal {O}_L$
is universally definable in L. The main tools are Hilbert’s Irreducibility Theorem and a new normal form theorem for existential definitions. The normal form theorem, which may be of independent interest, says roughly that every
$\exists $
-definable subset of an algebraic extension of
${\mathbb Q}$
is a finite union of single points and projections of hypersurfaces defined by absolutely irreducible polynomials.
Addressing System Deficiencies in the Protection of the Financial Interests of the EU: Preventing Harm and Incentivizing Change
Authors: Gadbled Robin 
Published: September 2023

AbstractThe article looks at how “systemic” irregularities or breaches of law imputable to EU Member States are defined in key legal documents relating to the protection of the EU budget – notably with regards to Agricultural, Structural and Recovery funds, and with regards to the Conditionality Regulation. It is argued that “system deficiencies” arise where the financial interests of the European Union are damaged or put at risk because the systems meant to protect these interests in a Member State are considered deficient themselves. The scope of these systems varies with documents: some systems are defined in sectoral legislation and only have relevance for specific funding programmes; other systems have a more constitutional character and are linked to the protection of the rule of law in EU member states. Moreover, the severity of system deficiencies can be graded on a scale. This has implications regarding the extent of the financial consequences which can be imposed on Member States for the protection of the EU budget – how much EU funding should be withheld from them. It is also argued that the rationales underlying the imposition of financial consequences – putting the EU budget out of harm’s way or incentivizing change to reduce risk? – have implications pertaining to the legal and constitutional relationship established between the EU and its Member States.
Transition of care in CHD: a single-centre experience: an enigma remains
Authors: Lopez Christine , Glassberg Brittany , Dembar Alexandra , Riasat Maria , Chan Alice , Govindarajulu Usha , Hopkins Kali A. , Zaidi Ali N. 
Published: September 2023

AbstractTransition of care refers to the continuity of health care during the movement from one healthcare setting to another as care needs change during a chronic illness. We sought to describe social, demographic, and clinical factors related to successful transition in a tertiary urban care facility in patients with CHD. Patients were identified utilising the electronic medical record. Inclusion criteria were patients with CHDs aged ≥15 years seen in the paediatric cardiology clinic between 2013 and 2014. Deceased patients were excluded. Clinical and demographic variables were collected. Patient charts were reviewed in 2015–2021 to determine if included patients were a) still in paediatric cardiology care, b) transitioned to adult cardiology/adult CHD, or were c) lost to follow-up. A total of 322 patients, 53% male (N:172), 46% female (N:149) were included. Majority had moderately complex lesions (N:132, 41%). Most patients had public insurance (N:172, 53%), followed by private insurance (N:67, 21%), while 15% of patients (N:47) were uninsured. Only 49% (N = 159) had successful transition, while 22% (N = 70) continued in care with paediatric cardiology, and 29% (N = 93) were lost to follow-up. Severity of CHD (p = 0.0002), having healthcare insurance (p < .0001), presence of a defibrillator (p = 0.0028), and frequency of paediatric cardiology visits (p = 0.0005) were significantly associated with successful transition. Most patients lost to follow-up (N:42,62%) were either uninsured or had public insurance. Lack of successful transition is multifactorial, and further efforts are needed to improve the process in patients with CHD.
How Do the Convective and Microphysical Characteristics of Extreme Precipitation Over the Pearl River Delta at Monsoon Coast Vary With Increasing Rainfall Extremity?
Authors: Gao Y. Y. , Li M. X. , Luo Y. L. , Wu C. , Qiu J. L. 
Published: September 2023

AbstractUsing 5‐year dual‐polarization radar observations, variations of convective and microphysical characteristics of extreme precipitation features (EPFs) with increasing rainfall extremity over a monsoon coastal region (Pearl River Delta; PRD) in South China are investigated through comparing three groups of EPFs (ER1, ER2, and ER3). The more extreme rainfall shows a notable increase and decrease in the fractions of “intense” convection and “weak” convection, respectively. The higher rainfall extremity is accompanied by statistically significant increases in ice and liquid water contents but a roughly equal fraction of coalescence in liquid‐phase processes. While the raindrop size distributions of ER1 to ER3 similarly feature a mean size larger than “maritime‐like” droplets and a concentration much higher than “continental‐like” raindrops, the mean size and concentration of raindrops tend to increase slightly with the increasing rainfall extremity. Two sensitivity experiments on EFP definition confirm the robustness and representative of the above results.
Drought and Waterlogging Stress Regimes in Northern Peatlands Detected Through Satellite Retrieved Solar‐Induced Chlorophyll Fluorescence
Authors: Valkenborg Bram , De Lannoy Gabriëlle J. M. , Gruber Alexander , Miralles Diego G. , Köhler Philipp , Frankenberg Christian , Desai Ankur R. , Humphreys Elyn , Klatt Janina , Lohila Annalea , Nilsson Mats B. , Tuittila Eeva‐Stiina , Bechtold Michel 
Published: September 2023

AbstractThe water table depth (WTD) in peatlands determines the soil carbon decomposition rate and influences vegetation growth, hence the above‐ground carbon assimilation. Here, we used satellite‐observed Solar‐Induced chlorophyll Fluorescence (SIF) as a proxy of Gross Primary Production (GPP) to investigate water‐related vegetation stress over northern peatlands. A linear model with interaction effects was used to relate short‐ and long‐term anomalies in SIF with WTD anomalies and the absolute WTD. Most locations showed the occurrence of drought and waterlogging stress though regions with exclusively waterlogging or drought stress were also detected. As a spatial median, minimal water‐related vegetation stress was found for a WTD of −0.22 m (short‐term) and −0.20 m (long‐term) (±0.01 m, 95% confidence interval of statistical uncertainty). The stress response observed with SIF is supported by an analysis of in situ GPP data. Our findings provide insight into how changes in WTD of northern peatlands could affect GPP under climate change.
Formation of Electron Butterfly Pitch Angle Distributions in Saturn's Magnetosphere Due To Scattering by Equatorial ECH Waves
Authors: Long Minyi , Cao Xing , Ni Binbin , Lou Yuequn , Yao Zhonghua , Roussos Elias , Qin Tianshu , Wu Siyuan 
Published: September 2023

AbstractThe features of electron pitch angle distributions (PADs) often imply different physical mechanisms in planetary magnetospheres. We report a simultaneous equatorial electrostatic electron cyclotron harmonic (ECH) wave event with butterfly PADs of electrons at L ∼ 7.6–9 observed by the Cassini spacecraft. Via calculating the bounce‐averaged electron diffusion rates, we found that Saturnian ECH waves can resonate with ∼10 eV to several keV electrons at <60° pitch angles at time scales from ∼10−8 to 10−4 s−1. Simulations show that the formation of ∼100 eV to ∼1 keV electron butterfly PADs are mainly caused by the pitch angle scattering of electrons at low pitch angles (<30°) and the momentum scattering at intermediate pitch angles of ∼30°–45°, though previous studies suggested the adiabatic transport is the dominated mechanism. Additionally, our results successfully reproduce the variation of peak pitch angles (αp) and phase space density ratios between α90° and αp with L‐shell.
Targeting cis-regulatory elements of FOXO family is a novel therapeutic strategy for induction of leukemia cell differentiation
Authors: Kurayoshi Kenta , Takase Yusuke , Ueno Masaya , Ohta Kumiko , Fuse Kyoko , Ikeda Shuji , Watanabe Takayoshi , Nishida Yuki , Horike Shin-ichi , Hosomichi Kazuyoshi , Ishikawa Yuichi , Tadokoro Yuko , Kobayashi Masahiko , Kasahara Atsuko , Jing Yongwei , Shoulkamy Mahmoud I. , Meguro-Horike Makiko , Kojima Kensuke , Kiyoi Hitoshi , Sugiyama Hiroshi , Nagase Hiroki , Tajima Atsushi , Hirao Atsushi 
Published: September 2023

AbstractDifferentiation therapy has been proposed as a promising therapeutic strategy for acute myeloid leukemia (AML); thus, the development of more versatile methodologies that are applicable to a wide range of AML subtypes is desired. Although the FOXOs transcription factor represents a promising drug target for differentiation therapy, the efficacy of FOXO inhibitors is limited in vivo. Here, we show that pharmacological inhibition of a common cis-regulatory element of forkhead box O (FOXO) family members successfully induced cell differentiation in various AML cell lines. Through gene expression profiling and differentiation marker-based CRISPR/Cas9 screening, we identified TRIB1, a complement of the COP1 ubiquitin ligase complex, as a functional FOXO downstream gene maintaining an undifferentiated status. TRIB1 is direct target of FOXO3 and the FOXO-binding cis-regulatory element in the TRIB1 promoter, referred to as the FOXO-responsive element in the TRIB1 promoter (FRE-T), played a critical role in differentiation blockade. Thus, we designed a DNA-binding pharmacological inhibitor of the FOXO-FRE-T interface using pyrrole-imidazole polyamides (PIPs) that specifically bind to FRE-T (FRE-PIPs). The FRE-PIPs conjugated to chlorambucil (FRE-chb) inhibited transcription of TRIB1, causing differentiation in various AML cell lines. FRE-chb suppressed the formation of colonies derived from AML cell lines but not from normal counterparts. Administration of FRE-chb inhibited tumor progression in vivo without remarkable adverse effects. In conclusion, targeting cis-regulatory elements of the FOXO family is a promising therapeutic strategy that induces AML cell differentiation.
The role of arsenic in the operation of sulfur-based electrical threshold switches
Authors: Wu Renjie , Gu Rongchuan , Gotoh Tamihiro , Zhao Zihao , Sun Yuting , Jia Shujing , Miao Xiangshui , Elliott Stephen R. , Zhu Min , Xu Ming , Song Zhitang 
Published: September 2023

AbstractArsenic is an essential dopant in conventional silicon-based semiconductors and emerging phase-change memory (PCM), yet the detailed functional mechanism is still lacking in the latter. Here, we fabricate chalcogenide-based ovonic threshold switching (OTS) selectors, which are key units for suppressing sneak currents in 3D PCM arrays, with various As concentrations. We discovered that incorporation of As into GeS brings >100 °C increase in crystallization temperature, remarkably improving the switching repeatability and prolonging the device lifetime. These benefits arise from strengthened As-S bonds and sluggish atomic migration after As incorporation, which reduces the leakage current by more than an order of magnitude and significantly suppresses the operational voltage drift, ultimately enabling a back-end-of-line-compatible OTS selector with >12 MA/cm2 on-current, ~10 ns speed, and a lifetime approaching 1010 cycles after 450 °C annealing. These findings allow the precise performance control of GeSAs-based OTS materials for high-density 3D PCM applications.
The promise of data science for health research in Africa
Authors: Adebamowo Clement A. , Callier Shawneequa , Akintola Simisola , Maduka Oluchi , Jegede Ayodele , Arima Christopher , Ogundiran Temidayo , Adebamowo Sally N. ,   BridgELSI Project as part of the DS-I Africa Consortium
Published: September 2023

AbstractData science health research promises tremendous benefits for African populations, but its implementation is fraught with substantial ethical governance risks that could thwart the delivery of these anticipated benefits. We discuss emerging efforts to build ethical governance frameworks for data science health research in Africa and the opportunities to advance these through investments by African governments and institutions, international funding organizations and collaborations for research and capacity development.
The global costs of extreme weather that are attributable to climate change
Authors: Newman Rebecca , Noy Ilan 
Published: September 2023

AbstractExtreme weather events lead to significant adverse societal costs. Extreme Event Attribution (EEA), a methodology that examines how anthropogenic greenhouse gas emissions had changed the occurrence of specific extreme weather events, allows us to quantify the climate change-induced component of these costs. We collect data from all available EEA studies, combine these with data on the socio-economic costs of these events and extrapolate for missing data to arrive at an estimate of the global costs of extreme weather attributable to climate change in the last twenty years. We find that US$$\$$$
$
143 billion per year of the costs of extreme events is attributable to climatic change. The majority (63%), of this is due to human loss of life. Our results suggest that the frequently cited estimates of the economic costs of climate change arrived at by using Integrated Assessment Models may be substantially underestimated.
YOLO object detection models can locate and classify broad groups of flower-visiting arthropods in images
Authors: Stark Thomas , Ştefan Valentin , Wurm Michael , Spanier Robin , Taubenböck Hannes , Knight Tiffany M. 
Published: September 2023

AbstractDeveloment of image recognition AI algorithms for flower-visiting arthropods has the potential to revolutionize the way we monitor pollinators. Ecologists need light-weight models that can be deployed in a field setting and can classify with high accuracy. We tested the performance of three deep learning light-weight models, YOLOv5nano, YOLOv5small, and YOLOv7tiny, at object recognition and classification in real time on eight groups of flower-visiting arthropods using open-source image data. These eight groups contained four orders of insects that are known to perform the majority of pollination services in Europe (Hymenoptera, Diptera, Coleoptera, Lepidoptera) as well as other arthropod groups that can be seen on flowers but are not typically considered pollinators (e.g., spiders-Araneae). All three models had high accuracy, ranging from 93 to 97%. Intersection over union (IoU) depended on the relative area of the bounding box, and the models performed best when a single arthropod comprised a large portion of the image and worst when multiple small arthropods were together in a single image. The model could accurately distinguish flies in the family Syrphidae from the Hymenoptera that they are known to mimic. These results reveal the capability of existing YOLO models to contribute to pollination monitoring.
Severe level of photochemical oxidants (Ox) over the western coast of Japan during autumn after typhoon passing
Authors: Itahashi Syuichi 
Published: September 2023

AbstractPhotochemical oxidants (Ox; mainly O3) are a concern in East Asia. Because of the prevailing westerly wind in the midlatitudes, O3 concentration generally shows a high in spring over Kyushu Island, western Japan, and Ox warnings have been issued in spring. However, the record from 2000 to 2021 of Ox warning days in Kyushu Island contains one warning case in autumn 2020. Interestingly, a typhoon had passed the day before this Ox warning. To relate these events, a modelling simulation was conducted and it showed the transboundary O3 transport from the Asian continent to the western coast of Japan due to the strong wind field determined by the location of Typhoon Haishen (2020). The sensitivity simulations for changing Chinese anthropogenic sources suggested that both nitrogen oxides (NOx) and volatile organic compound (VOC) emission regulations in China could decrease high O3 over the downwind region of Japan. Furthermore, VOC emission regulation in China led to an overall O3 decrease in East Asia, whereas NOx emission regulation in China had complex effects of decreasing (increasing) O3 during the daytime (nighttime) over China. The association between air quality and meteorology related to typhoons should be considered along with global warming in the future.