bluuebunny/crossref_metadata_2025_split huggingface dataset:
P36 Using the Australian National Antimicrobial Prescribing Survey portal (NAPS) to benchmark antibiotic prescribing within an Integrated Care Board (ICB): a pilot point prevalence survey (PPS) of two NHS Trusts
Authors: Jones Nicola , Ng Bee Yean , O’Riordan Bernadette , Ahmadi Aarash , O’Driscoll Jean , Brandish Claire 
Published: June 2023

Abstract

Background
PPS is useful in evaluating volume and appropriateness of antimicrobial prescribing to guide specific antimicrobial stewardship (AMS) interventions. Integrated care systems enable collaboration within an ICB and benchmarking of antimicrobial prescribing in constituent trusts to identify disparities and learn from sharing best practice. NAPS is a web-based qualitative auditing platform which is used to conduct an annual Australia-wide PPS. To assess the suitability of NAPS in benchmarking antimicrobial prescribing practices, we piloted the NAPS platform in the acute admission ward areas in two NHS Trusts within an ICB.

Methods
In OUHFT, admissions to 2 acute medicine wards on a single day were extracted using the Cerner electronic prescribing system. Antimicrobial prescriptions were anonymized, reviewed using NAPS protocol and uploaded to the NAPS platform. In BHT, antimicrobial prescriptions on 2 admission wards were collected manually using the NAPS parameters and audit standards and entered directly into Excel®. Ethical approval was not required due to the anonymized nature of this audit.

Results
A total of 124 patients at OUHFT and 53 patients at BHT were included. The proportion of patients prescribed antimicrobials varied, with a prevalence of 23% (n = 29) at OUHFT and 54% (n = 28) at BHT. The total number of antimicrobial prescriptions was approximately 40 per trust. Compliance with guidelines for OUHFT and BHT (88% versus 83%) and stewardship appropriateness (73% versus 80%) were similar. The main indication for antimicrobials was pneumonia. The most common reasons for inappropriateness were ‘incorrect duration’ and ‘spectrum too broad’. The most prescribed antimicrobials differed, with co-amoxiclav and amoxicillin (43%) at OUHFT and metronidazole and clarithromycin (24%) at BHT. Non-compliance with guidelines was frequently associated with the use of doxycycline and co-amoxiclav (47%) at OUHFT and amoxicillin and piperacillin/tazobactam (72%) at BHT.

Conclusions
Benchmarking of antimicrobial prescribing was possible as both PPSs were conducted using the NAPS parameters and standards. Focusing efforts on antibiotic prescribing for pneumonia, the use of broad-spectrum antimicrobials and reducing duration of courses will be taken forward as a key focus for AMS efforts. NAPS is a suitable tool for benchmarking, sharing best practice and facilitating discussion of AMS interventions across an ICB. This model should be considered as a template for national benchmarking of antimicrobial prescribing.
P38 The AMR Patient Shield (APS) project: patient empowerment in the fight against antimicrobial resistance
Authors: Gupta Aman , Famokunwa Dele , Ashfield Tom , Amos James , Cooray Mineli 
Published: June 2023

Abstract

Background
Pfizer and the Patient’s Association (PA) collaborated on the AMR Patient Shield project, which aimed to explore the role of patients in responding to antimicrobial resistance (AMR) and empower them to work with their clinicians to support appropriate use of antibiotics in their care. The project had two phases, with a focus on engagement and education of patients, culture change and education of healthcare professionals (HCPs).

Methods
In Phase I, patients were convened for a patient advisory board in 2021, and Phase II involved two subsequent resource co-creation workshops in 2022. PA recruited nine patients for each phase, and the meetings were co-facilitated by PA and Pfizer medical representatives. Two antimicrobial pharmacists also served as advisors in Phase II to provide input on the applicability of the proposed resources within the clinical setting.

Outcomes
The project resulted in a range of tailored resources for both patients and HCPs, aimed at supporting patients to also become stewards of appropriate antibiotic use. These resources included educational leaflets, a template patient-held microbiology record, an HCP antibiotic consent checklist, and audio-visual content. The resources developed for patients improved their literacy on AMR at both the population and individual health levels, enabling them to utilize the incorporated tools for shared decision-making conversations with their HCPs. The content designed specifically for HCPs aimed to improve their ability to obtain informed consent, maintain accurate records and support clinical decision making when prescribing antimicrobials.

Conclusions
The AMR Patient Shield project highlights the shift from working for patients to working with patients, emphasizing the vital importance of shared decision making between HCPs, industry, policy makers and patients in the stewardship agenda. By involving patients as active partners in the AMR response strategies, the project aims to empower them to participate in their own care, improve their understanding of AMR and engage in SDM discussions with their clinicians. In conclusion, the AMR Patient Shield project, a collaboration between Pfizer and the Patient’s Association, has resulted in tailored resources for patients and HCPs to support their engagement in appropriate antibiotic use. These resources aim to improve patient literacy on AMR and enhance HCPs’ ability to obtain informed consent and exercise clinical judgement. The project highlights the importance of shared decision making and collaboration among stakeholders in addressing AMR, placing patients as fundamental partners in the collective response to this global health challenge.
Whole genome sequencing of multidrug resistant Enterobacterales identified in children and their household members within Siem Reap, Cambodia
Authors: Singh Shweta R , Tang Cheng Yee , Mao Bunsoth , Soeng Sona , Ling Clare L , Teo Jocelyn Qi-Min , Vonthanak Saphonn , Turner Paul , Hsu Li Yang , Ong Rick Twee-Hee 
Published: June 2023

Abstract

Objectives
To explore the association of recent hospitalization and asymptomatic carriage of multidrug-resistant Enterobacterales (MDRE) and determine the prevailing strains and antibiotic resistance genes in Siem Reap, Cambodia using WGS.

Methods
In this cross-sectional study, faecal samples were collected from two arms: a hospital-associated arm consisted of recently hospitalized children (2–14 years), with their family members; and a community-associated arm comprising children in the matching age group and their family members with no recent hospitalization. Forty-two families in each study arm were recruited, with 376 enrolled participants (169 adults and 207 children) and 290 stool specimens collected from participants. The DNA of ESBL- and carbapenemase-producing Enterobacterales cultured from the faecal samples was subject to WGS on the Illumina NovaSeq platform.

Results
Of the 290 stool specimens, 277 Escherichia coli isolates and 130 Klebsiella spp. were identified on CHROMagar ESBL and KPC plates. The DNA of 276 E. coli (one isolate failed quality control test), 89 Klebsiella pneumoniae, 40 Klebsiella quasipneumoniae and 1 Klebsiella variicola was sequenced. CTX-M-15 was the most common ESBL gene found in E. coli (n = 104, 38%), K. pneumoniae (n = 50, 56%) and K. quasipneumoniae (n = 16, 40%). The prevalence of bacterial lineages and ESBL genes was not associated with any specific arm.

Conclusions
Our results demonstrate that MDRE is likely to be endemic within the Siem Reap community. ESBL genes, specifically blaCTX-M, can be found in almost all E. coli commensals, indicating that these genes are continuously propagated in the community through various unknown channels at present.
Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned
Authors: McMahon James M , Brasch Judith , Podsiadly Eric , Torres Leilani , Quiles Robert , Ramos Evette , Crean Hugh F , Haberer Jessica E 
Published: June 2023

Abstract

Objectives
Studies that combine medical record and primary data are typically conducted in a small number of health care facilities (HCFs) covering a limited catchment area; however, depending on the study objectives, validity may be improved by recruiting a more expansive sample of patients receiving care across multiple HCFs. We evaluate the feasibility of a novel protocol to obtain patient medical records from multiple HCFs using a broad representative sampling frame.

Materials and Methods
In a prospective cohort study on HIV pre-exposure prophylaxis utilization, primary data were collected from a representative sample of community-dwelling participants; voluntary authorization was obtained to access participants’ medical records from the HCF at which they were receiving care. Medical record procurement procedures were documented for later analysis.

Results
The cohort consisted of 460 participants receiving care from 122 HCFs; 81 participants were lost to follow-up resulting in 379 requests for medical records submitted to HCFs, and a total of 343 medical records were obtained (91% response rate). Less than 20% of the medical records received were in electronic form. On average, the cost of medical record acquisition was $120 USD per medical record.

Conclusions
Obtaining medical record data on research participants receiving care across multiple HCFs was feasible, but time-consuming and resulted in appreciable missing data. Researchers combining primary data with medical record data should select a sampling and data collection approach that optimizes study validity while weighing the potential benefits (more representative sample; inclusion of HCF-level predictors) and drawbacks (cost, missing data) of obtaining medical records from multiple HCFs.
Enhancing feature selection with GMSMFO: A global optimization algorithm for machine learning with application to intrusion detection
Authors: Hussein Nazar K , Qaraad Mohammed , Amjad Souad , Farag M A , Hassan Saima , Mirjalili Seyedali , Elhosseini Mostafa A 
Published: June 2023

Abstract
The paper addresses the limitations of the Moth-Flame Optimization (MFO) algorithm, a meta-heuristic used to solve optimization problems. The MFO algorithm, which employs moths' transverse orientation navigation technique, has been used to generate solutions for such problems. However, the performance of MFO is dependent on the flame production and spiral search components, and the search mechanism could still be improved concerning the diversity of flames and the moths' ability to find solutions. The authors propose a revised version called GMSMFO, which uses a Novel Gaussian mutation mechanism and shrink MFO to enhance population diversity and balance exploration and exploitation capabilities. The study evaluates the performance of GMSMFO using the CEC 2017 benchmark and 20 datasets, including a high-dimensional intrusion detection system dataset. The proposed algorithm is compared to other advanced metaheuristics, and its performance is evaluated using statistical tests such as Friedman and Wilcoxon rank-sum. The study shows that GMSMFO is highly competitive and frequently superior to other algorithms. It can identify the ideal feature subset, improving classification accuracy and reducing the number of features used. The main contribution of this research paper includes the improvement of the exploration/exploitation balance and the expansion of the local search. The ranging controller and Gaussian mutation enhance navigation and diversity. The research paper compares GMSMFO with traditional and advanced metaheuristic algorithms on 29 benchmarks and its application to binary feature selection on 20 benchmarks, including intrusion detection systems. The statistical tests (Wilcoxon rank-sum and Friedman) evaluate the performance of GMSMFO compared to other algorithms. The algorithm source code is available at https://github.com/MohammedQaraad/GMSMFO-algorithm.
Simulation to investigate site-based monitoring of pest insect species for trade
Authors: van Klinken Rieks D , Gladish Daniel W , Manoukis Nicholas C , Caley Peter , Hill Matthew P 
Published: June 2023

Abstract
Pest insect surveillance using lures is widely used to support market access requirements for traded articles that are hosts or carriers of quarantine pests. Modeling has been used extensively to guide the design of surveillance to support pest free area claims but is less commonly applied to provide confidence in pest freedom or low pest prevalence within sites registered for trade. Site-based surveillance typically needs to detect pests that are already present in the site or that may be entering the site from surrounding areas. We assessed the ability of site-based surveillance strategies to detect pests originating from within or outside the registered site using a probabilistic trapping network simulation model with random-walk insect movement and biologically realistic parameters. For a given release size, time-dependent detection probability was primarily determined by trap density and lure attractiveness, whereas mean step size (daily dispersal) had limited effect. Results were robust to site shape and size. For pests already within the site, detection was most sensitive using regularly spaced traps. Perimeter traps performed best for detecting pests moving into the site, although the importance of trap arrangement decreased with time from release, and random trap placement performed relatively well compared to regularly spaced traps. High detection probabilities were achievable within 7 days using realistic values for lure attractiveness and trap density. These findings, together with the modeling approach, can guide the development of internationally agreed principles for designing site-based surveillance of lure-attractant pests that is calibrated against the risk of non-detection.
Human Rights Beyond the Colonial Imagination: Legal Empowerment and Techniques of Delegitimation
Authors: Ilyés Emese , Chiponda Melania , Dhital Sukti , Satterthwaite Meg , Badkur Aakanksha , Gutierrez Antonio , Carson Bethany , Mustafa Dyari , Mesel Felipe , Feruglio Francesca , Mushin Noor , Chitalkar Poorvi , Sen Shreya , Kakuru Tim , Weerachat Tom , Walton Tyler 
Published: June 2023

Abstract
Community-based and participatory methods are often marginalized within institutions of power. In this article, we—a group of community advocates, lawyers, scholars, and researchers from across the globe including Thailand, India, Uganda, Zimbabwe, Italy, Iraq, Argentina, the UK, Puerto Rico, and the United States—have collectively gathered ways that community based, participatory legal empowerment research has been delegitimized across these contexts, and offer practical strategies to break out of this white supremacist colonial imagination and interrupt and respond to these instances of silencing and erasure. Our gatherings enable us to bring to life the rich particulars of each of our unique contexts and through this richness begin to see how larger dynamics span the globe. The micro illuminates the mechanics of the macro. This critical analysis that is possible in such a participatory space allowed us to identify these strategies of delegitimation that we were experiencing despite our very different positionalities and histories. These techniques of delegitimation fall into three broad themes: using traditional research as defence, attacking the credibility of communities including denying their humanity, and acts of self-invalidation. These techniques, whether enacted by donors, companies, government agencies, or academic institutions, seek to disempower the lived experiences of community members involved in legal empowerment. By cataloguing these experiences we hope to better understand techniques of silencing and oppression, and to trace the ways that systems of power reinforce their standing through these immediate and interpersonal responses to the voice of the collective.
Confidentiality, public interest, and the human right to science: when can confidential information be used for the benefit of the wider community?
Authors: Dove Edward S 
Published: June 2023

Abstract
This article explores whether the human right to science can support the public interest as a legal basis to use and disclose confidential information. The contextual focus is scientific research; the jurisdictional focus is England. The human right to science, as reflected in the Universal Declaration of Human Rights (Article 27) and the International Covenant on Economic, Social and Cultural Rights (Article 15), hitherto has not been invoked in support of a public interest basis for lawful disclosure, but the argument is made herein that there may be scope to develop this jurisprudentially. On grounds of both law and policy, and in line with the underlying rationale of recent UK Government deployment of ‘COPI Notices’ for lawful use of confidential patient information in the course of the COVID-19 pandemic, I contend that the human right to science may well serve as a valuable juridical buttress to an overriding public interest justification to lawfully share confidential information. However, this could occur only in restricted circumstances where the public interest is clearly manifest, namely studies researching serious, imminent health threats to the general population that rely on confidential information accessed outside of existing statutory gateways, and not more routine scientific endeavors.
Spotlight on Coenzyme Q10 in scopolamine-induced Alzheimer’s disease: oxidative stress/PI3K/AKT/GSK 3ß/CREB/BDNF/TrKB
Authors: Abuelezz Sally A , Hendawy Nevien 
Published: June 2023

Abstract

Objectives
Excess amyloid beta (Aβ) and oxidative stress (OS) are inextricable hallmarks of the neuronal damage associated Alzheimer’s disease. Aβ-induced cognitive and memory dysfunctions are mediated through different signalling pathways as phosphatidylinositol-3-kinase (PI3K) and their downstream intermediates including protein-kinase-B, known as Akt, glycogen-synthase-kinase-3β (GSK-3β), cAMP-response-element-binding-protein (CREB), brain-derived-neurotrophic factor (BDNF) and tropomyosin-related-kinase receptor-B (TrKB). The current work aims to investigate the protective potentials of CoQ10 against scopolamine (Scop)-induced cognitive disability and the contribution of PI3K/Akt/GSK-3β/CREB/BDNF/TrKB in the neuroprotection effects.

Methods
The chronic co-administration of CQ10 (50, 100 and 200 mg/kg/day i.p.) with Scop in Wistar rats for 6 weeks were assayed both behaviourally and biochemically.

Key findings
CoQ10 ameliorated the Scop-induced cognitive and memory defects by restoring alterations in novel object recognition and Morris water maze behavioural tests. CoQ10 favourably changed the Scop-induced deleterious effects in hippocampal malondialdehyde, 8-hydroxy-2ʹ deoxyguanosine, antioxidants and PI3K/Akt/GSK-3β/CREB/BDNF/TrKB levels.

Conclusions
These results exhibited the neuroprotective effects of CoQ10 on Scop-induced AD and revealed its ability to inhibit oxidative stress, amyloid deposition and to modulate PI3K/Akt/GSK-3β/CREB/BDNF/TrKB pathway.
Comparative dosimetric and radiobiological assessment of left-sided whole breast and regional nodes with advanced radiotherapy techniques
Authors: Huang Yuling , Gong Changfei , Luo Mingming , Yuan Xingxing , Ding Shenggou , Wang Xiaoping , Zhang Yun 
Published: June 2023

Abstract
The aim of this study was to analyze the dosimetric and radiobiologic differences of the left-sided whole breast and regional nodes in intensity-modulated radiotherapy (IMRT), volume-modulated arc therapy (VMAT), and helical tomotherapy (HT). The IMRT, VMAT, and HT plans in this study were generated for thirty-five left-sided breast cancer patients after breast-conserving surgery (BCS). The planning target volume (PTV) included the whole breast and supraclavicular nodes. PTV coverage, homogeneity index (HI), conformity index (CI), dose to organs at risk (OARs), secondary cancer complication probability (SCCP), and excess absolute risk (EAR) were used to evaluate the plans. Compared to IMRT, the VMAT and HT plans resulted in higher PTV coverage and homogeneity. The VMAT and HT plans also delivered a lower mean dose to the ipsilateral lung (9.19 ± 1.36 Gy, 9.48 ± 1.17 Gy vs. 11.31 ± 1.42 Gy) and heart (3.99 ± 0.86 Gy, 4.48 ± 0.62 Gy vs. 5.53 ± 1.02 Gy) and reduced the V5Gy, V10Gy, V20Gy, V30Gy, and V40Gy of the ipsilateral lung and heart. The SCCP and EAR for the ipsilateral lung were reduced by 3.67%, 3.09% in VMAT, and 22.18%, 19.21% in HT, respectively. While were increased for the contralateral lung and breast. This study showed that VMAT plans provide a more homogeneous dose distribution to the PTV, minimizing exposure to ipsilateral structures and significantly reducing SCCP and EAR, and slightly increasing dose to contralateral structures. Overall, the VMAT plan can be considered a beneficial technique for BCS patients whose PTV includes the whole breast and regional nodes.
Strategic two-sample test via the two-armed bandit process
Authors: Chen Zengjing , Yan Xiaodong , Zhang Guodong 
Published: June 2023

AbstractThis study aims to improve the power of two-sample tests by analysing whether the difference between two population parameters is larger than a prespecified positive equivalence margin. The classic test statistic treats the original data as exchangeable, while the proposed test statistic breaks the structure and proposes employing a two-armed bandit process to strategically integrate the data and thus a strategy-specific test statistic is constructed by combining the classic CLT with the law of large numbers. The developed asymptotic theory is investigated by using nonlinear limit theory in a larger probability space and relates to the ‘strategic CLT’ with a clearly defined density function. The asymptotic distribution demonstrates that the proposed statistic is more concentrated under the null hypothesis and less concentrated under the alternative than the classic CLT, thereby enhancing the testing power. Simulation studies provide supporting evidence for the theoretical results and portray a more powerful performance when using finite samples. A real example is also added for illustration.