bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic use in a tertiary healthcare facility in Ghana: a point prevalence survey
Authors: Labi Appiah-Korang , Obeng-Nkrumah Noah , Nartey Edmund Tetteh , Bjerrum Stephanie , Adu-Aryee Nii Armah , Ofori-Adjei Yaw Adjei , Yawson Alfred E. , Newman Mercy J. 
Published: January 2018

Abstract
Background
The global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our objective in this study was to determine the prevalence and indications for use of antibiotics at the Korle-Bu Teaching Hospital Accra, Ghana.

Methods
An antibiotic point prevalence survey was conducted among inpatients of the Korle-Bu Teaching Hospital between February and March 2016. Folders and treatment charts of patients on admission at participating departments were reviewed for antibiotics administered or scheduled to be administered on the day of the survey. Data on indication for use were also collected. Prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of survey by the total number of patients on admission.

Results
Of the 677 inpatients surveyed, 348 (51.4%, 95% CI, 47.6–55.2) were on treatment with antibiotics. Prevalence was highest among Paediatric surgery where 20/22 patients (90.9%, 95% CI, 70.8–98.9) were administered antibiotics and lowest among Obstetrics patients with 77/214 (36%, 95% CI, 29.5–42.8). The indications for antibiotic use were 245/611 (40.1%) for community-acquired infections, 205/611 (33.6%) for surgical prophylaxis, 129/611 (21.1%) for healthcare associated infections and 33/611 (5.4%) for medical prophylaxis. The top five antibiotics prescribed in the hospital were metronidazole 107 (17.5%), amoxicillin-clavulinic acid 82 (13.4%), ceftriaxone 17(12.1%), cefuroxime 61 (10.0%), and cloxacillin 52 (8.5%) respectively. Prevalence of meropenem and vancomycin use was 12(2%) and 1 (.2%) respectively. The majority of patients 181 (52%) were being treated with two antibiotics.

Conclusion
This study indicated a high prevalence of antibiotic use among inpatients at the Korle-Bu Teaching Hospital. Metronidazole was the most commonly used antibiotic; mainly for surgical prophylaxis. There is the need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.
Phase III, Randomized, Double-Blind Study Comparing the Efficacy, Safety, and Immunogenicity of SB3 (Trastuzumab Biosimilar) and Reference Trastuzumab in Patients Treated With Neoadjuvant Therapy for Human Epidermal Growth Factor Receptor 2–Positive Early Breast Cancer
Authors: Pivot Xavier , Bondarenko Igor , Nowecki Zbigniew , Dvorkin Mikhail , Trishkina Ekaterina , Ahn Jin-Hee , Vinnyk Yuriy , Im Seock-Ah , Sarosiek Tomasz , Chatterjee Sanjoy , Wojtukiewicz Marek Z. , Moiseyenko Vladimir , Shparyk Yaroslav , Bello Maximino , Semiglazov Vladimir , Song Sujeong , Lim Jaeyun 
Published: January 2018

Purpose This phase III study compared SB3, a trastuzumab (TRZ) biosimilar, with reference TRZ in patients with human epidermal growth factor receptor 2–positive early breast cancer in the neoadjuvant setting ( ClinicalTrials.gov identifier: NCT02149524). Patients and Methods Patients were randomly assigned to receive neoadjuvant SB3 or TRZ for eight cycles concurrently with chemotherapy (four cycles of docetaxel followed by four cycles of fluorouracil, epirubicin, and cyclophosphamide) followed by surgery, and then 10 cycles of adjuvant SB3 or TRZ. The primary objective was comparison of breast pathologic complete response (bpCR) rate in the per-protocol set; equivalence was declared if the 95% CI of the ratio was within 0.785 to 1.546 or the 95% CI of the difference was within ± 13%. Secondary end points included comparisons of total pathologic complete response rate, overall response rate, event-free survival, overall survival, safety, pharmacokinetics, and immunogenicity. Results Eight hundred patients were included in the per-protocol set (SB3, n = 402; TRZ, n = 398). The bpCR rates were 51.7% and 42.0% with SB3 and TRZ, respectively. The adjusted ratio of bpCR was 1.259 (95% CI, 1.085 to 1.460), which was within the predefined equivalence margins. The adjusted difference was 10.70% (95% CI, 4.13% to 17.26%), with the lower limit contained within and the upper limit outside the equivalence margin. The total pathologic complete response rates were 45.8% and 35.8% and the overall response rates were 96.3% and 91.2% with SB3 and TRZ, respectively. Overall, 96.6% and 95.2% of patients experienced one or more adverse event, 10.5% and 10.7% had a serious adverse event, and 0.7% and 0.0% had antidrug antibodies (up to cycle 9) with SB3 and TRZ, respectively. Conclusion Equivalence for efficacy was demonstrated between SB3 and TRZ on the basis of the ratio of bpCR rates. Safety and immunogenicity were comparable.
AP-2α and AP-2β cooperatively orchestrate homeobox gene expression during branchial arch patterning
Authors: Van Otterloo Eric , Li Hong , Jones Kenneth L. , Williams Trevor 
Published: January 2018

ABSTRACT
The evolution of a hinged moveable jaw with variable morphology is considered a major factor behind the successful expansion of the vertebrates. DLX homeobox transcription factors are crucial for establishing the positional code that patterns the mandible, maxilla and intervening hinge domain, but how the genes encoding these proteins are regulated remains unclear. Herein, we demonstrate that the concerted action of the AP-2α and AP-2β transcription factors within the mouse neural crest is essential for jaw patterning. In the absence of these two proteins, the hinge domain is lost and there are alterations in the size and patterning of the jaws correlating with dysregulation of homeobox gene expression, with reduced levels of Emx, Msx and Dlx paralogs accompanied by an expansion of Six1 expression. Moreover, detailed analysis of morphological features and gene expression changes indicate significant overlap with various compound Dlx gene mutants. Together, these findings reveal that the AP-2 genes have a major function in mammalian neural crest development, influencing patterning of the craniofacial skeleton via the DLX code, an effect that has implications for vertebrate facial evolution, as well as for human craniofacial disorders.
Taking a goal-centred dynamic snapshot as a possibility for local homing in initially naïve bumblebees
Authors: Lobecke Anne , Kern Roland , Egelhaaf Martin 
Published: January 2018

It is essential for central place foragers, such as bumblebees, to return reliably to their nest. Bumblebees, leaving their inconspicuous nest hole for the first time need to gather and learn sufficient information about their surroundings to allow them to return to their nest at the end of their trip, instead of just flying away to forage. Therefore, we assume an intrinsic learning program that manifests itself in the flight structure immediately after leaving the nest for the first time.
In this study, we recorded and analysed the first outbound flight of individually marked naïve bumblebees in an indoor environment. We found characteristic loop-like features in the flight pattern that appear to be necessary for the bees to acquire environmental information and might be relevant for finding the nest hole after a foraging trip.
Despite common features in their spatio-temporal organisation, first departure flights from the nest are characterised by a high level of variability in their loop-like flight structure across animals. Changes in turn direction of body orientation, for example, are distributed evenly across the entire area used for the flights without any systematic relation to the nest location. By considering the common flight motifs and this variability, we came to the hypothesis that a kind of dynamic snapshot is taken during the early phase of departure flights centred at the nest location. The quality of this snapshot is hypothesised to be ‘tested’ during the later phases of the departure flights concerning its usefulness for local homing.
Shorter Versus Longer Courses of Antibiotics for Infection in Hospitalized Patients: A Systematic Review and Meta‐Analysis
Authors: Royer Stephanie , DeMerle Kimberley M. , Dickson Robert P. , Prescott Hallie C. 
Published: January 2018

BACKGROUNDInfection is a leading cause of hospitalization with high morbidity and mortality, but there are limited data to guide the duration of antibiotic therapy.PURPOSESystematic review to compare outcomes of shorter versus longer antibiotic courses among hospitalized adults and adolescents.DATA SOURCESMEDLINE and Embase databases, 1990‐2017.STUDY SELECTIONInclusion criteria were human randomized controlled trials (RCTs) in English comparing a prespecified short course of antibiotics to a longer course for treatment of infection in hospitalized adults and adolescents aged 12 years and older.DATA EXTRACTIONTwo authors independently extracted study characteristics, methods of statistical analysis, outcomes, and risk of bias.DATA SYNTHESISOf 5187 unique citations identified, 19 RCTs comprising 2867 patients met our inclusion criteria, including the following: 9 noninferiority trials, 1 superiority design trial, and 9 pilot studies. Across 13 studies evaluating 1727 patients, no significant difference in clinical efficacy was observed (d = 1.6% [95% confidence interval (CI), ‐1.0%‐4.2%]). No significant difference was detected in microbiologic cure (8 studies, d = 1.2% [95% CI, ‐4.1%‐6.4%]), short‐term mortality (8 studies, d = 0.3% [95% CI, ‐1.2%‐1.8%]), longer‐term mortality (3 studies, d = ‐0.4% [95% CI, ‐6.3%‐5.5%]), or recurrence (10 studies, d = 2.1% [95% CI, ‐1.2%‐5.3%]). Heterogeneity across studies was not significant for any of the primary outcomes.CONCLUSIONSBased on the available literature, shorter courses of antibiotics can be safely utilized in hospitalized patients with common infections, including pneumonia, urinary tract infection, and intra‐abdominal infection, to achieve clinical and microbiologic resolution without adverse effects on mortality or recurrence.
Repair of syndesmosis injury in ankle fractures
Authors: Mak May Fong , Stern Richard , Assal Mathieu 
Published: January 2018

Conventional treatment of syndesmosis injuries in rotationally unstable ankle fractures is associated with an unacceptably high rate of malreduction, and this has led to a paradigm shift in the approach to a newer concept of anatomical repair. In the anatomical approach, the principle is to ‘directly fix what is broken and repair what is torn’. The approach is effective in reducing the rate of syndesmosis malreduction, increasing the biomechanical strength of syndesmosis fixation and avoiding the need for trans-syndesmotic fixation and its secondary removal. The objective of this review article is to compare the conventional treatment of these injuries (accepted usage, general consent, traditional, generally accepted) with a newer anatomical approach to be considered as a shift in thinking. Cite this article: EFORT Open Rev 2018;3:24-29. DOI: 10.1302/2058-5241.3.170017
Molecular Characterization of ESBL Gene in Citrobacter Spp and Antibacterial Activity of Omega-3 Against Resistant Isolates
Authors: Darwees Mayyada Farhan 
Published: January 2018

Abstract
This study aimed to investigated the prevalence and resistance pattern of different Citrobacter species phenotypically and genotypically to β-lactam and some most common antibiotics then evaluate the antibacterial activity of omega-3 extracted from flaxseed against isolates that harboring resistance genes. 19 Citrobacter isolates were isolated from100 stool and urine samples taken from patients attended to AL-Sadar Hospital during June-December 2016. Clinical samples were cultured on specific media, thereafter isolates were identified depending on morphological, biochemical characteristics and VITK-2. The results showed that the Citrobacter comprise 24% of isolated bacteria which divided into 11 (14.1%) were C. freundii, 5 (6.41%) C. kosaeri and C. farmeri were 3 (3.8%). The antagonistic activity was evaluated by observing a clear zone of inhibition growth, the results showed that all Citrobacter (100%) isolates were resistant to Ampicillin, cefoxitin and sensitive to Imipinim, also the isolates showed different degrees of resistant to β-lactam antibiotics initially. By confirmatory test the results observed 17/19 (89.4%) isolated were ESBL producers finally using PCR technique to detect bla–genes (blaCTX-M, OXA, SHV and Z). The results revealed that 14/17 (82.3) of potential ESBL producing Citrobacter were harbor one or more of ESBL genes they included 10 of C. freundii and 4 of C. koseri. The extraction of essential fatty acid semicarbazide (omega-3) from Linum usitatissium (Flax seed) were tested to evaluate their activity against resistant isolates, results explained broad spectrum antibacterial property of EFASC compounds against resistant bacteria. In conclusion, this study found increase prevalence of MDR Citrobacter spp as causative agents in clinical cases. Considering antibacterial activity of EFASC, it was observed highly activity against resistant pathogens deservedly, therefore attention must be paid to development their used as alternative antibiotics.
Application of Fuzzy Rayleigh Distribution in the Nonisothermal Pyrolysis of Loose Biomass
Authors: Dhaundiyal Alok , Singh Suraj Bhan 
Published: January 2018

Abstract
This paper studied the implementation of fuzzy logic on the relevant parameter of biomass pyrolysis. Frequency factor, the upper limit of ‘dE’, and the scale parameter of Rayleigh distribution are fuzzified in order to estimate the randomness in estimating the parametric values. Distribution function, f(E), of activation energies is assumed to follow the Rayleigh distribution. Thermo-analytical data has been found experimentally with the help of TGA/DTG analysis. The approximated solution of distributed activation energy model (DAEM) is obtained by using asymptotic approach.
Study on the current use of four important medicinal plants of Lamiaceae in Bulgaria
Authors: Nanova Zheni , Dragoeva Asya , Koleva Vanya , Chipev Nesho , Georgiev Borislav , Yotova Irina , Ivanov Milen 
Published: January 2018

Abstract
In contemporary society various demographic factors lead to changes of people habits to use medicinal plants. A matter of interest is to establish how specific demographic features of people influence the use of herbs. The present survey aimed at determining the current trends regarding the use of four valuable medicinal Lamiaceae species in Bulgaria: thyme, mint, lemon balm and oregano. In the survey, 220 people were interviewed. Demographic profiles of the respondents were evaluated. Then the participants were questioned for the following item: “Do you use any of these herbs: thyme, mint, lemon balm and oregano.” In order to disclose correlations between demographic features of the participants and their answers cross-relationships were analyzed. The majority of respondents reported to use these plants. Mint and thyme were more commonly used herbs. We identified that age of respondents had sufficient influence on the answer to the questionary. Level of education and living regions had moderate impact on the use of relatively lesser utilized herbs – oregano and lemon balm. The analysis showed the persistence of traditional knowledge for these plants. At the same time, the results revealed better knowledge on medicinal plants in groups of better educated people and in urban population.
The medicinal plants of Chepan Mountain (Western Bulgaria)
Authors: Zahariev Dimcho 
Published: January 2018

Abstract
Bulgaria is one of the European countries with the greatest biodiversity, including biodiversity of medicinal plants. The object of this study is Chepan Mountain. It is located in Western Bulgaria and it is part of Balkan Mountain. On the territory of the Chepan Mountain (only 80 km2) we found 344 species of medicinal plants from 237 genera and 83 families. The floristic analysis indicates, that the most of the families and the genera are represented by a small number of inferior taxa. The hemicryptophytes dominate among the life forms with 49.71%. The biological types are represented mainly by perennial herbaceous plants (60.47%). There are 7 types of floristic elements divided in 27 groups. The largest percentage of species are of the European type (58.43%). Among the medicinal plants, there are two Balkan endemic species and 18 relic species. We described 23 species with protection statute. The anthropophytes among the medicinal plants are 220 species (63.95%).
The medicinal plants of Frangensko Plateau (Northeastern Bulgaria)
Authors: Zahariev Dimcho , Kacheva Cvetelina 
Published: January 2018

Abstract
The Frangensko Plateau is located in the northeastern part of Bulgaria and covers an area of 360 km2. On the territory of the plateau there are two protected areas, as well as two areas of the European ecological network NATURA 2000. The study of the medicinal plants on the territory of the Frangensko Plateau is made for the first time. As a result of our research we found 362 species of vascular plants from 242 genera and 80 families. The most of the families and the genera are represented by a small number of inferior taxa. The analysis of their life form indicates that the hemicryptophytes dominate with 39.50%, followed by the phanerophytes (22.10%). The biological types are represented mainly by perennial herbaceous plants (52.21%), annual herbaceous plants (14.09%) and trees (10.50%). There are 8 types of floristic elements divided in 32 groups. The largest percentage of species is of European type (51.93%). Among the medicinal plants, there are two Balkan endemic species, one Bulgarian endemic species and 30 relic species. Thirty four species with protection statute are described. The anthropophytes among the medicinal plants are 242 species (66.85%).
Ecotourism revisited: Last twenty-five years
Authors: Chandel Abhinav , Mishra Sita 
Published: January 2018

AbstractThe concept of ecotourism evolves differently in developing and developed nations due to which the basic principles of ecotourism are in question. The existing literature on ecotourism suggests ambiguity in conceptual understanding of ecotourism. Due to this qualm, ecotourism is evolving into various forms. Different stakeholders with varying objectives related to ecotourism make it further difficult to form the consensus on what constitutes ecotourism. Without the clear understanding of ecotourism, it is difficult to evolve ethics on which the ecotourism principles are based. The focus of this research is to find out the principle components or themes of ecotourism using a content analysis for the development of ecotourism policy and applications. This study identified six key components of ecotourism which are widely accepted by researchers and could be used to shape the fundamental understanding of ecotourism. These themes are: (1) Nature oriented travel; (2) Support of conservation; (3) Learning and appreciation; (4) Socio-economic development of local area; (5) Support and respect for local culture and (6) Local people (area) participation.
Non-Standard Measures of the Monetary Policy – Mechanism for Overcoming Problems in the Implementation of the Neoliberal Concept of Monetary Policy During a Financial Crisis
Authors: Milošević Andriana , Jemović Mirjana 
Published: January 2018

AbstractAfter multiple decreases in the reference interest rate and its reaching zero bounds in certain countries during the recent global financial crisis, central banks in developed countries have started applying non-standard measures of monetary policy. This does not refer to introducing new monetary policy instruments, but rather to a certain relativisation within the framework of standard instruments, in terms of maturity of liquidity provision, collateral policy and counterparties. Therefore, the aim of this paper is to examine the role of non-standard measures of monetary policy as a mechanism for overcoming problems in the implementation of the neoliberal concept of monetary policy in the conditions of the financial crisis. The answer to this question is rather sensitive, considering the fact that the neoliberal concept was supported by the most developed countries, that is, in fact, their central banks were using non-standard instruments of monetary policy for the greatest part.
Cationic Surfactant-modified Clay as an Adsorbent for the Removal of Synthetic Dyes from Aqueous Solutions
Authors: Biglari Hamed , RodríguezíCouto Susana , Khaniabadi Yusef Omidi , Nourmoradi Heshmatollah , Khoshgoftar Mohammad , Amrane Abdeltif , Vosoughi Mehdi , Esmaeili Shirin , Heydari Rouhollah , Mohammadi Mohammad Javad , Rashidi Rajab 
Published: January 2018

AbstractIn this study, the potential of hexadecyl trimethyl ammonium bromide modified montmorillonite (HDTMA-Mt) to remove the synthetic dyes Alizarin Red S (ARS) and Bromocresol Green (BCG) from aqueous media was assessed. The effect of different factors including surfactant loading rate onto the clay, contact time, pH, adsorbent dosage and dye concentrations, on the removal of ARS and BCG in batch systems were investigated. The adsorbent was characterized by means of scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffractometry (XRD). The equilibrium time for ARS and BCG was reached at 40 and 20 min, respectively, under optimized conditions (i.e. pH = 3, adsorbent dosage=1 g/L, surfactant loading rate onto the clay 70% of the cation exchange capacity (CEC) for ARS and 120% of the CEC for BCG, ARS concentration 50 mg/L and BCG concentration 500 mg/L). The adsorption rate of both dyes fitted the pseudo-second-order kinetic model and the equilibrium data was described by the Freundlich isotherm equation. The maximum monolayer adsorption capacities were equal to 666.6 and 1250 mg/g for ARS and BCG, respectively. Therefore, the HDTMA-Mt can be considered as an effective adsorbent for the removal of ARS and BCG from aqueous solutions.
Investigation on the Removal of Chromium from Wastewater using Electrocoagulation
Authors: Thirugnanasambandham K. , Shine K. 
Published: January 2018

Abstract
Nowadays, treatment of chromium wastewater is very critical also important. The current study investigates the influence of electrocoagulation process parameters to reduce the chromium from wastewater. It has been observed that the initial pH (6), current density (25 mA/cm2), electrode distance (4 cm) and electrolysis time (30 min) were found to be optimum for a 97 % chromium removal. For the above said optimum condition, the electrical energy consumption was found to be 0.12 kWh/m3. A comparison between BBD and ANN shows high correlation coefficient values (R2 (ANN) > 0.90 and R2 (RSM) > 0.90). Results indicated that electrocoagulation process is a cheap and effective method to treat chromium wastewater.