bluuebunny/crossref_metadata_2025_split huggingface dataset:
P28 An analysis of the appropriateness of antimicrobial prescribing at a tertiary centre: reflections from the National Point Prevalence Survey
Authors: Salih Dylan Zeki , Bedford Luke , Enoch David , Wong Vanessa , Burrows Susannah , Santos Reem , Cooke Fiona , Gouliouris Theodore 
Published: August 2024

Abstract

Background
Between 18 September 2023 and 27 October 2023, Cambridge University Hospitals NHS Foundation Trust (CUH) partook in the UK Health Security Agency (UKHSA) National Point Prevalence Survey (PPS) of healthcare-associated infections, antimicrobial use and stewardship. This survey was the first to assess the appropriateness of individual antimicrobial prescriptions.

Objectives
To use the data collected during the PPS to identify antimicrobial agents associated with inappropriate prescribing at CUH and investigate the factors contributing to this trend.

Methods
Using the UKHSA PPS protocol, data pertaining to antimicrobial prescriptions at CUH during the survey period were collected. All prescriptions captured in the PPS with an associated appropriateness score were analysed. Grouping prescriptions by individual antimicrobial agent allowed identification of antimicrobial agents with a statistically significant proportion of ‘inappropriate’ prescriptions. Further analysis of the prescriptions of these agents, using the PPS data, permitted identification of factors which contributed to this association.

Results
A total of 1064 patient reviews were conducted on 51 wards. Overall, 477/1064 (45%) of patients were on antimicrobials (mean number of antimicrobial prescriptions per patient=0.7, SD=0.7). Of the 52 agents used, co-amoxiclav (n=147, 19%), piperacillin/tazobactam (n=86, 11%), fluconazole (n=45, 6%) and sulfamethoxazole/trimethoprim (n=44, 6%) were the commonest. Appropriateness was assessed for 565 (79.5%) of the 711 antimicrobial prescriptions with 488 (86.4%) considered appropriate and 77 (13.6%) inappropriate. Co-amoxiclav was identified as the only antimicrobial agent with a statistically significant association with inappropriate prescribing (P&lt;0.001, OR 2.9, 95% CI 1.7–4.8). Further analysis revealed that co-amoxiclav prescriptions for treatment were, relative to other antimicrobials, less likely to adhere to either national or local guidelines (P=0.006, OR 0.4, 95% CI 0.2–0.8) and significantly more likely to be prescribed to treat a condition which does not require antimicrobials (P=0.004, OR 0.3, 95% CI 0.1–0.7) and to treat an infection which required a broader spectrum agent (P&lt;0.001, OR 0.2, 95% CI 0.1–0.5).

Conclusions
Co-amoxiclav was most commonly associated with misuse/overuse and efforts to improve prescribing at CUH should focus on this agent. Further work is required to understand the factors that drive this association in order to improve prescribing.
Insights of temperature-dependent fluid characteristics on micropolar material in a rotating frame with cubic autocatalysis chemical reaction
Authors: Khattak Shahzad , Khan Muhammad Naveed , Riaz Muhammad Bilal , Lu Dianchen , Hussien Mohamed , Albalwi M Daher , Jhangeer Adil 
Published: August 2024

Abstract
The diverse use of heat and mass transport mechanisms on three-dimensional rotating systems has been discovered to improve the efficiency of several physiological and industrial processes. These include, for example, fiber technology, the process of extrusion, and polymer extraction. The purpose of this dissertation is to investigate the transportation of mass and heat in the flow of non-Newtonian fluid processing vortex viscosity and micro-inertial features along two horizontal plates in a rotating scenario. The thermal transport process is influenced by physical parameters such as irregular heat generation/absorption rate, linear radiative heat flow, variable thermal conductivity, and mass diffusion with cubic autolysis chemical reaction. After enforcing conservation laws, a simple constitutive equations are modelled in a rotating system. The mathematical formulation is converted into a dimensionless format by applying comparable variables. The bvp4c process is used to execute numerical experiments to arrive at the numerical solution for the governing problem. Through sketching, the related distribution (velocity, micro rotation, velocity, and concentration) is presented concerning the various parameters. Tabular data provides insights into relevant quantities against different parameters. The credibility of computed results is assumed by agreeing with previous studies.
Effects of surface type and distance traveled on the efficacy of a Beauveria bassiana (Hypocreales:Cordycipitaceae)-based biopesticide (Aprehend) for bed bug (Hemiptera: Cimicidae) control
Authors: Principato Simona , DeVries Zachary C 
Published: August 2024

Abstract
The cryptic behavior that characterizes bed bugs (Cimex lectularius L.) makes them one of the most difficult indoor pests to control. Thus, the use of products with long residual efficacy is a key component of successful bed bug management. Aprehend is a biopesticide for bed bug control, whose active ingredient is the entomopathogenic fungus, Beauveria bassiana. This product shows promise for extended bed bug control against pyrethroid-resistant bed bugs, causing mortality days after contact with the treated surface. However, it is unclear how surface type and distance traveled by bed bugs over a treated surface impact efficacy. Therefore, we evaluated the efficacy of different Aprehend band widths applied to different substrates commonly encountered by bed bugs, looking specifically at average time to mortality and overall mortality. Our findings indicate that exposure to fresh applications of Aprehend resulted in high mortality when bed bugs traveled very short distances (1 cm) over some Aprehend-treated surfaces (vinyl tile and cotton jersey fabric), while exposure to other treated surfaces (unfinished pinewood and painted drywall) resulted in comparatively lower mortality even over longer distances (5 cm). Furthermore, we found that bed bugs crawling on cotton jersey fabric picked up a significantly higher number of spores compared to unfinished pinewood. These results indicate that applications of Aprehend as 5 cm (2 inches) bands according to label recommendations can be effective, although surface type is an important determinator of efficacy. This information will help guide pest management professionals in their use of B. bassiana for bed bug control.
Identifying novel metrics of operative performance in surgical training: protocol for a Delphi consensus study
Authors: Dick Lachlan , Skipworth Richard J E , Tallentire Victoria R , Yule Steven 
Published: August 2024

Abstract
Introduction: Acquiring the technical and non-technical skills necessary to perform operations safely requires time and dedication. The learning curve is steep and regular feedback on operative performance is needed to help trainees identify strengths and development needs. Traditional methods of assessment are time consuming, prone to bias and lack reliability and scalability. Advances in digital technology in surgery have allowed for more objective measures of operative performance to be generated. Objective performance metrics can provide insights void of opinion and can complement and strengthen traditional methods of feedback. This protocol outlines a study that aims to reach consensus on which performance metrics are most relevant to surgical trainees and how they should be applied in training. Methods and analysis: A three-round electronic Delphi study will be used. Participants will be asked to rate the importance of statements relating to objective performance metrics in surgical training and the ways in which they could be applied. Statements will be created from extensive searches of the literature, discussion with experts and through a pilot. A panel consisting of trainees, trainers, researchers and institutions will be formed to participate in the study. Ethics and dissemination: Formal ethical approval has been granted for this study. Dissemination will be at surgical and education meetings, in addition to publication following peer review.
Inference of Host–Pathogen Interaction Matrices from Genome-Wide Polymorphism Data
Authors: Märkle Hanna , John Sona , Metzger Lukas ,   STOP-HCV Consortium, Barnes Eleanor , Hudson Emma , Klenerman Paul , Simmonds Peter , Holmes Chris , Cooke Graham , Dusheiko Geoffrey , McLauchlan John , Harris Mark , Irving William , Troke Philip , Brainard Diana , McHutchinson John , Gore Charles , Halford Rachel , Foster Graham R , Herath Cham , Ansari M Azim , Pedergnana Vincent , Tellier Aurélien 
Published: August 2024

Abstract
Host–pathogen coevolution is defined as the reciprocal evolutionary changes in both species due to genotype × genotype (G×G) interactions at the genetic level determining the outcome and severity of infection. While co-analyses of hosts and pathogen genomes (co-genome-wide association studies) allow us to pinpoint the interacting genes, these do not reveal which host genotype(s) is/are resistant to which pathogen genotype(s). The knowledge of this so-called infection matrix is important for agriculture and medicine. Building on established theories of host–pathogen interactions, we here derive four novel indices capturing the characteristics of the infection matrix. These indices can be computed from full genome polymorphism data of randomly sampled uninfected hosts, as well as infected hosts and their pathogen strains. We use these indices in an approximate Bayesian computation method to pinpoint loci with relevant G×G interactions and to infer their underlying interaction matrix. In a combined single nucleotide polymorphism dataset of 451 European humans and their infecting hepatitis C virus (HCV) strains and 503 uninfected individuals, we reveal a new human candidate gene for resistance to HCV and new virus mutations matching human genes. For two groups of significant human–HCV (G×G) associations, we infer a gene-for-gene infection matrix, which is commonly assumed to be typical of plant–pathogen interactions. Our model-based inference framework bridges theoretical models of G×G interactions with host and pathogen genomic data. It, therefore, paves the way for understanding the evolution of key G×G interactions underpinning HCV adaptation to the European human population after a recent expansion.
A case of immunoglobulin G4–related disease complicated by atopic dermatitis responsive to upadacitinib treatment
Authors: Kusaka Katsuhide , Nakayamada Shingo , Hanami Kentaro , Nawata Aya , Tanaka Yoshiya 
Published: August 2024

ABSTRACT
Immunoglobulin G4–related disease (IgG4-RD) is mainly treated with glucocorticoids. In many cases, this disease is resistant to glucocorticoids, and their toxicity can be a problem. We encountered a patient with IgG4-RD affecting multiple organs (such as the skin, lung, and lacrimal gland), who had comorbidities, including atopic dermatitis and diabetes. In this case, while glucocorticoid tapering was difficult, the introduction of upadacitinib resulted in the remission of both atopic dermatitis and IgG4-RD without glucocorticoid dose escalation. Peripheral blood flow cytometry analysis showed that the proportions of activated non-Th1/Th17 cell subset (Th2 cells), follicular helper T cells, and plasmocytes were increased before upadacitinib therapy, but all normalised after treatment. Interleukin-4 and interleukin-21 signals are important for the differentiation of CD4+ T cells into type 2 helper T or B cells in the peripheral blood. Our case suggested that inhibition of Janus kinase 1, which mediates these signals, might have contributed to improved pathological conditions in IgG4-RD.
The Neutron Skin-Thickness of 208Pb Determined by Electron and Proton Scattering
Authors: Suzuki Toshio , Danjo Rika , Suda Toshimi 
Published: August 2024

Abstract
Electron as well as proton elastic scattering is not able to determine the point proton and point neutron densities, $\rho _\tau (r), (\tau =p,n)$, separately. If both scatterings are analyzed consistently, those densities would be determined uniquely, since the two densities are observed by different combinations from each other. Previous experiments have not provided $\rho _\tau (r)$ uniquely, but the values of the mean square radii of $\rho _p(r)$, $\langle \, r^2\, \rangle _p$, and of $\rho _n(r)$, $\langle \, r^2\, \rangle _n$, are shown to be determined consistently through the fourth moment of the observed charge density, $\langle \, r^4\, \rangle _c$, in 208Pb. The previous analyses of $(\gamma , \pi ^0)$ and $\bar{p}$-nucleus obtained a similar value of $\langle \, r^2\, \rangle _n$, but they do not yield the experimental value of $\langle \, r^4\, \rangle _c$ observed in electron scattering.
Mannan oligosaccharides as a prebiotic for laying hens: effects on fertility, hatchability, productive performance, and immunity
Authors: Youssef Islam M , Aldhalmi Ahmed K , Felemban Shatha G , Elsherbeni Ahmed I , Khalil Hassan A , Hassan Magdy S , Abd El Halim Haiam S , Abd El-Hack Mohamed E , Youssef Khaled M , Swelum Ayman A , Tufarelli Vincenzo , Abo-Samra Maher A 
Published: August 2024

AbstractThis experiment examined how adding mannan-oligosaccharides (MOS) to the diet affected fertility, hatching rates, egg production, carcass characteristics, cost-effectiveness, and immune function in laying hens. One hundred and twenty Mandarah chickens (30 hens and 3 roosters per group) were randomly chosen between 34 and 50 wk old and divided into four groups. The first group was the control group, which was given just the basal diet. The basal diet was given to the second, third, and fourth experimental groups along with three different levels of MOS (0.1, 0.2, and 0.5 g/kg diet, respectively). Results found that hens fed MOS at various levels laid eggs at a significantly higher rate, enhanced egg number, egg mass and feed conversion ratio than the control group (P &lt; 0.05). MOS seemed to improve carcass quality. The best results for egg quality (Haugh unit) and testosterone levels were seen with a dose of 0.5 g/kg of MOS compared to the control birds (P &lt; 0.05). All MOS levels led to higher estradiol-17β (E2) levels and better economic efficiency (EE). MOS also improved the hens’ immune systems as compared to the control group. Hens-fed MOS had significantly greater levels of antibodies against Influenza viruses (H9N2) and Infectious Bronchitis Virus (P &lt; 0.05). Also, the spleen and thymus gland, both crucial immune system components, were slightly larger (P &lt; 0.05). It’s important to note that fertility rates, hatchability, and embryo mortality rates remained similar across all groups. So, our findings suggest that incorporating MOS into the birds’ diet enhances their productivity, strengthens their immune system, improves EE, and contributes to the overall health of the hens.
Identification of Genetic Loci for Grain Traits and Disease Resistance Reveals a Potential Trade-Off in Rice
Authors: Jia Yulin , Jia Melissa H. , Box Heather 
Published: August 2024

Understanding how plants utilize limited resources for reproductivity and disease resistance can improve the efficiency of plant breeding. In the present study, we mapped genes for grain traits, including grain length and width and thousand grain weight (TGW). A previously constructed linkage map of a recombinant inbred line population (MHM) was used, which was derived from a cross between an indica restorer rice variety (Minghui 63) and a temperate japonica rice variety (M-202). The MHM population was grown in replicated field plots, and grain trait data were collected. Upon a 3-year field evaluation, a total of 16 loci were mapped on 9 of 12 chromosomes, including 7 for grain length, 4 for grain weight, and 5 for TGW. A TGW locus ( qTGW2) and a grain width locus ( qWIG2.2) were mapped at the known blast resistance locus qBLAST2 on chromosome 2 that harbors a major blast resistance allele Pi-b. Another TGW locus ( qTGW3.3) and a grain length locus ( qLNG3.3) were mapped at qBLAST3 on chromosome 3. These results reveal potential trade-offs between disease resistance and productivity, which are important for breeders to develop high-yielding and disease-resistant rice varieties. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Standing strong: War‐related challenges in Ukrainian biomedical research and opportunities for support
Authors: Hondermarck Hubert , Finiuk Nataliya , Jiang Chen Chen , Stoika Rostyslav 
Published: August 2024

AbstractThe prolonged war in Ukraine is having a strong impact on all sectors of the Ukrainian society, including biomedical research. Although the material and psychological conditions are challenging, the country and its researchers are courageously managing to continue their activities. This perspective paper describes the multiple challenges faced by Ukrainian biomedical researchers during wartime and outlines strategies to support and enhance collaboration with the global scientific community. Ukraine has a rich scientific history and modern expertise in biomedical research, and developing more international collaborations with Ukraine can have mutual benefits for all involved parties.
Racial and Ethnic Patient Care Disparities in Anesthesiology: History, Current State, and a Way Forward
Authors: Mergler BD , Toles AO , Alexander A , Mosquera DC , Lane-Fall MB , Ejiogu NI 
Published: August 2024

(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006716)
The literature on disparities in racial and ethnic patient care in anesthesiology is increasing but more can be done to advance the field. This review paper examines research findings and offers potential solutions to eliminate structural racism and implicit and explicit bias. The focus is on disparities in perioperative care, labor and delivery, pain clinics, and intensive care units. The review focuses on US studies and does not include studies in pediatric anesthesia or palliative care.
Pregnancy-Associated Stroke and the Recurrence of Stroke and Other Complications in Subsequent Pregnancies: Population-Based Retrospective Cohort Study
Authors: Verho L , Tikkanen M , Äyräs O , Aarnio K , Rantanen K , Korhonen A , Richardt A , Laivuori H , Gissler M , Ijäs P 
Published: August 2024

(BJOG. 2023;130(11):1421–1429. doi: 10.1111/1471-0528.17503)
The incidence of pregnancy-associated stroke (PAS) is rare, estimated at 30 per 100,000 live births and potentially life threatening for mother and child. In recent years, the incidence of PAS is rising, thought to be a result of advancing maternal age and more frequent comorbidities. Although serious, patients may recover from PAS and even become pregnant again. There is a lack of published research on the risks of stroke recurrence during pregnancy and the early postpartum period in this population. This study aimed to further understand the risks to support family planning and decision making in women with history of PAS.
Real-Time Imaging as Visual Biofeedback in Active Second Stage of Labor Among Nulliparas: A Randomized Controlled Trial
Authors: Hamid NA , Hong JGS , Hamdan M , Vallikkannu N , Adlan AS , Tan PC 
Published: August 2024

(Am J Obstet Gynecol. 2023;229(4):443.e1–443.e9. doi:10.1016/j.ajog.2023.04.049)
Extended second-stage labor heightens the chances of severe perineal tears, postpartum bleeding, operative deliveries, and low Apgar scores, especially among first-time mothers. Maternal exertion during this stage aids the natural expulsion of the fetus. Biofeedback, a mind-body technique, empowers individuals to regulate their bodily functions for holistic well-being. Utilizing mirrors or monitors for real-time visual feedback enhances self-awareness. In a previous study, 88.5% of women who used a mirror during the second stage of labor felt that it motivated them to push, albeit with some clarity limitations. Similarly, in 2 additional small studies, visual aids like cameras or ultrasound shorten the second stage by inspiring effective pushing. The current study aimed to compare real-time introitus visualization (InV) against maternal face (MF) viewing (control) during pushing in first-time mothers, assessing its impact on delivery time and maternal satisfaction.
Impact of Discontinuing Oxytocin in Active Labor on Neonatal Morbidity: An Open-Label, Multicenter, Randomized Trial
Authors: Girault A , Sentilhes L , Desbrière R , Berveiller P , Korb D , Bertholdt C , Carrara J , Winer N , Verspyck E , Boudier E , Barjat T , Levy G , Roth GE , Kayem G , Massoud M , Bohec C , Guerby P , Azria E , Blanc J , Heckenroth H , Rousseau J , Garabedian C , Le Ray C ,   collaborators of the STOPOXY trial and the Groupe de Recherche en Obstétrique et Gynécologie (GROG)
Published: August 2024

(Lancet. 2023;402(10417)2091–2100. doi: 10.1016/S0140-6736(23)01803-2)
Oxytocin is a widely used drug worldwide, employed in either labor induction or labor augmentation. However, ambiguities persist regarding the ideal length of oxytocin delivery and its potential impact on neonatal and maternal outcomes. A previous clinical trial conducted in 2021 found a trivial rise in cesarean deliveries when oxytocin was discontinued, although this difference lacked both clinical and statistical significance. The current study sought to assess the effects of discontinuing oxytocin during the active phase of labor on neonatal morbidity and maternal complications.
Early Metformin in Gestational Diabetes: A Randomized Clinical Trial
Authors: Dunne F , Newman C , Alvarez-Iglesias A , Ferguson J , Smyth A , Browne M , O’Shea P , Devane D , Gillespie P , Bogdanet D , Kgosidialwa O , Egan A , Finn Y , Gaffney G , Khattak A , O’Keeffe D , Liew A , O’Donnell M 
Published: August 2024

(JAMA. 2023;330(16):1547–1556. doi: 10.1001/jama.2023.19869)
Gestational diabetes (gDM) is a common pregnancy complication, affecting up to nearly 3 million pregnancies globally every year. It is known to be associated with adverse pregnancy outcomes, including weight gain, cesarean delivery, preeclampsia, birth injuries, respiratory distress, and neonatal ICU admission. Optimal management of gDM is unclear. Current guidelines recommend lifestyle modifications with nutrition and exercise, and subsequent insulin administration if hyperglycemia persists. Although effective in improving outcomes, insulin is linked to increased hypoglycemia events, weight gain, cesarean delivery, and neonatal ICU admission. Metformin in pregnancy is also associated with improved maternal and fetal outcomes compared to insulin, although there are concerns relating to spontaneous preterm birth and small for gestational age infants. Though metformin is considered safe during pregnancy, it is currently only prescribed after lifestyle management failure; this study was designed to test the hypothesis that earlier administration of metformin upon diagnosis of gDM would be beneficial to the outcomes of mothers and babies, primarily assessing the effect on the composite of insulin initiation and fasting hyperglycemia at 32 or 38 weeks of gestation.
Metformin for Diabetes in Pregnancy: Are We Closer to Defining its Role?
Authors: Feig DS 
Published: August 2024

(JAMA. 2023;330(22):2167–2169. doi: 10.1001/jama.2023.18589)
Gestational (gDM) and type 2 (T2DM) diabetes mellitus during pregnancy are increasingly common, and adverse outcomes related to these conditions are likely. Recent randomized clinical trials (RCTs) have been conducted to find ways of improving outcomes in patients with these conditions. This article is an opinion editorial in response to recent trials published in JAMA that evaluate metformin during pregnancy to mitigate negative outcomes, with one trial in women with gDM and one in women with T2DM.