bluuebunny/crossref_metadata_2025_split huggingface dataset:
Theme and sentiment of posts in a weight loss subreddit predict popularity, engagement, and users’ weight loss: a computational approach
Authors: Yang Qinghua , Ledbetter Andrew M , Zhuang Jie , Richards Adam S 
Published: June 2023

Abstract
Despite the common use of social media to discuss health issues, little is known about how features of user-generated content influence users’ health outcomes. To address this gap, we longitudinally studied large-scale conversations on the subreddit r/loseit, an online weight loss community, by computationally analyzing the themes and sentiment of users’ posts and examining their associations with users’ self-reported weight loss. Our study identified 28 distinct topics on r/loseit, many of which significantly predicted post score and the number of responsive comments. We also found that the post score was predicted by positive sentiments, whereas the number of comments was predicted by negative sentiments. Further, users’ posts on the topic of goal setting significantly predicted their self-reported weight loss, and such association was amplified when the post score and the number of comments are high. Our findings have important theoretical and practical implications for the relationship between interactions in online communities and health outcomes.
GWAS identifies candidate genes controlling adventitious rooting in Populus trichocarpa
Authors: Nagle Michael F , Yuan Jialin , Kaur Damanpreet , Ma Cathleen , Peremyslova Ekaterina , Jiang Yuan , Zahl Bahiya , Niño de Rivera Alexa , Muchero Wellington , Fuxin Li , Strauss Steven H 
Published: June 2023

Abstract
Adventitious rooting (AR) is critical to the propagation, breeding, and genetic engineering of trees. The capacity for plants to undergo this process is highly heritable and of a polygenic nature; however, the basis of its genetic variation is largely uncharacterized. To identify genetic regulators of AR, we performed a genome-wide association study (GWAS) using 1148 genotypes of Populus trichocarpa. GWASs are often limited by the abilities of researchers to collect precise phenotype data on a high-throughput scale; to help overcome this limitation, we developed a computer vision system to measure an array of traits related to adventitious root development in poplar, including temporal measures of lateral and basal root length and area. GWAS was performed using multiple methods and significance thresholds to handle non-normal phenotype statistics and to gain statistical power. These analyses yielded a total of 277 unique associations, suggesting that genes that control rooting include regulators of hormone signaling, cell division and structure, reactive oxygen species signaling, and other processes with known roles in root development. Numerous genes with uncharacterized functions and/or cryptic roles were also identified. These candidates provide targets for functional analysis, including physiological and epistatic analyses, to better characterize the complex polygenic regulation of AR.
Contested Disability: Sickle Cell Disease
Authors: Srikanthan Sinthu 
Published: June 2023

Abstract
The world’s first “molecular disease,” sickle cell disease (SCD) has captivated the medical community’s attention as a multisystem blood disorder linked to abnormalities in one molecule: hemoglobin. While the molecular model of SCD has led to advances in medical management, its reductionism obfuscates the sociopolitical dimensions of the condition, affording little attention to the racialized, gendered, classed, and disabling disparities faced by people with SCD. Consequently, SCD is frequently contested as a disability—opportunities to support people with SCD in everyday challenges escape many healthcare providers. These trends speak to the legacy of anti-Black racism in the Global North, which deeply entwines disability with racialized boundaries of citizenship and broader debates about “deservingness” of welfare. To address these gaps, this article delineates the medical and social models of disability as well as anti-Black racism to explore how social workers can embed human rights for people with SCD in everyday practice. This article is contextualized in Ontario, Canada, a province that recently launched a quality standard, Sickle Cell Disease: Care for People of All Ages.
State-centric proportionality analysis in Chinese administrative litigation
Authors: Xiao Shiling 
Published: June 2023

Abstract
This article examines the application of proportionality in Chinese administrative litigation over the last two decades and argues that courts in administrative litigation that serve the party-state and tend to uphold state/collective interest have altered proportionality to be state-centric. It finds that the courts invoked proportionality in a negligible portion of all administrative litigation judgments and had inadequate emphases on protecting individual rights. Proportionality has not appreciably assisted the courts in enhancing their oversight of governmental power and protection of individual rights. This article suggests that this is attributable to the restricted function of administrative litigation in China’s party-state governance structure and owing to the country’s long-held belief that public interest takes precedence over individual rights. Administrative litigation, which China’s ruling party employs to resolve principal–agent issues, is seriously constrained. The courts are expected to review the formal legality of executive actions, but not their substance. Informed by the Chinese human rights belief, which favors collectivism over individualism, the courts are skewed toward public interest in the balancing analysis when applying proportionality.
From Norm Violations to Norm Development: Deviance, International Institutions, and the Torture Prohibition
Authors: Lesch Max 
Published: June 2023

AbstractHow do violations affect international norms? This article demonstrates that violations develop norms by analyzing how international institutions determine the meaning of deviant behavior and the breached norm. Decisions by courts, ad hoc tribunals, commissions of inquiry, and expert committees influence formal and informal lawmaking and drive the contested and often ambiguous development of international norms. To illustrate the impact of these norm applications and lawmaking efforts, the article compares two institutions with different mandates to oversee the international torture prohibition. In the 1960s and 1970s, the European human rights institutions defined torture for human rights law and found that Greece and the United Kingdom had violated the torture prohibition, but created ambiguity regarding the threshold of torture. In 1984, the UN Convention against Torture (CAT) adopted this definition, which was informed by earlier norm violations. In the 1990s and early 2000s, the UN Committee against Torture (CmAT) applied the torture prohibition to interrogation techniques used by Israel and the United States in counterterrorism operations. CmAT’s decisions that both countries had deviated from the norm led to General Comment No. 2 on CAT, which reaffirmed and specified the absolute and non-derogable nature of the torture prohibition.
P04 Assessment of antibiotic resistance formation predictors among medical students in developing countries
Authors: Bondaruk Iryna , Chichirelo-Konstantynovych Kiarina , Bevz Tetiana , Demchyshyn Yaroslav 
Published: June 2023

Abstract

Background
According to CDC (2019), antibiotic-resistant infections affect more than 2 million people. By 2030, 100 million people will die prematurely as a result of uncontrolled antibiotic use, and in 35 years, this figure will reach 300 million (BSAC, 2018). Despite of modern patient target approach to curing majority of diseases, the problem of antibiotics over usage is still urgent in middle-income countries due to non-profile prescription, absence of microbiological confirmation and the ease of availability of antibiotics.

Objectives
To investigate antibiotic usage expedience for a 1-year duration among Ukrainian and foreign medical students.

Subjects and methods
A total of 150 (Ukrainians 46%, foreigners 54%; aged 18–25 years) medical students were examined by questionnaire for antibiotic usage during last year with specification of reasons, course frequency and duration, expediency of appointment, treatment outcomes, possible reason for cancellation/replacement of antibiotic therapy and preventable usage cases.

Results
The majority of foreigners [60.5% (n = 49)] and 33.8% (n = 25) Ukrainians used antibiotics for different reasons during February 2022–January 2023 (P &lt; 0.01). Antibiotic usage by physician’s prescription was held among 24.49% (n = 12) foreign students and 68.18% (n = 12) Ukrainian ones (P &lt; 0.05). The frequency of antibiotic application due to positive result of bacteriological investigation was significantly lower among foreign responders: 27.27% versus 4.00% in Ukrainians (P &lt; 0.05). In the Ukrainian students sample 36.3% (n = 8) responders predisposed to antibiotic usage for infectious condition appearance [versus 6.1% (n = 3) in the foreign sample, P &lt; 0.01]. The frequency of ≥3 antibiotic courses per year prevailed in the foreign student group [12.25% (n = 6), P &lt; 0.05]. The analysis of post-antibiotic adverse events found out allergic reaction in 1.2% (n = 1) in the foreign sample, diarrhoea 1.56% (n = 1) and change of antibiotic due to ineffectiveness 1.56% (n = 1) in the Ukrainian sample.

Conclusions
Possible predictors of the formation of resistance to antibiotics among young people living in developing countries, such as incorrect clinical use, lack of control over the prescription of antibiotics, ease of availability of antibiotics and as a result of self-medication, were evaluated. The prophylactic prescription of broad-spectrum antibiotics for routine procedures, such as preparation for surgical interventions and in the postoperative period, also draws attention.
P09 Non-allergist Removal of Incorrect Penicillin Allergy Labels (RIPAL) in a UK hospital
Authors: Hearsey Daniel , Elkhalifa Shuayb , Sandoe Jonathan , Wilcock Michael , Owens Rhys , Gay Bethan , Wildblood Charlotte , Mendonca Jane , Leigh Nicola , Powell Neil 
Published: June 2023

Abstract

Objectives
We piloted a pharmacist-led multidisciplinary penicillin allergy de-labelling (PADL) daily ward round to determine the opportunity for PADL in a UK hospital.

Methods
A daily ward round, delivered by either an antibiotic pharmacist or a junior doctor, identified adult medical and surgical patients between 7 November 2022 and 31 January 2023 with a penicillin allergy (penA) record that was preventing first-line penicillin use. An allergy history was taken before risk stratifying likelihood of future harm from penicillin re-exposure and an allergy testing method was determined [de-label on history (DOH) or after direct drug provocation testing (DDPT)]. Following successful de-label, in agreement with the responsible clinician, the antibiotic was switched to a penicillin antibiotic.

Results
Of 7214 inpatients during the study period, 1133 (15.7%) had a penA record. Of 285 allergy histories taken, 105 (36.8%) met high-risk criteria, 45 (15.8%) met low-risk criteria eligible for DOH, 73 (25.6%) met low-risk criteria eligible for DDPT and we were unable to obtain a history from 62 (21.8%) patients. Of 45 low-risk patients eligible for DOH, 40 (88.9%) were de-labelled of which 24 (53.3%) were switched to a penicillin antibiotic. Of 73 patients with a low-risk allergy history eligible for DOC, 16 (21.9%) received DDPT, of which nine were switched to a penicillin antibiotic to complete their antibiotic course. Two DOH patients experienced harm (thrush within the first 5 days and delayed skin reaction after day 5), none of the DPTs had a reaction by day 5. The switches resulted in 170 DDDs of penicillin use (predominantly amoxicillin) and reduced alternative antibiotic use by 174 DDDs (predominantly meropenem and levofloxacin).

Conclusions
Penicillin allergy de-labelling patient pathway delivered by pharmacists and junior doctors was safe and effective and well accepted by patients and the wider clinical teams. Further work is required to optimize and streamline these patient pathways to maximize patient and health system benefit.
P10 Impact of miniaturization and early readout on antimicrobial susceptibility tests
Authors: Needs Sarah , Hayward Jessica , Kidd Stephen , Edwards Al 
Published: June 2023

Abstract

Background
New technologies offer the promise of faster, more accessible antibiotic susceptibility testing. UK policy includes the development and introduction of innovative diagnostics to tackle antimicrobial resistance, and whilst many new technologies are emerging, we still have limited evidence of their performance. Many of these emerging technologies are changing two core aspects of antimicrobial susceptibility tests (AST). Firstly, using microfluidic platforms to miniaturize standard antibiotic susceptibility testing and secondly measuring susceptibility at earlier timepoints, here, we report a comprehensive assessment of 1-mL volume broth microdilution with an early endpoint readout, proving that miniaturization and earlier timepoints of conventional antibiotic susceptibility testing is feasible and accurate.

Methods
The test measures bacterial growth in 1-mL capillaries in the presence of the metabolic dye resazurin. All other aspects of the test remain standard. Images of the capillaries are taken every 5 minutes over 18 h to determine accuracy at different timepoints during incubation at 37°C. Over a total of 3 sites in the UK, Spain and Thailand, we have tested 367 isolates from clinical samples for 8–17 antibiotics.

Results
Preliminary data shows that for 99 Gram-negative isolates tested in Thailand, after 6-h incubation, accuracy for antibiotics is as follows: cefotaxime 96%, ceftazidime 92%, meropenem 93%, amikacin 94%, amoxicillin–clavulanic acid 79%, cefuroxime 97%, cefoxitin 80%, ciprofloxacin 84%, gentamicin 93% and trimethoprim 97%. Further testing is ongoing, and isolates from urine samples are currently being collected from Basingstoke and North Hampshire hospital to expand the type of organism tested.

Conclusions
Unlike many microfluidic systems, the dip and test microcapillary–based broth microdilution test is manufactured in bulk, allowing rapid and testing of large sample sets with minimal investment. An understanding of the effect of miniaturization is vital to developers of microfluidic phenotypic antibiotic susceptibility tests and can provide confidence in emerging systems.
P13 Cost effectiveness of point of care diagnostics for AMR: a systematic review
Authors: Tolley Abraham , Bansal Akhil , Murerwa Becca 
Published: June 2023

Abstract

Objectives
Antimicrobial resistance (AMR) is a major threat to global health and is driven partly by overprescription of antibiotics. Point-of-care tests (POCTs) can reduce antibiotic prescribing by distinguishing different types of infections and the sensitivities of pathogens to antimicrobials. Although evidence for their clinical efficacy is mixed, they may be highly cost-effective interventions when their benefits in reducing the burden of AMR are considered. We aimed to systematically evaluate the cost effectiveness of different POCTs in reducing AMR for the first time to inform national and global health policies.

Methods
A systematic review was conducted in line with the PRISMA framework, and the protocol was registered on PROSPERO. MEDLINE, PubMed, EMBASE, Cochrane Library and Google Scholar were searched from January 2000 to November 2022 for studies that (i) were trial- or model-based economic evaluations, (ii) focused on POCTs aimed at reducing AMR or inappropriate antimicrobial prescription, (iii) included a cost-benefit metric and (iv) were original research written in English with full text available. Methodological quality was assessed using the Consensus of Health Economic Criteria.

Results
157 studies were retrieved of which 20 were included after screening. These included both trial (n = 9) and modelling-based (n = 11) evaluations. Most focused on POCTs for respiratory infections (n = 9) with sexually transmitted infections and febrile illness other common conditions evaluated. A majority of studies utilized C-reactive protein POCTs (n = 11) with others utilizing pathogen-specific PCR tests or procalcitonin. Most evaluated the cost effectiveness of POCTs at reducing antimicrobial prescribing, with only 3 studies considering the societal cost of AMR. Most studies found that POCTs reduced antibiotic use, but with varying cost effectiveness: 16 studies showed cost efficacy by the threshold or other standards stipulated by the study, with POCTs for group B streptococcus and urinary tract infections notably not found to be cost effective. The reporting and methodological quality of the included studies was mixed: good (4), moderate (13) and low (3).

Conclusions
There is limited research on the cost effectiveness of POCTs in reducing AMR, and most studies do not account for the wider societal costs of AMR. Current forecasts estimate that AMR will cause 10 million deaths and cost the world 100 trillion USD per year in 2050: consequently, it is vital that evaluations of POCTs include the significant benefits from reducing AMR additional to the short-term benefits of avoided antibiotic prescriptions. Given the rising burden of AMR, such interventions merit further evaluation and integration into healthcare policy.
P14 Surgical source control and colistin therapy for the management of osteomyelitis due to Pseudomonas aeruginosa with difficult-to-treat resistance
Authors: Nageshwaran V , Ferguson J , Ramsden A , Barrett L , Scarborough M , Wangrangsimakul T , Morgan M , Oakley S , Young B C , Stoesser N 
Published: June 2023

Abstract

Patient
A 45-year-old man from Lagos, Nigeria, now living in the UK, presented to his local hospital with purulent discharge from his knee. During a road traffic accident in 2019, he had sustained open fractures of his femur and tibia. These required surgical fixation and he underwent four surgeries over a 10-month period in Nigeria. He was reportedly on antibiotics throughout this period. In early 2022, he noticed discharge from the knee and was referred to the Bone Infection Unit in Oxford. On examination, left leg shortening and a sinus on the anterior proximal tibia were noted. Knee flexion was reduced to 30 degrees. He was otherwise systemically well. PET-CT revealed two areas of avidity, supporting the clinical diagnosis of fracture-related infection adjacent to a retained tibial plate.

Treatment
The patient underwent removal of the tibial plate, excision of infected bone, insertion of local antibiotic carrier (Cerament G with vancomycin added) and a medial gastrocnemius flap with split skin grafting. Five out of five intra-operative samples were culture positive for Pseudomonas aeruginosa, with NDM metallo-β-lactamase detected. This was resistant to ceftazidime, meropenem, piperacillin/tazobactam, gentamicin, tobramycin, amikacin, ciprofloxacin, ceftazidime/avibactam, imipenem/cilastatin/relebactam, ceftolozane/tazobactam and cefiderocol. The organism had an aztreonam MIC of 16 mg/mL and a colistin MIC of 2 mg/mL. The patient also had MRSA isolated from all intra-operative samples. Following multidisciplinary team discussion, he was started on aztreonam 2 g QDS and colistin loading with 9 million IU followed by 4.5 million IU BD for the P. aeruginosa and doxycycline 100 mg BD for the MRSA. After 8 days of therapy, he developed a symmetrical body rash, which was felt to be a delayed hypersensitivity reaction to aztreonam and resolved when aztreonam was stopped. He was subsequently treated with colistin monotherapy for 6 weeks via OPAT. Whilst on this treatment, his renal function was monitored regularly with appropriate dose reductions because of renal impairment. Follow-up at 9 months demonstrates good recovery with no pain or symptom recurrence.

Conclusions
This case illustrates the challenges of managing fracture-related infections with extensively drug-resistant organisms and the importance of multi-disciplinary input. Drug-resistant infections requiring prolonged courses of antibiotics can be successfully managed using an OPAT service. Finally, this case emphasizes the importance of understanding global patterns of antimicrobial resistance and stewardship to identify cases that are at risk of being infected with drug-resistant bacteria especially where there may be long intervals between establishment of the infection and presentation to healthcare services.
P29 Outcomes by baseline pathogen and susceptibility in the ReSTORE Phase 3 trial of rezafungin once weekly compared with caspofungin once daily in patients with candidaemia and/or invasive candidiasis
Authors: Thompson G R , Soriano A , Cornely O A , Kullberg B J , Kollef M , Vazquez J A , Das A F , Locke J B , Sandison T , Pappas P G 
Published: June 2023

Abstract

Background
Rezafungin is a next-generation, once-weekly echinocandin in development for treatment of candidaemia and invasive candidiasis (IC), and for prevention of invasive fungal diseases caused by Candida, Aspergillus, and Pneumocystis in allogeneic blood and marrow transplant recipients (Figure 1). ReSTORE (NCT03667690) is a global, double-blind, double-dummy, 1:1 randomized, controlled, Phase 3 non-inferiority trial that evaluated the efficacy and safety of rezafungin once weekly (QWk) versus caspofungin once daily (QD) in patients with candidaemia and/or IC. This analysis of the completed ReSTORE trial was conducted to evaluate outcomes by baseline pathogen and susceptibility.

Methods
In ReSTORE, adults (≥18 y) with systemic signs and mycological confirmation of candidaemia and/or IC received either rezafungin QWk (400 mg Week 1, then 200 mg QWk) or caspofungin QD for ≥14 days (up to 4 weeks) with optional oral fluconazole step-down in the caspofungin arm. The primary endpoints were global cure at day (D)14 (per Data Review Committee confirmation of investigator-assessed clinical cure [and radiological cure for IC) + mycological eradication]) and all-cause mortality (ACM) at D30 (Figure 2). Secondary endpoints included mycological eradication at D14. For this analysis, D14 global cure and mycological eradication by treatment group were analysed by Candida species and in vitro susceptibility at baseline (CLSI broth microdilution MIC values; M27 Ed4) (Figure 3).

Results
A total of 204 Candida isolates were recovered in 187 patients across both treatment groups. Of the 204 isolates, Candida albicans was the most common species, followed by Candida glabrata, Candida tropicalis, and Candida parapsilosis; 61% of all baseline isolates were non-albicans Candida (Figure 3). The rates of D14 global cure and mycological eradication by pathogen are shown in Tables 1 and 2. Overall, outcomes by Candida species and MIC did not appear to be affected by MIC values for either rezafungin or caspofungin (Table 3).

Conclusions
Rezafungin was efficacious across multiple Candida species in the Phase 3 ReSTORE trial that demonstrated non-inferiority of rezafungin to caspofungin. There was no clear correlation between increased MIC values and clinical outcomes.