bluuebunny/crossref_metadata_2025_split huggingface dataset:
P20 An evaluation of high oral bioavailability antibiotic prescriptions in Forth Valley Royal Hospital
Authors: Urquhart Eilidh , McGlone Margaret-Mary , Soulsby Hannah , Proud Euan 
Published: August 2024

Abstract

Background
Metronidazole, clindamycin, levofloxacin and ciprofloxacin have high oral bioavailability. In many cases, antibiotics are administered IV when the oral route would be appropriate. There are risks of IV administration including complications of IV access and prolonged hospital admission.

Objectives
To audit current prescribing practices of four antibiotics with high oral bioavailability across medical and surgical wards in Forth Valley Royal Hospital.

Methods
Patients receiving selected antibiotics were identified using the electronic prescribing system. Patients in intensive care, day units and maternity wards were excluded. An audit tool was used to collect information on antibiotic indication, the ward and specialty, and whether there were any contraindications to oral administration. Contraindications included being nil by mouth, clinically unwell or sepsis, and poor gastrointestinal absorption. Data were collected over a 5 month period.

Results
In total, 98 IV prescriptions were reviewed. These included metronidazole (87), clindamycin (6) and levofloxacin (5). There were no IV prescriptions of ciprofloxacin. Fifty-three (54%) IV prescriptions were for patients with no contraindication to an oral route. Of these, 37 (70%) were under the care of a surgical specialty and 15 (28%) were under the care of a medical specialty. The most common indication for metronidazole was intra-abdominal infection. A total of 45 of the 87 (52%) patients prescribed IV metronidazole had no contraindication to the oral route and 34 (76%) of these patients were under the care of general surgery.

Conclusions
High oral bioavailability antibiotics were frequently prescribed IV when the oral route may have been appropriate. Both medical and surgical departments could improve the use of oral antibiotics in appropriate patients. Work is needed to promote awareness among prescribers of these high oral bioavailability antibiotics, particularly the use of oral metronidazole in appropriate surgical patients.
P30 Evaluation of the hepatotoxic effect of unreasonable antibiotic therapy among patients in the pre-jaundice period of viral hepatitis A
Authors: Bondaruk Iryna , Bevz Tetiana , Myroniuk-Konstantynovych Kiarina 
Published: August 2024

Abstract

Background
Despite its predominant gastrointestinal localization, the onset of viral hepatitis A (HAV) in most cases is characterized by extra-hepatic manifestations (in 98%—flu-like syndrome in the pre-jaundice period), which complicates timely diagnosis in the primary care, leads to erroneous and unreasonable prescription of antibiotics and therefore creates favourable conditions for formation of antibiotic-resistant strains.

Patients and methods
From the beginning of the outbreak of HAV (Vinnytsia, Ukraine) October–November 2023, 250 patients (64% male, average age 45±8.5 years) were examined for biochemical markers of cytolysis (ALT, AST) and cholestasis (GGT, fractional bilirubin).

Results
A total of 50 examinees (20%) in the pre-jaundice period of HAV indicated antibiotic use (azithromycin, 29 [58%]; amoxicillin/clavulanate, 16 [32%]; cefixime, 5 [10%]). The level of total bilirubin in the blood of all patients amounted to 300–500 μmol/L, the level of ALT was up to 2000–5000 U/L and GGT was 220–260 μmol/L. Among the patients who took antibiotics in the pre-jaundice period, the cytolysis rates were probably higher: ALT 2035.6±166.4 U/L (P&lt;0.0001) and AST 1545.5±154.7 U/L (P&lt;0.005). Indicators of cholestasis were GGT 254.6±22.2 μmol/L (P&lt;0.001), total bilirubin 111.9±8.2 mmol/L (P&lt;0.005), direct bilirubin 65.4±5.5 mmol/L (P&lt;0.005) and indirect 46.4±5.7 mmol/L (P&lt;0.05). Patients who did not take antibiotics in the pre-jaundice period had ALT 2000.6±88.2 U/L, AST 515.5±37.2 U/L, GGT 81.1±12.2μmol/L, total bilirubin 89.9±3.2 mmol/L, direct 43.4±1.5 mmol/L, indirect 33.9±2.2 mmol/L. The duration of jaundice in respondents among those who took antibiotics reliably lasted 14–18 days longer (P&lt;0.05).

Conclusions
Errors in the diagnosis of viral diseases lead to inappropriate use of antibacterial drugs, which cause changes in the clinical picture and create prerequisites for a severe course of the disease by combination of the mesenchymal-inflammatory link of the HAV pathogenesis and the hepatotoxic effect of antibacterial therapy.
P34 Hospital clinician knowledge, opportunity and motivation to prescribe short course antibiotic therapy for common infections
Authors: Hearsey Daniel , Wilcock Mike , Slatter Mandy , Powell Neil 
Published: August 2024

Abstract

Background
Antibiotic use drives antimicrobial resistance (AMR), with longer durations increasing the risk of AMR and patient harm through side effects.1,2

Objectives
We aimed to assess clinicians’ knowledge of the course length recommendations for the management of community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), infective exacerbation of chronic obstructive pulmonary disease (IECOPD), cellulitis and pyelonephritis.3 In addition, we explore clinician opportunity and motivation for prescribing short course therapy.

Methods
A Google forms survey was developed using the COM-B behaviour change model to explore the barriers and enablers to short antimicrobial course length prescribing. The questions were developed by the study team and piloted. The survey link was emailed to all prescribers working in adult medical specialties in two hospitals in England. Reminders were sent out periodically over a 6 week period between 29 November 2023 and 10 February 2024. Survey responses from both hospitals were pooled before analysis.

Results
One hundred and sixty-five responses were completed: 82 from RCHT and 83 from RUHB, overall response rate was 23%. Overall, 124 responders were medics (75%) and 31 (19%) were from surgical specialities; 10 (6%) did not state their speciality. Knowledge of the recommended short antimicrobial course lengths was high overall with 72% of responses correctly opting for the recommended short antibiotic course lengths for each of the infections. Knowledge on short course lengths for severe CAP/HAP was an exception with only 72 (44%) respondents opting for the shorter 5 days compared with 92 (56%) for protracted courses; one respondent opted for 3 days. A quarter of respondents reported familiarity with the published evidence for short courses. Most respondents said course length recommendations were clearly indicated in the hospital’s guidelines, they were able to prescribe the courses they believed to be appropriate, and the e-prescribing system facilitated prescribing short courses. The majority didn’t believe longer courses were more effective than shorter courses, acknowledging the increased risk of AMR and side effects. Factors that contributed to protracted courses lengths were diagnostic uncertainty and slow to improve clinical signs of infection, with a minority prescribing longer courses to protect them as prescribers. Ward pharmacist challenge of protracted course lengths and audit feedback would motivate the majority to prescribe short course therapy.

Conclusions
Knowledge of recommended short course therapy for the management of non-severe CAP/HAP, IECOPD, cellulitis and pyelonephritis was high but low for severe CAP/HAP. Slow to resolve symptoms and diagnostic uncertainty were identified as barriers to short courses.
Bacterial allelopathy: An approach for biological control of weeds
Authors: Dar Abubakar , Zahir Zahir Ahmad , Ahmad Maqshoof , Hussain Azhar , Jaffar Muhammad Tauseef , Kremer Robert Jhon 
Published: August 2024

Abstract
Weed infestation is one of the most damaging biotic factors to limit crop production by competing with the crop for space, water, and nutrients. Different conventional approaches are being used to cope with weed infestation including labor intensive manual removal and the use of soil-degrading and crop-damaging, and environment-deteriorating chemical herbicides. The use of chemicals for weed control has increased two-fold after the Green Revolution and their non-judicious use is posing serious threats to mankind, animals, and biodiversity. The detrimental effects of these approaches have shifted the researchers’ attention from the last two decades towards alternate, sustainable, and ecofriendly approaches to cope with weed infestation. The recent approaches of weed control including plant and microbial allelopathy have gained popularity during last decade. Farmers still use conventional methods, but the majority of farmers are very passionate about organic agriculture and describe it as a slogan in the developed world. The effectiveness of these approaches lies in host specificity by selective bacteria and differential response towards weeds and crops. Moreover, the crop growth promoting effect of microorganisms (allelopathic bacteria) possessing various growth promoting traits i.e., mineral solubilization, phytohormone production and beneficial enzymatic activity, provide additional benefits. The significance of this review lies in the provision of a comprehensive comparison of the conventional approaches along with their potential limitations with advanced/biological weed control approaches in sustainable production. In addition, the knowledge imparted about weed control will contribute to a better understanding of biological control methods.
Effects of dietary stevia extract supplementation on growth performance, serum biochemical indices, and intestinal health of yellow-feathered broilers
Authors: Liu Xiubin , Jing Yidan , Li Zhen , Wang Xin , Song Yunfei , Zeng Jianguo , Lin Qian 
Published: August 2024

Abstract
Stevia, a perennial shrub from the genus Stevia in the Asteraceae family, contains active ingredients like chlorogenic acid and shows promise as a natural feed additive. Despite this potential, there is limited research on the impact of stevia extract specifically on yellow-feather broilers. The study aimed to evaluate the effects of dietary stevia extract with varying concentrations of chlorogenic acid on the growth performance, serum biochemical indices, and intestinal health of yellow-feathered broilers. A total of 425 1-d-old female yellow-feathered broilers were randomly allocated into five treatment groups with five replicates of 17 broilers each, and the feeding trial lasted 63 d. The groups included control and those supplemented with stevia extract at concentrations of 100, 200, 300, and 400 mg/kg. Results showed that adding 100 mg/kg of stevia extract to the basal diet significantly increased the daily weight gain (ADG) of the broilers while reducing the average daily feed intake and feed conversion ratio (F/G). However, supplementation with stevia extract at concentrations up to 300 mg/kg led to decreased final weight and ADG. Conversely, dietary supplementation with 100-200 mg/kg of stevia extract improved serum antioxidant capacity and reduced serum total cholesterol levels compared to the control group. Additionally, the cecum n-butyric acid level was significantly higher in the 200 mg/kg stevia extract group than in the control group. In conclusion, supplementing yellow-feathered broilers’ diets with stevia extract can enhance growth performance, antioxidant and immune capacity, and intestinal health. The optimal concentration of stevia extract for these benefits is between 100 and 200 mg/kg.
Ecosystem engineers show variable impacts on habitat availability for cavity nesters in South American temperate forests
Authors: Cuatianquiz Lima Cecilia , Altamirano Tomás A , Jara Rocío , Price Edwin R , Novoa Fernando J , Ibarra José Tomás 
Published: August 2024

Abstract
Ecosystem engineers are organisms that impact their environment and co-existing species by creating or modifying habitats, and thus they play important roles as drivers of community assembly. We examined whether cavity characteristics and/or habitat attributes associated with cavities provided by 4 ecosystem engineers influence the presence of nests of 3 secondary cavity-nesting birds—Aphrastura spinicauda (Thorn-tailed Rayadito), Tachycineta leucopyga (Chilean Swallow), and Troglodytes aedon (Southern House Wren)—and whether these variations influence their reproductive success. We tested this by: (1) assessing nest presence in cavities supplied by ecosystem engineers and (2) quantifying the reproductive success of secondary cavity nesters as a function of cavity characteristics and habitat attributes supplied by ecosystem engineers. Between 2009 and 2022, we recorded 757 cavities in 546 trees in old-growth and second-growth forests in a Global Biodiversity Hotspot in the Andes of southern Chile. Insect/fungi and Pygarrhichas albogularis (White-throated Treerunner) play a key role as the primary producers of cavities. Insect/fungi generated the cavities for 82% of A. spinicauda nests and 95% of T. aedon nests; in contrast, 57% of T. leucopyga nests were cavities excavated by P. albogularis. Characteristics of cavities (size of cavity entrance, volume, and height above ground) were associated with nest presence of secondary cavity nesters and with reproductive success of A. spinicauda and T. aedon. Habitat attributes such as tree density and canopy cover influenced nest presence for A. spinicauda and T. leucopyga, but did not correlate with the reproductive success of any secondary cavity nester. Bamboo density and forest type were related to reproductive success of A. spinicauda and T. aedon. Diameter at Breast Height of trees was related to the reproductive success of T. leucopyga. This study contributes to understanding the importance of various ecosystem engineers for the conservation of secondary cavity-nesting birds in temperate forests and beyond.
Self-assembled peptide hydrogel loaded with functional peptide Dentonin accelerates vascularized bone tissue regeneration in critical-size bone defects
Authors: Liu Yijuan , Li Li , He Mengjiao , Xu Yanmei , Wu Zekai , Xu Xiongcheng , Luo Kai , Lv Hongbing 
Published: August 2024

Abstract
Regeneration of oral craniofacial bone defects is a complex process, and reconstruction of large bone defects without the use of exogenous cells or bioactive substances remains a major challenge. Hydrogels are highly hydrophilic polymer networks with the potential to promote bone tissue regeneration. In this study, functional peptide Dentonin was loaded onto self-assembled peptide hydrogels (RAD) to constitute functionally self-assembling peptide RAD/Dentonin hydrogel scaffolds with a view that RAD/Dentonin hydrogel could facilitate vascularized bone regeneration in critical-size calvarial defects. The functionalized peptide RAD/Dentonin forms highly ordered β-sheet supramolecular structures via non-covalent interactions like hydrogen bonding, ultimately assembling into nano-fiber network. RAD/Dentonin hydrogels exhibited desirable porosity and swelling properties, and appropriate biodegradability. RAD/Dentonin hydrogel supported the adhesion, proliferation and three-dimensional migration of bone marrow mesenchymal stem cells (BMSCs) and has the potential to induce differentiation of BMSCs towards osteogenesis through activation of the Wnt/β-catenin pathway. Moreover, RAD/Dentonin hydrogel modulated paracrine secretion of BMSCs and increased the migration, tube formation and angiogenic gene expression of human umbilical vein endothelial cells (HUVECs), which boosted the angiogenic capacity of HUVECs. In vivo, RAD/Dentonin hydrogel significantly strengthened vascularized bone formation in rat calvarial defect. Taken together, these results indicated that the functionalized self-assembling peptide RAD/Dentonin hydrogel effectively enhance osteogenic differentiation of BMSCs, indirectly induce angiogenic effects in HUVECs, and facilitate vascularized bone regeneration in vivo. Thus, it is a promising bioactive material for oral and maxillofacial regeneration.
In situ MgO nanoparticle-doped Janus electrospun dressing against bacterial invasion and immune imbalance for irregular wound healing
Authors: Zhou Tao , Chen Yedan , Fu Liangmin , Wang Shan , Ding Haihu , Bai Qiaosheng , Guan Jingjing , Mao Yingji 
Published: August 2024

Abstract
Owing to the unpredictable size of wounds and irregular edges formed by trauma, nanofibers’ highly customizable and adherent in situ deposition can contribute to intervention in the healing process. However, electrospinning is limited by the constraints of conventional polymeric materials despite its potential for anti-inflammatory and antimicrobial properties. Here, inspired by the Janus structure and biochemistry of nanometal ions, we developed an in situ sprayed electrospinning method to overcome bacterial infections and immune imbalances during wound healing. The bilayer fiber scaffold has a hydrophobic outer layer composed of polycaprolactone (PCL) and a hydrophilic inner layer composed of gelatin, poly(L-lactic acid) (PLLA), and magnesium oxide nanoparticles, constituting the PCL/PLLA-gelatin-MgO (PPGM) electrospun scaffold. This electrospun scaffold blocked the colonization and growth of bacteria and remained stable on the wound for continuous anti-inflammatory properties to promote wound healing. Furthermore, PPGM electrospinning modulated collagen deposition and the inflammatory microenvironment in the full-thickness skin model, significantly accelerating vascularization and epithelialization progression. This personalized Janus electrospun scaffold has excellent potential as a new type of wound dressing for first aid and wound healthcare.
From adversity to advancement: uncovering how race and class shape Black tech entrepreneurial experiences
Authors: Sheares Alicia Myles 
Published: August 2024

Abstract
Black people in the technology industry face various barriers, from encountering micro-aggressions from their coworkers to facing blocked advancement in their professional careers. These challenges are particularly pronounced in entrepreneurship, where Black founders receive just one percent of all venture capital funding. But amidst these shared struggles, questions arise as to what ways, if any, these experiences vary. Using an intersectional lens to inductively study forty-six Black tech entrepreneurs in Silicon Valley, I reveal how class shapes Black entrepreneurial processes differently at various phases of entrepreneurship. Lower- and middle-class Black entrepreneurs faced more financial and network-based obstacles as they struggled to raise money from family and friends and had fewer effective networks when starting their businesses. Conversely, Black upper-class entrepreneurs had familial wealth and personal networks that aided their entrepreneurial efforts but faced challenges as they were not a “racial fit” within the industry. Consequently, they perceived that they confronted more instances of individual-level discrimination. Black lower and middle-class entrepreneurs were less likely to discuss instances of perceived individual-level discrimination because many had not reached the step of meeting with an investor. This research offers unique and nuanced insights into how class shapes the entrepreneurial pursuits of Black founders. Contributions to the sociology of race and ethnicity, intersectionality, and the sociology of entrepreneurship are also discussed.
Ultrasound Discrimination Between Placenta Accreta Spectrum and Urinary Bladder Varices
Authors: Theophilus K A-B , Collins SL , Nieto-Calvache AJ 
Published: August 2024

(Aust N Z J Obstet Gynaecol. 2023;63(5):725–727. doi: 10.1111/ajo.13703)
Differentiating between placenta accreta spectrum (PAS) and urinary bladder varices can be difficult on prenatal US because the 2 conditions have similar appearances. It is important to distinguish between the 2 before birth, however, because each requires a different treatment. In this opinion piece, the authors outline how they make the diagnosis and note that a definitive diagnosis can be made only during surgery.
Evaluation of Practice Change Following “Safer Anesthesia From Education” Obstetric Courses in Tanzania: A Prospective Cohort Study
Authors: Lilaonitkul M , Zacharia A , Law TJ , Yusuf N , Saria P , Moore J 
Published: August 2024

(Anaesthesia. 2023;78(11):1354–1364. doi: 10.1111/anae.16091)
The absence of access to anesthetic care during cesarean deliveries (CDs) contributes to an exponentially higher risk of death than those who have access to anesthesia. In Tanzania, maternal mortality is estimated higher than 500 per 100,000 live births, and anesthesia is very difficult to access, with only 50 physician anesthesia providers, 140 nurse anesthetists, and 40 other cadre providers in a country with a population of nearly 54 million. Training for anesthesia providers is not standardized and has great variability in duration and clinical exposure. The recent implication of the educational intervention Safer Anesthesia from Education–Obstetric Anesthesia (SAFE-OB) course has been shown to improve disparities in education through a 3-day refresher course. This study was designed to assess the main behavioral changes following SAFE-OB participation, as well as examine the degree and sustainability of said changes.
Risk of Autism After Prenatal Topiramate, Valproate, or Lamotrigine Exposure
Authors: Hernández‐Díaz S , Straub L , Bateman BT , Zhu Y , Mogun H , Wisner KL , Gray KJ , Lester B , McDougle CJ , DiCesare E , Pennell PB , Huybrechts KF 
Published: August 2024

(N Engl J Med. 2024;390(12):1069-1079. DOI: 10.1056/NEJMoa2309359)
Maternal use of valproate during pregnancy has been linked to a heightened risk of neurodevelopmental disorders in children. While most studies on other antiseizure medications did not show increased risks of these disorders, insufficient and inconsistent data exist regarding the risk of autism spectrum disorder (ASD) associated with maternal topiramate use. A study conducted on maternal use of antiseizure medications during pregnancy, particularly focusing on the risk of ASD in children, revealed noteworthy findings.
In Utero Enzyme-replacement Therapy for Infantile-onset Pompe Disease
Authors: Cohen JL , Chakraborty P , Fung-Kee-Fung K , Schwab ME , Bali D , Young SP , Gelb MH , Khaledi H , DiBattista A , Smallshaw S , Moretti F , Wong D , Lacroix C , El Demellawy D , Strickland KC , Lougheed J , Moon-Grady A , Lianoglou BR , Harmatz P , Kishnani PS , MacKenzie TC 
Published: August 2024

(N Engl J Med. 2022;387(23):2150–2158. doi: 10.1056/NEJMoa2200587)
Early-onset lysosomal storage diseases often involve multiple organ systems, and organ damage begins in utero. In many cases, the damage is severe enough that affected infants do not live long, with the duration of life affected greatly based on what organ systems are affected and how severely. Individuals with these diseases are good candidates for in utero enzyme-replacement therapy (ERT) with recombinant enzymes. Previous studies in animal models have shown that this therapy can mitigate the effect of disease, though not eradicate it. This study was a report of a phase 1 clinical trial that included ERT treatment for an infant diagnosed with Pompe disease, which is caused by acid α-glucosidase (GAA) enzyme deficiency. Without treatment, Pompe disease is typically fatal by 2 years of age and often results in prenatal hypertrophic cardiomyopathy and hypotonia at birth. This article describes the treatment of a cross-reactive immunologic material (CRIM)-negative fetus with infantile-onset Pompe disease after the early postnatal death of 2 older siblings.