bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synergistic effect of V2O5 and Bi2O3 on the grain boundary structure of high-frequency NiCuZn ferrite ceramics
Authors: Fan Xiuyuan , Bai Guohua , Zhang Zhenhua , Chen Qiming , Jin Jiaying , Xu Jiafeng , Zhang Xuefeng , Yan Mi 
Published: May 2022

AbstractHigh-frequency soft magnetic ferrite ceramics are desired in miniaturized and efficient power electronics but remain extremely challenging to deploy on account of the power loss (Pcv) at megahertz frequencies. Here, we prepared NiCuZn ferrite with superior high-frequency properties by V2O5 and Bi2O3 synergistic doping, which proves to be a potent pathway to reduce Pcv of the ferrite at megahertz frequencies. The sample doped with 800 ppm V2O5 and 800 ppm Bi2O3 yielded the most optimized magnetic properties with a Pcv of 113 kW/m3 (10 MHz, 5 mT, 25 °C), an initial permeability (μi) of 89, and a saturation induction (Bs) of 340 mT, which is at the forefront of the reported results. These outstanding properties are closely related to the notable grain boundary structure, which features a new type of nano-Bi2Fe4O9 phase around ferrite grains and a Ca/Si/V/O amorphous layer. Our results indicate great strides in correlating the grain boundary structure with multiple-ion doping and set the scene for the developing high-frequency soft magnet ferrites.
Global Entropy Solutions and Newtonian Limit for the Relativistic Euler Equations
Authors: Chen Gui-Qiang G. , Schrecker Matthew R. I. 
Published: May 2022

AbstractWe analyze the relativistic Euler equations of conservation laws of baryon number and momentum with a general pressure law. The existence of global-in-time bounded entropy solutions for the system is established by developing a compensated compactness framework. The proof relies on a careful analysis of the entropy and entropy-flux functions, which are represented by the fundamental solutions of the entropy and entropy-flux equations for the relativistic Euler equations. Based on a careful entropy analysis, we establish the compactness framework for sequences of both exact solutions and approximate solutions of the relativistic Euler equations. Then we construct approximate solutions via the vanishing viscosity method and employ our compactness framework to deduce the global-in-time existence of entropy solutions. The compactness of the solution operator is also established. Finally, we apply our techniques to establish the convergence of the Newtonian limit from the entropy solutions of the relativistic Euler equations to the classical Euler equations.
Efficient WENO-Based Prolongation Strategies for Divergence-Preserving Vector Fields
Authors: Balsara Dinshaw S. , Samantaray Saurav , Subramanian Sethupathy 
Published: May 2022

AbstractAdaptive mesh refinement (AMR) is the art of solving PDEs on a mesh hierarchy with increasing mesh refinement at each level of the hierarchy. Accurate treatment on AMR hierarchies requires accurate prolongation of the solution from a coarse mesh to a newly defined finer mesh. For scalar variables, suitably high-order finite volume WENO methods can carry out such a prolongation. However, classes of PDEs, such as computational electrodynamics (CED) and magnetohydrodynamics (MHD), require that vector fields preserve a divergence constraint. The primal variables in such schemes consist of normal components of the vector field that are collocated at the faces of the mesh. As a result, the reconstruction and prolongation strategies for divergence constraint-preserving vector fields are necessarily more intricate. In this paper we present a fourth-order divergence constraint-preserving prolongation strategy that is analytically exact. Extension to higher orders using analytically exact methods is very challenging. To overcome that challenge, a novel WENO-like reconstruction strategy is invented that matches the moments of the vector field in the faces, where the vector field components are collocated. This approach is almost divergence constraint-preserving, therefore, we call it WENO-ADP. To make it exactly divergence constraint-preserving, a touch-up procedure is developed that is based on a constrained least squares (CLSQ) method for restoring the divergence constraint up to machine accuracy. With the touch-up, it is called WENO-ADPT. It is shown that refinement ratios of two and higher can be accommodated. An item of broader interest in this work is that we have also been able to invent very efficientfinite volumeWENO methods, where the coefficients are very easily obtained and the multidimensional smoothness indicators can be expressed as perfect squares. We demonstrate that the divergence constraint-preserving strategy works at several high orders for divergence-free vector fields as well as vector fields, where the divergence of the vector field has to match a charge density and its higher moments. We also show that our methods overcome the late time instability that has been known to plague adaptive computations in CED.
Integrative studies on the taxonomy and molecular phylogeny of four new Pleuronema species (Protozoa, Ciliophora, Scuticociliatia)
Authors: Liu Mingjian , Liu Yujie , Zhang Tengteng , Lu Borong , Gao Feng , Gu Jing , Al-Farraj Saleh A. , Hu Xiaozhong , Song Weibo 
Published: May 2022

AbstractThe ciliate genus Pleuronema comprises approximately 30 nominal species and has been reported in freshwater, brackish water, and marine habitats. Nevertheless, recent studies have indicated that there might be a large undiscovered species diversity. In the present work, four new Pleuronema species, namely P. foissneri sp. nov., P. parasmalli sp. nov., P. parasalmastra sp. nov., and P. paraorientale sp. nov., collected from Shenzhen, southern China, was investigated using taxonomic methods. The diagnosis, description, comparisons with morphologically related species and detailed morphometric data are supplied for each. The small subunit ribosomal RNA (SSU rRNA) gene of the four new species is sequenced and their molecular phylogeny is analyzed. The SSU rRNA gene tree shows that Pleuronema is polyphyletic comprising several separate clades. All four new species cluster consistently with P. orientale KF206429, P. puytoraci KF840520 and P. setigerum FJ848874 within the core Pleuronematidae + Peniculistomatidae clade. Phylogenies of Pleuronematidae-related taxa are also discussed.
Evaluation of the genomic epidemiology and transmission of Clostridioides difficile infection across a community
Authors: Tesini Brenda , Taffner Samantha , Hatwar Trupti , Gill Steven , Dumyati Ghinwa , Pecora Nicole 
Published: May 2022

Background:Clostridioides difficile infection (CDI) is a major cause of morbidity and healthcare costs in the United States. The epidemiology of CDI has recently shifted, with healthcare-associated (HCA) CDI trending downward and community-associated (CA)-CDI becoming more prominent. The cause of this shift is not well understood but may be related to changing genomic epidemiology. We assessed C. difficile strains across a CDC Emerging Infections Program (EIP) site in Western New York, including strains from both HCA-CDI and CA-CDI cases to characterize predominating strains and putative transmission across epidemiological classifications and between index and recurrent cases. Methods: In total, 535 isolates of C. difficile were collected over a 6-month period in 2018 from the Monroe Country, New York, EIP site and were analyzed using whole-genome sequencing (WGS). Standard epidemiological definitions were used to classify cases as hospital onset (HO-CDI); community associated (CA-CDI); community onset, healthcare associated (CO-HCFA-CDI); or long-term care onset (LTCO-CDI). Recurrent cases were defined as those diagnosed within 8 weeks of an initial positive test. Multilocus sequence types (MLSTs) were assigned according to PUBMLST and single-nucleotide polymorphisms (SNPs) were determined using a modified CFSAN analytical pipeline. Cases resulting from putative transmission were defined as those separated by 0–1 core SNPs. Results: Of 535 isolates, 454 were from index and 81 were from recurrent cases. The index cases were comprised of CA-CDI (47.4%), CO-HCFA-CDI (24%), LTCO-CDI (8.1%), and HO-CDI (19.3%). Cases with recurrent disease mirrored the epidemiological distribution of the larger set. Common MLSTs included ST2 (12.3%), ST8 (10.5%), ST42 (7.9%), ST58 (4.9%), ST43 (4.5%), and ST11 (4.3%). The previously widespread epidemic strain, NAP1/ST1/RT027 accounted for Conclusions: The genomic epidemiology of C. difficile across this large community cohort demonstrated a diverse group of strain types that was similarly distributed across epidemiological classifications and between index and recurrent cases. SNP analysis indicated that direct transmission between cases was uncommon.Funding: NoneDisclosures: None
Central-line associated bloodstream infection (CLABSI) in patients hospitalized with COVID-19
Authors: Kang Minji , Conrad Zane , Thomas Elizabeth , Arocha Doramarie , Trivedi Julie 
Published: May 2022

Background: Significant increases in healthcare-associated infections (HAIs) including central-line associated blood stream infections (CLABSIs) have been reported during the COVID-19 pandemic. Acute-care hospitals have faced staffing and personal protective equipment shortages, increased critical care capacity, and diversion of resources from traditional HAI surveillance and prevention efforts. In this study, we characterized CLABSIs among patients with COVID-19 and compared demographics, comorbidities, and outcomes between patients diagnosed with CLABSI with and without COVID-19. Methods: This is an observational retrospective cohort study of all patients diagnosed with CLABSI as defined by NHSN at William P. Clements Jr. University Hospital from April 1, 2020, through September 30, 2021. A retrospective chart review was conducted to identify demographics, comorbidities, and outcomes of hospitalized patients diagnosed with CLABSI. Patients hospitalized with and without COVID-19 were compared using the independent-sample t test for means and the χ2 test for proportions. Results: Overall, 82 patients diagnosed with CLABSI between April 1, 2020, to September 30, 2021, among whom 31 (38%) were hospitalized with COVID-19 and 51 (62%) were not hospitalized with COVID-19. Patients hospitalized with COVID-19 were significantly more likely to be obese (58% for COVID-19 positive vs 26% for COVID-19 negative; P = .01) and to require extracorporeal membrane oxygenation (19% vs 4%; P = .04). However, COVID-19 patients were significantly less likely to have hematologic malignancy (7% vs 28%; P = .03), undergone bone marrow transplantation (0% vs 18%; P = .01), or have neutropenia (3% vs 22%; P = .03). There were no significant differences in line type or organism identified. Gram-positive pathogens were identified in 16 patients (52%) hospitalized with COVID-19. Gram-negative pathogens were identified in 3 patients (10%); fungal organisms were identified in 10 patients (32%), and 2 cases (7%) were polymicrobial. Patients with COVID-19 were significantly more likely to require an ICU stay (84% vs 43%). p Conclusions: High device utilization as well as prolonged hospitalization and line days among patients with COVID-19 along are contributing risk factors for CLABSI among patients hospitalized with COVID-19. This finding highlights the need for ongoing HAI surveillance and prevention efforts in patients hospitalized with COVID-19 given their characteristics and increased risk for CLABSI. Reinforcing infection prevention efforts by accentuating the importance of optimal line care and regular feedback are crucial, especially among patients hospitalized with COVID-19.Funding: NoneDisclosures: None
Challenges in IPC training for non–healthcare workers
Authors: Abdul Majid Faridah Binte , Lee Lai Chee , Yuen Tan Kwee , Ling Moi Lin 
Published: May 2022

Background: In the last 2 years of the COVID-19 pandemic, Singapore has been forced to explore alternative sites to quarantine persons or manage infected cases during surge periods in a national effort not to overwhelm the public healthcare facilities. External quarantine facilities were created at the EXPO and further extended to D’Resort and other hotels in May 2020. Infection prevention (IP) practices were implemented at these external facilities, where training non–healthcare staff to quickly learn and understand these required practices has been challenging. A team of staff from different clinical disciplines was formed to manage the COVID-19 patients at these facilities. The Infection Prevention and Epidemiology (IPE) department was invited to train all staff, including the clinical team, management agency, and security staff, regarding IP measures. We have described the system and approach used in the rapid training of all staff in IP measures where the goal is zero transmission while providing care to COVID-19 patients. Methods: Training materials were developed to facilitate rapid learning by all staff; medical jargon was avoided. Curriculum included precautions to be taken while performing terminal cleaning of patient rooms, serving meals, disinfecting phones and thermometers, as well as donning and doffing personal protective equipment (PPE). “Green” and “red” zones were created to assist staff in remembering appropriate PPE to be used. PPE training was provided using slides and video. Posters were created as a guide for staff at donning and doffing stations. Additionally, the IPE training team utilized an online data collection tool to capture staff completion on IP training and PPE competency for record keeping. We used a ‘soft’ approach because staff members were fearful of the unknown when caring for COVID-19 patients. Daily audits were conducted with immediate concurrent feedback to engage the relevant stakeholders. Infection prevention liaison officers (IPLOs) were appointed to assist in the daily audits. An electronic audit tool was used to facilitate audit and quick analysis. Conclusions: The experience gained in the last 2 years has been useful and may provide a template if new external sites are needed in the future because of the potential surge associated with the ο (omicron) variant.Funding: NoneDisclosures: None
Care innovations and health disparities: An exploration of COVID-19 outcomes in inpatient and hospital-at-home care settings
Authors: Priem Jennifer , Krinner Lisa , Murphy Stephanie , Monahan Sveta , Hole Colleen 
Published: May 2022

Background: Hospital at home (HaH) programs have been a critical resource for providing inpatient care to acutely ill patients throughout the COVID-19 pandemic. Given that this innovative care delivery model relies on technology and environmental concerns, questions have been raised about the effectiveness of HaH for vulnerable groups. However, evidence is extremely limited regarding equity issues in the HaH context. Thus, we explored COVID-19 outcomes within vulnerable groups. Methods: We conducted a matched, retrospective study of 116 acutely ill patients with COVID-19, aged ≥18 years, who presented to an AH emergency department (ED) and were admitted for inpatient care. Treatment patients were admitted to AH HaH between July 15 and September 31, 2020, and control patients were hospitalized between May 8 and June 25, 2020. Patients were matched based on oxygen requirement and DS CRB-65 (DEFINE) score. Race or ethnicity and area deprivation index (ADI) were chosen as predictors of health disparities. The ADI incorporates 17 indicators of poverty, educational attainment, and housing quality at the census tract level. Outcomes included 30-day (from discharge) severe illness or death composite, IP readmission, and ED visit. Results: The frequency of 30-day severe illness or death and ED visits were equivalent between the groups (n = 11; ED n = 5); the proportion of severe illness was higher for White patients in AH-HaH (n = 9 vs n = 5), and for Hispanic patients treated in the hospital (n = 5 vs n = 0; Fig. 1). There were no 30-day inpatient readmissions in the AH-HaH group, but 8 readmissions occurred with inpatients. The distribution of severe illness among the ADI quintiles varied. For traditional inpatients, disease progression was limited to ADI Q3–5 (Q3 = 3, Q4 = 6, Q5 = 2); for AH-HaH patients, disease progression was not influenced by ADI. The effect of ADI on 30-day ED readmission was nonsignificant. Conclusions: Although exploratory in nature, the results suggest that HaH may help combat sources of health disparities that have dominated the pandemic. Although inpatient care resulted in inpatient readmissions, mainly among Black and Hispanic patients, AH-HaH stays were not associated with any inpatient readmissions. The equivalent distribution among ADI quintiles of patients who became severely ill within 30 days of their AH-HaH stay suggests that HaH may be able to leverage innovation to reach vulnerable populations and reduce the impact of factors that contribute to inequity.Funding: NoneDisclosures: None
The impact of GenMark Dx ePlex blood-culture identification on the treatment and outcomes of gram-positive bacteremia
Authors: Kiszla B. Matthew , McCarty Todd , White Cameron , Moates Derek , Leal Sixto , Lee Rachael 
Published: May 2022

Background: In the treatment of bloodstream infections, the identification of the causal pathogen, and the evaluation of its susceptibility to antibiotics, often serve as the rate-limiting steps of the patient’s hospital stay. The GenMark Dx ePlex blood culture identification gram-positive (BCID-GP) panel aims to alleviate this bottleneck, thereby reducing the risk of severe complications and the spread of resistance, using electrowetting technology to detect the most common causes of GP bacteremia (20 targets) and 4 antimicrobial resistance (AMR) genes. We hypothesized that implementation of the ePlex BCID-GP panel would improve antimicrobial choice and de-escalation where appropriate. Methods: A mixed blinded and unblinded study was conducted to assess the effect of the BCID-GP panel on the outcomes and antibiotic stewardship of GP bacteremic patients before ePlex results were made clinically available (before implementation, N = 73) and once they accompanied the standard-of-care work-up (after implementation, N = 82). Differences in time to different benchmarks between the 2 modalities and the effect on patient outcomes were analyzed using null-hypothesis significance testing. Results: During the study, the BCID-GP panel identified 63 (42%) Staphylococcus epidermidis isolates, 31 (21%) Staphylococcus spp, 24 (16%) Staphylococcus aureus isolates, 12 (8%) Streptococcus spp, and 7 (5%) Enterococcus spp, and results were similar in the pre- and postimplementation groups (P = .13). The panel saved an average of 32.0 ± 24.2 hours in pathogen identification over standard-of-care methods, with no statistical difference made by the clinical availability of the data (Table 1). In terms of susceptibility testing, the panel saved an average of 70.1 ± 58.2 hours but with less unity between the 2 cohorts (P = .005). Of the 66 cases with follow-up, identification via ePlex indicated an escalation of therapy in 20 (30%) and a narrowing of coverage in 31 (47%). In patients identified to have Staphylococcus aureus, BCID-GP could change antimicrobial therapy in 79%; the need for escalation of antibiotics was identified in 58% of cases. In patients with Staphylococcus epidermidis bacteremia, implementation of BCID-GP panel could have resulted in de-escalation of antimicrobial therapy in 67% of patients. The implementation of the BCID-GP panel was correlated with no significant change of in-hospital mortality (P = .72) but was correlated with a significantly decreased death-censored total length of stay (LOS) (P < .001) and LOS after culture (P = .001). Conclusions: Our study has demonstrated that nonculture identification of bacteria and susceptibility can result in major improvements in antimicrobial therapy in patients, particularly those with contaminants identified.Funding: GenMark DXDisclosures: None
Compliance and constraints of hand hygiene among healthcare workers in Bangladesh
Authors: Harun Md. Golam Dostogir , Sumon Shariful Amin , Mohona Tahrima Mohsin , Hassan Md. Zakiul , Rahman Aninda , Abdullah Syed Abul Hassan Md , Islam Md. Saiful , Styczynski Ashley 
Published: May 2022

Background: Hand hygiene (HH) is a core element of patient safety and the single most essential strategy for preventing healthcare-associated infections (HAIs). Adherence to HH among healthcare workers (HCWs) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies. We observed HH compliance among HCWs to determine the factors influencing practices in tertiary healthcare facilities in Bangladesh. Methods: During September 2020–February 2021, we conducted nonparticipatory observations at 11 tertiary-care hospitals in Bangladesh using the WHO “Five Moments for Hand Hygiene” tool to record compliance among physicians, nurses, and cleaning staff. We also performed semistructured interviews to determine the key barriers to complying with hand hygiene. Furthermore, we noted the presence, location, and functionality of existing HH stations within each hospital ward. Results: We observed 14,668 HH opportunities among HCWs. The overall HH compliance was 25.3%, and compliance differed significantly by professional category (P < .001). Physicians had the highest HH compliance at 28.5% (2,264 of 7,930), followed by nurses at 25.4% (1,272 of 5,008). Cleaning staff had the lowest rates of HH at 9.9% (171 of 3,221). HCWs of public hospitals had significantly higher odds of complying with HH practices than those in private hospitals (27.4% vs 17.9%; aOR, 1.73; 95% CI, 1.55–1.93; P < .001). HH compliance also varied by WHO Five Moments indicators. HCWs were 3 times more likely to perform HH ‘after touching a patient’ than ‘before touching patient’ (aOR, 3.36; 95% CI, 2.90–3.90; P < .001). Common barriers to using hand sanitizer were insufficient supply (57.9%), skin reaction (26.3%), shortage of time (14.5%), and lack of awareness (11.9%). Regarding handwashing with soap, inadequate supplies (27.0%), high workload (26.3%), and lack of facilities (22.7%) were the key factors for low adherence. The HH infrastructure observation in 82 wards showed that running water and soap were available in 168 (86.2%) of 195 HCW-designated basins, compared to 51 (35.9%) of 142 for the patient- and attendant-assigned basins. Handwashing posters were found in only 44 (13.1%) of 337 basin surroundings, and no hand drying supplies were observed for patients or attendants. Conclusions: Hand hygiene compliance among HCWs fall significantly short of the standard for safe patient care. Inadequate HH supplies in a resource-constrained setting like Bangladesh demonstrates a lack of leadership in prioritizing, promoting, and investing in infection prevention and control. The findings of this study might help to motivate and design interventions for HH compliance, which will help reduce HAIs in the hospital setting.Funding: NoneDisclosures: None